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

The sequential method of contraception with megestrol acetate with ethinyl estradiol was offered to 61 women for 549 cycles in this study. No pregnancies occurred. Flow was less in 7 women and greater in 3; duration of flow was longer in 5 women and shorter in 3. There were 2 instances of breakthrough bleeding. Persistant postnatal amenorrhea occurred in 1 woman and menorrhagia in another. Random endometrial biopsies showed proliferative activity in the majority of cases. Side effects observed were: nausea, vomiting, giddiness, leucorrhea, headache, weakness and abdominal pain. Most of these symptoms occurred in the first 2 cycles. 29 women dropped out after the first year, and 8 of these women conceived. Ethinyl estradiol was used in .1mg dose, megestrol acetate in 1 mg.
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PMID:Evaluation of sequential method of contraception with megestrol acetate and ethinyl oestradiol. 1215 52

The observation that estrogens in sufficient dosage given postcoitally may prevent implantation of the ovum have led to studies regarding practical clinical application. Estrogens that appear effective in humans include stilbestrol and ethinyl estradiol orally and estrone parenterally. Mestranol should also be effective as well as ORF-3858. Any estrongenic substance in sufficient dosage would probably prevent implantation. Effective period of administration is only between time of fertilization and implantation or 4 to 6 days following coitus. Test dosages have been 25-50 mg stilbestrol or .5-2 mg esthinyl estradiol daily for 5 days. It is now considered that 2-5 mg ethinyl estradiol would be more effective. In over 100 midcycle exposures there have been no pregnancies. Others have reported failures with inadequate dosage. Injectable estrone, 2-20 mg on alternate days for 3 doses, has also been reported effective. The process of implantation is discussed. Endometrial biopsies have usually revealed a "retarded endometrium," a possible mode of action. Side effects have been those usually associated with estrogens: nausea, vomiting, breast soreness, prolonged menses.
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PMID:Post-coital oral contraception. 1225 49

3 conditions may be responsible for absence of menstruation in women taking the minipill: pregnancy, extrauterine pregnancy, or endometrial atrophy which is the most frequent cause but should be treated only after the other 2 possibilities are excluded. The most frequent cause of pregnancy while taking minipills is error in pill consumption due to forgetting, but malabsorption due to vomiting less than 2 hours after taking the pill or an interaction with some other medication may be responsible. The possibility of extrauterine pregnancy should be systematically considered, and the possibility that a micropill and not a minipill is involved should be ruled out. With a sequential minipill contraceptive efficacy does not reach 100% but iatrogenic amenorrhea is infrequent because of the strong dose of ethinyl estradiol. In the case of a preexisting amenorrhea that does not respond to the estrogen or progestin dose, a prolactin adenoma may be suspected. After 2 consecutive beta tests of pregnancy 8 days apart have been negative, it may be concluded that endometrial atrophy is the cause of the amenorrhea. Unprotected sexual relations should be avoided and the patient should be given a fast-acting combined oral contraceptive such as Lutestral to induce bleeding, after which the minipill can be resumed. If unprotected intercourse occurs there is a risk of pregnancy since amenorrhea and anovulation are not synonymous. A morning after pill can be used if the unprotected sexual relations occurred within the last 72 hours. If a pill was forgotten or probably forgotten before the emenorrhea, the most prudent attitude would be to consider the pill to have been ineffective during the preceding 21 days and to test for pregnancy. Unprotected intercourse should be avoided, a fast-acting combination pill should be prescribed to induce bleeding, and the minipill should then be resumed. Amenorrhea in the 1st month of use after an abortion is not significant. This secondary effect of the minipill should be explained to the patient to avoid unnecessary worry.
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PMID:[Do's and don'ts in treating amenorrhea in women taking the minipill]. 1226 2

During a 9-month period, 84 female patients received post-coital contraception consisting either of an association of ethinyl estradiol/norgestrel or of danazol, in order to compare the safety and any adverse reaction of these 2 treatments. Overall, the patients treated with danazol presented 1/3 as many side effects. Nausea was reduced to 1/3 in frequency and vomiting to 1/9 in this group. 5 pregnancies were confirmed in the ethinyl estradiol/norgesterol group and 2 in the danazol group. Although more cases are needed, it would appear that danazol is characterized by greater efficacy and patient acceptability.
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PMID:[Danazol: a new hormonal post-coital contraceptive method]. 1226 99

