Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0162316 (iron deficiency anemia)
 3,806 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

For women beyond the desire for childbearing, the contraceptive options are discussed as appropriate for the age and in light of risks and benefits. Reeducation and careful history taking are important. A pregnancy for a woman 40 years places a woman at greater risk for an elective abortion and greater risk of maternal mortality from abortion; low dose contraceptive use can have beneficial effects for menopausal women. Methods are grouped as contraceptive steroids (combination pills, progestin-only pills, oral preparations, implants, and injections), IUDs, barrier methods (diaphragms, cervical caps, vaginal sponges, spermicides, and contraceptive film), condoms, sterilization, and natural family planning. Empowering women means providing current scientific information and urging women to examine their lives, and to review how and why contraceptive choices were made, and the consequences of the choices. Sexually transmitted disease counseling is appropriate for women in new relationships. A positive attitude toward menopause needs to be conveyed. Combination pills at the lowest dose possible are recommended for women 35 years who are healthy, nonsmoking (or smoking 15 cigarettes/day), blood group O, and able to derive benefits from the pill. Benefits include a 30% reduction in uterine fibroids and protection against endometrial cancer, and decreased risk of ectopic pregnancy, pelvic inflammatory disease (PID), and iron deficiency anemia. Multivitamin use with the pill is recommended due to reduced liver stores of vitamin A. Women 40 years with a parent dying of cardiac disease 50 years or with a history of hypertension, diabetes, or hyperlipidemia are not suitable candidates. 35 mcg preparations are recommended for women 35-45 years, and 20 mcg for women over 45 years. Progestin-only pills are recommended for those with contraindication to estrogen, but have a higher pregnancy rate. IUD use among older women may be difficult due to cervical or pelvic surgery; there is a higher incidence of PID and ectopic pregnancy with IUD use. Barrier methods are more successful for older women due to the changing vaginal anatomy. Vasectomy is the safest sterilization procedure.
 ...
PMID:Contraception for midlife women. 159 31

Studies show that OCs have several benefits besides prevention of pregnancy. They protect against ovarian and endometrial cancer, pelvic inflammatory disease, and ectopic pregnancy. OCs also prevent iron deficiency anemia, primary dysmenorrhea, functional ovarian cysts, and benign breast disease. They may even protect against some benign uterine tumors, osteoporosis, toxic shock syndrome, and rheumatoid arthritis. Despite many concerns, some large studies have not identified an overall effect of OCs on breast cancer, but subgroup analyses showed increased risk in 30-34 year old women and in women with 1 child. A reanalysis of a large US study indicated an increase risk of breast cancer in nulliparous women with increasing use of OCs by young women. Cervical cancer is the leading cancer of women in developing countries which emphasizes the need to examine the link between OC use and cervical cancer. Several studies show an increased risk of cervical cancer. Several studies show an increased risk of cervical cancer in long term OC users. In 1 study, long term use meant 5 years. Yet these studies did not adequately address confounding factors such as smoking and sexual behavior. 3 case control studies in the US and the UK found an increased risk of liver cancer among OC users, yet a large case control study in developing countries did not find a link between OC use and liver cancer. Studies of high dose OCs found considerable increased risks of cardiovascular disease in OC users, but they did not take into account cigarette smoking which indeed increases the risk. Further health practitioners today do a more thorough job of identifying underlying medical problems before prescribing OCs. Moreover estrogen doses have fallen 10 fold since the original OCs. Finally, despite a transient delay, women who take OCs experience a return to fertility at the same rate as those who use other contraceptives.
 ...
PMID:The safety of oral contraceptives: epidemiologic insights from the first 30 years. 160 84

The benefits of oral contraceptives are emphasized in this review, which begins by listing the priorities an older career woman seeks in a contraceptive. She needs a highly reliable, reversible method while she postpones childbearing until as late as age 35, with no long-term adverse effects. The method must not affect cardiovascular health or fertility, nor increase risk of endometrial or ovarian cancer. Polls indicate that many women believe the pill has serious health risks, causes cancer, and is not very reliable. Actually it is almost as reliable as sterilization, has no lasting effect on fertility, adds no risk of cardiovascular disease if patients are screened for risk factors, and probably does not increase the change of getting breast cancer in most women. The non-contraceptive benefits of oral contraceptives are significant to health: protection against endometrial and ovarian cancer, heavy menses, dysmenorrhea, ovarian cysts, reduced risk of pelvic inflammatory disease, endometriosis, benign breast disease, iron deficiency anemia, and osteoporosis. With today's low-dose pills and proper screening of patients, most practitioners will never see a major complication. The Food and Drug Administration has lengthened the approved use of oral contraceptives in health non-smokers up to menopause.
 ...
PMID:The career woman and oral contraceptive use. 167 23

