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Peer Reviewed

Title: Use of contraceptive methods by women with current venous thrombosis on anticoagulant therapy: a systematic review.
Author: Culwell KR; Curtis KM
Source: Contraception. 2009 Oct;80(4):337-45.
Abstract: BACKGROUND: As nearly all women with venous thromboembolism (VTE) will be treated with anticoagulant therapy, it is important to consider how anticoagulation affects the safety of contraceptive use. STUDY DESIGN: We conducted a systematic review of the literature regarding use of contraceptive methods in women with current VTE on anticoagulant therapy. Due to the limited direct evidence that was identified, we expanded our search to include women on anticoagulant therapy for indications other than VTE and women with bleeding disorders. RESULTS: Six articles met our inclusion criteria. Three observational studies found the levonorgestrel-releasing IUD (LNG-IUD) was an effective treatment for menorrhagia for women on anticoagulation therapy or with bleeding disorders. Prevention of recurrent hemorrhagic ovarian cysts was seen in women on chronic anticoagulation treated with depot-medroxyprogesterone acetate (DMPA) in one small observational study. Among women with bleeding disorders, no complications were seen in 16 women with placement of the LNG-IUD. One pharmacokinetic study found no statistically significant interaction between combined oral contraceptives and warfarin. Other than one case report, no evidence was found regarding the risk of recurrent thrombosis in women on anticoagulation therapy using a contraceptive method. CONCLUSION: The majority of studies in this review examined treatment effects of the LNG-IUD or DMPA on complications of anticoagulation and found overall beneficial effects of their use in these circumstances. Minimal evidence in women with inherited bleeding disorders suggests that insertion of the LNG-IUD does not pose major bleeding risks in these women with appropriate management.
Language: English
Keywords:
GLOBAL | LITERATURE REVIEW | THROMBOSIS | COMPLICATIONS | DRUGS | IUD, HORMONE RELEASING | IUD SIDE EFFECTS | INSERTION | DEPO-PROVERA | BLOOD COAGULATION EFFECTS | HEREDITARY DISEASES | MENSTRUATION DISORDERS | CONTRACEPTIVE SAFETY | Thromboembolism | Embolism | Vascular Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | IUD | Contraceptive Methods | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Hematological Effects | Hemic System | Physiology | Biology | Safety | Public Health
Document Number: 342773

2.
Title: [Efficacy and safety of drospirenone-ethinylestradiol on contraception in healthy chinese women: a multicenter randomized controlled trial]
Author: Fan GS; Bian ML; Cheng LN; Cao XM; Huang ZR; Han ZY; Jing XP; Li J; Wu SY; Xiong CL; Xiong ZA; Yue TF
Source: Zhonghua Fu Chan Ke Za Zhi. 2009 Jan;44(1):38-44.
Abstract: OBJECTIVE: To evaluate the contraception efficacy, mode of bleeding, side effects and other positive effects of drospirenone-ethinylestradiol (Yasmin) in healthy Chinese women. METHODS: This was a multicenter, randomized, control study of 768 healthy Chinese women who consulted about contraception. The subjects were randomized into Yasmin group (30 microg ethinylestradiol plus 3 mg drospirenone, 573 cases) or desogestrel group (30 microg ethinylestradiol plus 150 microg desogestrel, 195 cases) with the ratio of 3:1. Each individual was treated for 13 cycles. Further visits were required at cycle 4, cycle 7, cycle 10 and cycle 13 of treatment Weight, height, body mass index were evaluated at each visit. The menstrual distress questionnaire (MDQ) was given to the women at baseline, visit 3 (cycle 7) and visit 5 (after cycle 13). RESULTS: The values of basal features were similar between two groups (P > 0.05). The Pearl index (method failure) of Yasmin was 0. 208/hundred women year which was lower than that of desogestrel (0. 601/hundred women year). The mode of bleeding was similar between two groups after trial without showing any significant difference. According to MDQ subscale, the improvement of water retention and increasing appetite during inter-menstrual period and water retention and general well-being during menstrual period in the Yasmin group (-0.297, -0.057, 0.033, 0.150 respectively) was more obvious than that in the desogestrel group (-0.108, 0.023, 0.231, -0.023 respectively) with a significant difference (P < 0.05). Some other values which improved in both two groups, especially the improvement of breast tenderness and pain and skin abnormality in Yasmin group (18.0%, 89/494; 12.6%, 62/494) was more distinct than that in desogestrel group (11.3%, 19/168; 5.4%, 9/168). The mean weight increased in desogestrel group (0.57 kg) while it decreased in Yasmin group (-0.28 kg) with a significant difference (P < 0.01). CONCLUSIONS: Both Yasmin and desogestrel have good efficacy on contraception and similar modes of menstrual bleeding. Yasmin is better than desogestrel in terms of weight control and premenstrual syndrome of oral contraceptive.
Language: Chinese
Keywords:
CHINA | RESEARCH REPORT | WOMEN | PEARL'S FORMULA | BODY WEIGHT | BODY HEIGHT | MENSTRUATION DISORDERS | DESOGESTREL | ETHINYL ESTRADIOL | TREATMENT | TESTING | Asia, Eastern | Asia | Developing Countries | Demographic Factors | Population | Contraceptive Use-Effectiveness | Contraceptive Effectiveness | Contraception | Family Planning | Physiology | Biology | Diseases | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Estrogen | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Research Methodology
Document Number: 341804