The experience of the Utrecht State University with postcoital estrogens in high and low combined doses and with postcoital placement of IUDs since 1964 with over 4000 patients is summarized. The high dose postcoital estrogen treatment consists of 5 mg ethinyl estradiol for 5 days, either orally, or in case of vomiting not controlled by an antiemetic, estradiol benzoate 30 mg by injection. Side effects recorded in 3016 women were nausea in 54%, vomiting in 24%, tender breasts in 23%, menorrhagia in 11%, altered cycle length in 24%. Complications were 1 case of non-fatal pulmonary edema and 1 case of an 8 kg weight gain during treatment. There were 3 pregnancies. The overall failure rate in the whole series was 0.15%, with 10% ectopic pregnancies. There were no thromboembolisms or teratogenic effects. The combined estrogen treatment consisted of 50 mc ethinyl estradiol with 250 mc levonorgestrel (Neogynon oral contraceptive), 2 pills followed by 2 pills 12 hours later. A double-blind randomized trial resulted in no significant differences in pregnancy rates or side effects between the high and low dose regimens. The alternate treatment, if the woman presents more than 72 hours after intercourse, or if estrogens are contraindicated, is postcoital insertion of an IUD. The Dept. of Obstetrics and Gynecology does not place an IUD in a woman with infection nor in case of rape unless there is time for a complete work-up. Nulliparas are informed of the increased risk of pelvic inflammatory disease. Recently, the Multiload-copper 250 and later ML 375 were used exclusively, to achieve better blastocidal effect and lower expulsion rates. The ethical debate over use of postcoital methods centers around the morality of "procuring a miscarriage," but this argument is not relevant since these methods will not terminate a pregnancy once implantation has occurred. In the Netherlands, 25% of all abortion clients become pregnant during their 1st intercourse. In 1982, 35,000 postcoital contraceptives were administered, (roughly 16% of all pregnancies), compared to 15,000 abortions (7% of pregnancies; a total of 23% of pregnancies terminated). Compare these figures with 29% unwanted pregnancies all terminated by abortion in Sweden in that year. The postcoital methods are cheap, effective, and invaluable in emergency cases of rape, incest, intoxication, failure of barrier contraceptives, or unwanted pregnancy in women fearful or opposed to abortion.
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PMID:Post coital contraception. 1226 14

A review of oral contraceptives, their potency, side effects, and factors in the choice of preparation, is presented. The type of oral contraceptive regimen influences the patient's reactions toward the pill. The regimens, unequal in biological properties, efficacy and side effects include: combined pills, sequential pills, and continuous low-dose progestagens or luteal supplementation. If the assumed role of endocrine balance in the genesis of some side-effects is correct, relief should clearly be obtained by changing preparations. Side-effects from estrogen excess decrease with a switch to a less estrogenic preparation and so forth. Regarding initial choice of preparation, an approximation to an individual's steroid balance can be made by carefully examining her genital tract, and by inquiring about symptoms of increased sensitivity to endogenous steroids. Estrogen sensitivity are suggested by symptoms that include nausea, emesis gravidarum premenstrual and/or intermenstrual congestion and abundant discharge of mucous at time of ovulation. Sensitivity to progestagen are seen in excessive anabolic weight gain during previous pregnancies.
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PMID:Choice of oral contraceptives. 1227 80