This review on the risks and benefits of oral contraceptives clarifies the risks and misperceptions, and discusses 10 potential health benefits. In the U.S. where maternal mortality is about 20.6/100,000, the risk of death from pills ranges from 1.8 for nonsmokers to 6.5 for smokers. It is likely that most of the small existing mortality risk of pill use is due to thromboembolism. Atherosclerosis, the major cause of death for U.S. women, may be reduced by the pill. It is still controversial whether pills increase risk of hepatocellular carcinoma and malignant melanoma; they protect against endometrial cancer (the 3rd greatest cancer killer) and ovarian (the 4th) cancer; they may increase risk slightly in some subgroups for breast and cervical cancer, although data are conflicting. Pills also protect against ectopic pregnancy, benign breast disease, pelvic inflammatory disease, ovarian cysts, iron deficiency anemia and possibly uterine fibroids and osteoporosis. It is no longer held that orals protect against toxic shock syndrome or rheumatoid arthritis. It is estimated that oral contraceptives avert 50,000 hospital admissions per year in the U.S.
 ...
PMID:The health effects of oral contraceptives: misperceptions, controversies, and continuing good news. 266 76

The benefits of combined oral contraceptives are put into perspective, considering their effectiveness as a contraceptive, actual risks for breast, ovarian, endometrial and cervical cancer, and effects of reproductive and other body systems. Combined oral contraceptives are the best contraceptives available except for injectable progestogens, therefore they an reduce the risk of maternal mortality by at least 5 in nonsmoking western women, or over 100 in developing countries. No data are available on mortality risk of the presumed safer low-dose pills. Pills reduce ectopic pregnancy to virtually nil. They decrease the risk of endometrial cancer, and of ovarian cancer for up to 15 years after use. Although they protect against benign breast disease, both fibrocystic disease and fibroadenoma, which are risk factors for breast cancer, it is unsettled whether pills affect breast cancer incidence. Cervical cancer risk may be slightly higher. Functional ovarian cysts requiring surgery are cut about 10-fold; corpus luteum and follicular cysts are also reduced. Fibroids are decreased in proportion to duration of use. Pelvic inflammatory disease rates fall 50% during use. Chlamydial infections have not fallen in pill users, but it is not known whether sexual activity is a factor. Combined pills cut abnormal uterine bleeding by about half, reduce the incidence of iron deficiency anemia and of premenstrual tension. Seizures related to menses also are controlled. Some studies find a reduction in rheumatoid arthritis. Most of the cardiovascular complications of pills are thought to be dose related. Since today's pills contain approximately the same dose as a whole cycle of the original pills, it is expected that these risks will be greatly reduced, especially with better screening of candidates that is now the rule.
 ...
PMID:The benefits of combined oral contraceptives. 269 95

Use of oral contraceptives has been shown to reduce the risk of gynecologic conditions that cause significant mortality, including ovarian cancer, endometrial cancer and ectopic pregnancy. Additionally, its use has been linked to quality-of-life issues, such as the prevention of pelvic inflammatory disease, benign breast disease and functional ovarian cysts, as well as to dysmenorrhea, premenstrual syndrome and iron deficiency anemia. Such information should be conveyed to women of reproductive age during their contraceptive counseling session.
 ...
PMID:Oral contraceptives. Assessment of benefits. 377 7

Although the adverse effects of oral contraceptives (OCs) should be given serious consideration, the many beneficial effects of OC use should also receive recognition. The main advantage of the pill is its effectiveness as a method of reversible fertility control, enabling women to be free of the fear of unwanted pregnancy and its psychological, social, and physical implications. In addition, however, there are numerous noncontraceptive advantages. Many symptoms related to ovulation and menstruation, such as dysmenorrhea, premenstrual syndrome, irregular menses, menorrhagia, and ovulation pain, disappear or are greatly reduced through OC use, especially in young women. Endometriosis and functional ovarian cysts are less common in OC users, and the risk of pelvic inflammatory disease in OC users is about half that in nonusers of contraception. The reduced menstrual blood loss resulting from OC use cuts the risk of iron deficiency anemia by 50%. In addition, the pill has a protective effect against benign breast disease and appears to reduce the risk of ovarian and endometrial cancer. Other beneficial effects include a reduction in the rate of thyroid disease, rheumatoid arthritis, and possibly duodenal ulcers.
 ...
PMID:The benefits of oral contraceptives. 392 18