Title: Hormonal contraceptive regimens in the perimenopause.
Author: Hardman SM; Gebbie AE
Source: Maturitas. 2009 Jun 11;
Abstract: Perimenopausal women have low fertility but still need contraception if they are sexually active. They often have co-existing menstrual problems and menopausal symptoms. No method of contraception is contraindicated by age alone. In addition to highly effective contraception, hormonal methods offer non-contraceptive benefits which can improve quality of life for perimenopausal women. Combined hormonal oral contraception has been available for many decades. The combined vaginal ring and transdermal patch are newer methods offering alternative delivery systems but similar risk profiles to oral preparations. New combinations containing naturally occurring estrogens in place of the synthetic hormone ethinylestradiol are now available and, in theory, could be safer. The progestogen-only methods have an excellent safety profile and have a range of delivery systems and dosages to suit all. Concerns regarding loss of bone mineral density with the injectable depot medroxyprogesterone acetate continue but to date there is no evidence that this translates into higher fracture risk. Effective use of any method of contraception is strongly dependent on good counselling and support from healthcare professionals. Risks should be explained in absolute terms for each individual woman, enabling her to make an informed choice on evidence-based medicine and not influenced by ill-informed media publicity.
Language: English
Keywords:
UNITED KINGDOM | CRITIQUE | MENOPAUSE | AGE FACTORS | SIGNS AND SYMPTOMS | HORMONES | CONTRACEPTIVE METHODS | CONTRACEPTIVE SAFETY | RISK FACTORS | MENSTRUATION DISORDERS | Developed Countries | Europe, Western | Europe | Reproduction | Population Characteristics | Demographic Factors | Population | Diseases | Endocrine System | Physiology | Biology | Contraception | Family Planning | Safety | Public Health | Health
Document Number: 341711

Peer Reviewed

Title: Menstrual pattern changes from levonorgestrel subdermal implants and DMPA: systematic review and evidence-based comparisons.
Author: Hubacher D; Lopez L; Steiner MJ; Dorflinger L
Source: Contraception. 2009 Aug;80(2):113-8.
Abstract: BACKGROUND: Many women want a lengthy duration of contraception but are wary of the menstrual changes from depot medroxyprogesterone acetate (DMPA). A subdermal levonorgestrel (LNG) implant may be a reasonable alternative. However, information on menstrual changes from these methods has not been summarized and compared in an easy-to-understand form. STUDY DESIGN: We systematically reviewed the published literature on these contraceptives to find research that used menstrual diaries and standard World Health Organization definitions. We attempted to find information on amenorrhea, number of bleeding or spotting episodes, number of bleeding or spotting days and normal patterns, as reported in four consecutive 90-day reference periods. RESULTS: We found 16 published articles meeting our criteria and involving diaries of up to 1600 DMPA users and 2300 LNG implant users. We were able to compare the two methods on only three outcomes. For DMPA use, the weighted prevalence of amenorrhea at successive 90-day periods was 12%, 25%, 37% and 46%. The comparable estimates for the LNG implant were 11%, 13%, 9% and 13%. Levonorgestrel implant users experienced a higher average number of bleeding or spotting days compared to DMPA users, but this average was similar to what is expected naturally. At 12 months, normal menstrual patterns were experienced by 23% of LNG implant users compared to 11% of DMPA users. CONCLUSIONS: Like most hormonal contraception, LNG implants usually produce menstrual changes; however, the changes do not appear to deviate from normal patterns as much as the changes from DMPA. Understanding these differences and other method attributes might help women make an informed choice about which contraceptive to use.
Language: English
Keywords:
GLOBAL | LITERATURE REVIEW | COMPARATIVE STUDIES | CONTRACEPTIVE IMPLANTS | LEVONORGESTREL | DEPO-PROVERA | CONTRACEPTIVE AGENTS, SIDE EFFECTS | MENSTRUATION DISORDERS | AMENORRHEA | Studies | Research Methodology | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Medroxyprogesterone Acetate | Diseases
Document Number: 342394

