Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0547004 (Intermenstrual bleeding)
 32 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Dr. J.M. Manautou, Director of Research, Mexican Institute of Social Security, gave a report on a study of continuous administration of 500 mug. of chlormadinone acetate to regulate fertility without inhibiting ovulation. Smaller doses (400,300 and 250 mug.) were used as well, in fewer patients and with less satisfactory results. The 500 mug. dose was used in 1123 women for a total of 13,202 cycles; 121 of these women received the treatment for 21 uninterrupted cycles. All the women in this study were under 36 years of age. Of the 1123 women on the 500 mug. dose, 40 became pregnant; six of these pregnancies were taken to be method failures because the women denied suspending treatment at any stage, and the other 34 were classed as patient failures. This gave a clinical efficiency for the method of 3.7 pregnancies per 100 woman-years. A special test was carried out on some of the women taking part in the study to check their accuracy regarding omission of treatment. Nearly half of those tested left out one or more tablets without admitting this; the presentation of the tablets did not allow the women to check whether they had omitted tablets or not. Dr. Manautou considered that better presentation would keep the women informed about the number of tablets they had taken and would obviate patient failures. Chlormadinone acetate was taken by 10 women who had become pregnant, until their amenorrhoea was correctly diagnosed. All these pregnancies were normal, with eight male and two female babies. No congenital abnormalities or signs of virilization were found. On continuous administration of chlormadinone acetate, menstrual bleeding occurred at 21-24 day intervals in 11.8% of cycles, at 25-35 day intervals in 65.5% of cycles, and at 36-59 day intervals in 20.6%. In no case did menstruation cease. In only 19 women was there menorrhagia of such proportions that the tablets had to be stopped. Intermenstrual bleeding occurred in 20.3% during the first cycle of administration; this percentage decreased over successive cycles until by the 20st cycle it occurred in only 2.1%. In most cases it was slight. Mechanism of action: This is not yet completely clear, but a number of investigations were carried out to try to discover how the compound acts. In 380 endometrial biopsies, 37.9% were irregularly secretory, 30.5% normally secretory, 15% irregular, 9.5% proliferative, and only 7.1% inactive. Culdoscopic studies were carried out in 50 women; in 37 a corpus luteum was present, in six the ovary appeared inactive, in three there was follicular activity without corpus luteum formation, three had cysts in the ovary, and one had a -corpus luteum not of recent origin. In 18 of the 37 cases in which a corpus luteum was found ovarian biopsy was done. The presence of an active corpus luteum was diagnosed in 12. Cervical mucus was investigated in 115 women between the 12th and 16th days of the first three cycles of continuous treatment. The physico-chemical characteristics of the mucus were modified in a way that made it hostile to the entry of sperms. Further, more precise, tests on the cervical mucus will need to be done to reach definite conclusions in this respect. There was a low incidence of side-effects caused by hormonal imbalance, such as nausea, vomiting, chloasma, and mastalgia. The only side-effect that was troublesome was breakthrough bleeding.
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PMID:Low-dose oral products. 1225 2