Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients with a history of recurrent candidiasis and who were using Depo-Provera (medroxyprogesterone acetate, DMPA) for contraception were reviewed in order to determine the time relationship between episodes of proven candidiasis, episodes of pruritus vulvae suggestive of this infection (but unproven), and injection of DMPA. Recently, patients were included in the study who had been given DMPA specifically to prevent recurrences of candidiasis even when the drug's contraceptive action was unnecessary, such as after sterilization. In all cases, the infection was initially treated with a vaginal candidacide, most commonly 1 week of an imidazole. The patients ranged in age from 19-37 years at the time of the 1st injection. Diabetes had been eliminated in all the cases. DMPA was given intramuscularly at a dose of 150 mg every 12 weeks. Prior to 1983, an estrogen supplement was prescribed in most cases in an effort to produce monthly menstrual periods. Estrogen supplementation is no longer used routinely, with amenorrhea the aim, although it is occasionally given to women who experience breakthrough bleeding. Candidal infection was considered proven when the branching filaments of the species were seen on a stained vaginal smear or when the species were cultured in a laboratory from a vaginal swab taken a symptomatic patient. With the exception of 2 patients, clinical candidiasis did not occur within the time in which 150 mg of intramuscular DMPA is known to suppress ovulation in all women, i.e., 12 weeks -- except in the presence of exogenous estrogen (cases 1, 2, and 14) and in one case (15) in which the patient had an unplanned conception prior to the injection. Both patients who experienced clinical despite the use of DMPA alone (cases 8 and 13) asked remain on the drug because believe it was responsible for their longest remissions in the past few years. The study seemed to provide evidence that DMPA will prevent a recurrence of clinical candidiasis in many women who are prone to this condition. The study further indicated that estrogens may predispose women to this infection.
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PMID:Depo-Provera in the treatment of recurrent vulvovaginal candidiasis. 294 26

Symptoms due to estrogen deficiency begin in the perimenopausal years and progress as serum levels of this hormone decrease Vasomotor instability, manifested by hot flushes or night sweats, may persist for several months to a few years. Psychologic symptoms include anxiety, tension, depression, insomnia, palpitations, and headaches. Atrophy of the genital epithelium may result in senile vaginitis with symptoms of irritation, burning, pruritus, dyspareunia, and even vaginal bleeding. Even the lower urinary tract mucosa is dependent upon estrogen. Postmenopausal osteoporosis affects 25 to 50% of older women and increases the risk for vertebral, hip, and other fractures. Estrogen therapy for menopausal complaints has received adverse publicity because several reports have indicated that unopposed estrogens increase the risk of endometrial cancer. Added progestogen not only negates this risk but reduces the incidence of endometrial adenocarcinoma in estrogen-progestogen users to less than that observed in untreated women. Estrogen replacement therapy does not increase the risk of breast cancer; the incidence of this malignancy, however, was also less in the estrogen-progestogen users when compared with either the untreated women or from that expected from the national cancer surveys. In evaluating postmenopausal women for hormone replacement, the benefits of estrogen-progestogen therapy must be weighed against possible risks.
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PMID:The menopause. 351 23

A study was conducted to determine the effects of an oral contraceptive containing 250 mcg of d-norgestrel with 50 mcg of ethinyl estradiol on lactation and other functions. 134 healthy women of childbearing age who were breast feeding their young completed more than 3 cycles each, for a total of 1377 cycles for the study. The reported side effects were 1) 12 instances of disturbances in menstruation, 2) 4 instances of abdominal distress, 3) 55 instances of weight change, 4) 11 cases of headache and giddiness, and 5) some dermatitis, pruritus, and breathlessness, none of which was severe enough to warrant discontinuance of therapy. A random sample of 21 women was taken to determine the effect on lactation. 18 of the 21 reported no change in milk production and continued to lactate until the end of the treatment period. Lactation decreased in the other 3 women. Further intensive studies are required before any definitive conclusion can be reached on the effect of this combination on the quality of the breast milk and duration of lactation.
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PMID:Effects of "Nordiol' on fertility and lactation: some preliminary observations. 427 7

It is noted that advertisements in medical journals recommend treatment of emotional symptoms in menopausal patients with Premarin (Ayerst brand of conjugated estrogens), Ogen (Abbott brand of piperazine estrone sulfate), or other compounds. There are no acceptable studies proving the usefulness of such combinations for symptoms relating to the menopause and no persuasive evidence to justify use of conjugated or any other type of estrogen in the treatment of emotional symptoms in menopausal women. Vasomotor symptoms, flushing, and sweats respond to estrogens. Symptoms do not recur if treatment is stopped after 1 or 2 years. Systematic or topical use of estrogens fails to promote the appearance of youthfulness. Vaginal pruritus and dyspareunia due to atrophic vaginitis may be relieved by estrogens either applied locally or orally. Libido is not heightened by exogenous estrogens but sufficient androgen doses cause virilization. It is doubtful if osteoporosis is favorably influenced by long-term use of estrogens. Estrogen therapy may cause spotting, menarrhagia, nausea, breast tenderness, or fluid retention. Prolonged use may cause increase in size of uterine fibroids. Personal or even family history of breast or genital cancer are considered contraindications.
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PMID:Estrogens and the menopausal patient. 434 58