Peer Reviewed

Title: A randomized controlled trial of treatment options for troublesome uterine bleeding in Implanon users.
Author: Weisberg E; Hickey M; Palmer D; O'Connor V; Salamonsen LA; Findlay JK; Fraser IS
Source: Human Reproduction. 2009 Aug;24(8):1852-61.
Abstract: BACKGROUND: Pilot data have indicated that both doxycycline alone and mifepristone combined with ethinyl estradiol (EE) are effective in stopping episodes of bleeding in Implanon users with troublesome bleeding. We compared four treatments against a placebo in Implanon users and tested whether repeated treatment improved subsequent bleeding patterns. METHOD: Implanon users aged 18-45 years were randomized to treatment with (i) mifepristone 25 mg given twice on day 1 followed by 4 days of EE 20 microg; (ii) doxycycline 100 mg twice daily for 5 days; (iii) mifepristone 25 mg given twice on day 1 plus doxycycline 100 mg twice daily for 5 days; (iv) doxycycline 100 mg twice daily with EE 20 microg daily; and (v) placebo twice daily for 5 days. The primary end-point was the number of days of bleeding/spotting immediately following initiation of the first 5-day course of each therapy, compared with placebo. RESULTS: There were 204 women assigned to treatment. Mifepristone in combination with either EE or doxycycline was significantly more effective in stopping an episode of bleeding (mean 4.0 days (CI 3.5-4.6) and 4.4 days (CI 3.8-5.2), respectively) than doxycycline alone or in combination with EE, or placebo (6.4 days (CI 4.4-9.2), 6.4 days (CI 4.8-8.6) and 6.4 days (CL 5.1-8.0), respectively). CONCLUSION: Mifepristone combined with either EE or doxycycline was significantly more effective than placebo in terminating an episode of bleeding in Implanon users. However there was no improvement in subsequent bleeding patterns. Trial registration number: ACTR # 012605000206628.
Language: English
Keywords:
AUSTRALIA | RESEARCH REPORT | CONTROL GROUPS | CONTRACEPTIVE IMPLANTS | CONTRACEPTIVE AGENTS, SIDE EFFECTS | MENSTRUATION DISORDERS | TREATMENT | RU-486 | ETHINYL ESTRADIOL | ANTIBIOTICS | ENDOMETRIAL EFFECTS | Oceania | Developed Countries | Research Methodology | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Drugs | Endometrium | Uterus | Genitalia, Female | Genitalia | Urogenital System
Document Number: 342798

