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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

294 women between 18 and 35 years of age -- without absolute contraindications to estrogen use, with regular menses, who had had intercourse from 3 days before to 2 days after presumptive ovulation -- were given ethinyl estradiol (EE) in dosages of 5 mg/day and domperidon 20 ng twice/day for 5 days between and 72 hours from intercourse. Follow-up visits 30 days later showed that only 243 women had adhered to the protocol. It was calculated that 32.9 pregnancies were statistically probable in the absence of therapy in the study group; none actually occurred. Even among the 27 women who presented not having followed the therapeutic protocol correctly, there were no pregnancies. Side-effects such as vomiting, nausea and breast tenderness occurred in 54% of the patients, even though domperidon is an efficacious anti-emetic.
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PMID:[Use of estrogens in post-coital contraception. Our case material of 243 cases]. 337 30

To collect data on clinical and laboratory effects of the oral contraceptives (OCs) marketed in Hungary, a prospective study was initiated in January 1983. Patient data were collected in regular intervals using standard statistical forms. During the first 2 years of the study, data were collected on 1256 women. A complete segment of the data was selected to be reported in this paper and included 1844 cycles of 121 women using a biphasic OC compared to 1940 cycles of 142 women using a classical formulation pill. The biphasic preparation was characterized by a very low levonorgestrel content with an average ethinyl estradiol dose; the reference preparation was a relatively high dose classical OC. No biologically significant difference was found between hormone and receptor levels. The basis of the comparison of the 2 preparations was the termination of OC use in the 2 groups as a function of time. The primary reasons for stopping administration of these preparations were unwanted pregnancy, medical reasons, critical age above 35, planned pregnancy, and other personal reasons. The difference between the 2 groups proved significant according to the life table method only in the category of medical reasons. Slightly more patients were lost to followup in the higher dose group. In the category of medical reasons, digestive tract complaints like nausea, vomiting, menstrual bleeding anomalies, too frequent bleeding-spotting, episodes of amenorrhea, weight gain, psychic disturbances, headache, breast tenderness, and swelling were prominent. These symptoms were most frequent in the first 3-4 months of OC use. The difference was due to the significantly higher rate of amenorrhea/hypomenorrhea, weight gain, and headache in the high dose monophasic pill group. The biphasic pill group was characterized by a slightly higher rate of gastrointestinal complaints and breast swelling. The overall difference favored the latter preparation. The biphasic OC did not cause a thrombotic change in homeostasis despite the fact that it was estrogen dominated. The basal levels of luteinizing hormone and follicle stimulating hormone were less affected in the biphasic OC users compared to the classical formulation OC users. Estradiol levels did not change significantly. The inhibition of ovulation was about the same with both treatment regimens.
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PMID:Clinical and endocrine effects of long-term hormonal contraception. 358 64

The term "pregnancy interception" covers all fertility control methods that interfere with implantation of the fertilized egg, either by inhibiting its transport or implantation or by eliminating the already implanted blastocyst. A few researchers beginning in 1960 used high doses of estrogen in the immediate postovulatory period to prevent implantation. It was discovered that administration had to occur soon after coitus to be effective. Estrogens were administered orally for 5 days beginning in the 72 hours following unprotected intercourse in the ovulatory phase. Secondary effects were common: vomiting in 40% of cases, menometrorrhagia in 30%, and almost constant breast discomfort. About 10% of pregnancies in case of failure of the method were ectopic. The mechanism of action is still not understood. A combined treatment of 50 mcg ethinyl estradiol and a 19-norsteroid progestin has been used since 1975. It must be administered in the 48 hours following coitus and repeated 12 hours later. The duration of treatment and quantity of hormones are significantly reduced, but the secondary effects are similar to those of estrogens used alone, and the failure rate is 2%. Some progestins can also be used alone. IUD insertion up to 7 days after the unprotected intercourse has a contragestive effect, but the risk of infection is considerable and 3% of patients develop endometritis. The risk of secondary sterility discourages use of the method, especially in nulliparas. The prostaglandins E and F are effective in early pregnancy termination, but their side effects considerably limit their use. The average duration of bleeding is acceptable, but prostaglandins cause very painful uterine contractions in 30-40% of cases. Gastrointestinal secondary effects often require termination of treatment. The recent synthesis and use of the antiprogesterone compound RU-486 offers real promise for a widely usable contragestive method. Progesterone is indispensable for the continuation of pregnancy, and inhibiting its action on the endometrium interrupts pregnancy. An antiprogesterone acts by competing directly with progesterone at the target cells. The antiprogesterone RU-486 also has dose-dependent luteolytic and antigonadotropic effects whose mechanisms are not completely understood. Clinical trials have proven the innocuity of RU-486, and its efficacy of about 90% will undoubtedly be improved. Interruption of early pregnancy is a major indication for RU-486. The duration of the pregnancy appears to be the determining factor in the percentage of success, but most researchers have had failure rates of 15% even in pregnancies of less than 5 weeks. Possible heavy bleeding or failure in case of ectopic pregnancy indicate the need for medical surveillance. A different route of administration and combination with a small dose of prostaglandin would undoubtedly raise the success rate. RU-486 may have more promise as a post-coital agent, and may potentially be the basis for development of a once-a-month pill.
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PMID:[Contragestion]. 365 95