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

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

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

Although oral contraceptives (OCs) are yet to be legalized in Japan, it is estimated that at least 500,000 women were on pills in 1975. Intrahepatic cholestasis has been associated with OC in the Western countries, but only a few cases have been reported in Japan. A case of pill-related intrahepatic cholestasis in a 25-year old housewife will be presented in terms of clinical/pathological findings, changes in plasma and bile acid levels, and the effect of phenobarbital on bile stagnation. The patient had been taking 1 pill (Anovlar)/day, 25 days a month, for 5 months, and had experienced exhaustion, nausea, and constipation after 3 months of use; body itch and jaundice symptoms after 4 months. Cholangiography showed neither enlargement of the bile duct nor obstruction of the bile duct outside the liver. The condition was diagnosed as pill-related intrahepatic cholestasis. Total bilirubin was considerably raised; serum transaminase was moderately raised. Electromicroscopy showed the enlargement of bile canaliculi, which had electron dense bile content. Hepatic cellular peroxisome significantly increased. Plasma bile acid level, which was slightly raised initially, came down to the normal range when total bilirubin was back to normal with daily administration of phenobarbital 2 mg/kg. Studies which included experiments with rats as well as clinical-pathological results mentioned above suggested that bile stagnation was caused by ethinyl estradiol. By lowering bile canaliculi Na-K ATPase activity, ethinyl estradiol decreased bile acid independent of bile flow. Phenobarbital was effective for cholestasis by increasing bile canaliculi Na-K ATPase activity.
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PMID:[Intrahepatic cholestasis caused by oral contraceptives]. 714 55

To determine the effects of an estrogen-progestogen therapy in surgically castrated women, a double-blind crossover study was conducted using as sample 49 women (mean age, 46.2 + or - 8.9 years) who had undergone hysterectomy and bilateral salpingo-oophorectomy. The patients were given ethinyl estradiol 50 ug/day, norgestrel 250 ug/day, combination of ethinyl estradiol and norgestrel (Nordiol) and placebo. Initial and monthly assessment of patients included a semi-structured interview detailing frequency and intensity of certain clinical features, psychological tests, and measurement of weight and blood pressure. The combination pill therapy resulted in increased oiliness of skin. It also significantly increased mastalgia and breast size during the 1st 2 months of therapy. Lack of significant effects on complaints such as pruritus vulvae, vaginal discharge or dyspareunia may be due to short time interval of each drug regimen. Longer periods may be required for atrophic changes to develop. Significant reduction in diastolic blood pressure during study period may be due to initial anxiety. Further research with longer periods of hormone administration should be done.
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PMID:Some clinical effects of oestrogen-progestogen therapy in surgically castrated women. 740 84

Urogenital complaints such as vaginal discomfort, dysuria, dyspareunia, recurrent lower urinary tract infections (UTIs) and urinary incontinence have been reported to affect more than 50% of postmenopausal women. These symptoms cause considerable suffering and an obvious reduction in quality of life for the afflicted individual, as well as being costly in economic terms for the health service. Urinary incontinence alone has been estimated to account for approximately 2% of health care costs in both the US and Sweden. Treatment with low potency estrogens given locally or orally has been shown to alleviate urgency, urge incontinence, frequency, nocturia and dysuria, but there is no conclusive evidence that estrogens alone improve or cure stress incontinence. Estrogen therapy has also been shown to cure or alleviate local urogenital atrophy symptoms, and to induce positive changes in the vaginal bacterial flora of postmenopausal women, which in turn reduces the risk of developing a UTI. There is little or no documentation to support the use of antibiotics in the treatment of local urogenital complaints such as pruritus, vaginal discomfort and discharge, or urinary incontinence in postmenopausal women. Antibiotics are, however, indicated for the treatment of UTIs, and in some cases for prophylactic treatment in women with recurrent UTIs. The number of women with urogenital complaints is expected to increase in the future, as the proportion of elderly women will be greater due to a higher life expectancy. Thus, in the future there will be an even greater need for simple, effective forms of treatment for large numbers of elderly women. Low potency estrogens given topically or orally have been shown to be an effective form of treatment for urogenital symptoms in postmenopausal women.
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PMID:Rational prescribing for postmenopausal urogenital complaints. 882 Jul 93


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