Title: Selected practice recommendations for contraceptive use. 2008 update.
Author: World Health Organization [WHO]. Department of Reproductive Health and Research
Source: Geneva, Switzerland, WHO, Department of Reproductive Health and Research, 2008. [4] p.
Abstract: The Selected practice recommendations for contraceptive use -one of the four cornerstones of the World Health Organization's (WHO) evidence-based family planning guidance -provides evidence-based recommendations on how to safely and effectively use contraceptive methods once they are deemed medically appropriate for an individual. This guideline is intended for use by policy-makers, programme managers, and the scientific community in the preparation of national family planning/sexual and reproductive health programmes for delivery of contra�ceptives. The first edition of the Selected practice recommendations for contraceptive use was published in 2002, and the second edition in 2004. On 1-4 April 2008, WHO convened an expert Working Group in Geneva, Switzerland, to revise the second edition in response to newly published evidence and requests for clarification of specific recommendations from users of the guideline. The meeting brought together 43 participants from 23 countries, including nine agency representatives. The expert Working Group was comprised of: international family planning experts, including clinicians, epidemiologists, policy-makers, programme managers; experts in evidence identification and synthesis; experts in pharmacology; and users of the guideline. All members of the expert Working Group were asked to declare any conflict of interest; three of the experts declared a conflict of interest relevant to the subject matter of the meeting. They were not asked to withdraw from recommendation formulation.
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | RECOMMENDATIONS | FAMILY PLANNING ACCEPTORS | COUPLES | CONTRACEPTIVE USAGE | CONTRACEPTIVE METHODS CHOSEN | CONTRACEPTIVE SAFETY | CONTRACEPTIVE USAGE DETERMINANTS | DECISION MAKING | REPRODUCTIVE RIGHTS | SEXUALLY TRANSMITTED DISEASES | IUD | SIGNS AND SYMPTOMS | MENSTRUATION DISORDERS | ORAL CONTRACEPTIVES | CONTRACEPTIVE METHOD SWITCHING | INJECTABLES | CONTRACEPTIVE AGENTS, PROGESTIN | PROGESTERONE | POSTPARTUM PROGRAMS | Family Planning Programs | Family Planning | Family Characteristics | Family and Household | Sociocultural Factors | Contraception | Safety | Public Health | Health | Behavior | Human Rights | Political Factors | Reproductive Tract Infections | Infections | Diseases | Contraceptive Methods | Contraceptive Agents, Female | Contraceptive Agents | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology
Document Number: 329562

Title: Polycystic ovary syndrome in the Indian subcontinent.
Author: Allahbadia GN; Merchant R
Source: Seminars in Reproductive Medicine. 2008 Jan;26(1):22-.
Abstract: Polycystic ovary syndrome (PCOS) is a complex, multifaceted, heterogeneous disorder that affects ~5 to 10% of women of reproductive age. It is characterized by hyperandrogenism, polycystic ovaries, and chronic anovulation along with insulin resistance, hyperinsulinemia, abdominal obesity, hypertension, and dyslipidemia as frequent metabolic traits (metabolic syndrome) that culminate in serious long-term consequences such as type 2 diabetes mellitus, endometrial hyperplasia, and coronary artery disease. It is one of the most common causes of anovulatory infertility. However, the heterogeneous clinical features of PCOS may change throughout the life span, starting from adolescence to postmenopausal age, largely influenced by obesity and metabolic alterations, and the phenotype of women with PCOS is variable, depending on the ethnic background. The etiology of PCOS is yet to be elucidated; however, it is believed that in utero fetal programming may have a significant role in the development of PCOS phenotype in adult life. Though a woman may be genetically predisposed to developing PCOS, it is only the interaction of environmental factors (obesity) with the genetic factors that results in the characteristic metabolic and menstrual disturbances and the final expression of the PCOS phenotype. Irrespective of geographic locations, a rapidly increasing prevalence of polycystic ovarian insulin resistance syndrome, excess body fat, adverse body fat patterning, hypertriglyceridemia, and obesity-related disease, such as diabetes and cardiovascular disease, have been reported in Asian Indians, suggesting that primary prevention strategies should be initiated early in this ethnic group. In lieu of the epidemic increase in the prevalence of obesity and diabetes mellitus in most industrialized countries including China and India owing to Westernization, urbanization, and mechanization, and evidence suggesting a pathogenetic role of obesity in the development of PCOS and related infertility, active intervention to combat the malice of these disorders is warranted. Pharmacologic therapy is a critical step in the management of patients with metabolic syndrome when lifestyle modifications fail to achieve the therapeutic goals, and studies in China and India have proved to be effective. (author's)
Language: English
Keywords:
INDIA | RESEARCH REPORT | WOMEN | OVARIAN CYSTS | PREVALENCE | MENSTRUATION DISORDERS | DIABETES | METABOLIC EFFECTS | BODY WEIGHT | DRUGS | GONADOTROPINS | TREATMENT | Developing Countries | Asia, Southern | Asia | Demographic Factors | Population | Diseases | Measurement | Research Methodology | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Hormones | Endocrine System
Document Number: 323539