A review of prospective and retrospective epidemiologic studies of oral contraceptives (OCs) shows that in addition to pregnancy prevention, OCs provide other health benefits resulting from the antiestrogenic action of the progestin in the pills and from its main action, inhibition of ovulation. The antiestrogenic effects include reduction of risk of iron deficiency anemia by about 50% because of reduced menstrual blood loss. The Royal College of General Practitioners (RCGP) study reports that OCs protect about 7 of 1000 pill users/year from iron deficiency anemia, and that OC use significantly reduces the incidence of menstrual disorders (menorrhagia, irregular menses, intermenstrual bleeding). Other studies report elimination of endometrial hyperplasia (Sturdee et al.), 50% reduction in risk of endometrial cancer (Weiss and Sayvetz, Boston University Epidemiologic Survey), and reduction in incidence of benign breast diseases (at least 12 published studies). The noncontraceptive benefits resulting from inhibition of ovulation include significant reduction in the incidences of dysmenorrhea (RCGP study), functional ovarian cysts (RCGP study, Boston Collaborative Surveillance Program, Ory), and ovarian cancer (Beral et al., Casagrande et al.) OCs are also found to protect against rheumatoid arthritis (RCGP, Rochester Epidemiologic Project), and salpingitis or pelvic inflammatory disease (PID). 6 epidemiologic studies show that the relative risk of developing PID among pill users compared with nonusers ranges from 0.3 - 0.9. Increased OC use by the population at greatest risk--sexually active women between 15-24 years old--would significantly reduce PID with its high cost of treatment and resulting infertility. It is hoped that healthy young women will realize that OCs provide benefits (including prevention of unwanted pregnancy) that far outweigh their more widely publicized, infrequent risks.
 ...
PMID:Noncontraceptive health benefits of oral steroidal contraceptives. 706 59

During the 20 years since the oral contraceptive was introduced, it has been used by some 150 million women around the world, and is perhaps the most carefully monitored medication in history. This vast body of research shows that for the overwhelming majority of healthy women under 30, the benefits of the pill continue to outweigh the risks. The most serious life threatening risks are those involving the cardiovascular system: heart attack, stroke, and throboembolism. However, deaths from these causes would be reduced by 1/2 if women using the pill did not smoke; further reductions would result if women with high blood pressure, high chloresterol levels and diabetes millitus did not use the pill. There is no evidence thus far to justify fears that the pill might be associated with an increased risk of cancer. Most studies show that not only is there no association between pill use and cancer of the ovaries, uterus and breast, but pill use may protect against ovarian and endometrial cancer. Women taking the pill are 1/4 as likely to develop benign breast lumps as nonusers, 1/14 as likely to develop ovarian cysts, 2/3 as likely to develop iron deficiency anemia, and 1/2 as likely to develop rheumatoid arthritis -- all relatively common conditions. In addition, pelvic inflammatory disease, a major cause of infertility, appears to occur only 1/2 as often among pill users as among nonusers. The risk to life among pill users younger than 30 who do not smoke is very small (virtually the same as that of users of the IUD, diaphragm, or condom) and is much lower than the risk of birth-related deaths among women who use no birth control.
 ...
PMID:The pill at 20: an assessment. 720 90

Women throughout the world and throughout time have ingested substances such as mercury, diluted copper ore, and various noxious solutions in the mistaken belief that these substances would prevent pregnancy. The era of modern contraception began in 1937 with the discovery that the administration of progesterone could halt ovulation in rabbits. During the next decade, work proceeded on finding an easy and less expensive way to synthesize progesterone and to develop the synthetic estrogens mestranol and ethinyl estradiol. Initial trials in humans proved that these hormones could prevent ovulation. In 1950, with support from Margaret Sanger and Katharine Dexter McCormick, Gregory Goodwin Pincus developed the first oral contraceptive (OC), which consisted of supplemental progestin and 0.5 mg norethindrone. In the early 1990s, the Ortho Pharmaceutical Corporation introduced an OC that combined the synthetic progesterone norgestimate and 35 mcg of ethinyl estradiol. By 1988, several noncontracepting health benefits of the OC were recognized, including decreased rates of ovarian cancer, endometrial cancer, pelvic inflammatory disease, ovarian cysts, benign breast disease, iron deficiency anemia, and dysmenorrhea. These health benefits outweigh risks even in nonsmoking women over 40. In the US, 80% of women have used the OC at one time, and they are using this most popular form of reversible contraception longer than ever.
 ...
PMID:A history of oral contraception: from evolution to revolution. 767 Apr 17


1 2 3 Next >>