Postcoital contraception with ethinyl estradiol/dl-norgestrel in combination has been available to women students attending the University of British Columbia since 1974. This paper reports on the side effects, cycle control and efficacy, for a six-year period (1979-1985). In this sample of women 50% reported side effects of nausea alone or nausea with vomiting. Length of the menstrual cycle was shortened in women who took the medication prior to the expected day of ovulation. The number of pregnancies reported was significantly (p less than 0.002) less than the number expected had the medication not been taken. Some women took the medication even though there was a possibility of conception earlier in the cycle and this might account for four of the failures. The mode of action of the postcoital medication remains unsolved making it difficult to understand possible reasons for the other 14 failures.
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PMID:Postcoital contraception with dl-norgestrel/ethinyl estradiol combination: six years experience in a student medical clinic. 367 75

At this time 3 triphasics are widely used in the US: Ortho-Novum 7/7/7, Tri-Norinyl, and Triphasil. Ethinyl estradiol is the preferred estrogenic agent for the triphasic products. Torethindrone and levonorgestrel were chosen as the progestins for the triphasic products. It is the combined effects of estrogen and progestin in the triphasics that provide their contraceptive action. Triphasil increases both the estrogen and the progestin at midcycle; Tri-Norinyl and Ortho-Novum 7/7/7 elevate the progestin only. The midcycle surges of estrogen and luteinizing hormone are dampened, and ovulation is inhibited. The triphasics represent a 98.7% reduction in total steroid content since oral contraceptives (OCs) were introduced. An estrogen dose of 30-50 mcg will inhibit ovulation, and side effects with such a dose are considered tolerable. The triphasic OCs are in this range. An estrogen dose of 20 mcg has been tested but is slightly less effective and is not recommended. Contraceptive failures have occurred with the triphasic products. In 1486 women studied, 6 pregnancies have occurred. Of these failures, one may have been because of a drug interaction with a barbituate. 1 pregnancy was due to patient failure; 3 consecutive pills were missed. Only 2 pregnancies were certain drug failures. Because of the gentle suppression of ovarian function, it has been observed that the menstrual flow is less affected than by standard OCs. Due to the fact that less total steroid is delivered and more endometrial shedding occurs, it is hoped that the triphasic preparations will have less of a "lingering" effect on the return to functional fertility. Most of the published data on side effects is available from the UK, North America, and Europe on the formulation known in the US as Triphasil. Nausea, vomiting, breakthrough bleeding, weight gain, and breast tenderness appear to be the most common side effects. The major medical reasons for triphasic discontinuation include breast tenderness, weight gain, breakthrough bleeding, nausea and vomiting, headache, and increased bleeding during the 1 week of withdrawal. Rifampin and phenobarbital are examples of drugs found to decrease pill efficiency, including triphasics. Also, a triphasic may interfere with the action of another drug. The new triphasics are appropriate when starting new patients on OCs. Patient counseling is essential. Due to the low margin of error as a consequence of lesser suppression of ovarian function, the patient needs to be well instructed in how to take the pill and advised of the consequences of missed tables.
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PMID:The triphasics: insights for effective clinical use. 382 67

This study was conducted to assess the efficacy of d-Norgestrel associated with Ethinylestradiol (Neogynon 21) as postcoital contraception and to report on the clinical experience obtained with this type of contraception. 323 women were treated during 72 h. period following unprotected intercourse. All subjects received 0,2 mg Ethinylestradiol and 1 mg d-Norgestrel (Levonorgestrel) in 2 equally divided doses 12 hours apart. - 1 mg Levonorgestrel was observed to be as effective as 2 mg of the racemic Norgestrel. PCC given during the first part of the cycle, shortened the latter in 80% of relevant cases. Nausea occurred in 30.3% of all patients; among these 14.2% also mentioned vomiting. Three pregnancies occurred of which only one could be attributed to method failure. The corrected failure rate is thus estimated at 0.3%.
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PMID:[Post-coital contraception using a combination of d-norgestrel and ethinyloestradiol]. 403 32

The efficacy, safety, and patient acceptance of an oral contraceptive containing 150 mcg d-norgestrel and 30 mcg ethinyl estradiol (150/30) were studied in 99 women who completed 754 cycles of medication between late 1971 and October 1973. 1 pregnancy occurred giving a pregnancy rate of 1.6 per 100 woman-years. This woman's previous history indicated unreliability in pill taking. The mean pretreatment length of menses was 4.9 days and during treatment, 4 days. Although intermenstrual bleeding and amenorrhea were noted in early cycles, there was a decrease in the usual incidence of headaches, nausea, vomiting, and depression. Results of the study and patients' acceptance suggest that the 150/30 combination may be used as the oral contraceptive of first choice.
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PMID:Clinical assessment of a low-dose oestrogen, low-dose progestogen combined oral contraceptive. 482 25