Peer Reviewed

Title: Menstrual and reproductive factors in the risk of differentiated thyroid carcinoma in native women in French Polynesia: A population-based case-control study.
Author: Brindel P; Doyon F; Rachedi F; Boissin JL; Sebbag J
Source: American Journal of Epidemiology. 2008 Jan 15;167(2):219-229.
Abstract: French Polynesia has one of the world's highest incidence rates of thyroid cancer. A case-control study among native residents of French Polynesia included 201 women diagnosed with differentiated thyroid cancer before the age of 56 years, between 1981 and 2004, matched to 324 population controls on date of birth. Face-to-face interviews were conducted from 2002 to 2004. Odds ratios were calculated by using conditional logistic regression and were reported in the total group and by ethnic group ("Polynesian" vs. "mixed"). The risk of thyroid cancer increased with natural (odds ratio = 1.9) or artificial (odds ratio = 4.5) menopause compared with that associated with a premenopausal status and with number of births (p for trend = 0.03): odds ratios for one, two, three, four or five, six or seven, and eight or more births were, respectively, 0.90, 1.6, 2.3, 2.2, 2.7, and 1.7 compared with a nulliparous status. Similar results were observed for Polynesian women. No association was observed with irregular menstrual cycles, age at menopause, history of miscarriage or induced abortion, time since last birth, age at and outcome of first pregnancy, or breastfeeding. This study confirms the role of menstrual and reproductive factors in the risk of differentiated thyroid cancer in Pacific island populations. (author's)
Language: English
Keywords:
FRENCH POLYNESIA | RESEARCH REPORT | CASE CONTROL STUDIES | MULTIVARIATE ANALYSIS | INTERVIEWS | WOMEN | INDIGENOUS POPULATION | NEOPLASMS | THYROID EFFECTS | MENSTRUATION DISORDERS | MENOPAUSE | REPRODUCTIVE BEHAVIOR | BIRTH HISTORY | BREASTFEEDING | Developed Countries | Oceania | Studies | Research Methodology | Data Analysis | Data Collection | Demographic Factors | Population | Population Characteristics | Diseases | Endocrine Effects | Endocrine System | Physiology | Biology | Reproduction | Fertility | Population Dynamics | Pregnancy History | Fertility Measurements | Infant Nutrition | Nutrition | Health
Document Number: 323776

10.

Peer Reviewed

Title: Clinical and biochemical characteristics of polycystic ovary syndrome in Korean women.
Author: Chae SJ; Kim JJ; Choi YM; Hwang KR; Jee BC
Source: Human Reproduction. 2008;23(8):1924-1931.
Abstract: BACKGROUND: We investigated the differences in anthropometrical, hormonal and insulin resistance parameters according to the subtype of polycystic ovary syndrome (PCOS) in Korean women. METHODS: We recruited 166 women with PCOS and retrospectively recruited 277 controls. PCOS was diagnosed by irregular menstruation (IM), polycystic ovary (PCO) and hyperandrogenism (HA). Subjects were divided into four subgroups: the IM/HA/PCO group (n = 87, 52.4%), the IM/PCO group (n = 52, 31.3%), the IM/HA group (n = 23, 13.9%) and the HA/PCO group (n = 4, 2.4%). Clinical and biochemical variables were compared among the PCOS subgroups. RESULTS: The IM/HA/PCO and IM/HA groups showed higher body mass index (P < 0.001) and waist-to-hip ratio (P < 0.001) than the IM/PCO group. The IM/HA group had higher triglyceride levels than the other groups (P < 0.001). Higher fasting insulin (P < 0.001) and postprandial 2 h insulin (P < 0.01) were noted in the IM/HA/PCO group and the IM/HA group, compared with the IM/PCO group. Women with PCOS showed lower sex hormone-binding globulin (P < 0.001) and higher systolic blood pressure (BP) (P = 0.004), diastolic BP (P = 0.001), fasting insulin (P < 0.001), postprandial 2 h insulin (P < 0.001), homeostatic model for insulin resistance (P < 0.001) and clinical and biochemical parameters of metabolic syndrome (P < 0.05) compared with subjects without PCOS. CONCLUSIONS: Women with PCOS without HA are common in Korea and are less likely to have metabolic dysfunction, insulin resistance and elevated BP. PCOS without HA may be a mild phenotype of PCOS. Therefore, women with PCOS in Korea could have a reduced likelihood of having metabolic syndrome compared with women of other ethnicities.
Language: English
Keywords:
KOREA | RESEARCH REPORT | RETROSPECTIVE STUDIES | OVARIAN EFFECTS | BLOOD PRESSURE | FOLLICLE STIMULATING HORMONE | LUTEINIZING HORMONE | MENSTRUATION DISORDERS | METABOLIC EFFECTS | Studies | Research Methodology | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Hemic System | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Diseases
Document Number: 327760

11.