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

Since "sexarche" -- the age of 1st coitus -- is occurring at very young ages and 60% of these 1st sexual exposures are unprotected, an effective method of postcoital contraception is necessary, if abortion is to be avoided. In the Netherlands, where the incidence of induced abortions (18,000/180,000 live births) and the incidence of adolescent pregnancy (14/100) are both the lowest in the world, 4 methods of postcoital contraception are used. Within 72 hours of intercourse high-dose or combined estrogens may be used to interfere with endometrial hyperplasia. 1 method involves the administration of 5 mg of ethinyl estradiol daily for 5 days. The other method involves the administration of 50ug of ethinyl estradiol combined with 250 ug of levonorgestrel. 2 tablets are given immediately and 2 more 12 hours later. Side effects -- nausea, vomiting, sore breasts, and menstrual irregularities -- are the same with both regimens, as was the failure rate, .15%. If the woman requests intervention more than 72 hours but less than 7 days after intercourse, insertion of the Multiload Cu 250 or the ML 375 IUD prevents pregnancy through blastocidal effects of copper salts. However, nulliparas, sexually active women, and rape victims are at high risk for pelvic inflammatory disease. The newest postcoital contraceptive is mifepristone (RU-486), which binds competitively to endometrial progesterone receptors and can prevent pregnancy irrespective of the time lapse following intercourse. 3 tables of 200 mg, taken on day 27 of the cycle will induce menstruation within 3 days, with a failure rate of 1.6%. Because of their interference with early gestation, postcoital use of antiprogesterones is called "contragestion." Since they interfere with gestation before implantation is completed, antiprogesterones are classed as contraceptives rather than abortifacients. Postcoital contraceptives should not be used as an ongoing contraceptive regimen except by women who have intercourse very infrequently.
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PMID:Post-coital contraception. 1228 24

18 young women with an average age of 21.5 years and average duration of acne symptoms of 3.6 years were treated with Diane 35, a new antiandrogen contraceptive containing 35 mcg ethinyl estradiol in addition to 2 mg cyproteroneacetate (CPA) for 12 months. Gynecological exams were carried out prior to treatment, and 6 and 12 months later. Diane was taken for 21 days with 1 week of cessation. During monthly checkups acne lesions, seborrhea, weight, blood pressure, and side effect were examined. A recidivism follow-up of several months included 11 patients no longer taking the contraceptive. 14 patients became symptomless, and 4 of them improved indicating an effective treatment for all patients. The loss of symptoms started after 4 months (2-7) and they became completely symptomless after 7-10 months. 8 of the 11 patients in the follow-up study stayed symptomless at the end of treatment. Although relapse occurred in 7 cases, their condition was still better than before treatment. Side effects occurred in 11 patients mostly in the first months of treatment: nausea, vomiting (6), headache (4), vertigo (3), chest ache (2), bleeding (4). Treatment may exceed 12 months because after 7-10 months relapse occurred. If the treatment fails to improve the symptoms, administration of 10-20 mg CPA/day in the first 10 days of cycle is suggested.
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PMID:[Treatment of acne with an antiandrogen containing contraceptive (Diane 35)]. 1228 88

2 types of combined estrogen-progestogen oral contraceptives (OCs) were administered to 40 women for 3 cycles. The women were selected on the basis of willingness to participate and attend the clinic at monthly intervals as well as absences of contraindications to contraceptive steroid therapy. 32 of the women had a family income below Rs. 250/month, 15 had below Rs. 100/month, all at poverty level. Group A was given a combination of Lynestrenol 2.5 mg with Mestranol 0.75 mg (Noracycline 2.5) from day 5 to day 26 of each of 3 cycles. Group B was given Megestrol acetate 4 mg with 0.05 mg ethinyl estradiol from day 5 to day 26 of each of 3 cycles (both groups were equally divided into 20 women each). The women reported for follow-up between 22-25 days of each cycle. Blood samples were collected in 4 consecutive cycles (1st cycle was a control) and analyzed. Side effects such as nausea, vomiting, bleeding, and measures of blood pressure and weight were recorded. No significant differences were noted in mean transominases, bilirubin levels, serum proteins, or albuminium/globulin ratio and all were in normal ranges. The women's weights ranged from 26-50 kg and hemoglobin values from 9.6-12 gm. In other tests performed with low dosages of progestogens (0.5-2.5 mg) and estrogens (0.05-0.075 mg) no biochemical evidence of liver dysfunction was found except a slightly higher percentage of raised BSP retention in some series. Though gross abnormalities were not observed in commonly used parameters of liver function, it is suggested that previous liver disease with residual damage or history of idiopathic jaundice with pregnancy should be contraindications for use of these drugs. Dosage used should be minimum, compatible with efficacy for both the estrogens and the progestogens.
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PMID:Metabolic effects of contraceptive steroids IV. Liver function tests--short term observations. 1231 Apr 10


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