264 women (about 50% private patients), all less than 40 years old and none with history contraindicating oral contraception, were started on a regimen with Ovral (.5 mg norgestrel and .05 mg ethinyl estradiol). Medication started on Day 5 of a menstrual cycle. Then therapy followed a 3 weeks on, 7 days off schedule. Patients continued for 1-22 cycles (mean 7 cycles) for a total of 1918 cycles. Despite the omission of 42 doses by 32 patients, no pregnancies occurred. The percentages of cycles with average flow, spotting, breakthrough bleeding, and dysmenorrhea were 74.4, 2.5, .4, and .6, respectively. The incidence of amenorrhea, .2%, was spectacularly low in comparison with findings in other studies. Papanicolaou smears (483) were all normal (Class I or II). Morphologic changes seen at endometrial biopsy (61) were similar to those produced by other available progestogen-estrogen compounds. No significant variation from control findings (1878) were found in 1463 laboratory studies. The studies included leukocyte and differential counts (724), and determinations of hemoglobin and hematocrit (388), fasting blood sugar and blood urea nitrogen (114), bilirubin and liver function (61), and renal function (176). Minor symptoms (nausea, vomiting, headache, etc.) were few and disappeared after the first few cycles. The preparation suppresses ovulation (probably through action of the estrogen), probably alters the cervical mucus to inhibit sperm penetration, possibly interferes with nidation, and may interfere with follicular development.
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PMID:Norgestrel, a low dose, oral progestogen for fertility contro. Supplementary report. 564 94

This general review describes the progestagens and estrogens and their combinations marketed in France, their biologic effects (on ovulation, pharmacological and hormonal effects, effects on the female reproductive organs), the mechanism of inhibiting ovulation, indications, and trivial and serious side effects. The 3 series of progestagens are 17-alpha-hydroxyprogesterone derivatives, 19-nor-testosterone and 3-deoxy-19-nor-testosterone derivatives; the estrogens are ethinyl estradiol and mestranol. Indications discussed here are therapeutic tests, functional uterine bleeding, endometriosis, polycystic ovary, amenorrhea, Stein-Levanthal syndrome, sterility, intermenstrual pain, premenstrual breast congestion, and acne. Minor side effects include vomiting, bleeding, weight gain, depression, and vaginitis. Complications mentioned are thromboembolism, virilization, cholasma, jaundice, and fibroids. Genetic and congenital defects are not more common in steroid users than in the general population; it is too early to predict whether these drugs are carcinogenic.
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PMID:[The steroids, inhibitors of ovarian function]. 574 50

The increased risk of thromboembolism in women using estrogen-containing (OCs) oral contraceptives has been related to decreased (AT3) antithrombin 3 levels of about 10%. A dose-dependent effect on AT3 has been suggested. Using an automated chromogenic technique, we have studied the effect on AT3 of a very high dose of ethinyl estradiol (5 mg daily for 5 days), popularly known as the "morning after pill," which in the Netherlands is prescribed to 45,000 women. The mean decrease in AT3 level in 13 patients of average age 23 was 17% of the pretreatment value (p=0.0013). Values in U/ml as mean + or - 50 were 1.03 + or - 0.12 on day 0, 0.86 + or - 0.12 on day 5, and 0.97 + or - 0.15 on day 12. The day 0 samples were taken immediately before the start of therapy and those on day 12 were taken 1 week after discontinuing therapy. The normal range is 0.80-1.40 U/ml. The effect of this dose was also studied in 2 volunteers. The 1st volunteer did not wish to continue after the first dose of 5 mg ethinyl estradiol because of vomiting. On day 2 AT3 had increased by 22% and on day 4 had decreased by 12% of the pretreatment level. The 2nd volunteer also vomited on day 1, but continued the medication. AT3 increased on day 2 and then fell to 18.5% of pretreatment level on day 4. Changes in AT3 ran parallel with changes in hematocrit (seen in figure). High doses of estrogen have been reported to cause an increase in blood volume of 18% and a decrease in hematocrit of 15%. Plasma volume increases by 11% during OC use. Estrogen induced retention of salt and water causing hemodilution rather than increased consumption or decreased synthesis, may explain the reported decreases in AT3 levels. This does not rule out the possibility that subnormal values contribute to a hypercoagulable state. In 1 of our patients on day 5 of treatment AT3 fell to 0.60 U/ml, which is within the range where thromboembolism may occur in certain settings, such as emergency surgery or a history of thrombosis.
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PMID:"Morning after pill" and antithrombin III. 611 73


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