Title: Selective serotonin reuptake inhibitors and initial oral contraceptives for the treatment of PMDD: effective but not enough.
Author: Halbreich U
Source: CNS Spectrums. 2008 Jul;13(7):566-72.
Abstract: BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) are almost unanimously considered to be very efficacious and the first line of pharmacologic treatment for premenstrual dysphoric disorder (PMDD) and premenstrual syndrome (PMS). There is a need to examine if this is actually the case. More recently, combined oral contraceptives (COCs) have been pursued due to their ovulation suppression effects. Their effects on PMS/PMDD should be further examined as well. METHODS: For this review of the literature from 1990 to the present, MEDLINE, PsychLit, and Cochrane controlled trials register were searched. Randomized, double-blind, placebo-controlled clinical trials of SSRIs and COCs (N>20) that report the rate of responders and not just percent improvement in severity of symptoms were selected for study. The data extraction were the percentage or number of responders as reported by the original authors. RESULTS: In many studies, only mean improvement in severity was reported. In all studies, the main inclusion criterion was meeting criteria for PMDD; this has not, however, been an outcome measure. However, only 16 reports that provided actual rate of responders could be included. The percentage of non-responders (100% minus active medication) to SSRIs and COCs was found to be higher than the reported percentage of women who responded to active medication (response rate to an SSRI or COC minus the response rate to placebo). CONCLUSION: In the majority of larger-scale studies, once the placebo effect is accounted for, the percentage of women who respond to SSRIs or COCs is actually less than the percentage of women who do not respond at all. SSRIs provide an important step forward in the treatment of PMDD and PMS. COCs provide a different option, still, approximately 40% of women with PMDD do not respond to SSRIs. Treatment with a currently approved COC does not substantially improve the percentage of responders. Therefore, additional alternative targeted treatment modalities need to be developed.
Language: English
Keywords:
GLOBAL | LITERATURE REVIEW | CLINICAL TRIALS | WOMEN | MENSTRUATION DISORDERS | ORAL CONTRACEPTIVES, COMBINED | SEROTONIN | SIGNS AND SYMPTOMS | TREATMENT | Clinical Research | Research Methodology | Demographic Factors | Population | Diseases | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 328468

12.

Title: Non-contraceptive benefits of oral contraceptives.
Author: Huber JC; Bentz EK; Ott J; Tempfer CB
Source: Expert Opinion On Pharmacotherapy. 2008 Sep;9(13):2317-25.
Abstract: BACKGROUND: There is increasing awareness of the opportunity that many contraceptive interventions may provide for additional health benefits. However, treatment of medical problems with oral contraceptives (OCs) is often an 'off-label' practice. OBJECTIVE: The aim of this review is to summarize available data on non-contraceptive benefits of OCs. METHODS: Review of the literature. RESULTS: OCs have been shown to reduce the risk of ovarian, endometrial, and colorectal cancer. It has been suggested that OCs may be used in treatment of endometriosis, menorrhagia, and uterine leiomyomas. Pelvic inflammatory disease, dysmenorrhea, premenstrual syndrome, and acne have been shown to improve under OCs. CONCLUSION: OCs are important for global and female health. Besides contraception, non-contraceptive effects of OCs are evidence based, well established, and commonly used in clinical practice.
Language: English
Keywords:
GLOBAL | RESEARCH REPORT | ENDOMETRIOSIS | ACNE | ENDOMETRIAL CANCER | MENSTRUATION DISORDERS | OVARIAN CANCER | PELVIC INFECTIONS | PREMENSTRUAL TENSION | ORAL CONTRACEPTIVES | Diseases | Dermatitis | Cancer | Neoplasms | Infections | Contraceptive Methods | Contraception | Family Planning
Document Number: 328808

13.

