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Query: UMLS:C0745411 (irregular bleeding)
 386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Exogenous estrogen is an effective means of prevention for postmenopausal symptoms. Estrogen treatment should be combined with progesterone in non-hysterectomized women to prevent estrogen-induced malignant transformation of the endometrium. Progesterone supplementation using continuous combined estrogen + progesterone treatment may result in an increased incidence of breast cancer and cardiovascular disease. In addition, progesterone supplementation with sequential estrogen + progesterone treatment may cause immediate adverse effects, such as irregular bleeding and spotting, breast congestion, fluid retention, abdominal distention, and a change in lipid profile. All these effects are related, at least in part, to the progesterone component of the therapy.To avoid these complications, researchers are seeking safer progestational components and different modes of administration. In this article we review the findings on the use of the novel levonorgestrel-releasing intrauterine system as a therapeutic tool for localized, rather than systemic, progesterone administration in postmenopausal women.
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PMID:Levonorgestrel-releasing intrauterine system as an adjunct to estrogen for the treatment of menopausal symptoms--a review. 1722 52

Oral contraceptives remain a popular method of contraception over 50 years after their introduction. While safe and effective for many women, the failure rate of oral contraception is about 8%. Concerns about the risk of venous thromboembolism continue to drive the search for the safest oral contraceptive formulations. The oral contraceptive NOMAC-E2 contains nomegestrol acetate (NOMAC) 2.5 mg + 17b-estradiol (E2) 1.5 mg. The approved dosing regimen is 24 days of active hormone, followed by a 4-day hormone-free interval. NOMAC is a progestin derived from testosterone, which has high bioavailability, rapid absorption, and a long half-life. Estradiol, though it has a lower bioavailability, has been successfully combined with NOMAC in a monophasic oral contraceptive. Two recently published randomized controlled trials demonstrate that NOMAC-E2 is an effective contraceptive, with a Pearl Index less than one pregnancy per 100 woman-years. The bleeding pattern on NOMAC-E2 is characterized by fewer bleeding/spotting days, shorter withdrawal bleeds, and a higher incidence of amenorrhea than the comparator oral contraceptive containing drospirenone and ethinyl estradiol. The adverse event profile appears to be acceptable. Few severe adverse events were reported in the randomized controlled trials. The most common adverse events were irregular bleeding, acne, and weight gain. Preliminary studies suggest that NOMAC-E2 does not seem to have negative effects on hemostatic and metabolic parameters. While no one oral contraceptive formulation is likely to be the optimum choice for all women, NOMAC-E2 is a formulation with effectiveness comparable with that of other oral contraceptives, and a reassuring safety profile.
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PMID:Nomegestrol acetate-17b-estradiol for oral contraception. 2383 65


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