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)

An extensive review of the literature, supplemented by experimentation on progestagen-only minipills taken continuously finds the 4 most effective progestagens. They were tested for 4358 cycles in 483 women. In general lynestrenol and norethisterone acetate give fairly regular cycles with a longer menstrual period. Intermenstrual bleeding is frequent at the beginning but tends to regulate itself. D-norgestrel seems to give shorter cycles with less intermenstrual bleeding. NOrgestrienone gives longer cycles with less bleeding. Problems include spotting or amenorrhea which are often worrisome for the patient. The advantage of the minidose progestagen-only pill is that it has no estrogen and therefore can be used when estrogen is contraindicated: in the case of tumors, history of thromboembolism, disorders of lipid metabolism, fibromatosis, mastitis, prediabetes, and arterial hypertension.
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PMID:[Oral contraception by means of progestagen-only micropills taken continuously in the light of four recent trials (author's transl)]. 102 28

3 parenteral progestogens (medroxyprogesterone acetate, northisterone enanthate, and dehydroxyprogesterone acetophenide with estradiol enanthate, DPA) were studied in 907 women during 14,958 cycles over a 10-year period. The findings are summarized in 9 diagrams. The frequency of the principal side effects - intermenstrual bleeding, amenorrhea, headache, dizziness and nervousness - varied with the different substances. Intermenstrual bleeding and amenorrhea were least serious using DPA. When the injections were administered at the appropriate intervals, the drugs were effective and no pregnancies occurred. After suspending the treatment, the menstrual pattern returned to normal and the endometrium was fully regenerated. To date no fetal abnormalities have been reported after discontinuing the treatment.
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PMID:[Injectable contraceptives. 10 years' clinical experience]. 427 10

This study describes a clinical evaluation of the Progesterone T IUD which releases a daily dose of 65 mcg of progesterone. The device is made of a copolymer of ethylene vinyl and has a transversal arm measuring 3.18 cm and a longitudinal arm 3.61 cm. The longitudinal arm contains 38 mg of natural progesterone, Barium sulfate, and silicone acetate. 146 new users of the Progesterone T were compared with 149 using the Copper 7 Gravigarde. Patients in both groups ranged in age from 17-40 years with an average of 27.2 for Progesterone T and 27.1 for Copper 7 users. Parity ranged from 1-11 with an average of 2.8 for the Progesterone T group and from 1-10 with an average of 2.7 for the Copper 7 group. The average number of spontaneous abortions was .7 for the Progesterone T group and .5 for the Copper 7 group. The groups were also comparable in previous contraceptive usage. In another study, 51 Lippes Loop D users, 52 Progesterone T users, and 50 Copper 7 users were evaluated for menstrual and intermenstrual blood loss in the 3 months prior to and the 1st, 2nd, 4th, 6th, 9th, and 12th months after insertion. At the end of 12 months, the Progesterone T and Copper 7 users respectively had pregnancy rates of 1.4 and 1.5, expulsion rates of 4.2 and 5.8, rates of removal for medical reasons of 2.8 and 3.0, and continuation rates of 87.2 and 84.6. After 1569 women-months of Progesterone T use and 1558 of Copper 7 use there were no statistically significant differences. With the Progesterone T there was 1 removal for pain, 1 for pelvic inflammation, and 2 for menstrual alterations. 4 Copper 7s were removed for bleeding. The average duration of menstrual bleeding was 6.0 days with the Progesterone T and 6.2 with the Copper 7. The number of days of true bleeding were 4.8 on average for the Progesterone T and 5.3 for the Copper 7. Intermenstrual bleeding was twice as common for the Progesterone T. There was no statistically significant difference in incidence of pain reported by the 2 groups at the beginning and end of the study. Both groups had a decline in pain at the end of the study, with the Progesterone T having a slightly more pronounced decline. The average volume of menstrual blood loss increased by 87.8% after insertion of the Lippes Loop D and by 24.3% with the Copper 7 but declined by 44.5% for the Progesterone T.
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PMID:[Clinical evaluation of the progesterone T intrauterine device]. 676 70

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