Peer Reviewed

Title: Female genital schistosomiasis--a differential diagnosis to sexually transmitted disease: genital itch and vaginal discharge as indicators of genital Schistosoma haematobium morbidity in a cross-sectional study in endemic rural Zimbabwe.
Author: Kjetland EF; Kurewa EN; Ndhlovu PD; Midzi N; Gwanzura L; Mason PR; Gomo E; Sandvik L; Mduluza T; Friis H; Gundersen SG
Source: Tropical Medicine and International Health. 2008 Dec;13(12):1509-17.
Abstract: OBJECTIVE: To examine the association between schistosomiasis and reproductive tract symptoms. METHOD: A cross-sectional study was conducted in a Schistosoma haematobium-endemic area of rural Zimbabwe. A total of 483 permanently resident adult women of Mupfure Ward aged 20-49 were interviewed and examined clinically, each providing three consecutive urine samples. Logistic regression analysis was used to control for sexually transmitted diseases (STDs). RESULTS: Women with genital sandy patches had significantly more genital itch (P = 0.009) and perceived their discharge as abnormal (P = 0.003). Eighty percent of the women who had genital itch, yellow discharge, and childhood or current waterbody contact had sandy patches. Fifty-two percent of the women with genital sandy patches did not have detectable S. haematobium ova in urine. Genital schistosomiasis was associated with stress incontinence and pollakisuria, but not with menstrual irregularities, current or previous ulcers, or tumours. CONCLUSION: Genital schistosomiasis may be a differential diagnosis to the STDs in women who have been exposed to fresh water in endemic areas. Because of the chronic nature of the disease in adults, we suggest to pay special attention to the prevention of morbidity.
Language: English
Keywords:
ZIMBABWE | RESEARCH REPORT | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | STATISTICAL REGRESSION | WOMEN IN DEVELOPMENT | RURAL POPULATION | SCHISTOSOMIASIS | SEXUALLY TRANSMITTED DISEASES | VAGINAL DESQUAMATE EFFECTS | SIGNS AND SYMPTOMS | MENSTRUATION DISORDERS | PHYSICAL EXAMINATIONS AND DIAGNOSES | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Data Analysis | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases | Reproductive Tract Infections | Infections | Vaginitis | Vaginal Abnormalities | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 330045

14.

Title: Oral contraceptives containing drospirenone for premenstrual syndrome (Review).
Author: Lopez LM; Kaptein A; Helmerhorst FM
Source: Cochrane Database of Systematic Reviews. 2008;(1):1-43. ID:CD006586
Abstract: Premenstrual syndrome (PMS) is a common problem. Premenstrual dysphoric disorder (PMDD) is a severe form of PMS. Combined oral contraceptives (COCs), which have both progestin and estrogen, have been examined for their ability to relieve premenstrual symptoms. A COC containing drospirenone and low estrogen has been approved for treating PMDD in women who choose COCs for contraception. The objectives were to review all randomized controlled trials comparing combined oral contraceptives containing drospirenone versus a placebo or another COC for effect on premenstrual symptoms. We searched the computerized databases MEDLINE, POPLINE, CENTRAL, EMBASE, LILACS, PsycINFO, and CINAHL for studies of drospirenone and premenstrual syndrome. We also examined references lists of relevant articles, and wrote to known investigators to find other trials. We included randomized controlled trials in any language that compared a COC containing drospirenone versus a placebo or another COC for effect on premenstrual symptoms. Primary outcome was the prospective recording of premenstrual symptoms (affective and physical). Adverse events related to COC use were examined. Two review authors independently abstracted data and assessed study quality. We included five trials with a total of 1600 women. Two placebo-controlled trials of women with PMDD showed less severe premenstrual symptoms after three months with drospirenone (plus ethinyl estradiol (EE) 20g) than with the placebo (WMD -7.83; 95% CI -10.91 to -4.75). The drospirenone group had greater decreases in impairment of productivity (WMD -0.42; 95% CI -0.64 to -0.20), social activities (WMD -0.39; 95% CI -0.62 to -0.15), and relationships (WMD -0.38; 95% CI -0.61 to -0.51). Side effects more common with COC use were nausea, intermenstrual bleeding, and breast pain. Little effect was found on less severe symptoms when comparing drospirenone plus more estrogen to another COC. A six-month study showed fewer symptoms with drospirenone, while a two-year trial found the groups to be similar. Drospirenone plus EE 20 microg may help treat premenstrual symptoms in women with PMDD. The placebo also had a large effect. We do not know whether the COC works after three cycles, for women with less severe symptoms, or better than other COCs. Larger and longer trials of higher quality are needed to address these issues. Trials should follow CONSORT reporting guidelines. (author's)
Language: English
Keywords:
GLOBAL | LITERATURE REVIEW | CLINICAL TRIALS | WOMEN | PREMENSTRUAL TENSION | MENSTRUATION DISORDERS | SIGNS AND SYMPTOMS | TREATMENT | ORAL CONTRACEPTIVES | Clinical Research | Research Methodology | Demographic Factors | Population | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning
Document Number: 324879

15.

