Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C1291077 (bloating)
 1,674 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recent cohort and case control studies of low-dose combined oral contraceptives (COCs) containing the new generation of progestogens have allowed classification of adverse effects into those which are rare but serious and should be considered risks and those which are more frequent but are less of a threat to health. Low-dose COCs continue to affect coagulation in a complex way, but the risk is less than with the older preparations, and it can be minimized by screening women for a personal or familial history of early or unusual thrombosis and for levels of protein C, S, and antithrombin III. Women with true migraine with focal signs should also avoid using COCs. The relative risk of myocardial infarction (MI) may increase from 4:1 in women with one risk factor (age, smoking, hypertension, hyperlipidemia, and diabetes) to 20:1 with two risk factors and 128:1 with three or more risk factors. In the absence of all risk factors, a recent study indicated that the relative risk of MI with COC use was 1.9 for current and past use. COC use also causes a slight increase in hypertension in most women, especially those who are older or have a family history of hypertension. While the COC can affect carbohydrate and lipid metabolism, the new generation of progestogens has reduced these effects. The COC may accelerate presentation of gallbladder disease in predisposed women. The COC protects against benign breast disease but may increase the risk of breast cancer and cervical cancer slightly. There is a strong link between hepatocellular adenoma and COC use, but the incidence is low. Return to fertility after use has not been a problem. Both estrogenic adverse effects (nausea, dizziness, irritability, weight gain, bloating) and progestogenic adverse effects (vaginal dryness, acne, hirsutism, weight gain, depression, loss of libido) can occur in 50% of women, but these generally disappear after a few months of use. In conclusion, the low-dose, third generation COCs are associated with minimal risks in the absence of other risk factors and have many beneficial effects such as the prevention of ovarian and endometrial cancer; a decrease in pelvic inflammatory disease and ectopic pregnancies; and protection from anemia, primary dysmenorrhea, functional ovarian cysts, and benign breast disease as well as from the morbidity and mortality associated with pregnancy.
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PMID:The combined oral contraceptive. Risks and adverse effects in perspective. 776 40

324 patients were given 1437 intramuscular injections of 200 mg norethisterone enanthate in 1 ml castor oil and benzyl benzoate between 1974-77, for a total of 3503 woman-months of protection. 87.5% of injection intervals were 70 days although some intervals of 84 days were employed. Patients were seen halfway between the 1st and 2nd injection and subsequently at injections, and noted all bleeding on diary cards. 141 patients chose the method for personal reasons, 71 had medical contraindications to other methods, 68 were unable to use other methods effectively, and 44 used it temporarily while awaiting sterilization. Mean age of patients was 27.8 years; 92% were of proven fertility, and 79% were white. 151 women received their 1st injection during menstruation, 94 within 6 weeks of delivery, and 71 within 6 weeks of abortion. Excluding the temporary users, the continuation rate after 1 year was 63.6%. 4 patients discontinued due to pregnancy within 70 days of injection, 58 due to unacceptability of menstrual irregularity, 7 for other side effects, and 21 for other methods. 51 discontinuances were apparently unrelated to the method. The life table failure rate was 1.3 pregnancies/100 woman years. 3 of the 4 failures had normal intrauterine pregnancies, 2 delivering normal babies. 1 patient with a history of pelvic inflammatory disease had an ectopic pregnancy. The only side effects apart from menstrual irregularity, which all patients had, were occasional abdominal bloating and discomfort in the breasts or injection site. There was no tendency for blood pressure or weight to rise. Menstrual diary cards from 118 women accounting for 1290 woman-months showed an average of 2 episodes of bleeding during each injection interval, with mean cycle length of 28.45 days and mean duration of bleeding of 3.6-7.1 days. 6% of the subjects experienced 68.5% of the epidodes of amenorrhea lasting more than 70 days. It was concluded that norethisterone enanthate 200 mg is a safe, effective, and useful contraceptive method despite imperfect cycle control.
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PMID:Clinical experience with intramuscular norethisterone oenanthate as a contraceptive. 1226 97