Peer Reviewed

Title: The effects of Implanon on menstrual bleeding patterns.
Author: Mansour D; Korver T; Marintcheva-Petrova M; Fraser IS
Source: European Journal of Contraception and Reproductive Health Care. 2008 Jun;13 Suppl 1:13-28.
Abstract: The objectives were to evaluate an integrated analysis of bleeding patterns associated with use of the subdermal contraceptive implant Implanon (etonogestrel, Organon, part of Schering-Plough) and to provide physician guidance to optimize patient counselling. Data from 11 clinical trials were reviewed (N = 923). Assessments included bleeding-spotting records, dysmenorrhoea, and patient-perceived reasons for discontinuation. Bleeding patterns were analysed via reference period (RP) analyses. Implanon use was associated with the following bleeding irregularities: amenorrhoea (22.2%) and infrequent (33.6%), frequent (6.7%), and/or prolonged bleeding (17.7%). In 75% of RPs, bleeding-spotting days were fewer than or comparable to those observed during the natural cycle, but they occurred at unpredictable intervals. The bleeding pattern experienced during the initial phase predicted future patterns for the majority of women. The group of women with favourable bleeding patterns during the first three months tended to continue with this pattern throughout the first two years of use, whereas the group with unfavourable initial patterns had at least a 50% chance that the pattern would improve. Only 11.3% of patients discontinued owing to bleeding irregularities, mainly because of prolonged flow and frequent irregular bleeding. Most women (77%) who had baseline dysmenorrhoea experienced complete resolution of symptoms. Implanon use is associated with an unpredictable bleeding pattern, which includes amenorrhoea and infrequent, frequent, and/or prolonged bleeding. The bleeding pattern experienced during the first three months is broadly predictive of future bleeding patterns for many women. Effective preinsertion counselling on the possible changes in bleeding patterns may improve continuation rates. (author's)
Language: English
Keywords:
GLOBAL | RESEARCH REPORT | LITERATURE REVIEW | CLINICAL TRIALS | CONTRACEPTIVE IMPLANTS | CONTRACEPTIVE AGENTS, FEMALE | CONTRACEPTIVE AGENTS, PROGESTIN | MENSTRUATION | MENSTRUATION DISORDERS | BLEEDING | CONTRACEPTIVE AGENTS, SIDE EFFECTS | CONTRACEPTION CONTINUATION | Clinical Research | Research Methodology | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents | Reproduction | Diseases | Signs and Symptoms | Contraceptive Usage
Document Number: 325040

16.
Title: Dysfunctional uterine bleeding: close-up on a complex case.
Author: Marcum C
Source: Advance For Nurse Practitioners. 2008 Jul;16(7):57-60.
Abstract: Dysfunctional uterine bleeding (DUB) represents a disruption in normal cyclic ovulatory stimulation of the endometrial lining. The bleeding associated with DUB may be heavy and prolonged, or it may be light and random. The diagnosis of DUB is made only after ruling out other causes of abnormal bleeding. This article presents a case report of a 51-year-old women with previous history of myocardial infarction with bleeding that was heavier than that of her normal menstrual cycle.
Language: English
Keywords:
UNITED STATES OF AMERICA | SUMMARY REPORT | ADOLESCENTS, FEMALE | WOMEN | MENSTRUATION DISORDERS | ENDOMETRIOSIS | NUTRITION | WOMEN'S HEALTH | REPRODUCTIVE HEALTH | BLEEDING | SIGNS AND SYMPTOMS | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Health
Document Number: 330890

17.

Peer Reviewed

Title: Contraception in the cosmos: The combined oral contraceptive pill in space.
Author: Murad A
Source: Journal of Family Planning and Reproductive Health Care. 2008;34(1):55-59.
Abstract: The combined oral contraceptive pill (COC) is one medication that could be used to prevent health problems in space. Whilst there is no official requirement for them to do so, the vast majority of the National Aeronautics and Space Administration's (NASA) female astronauts choose to use the COC whilst in space (P Stepaniak, NASA Flight Surgeon, personal communication, 23 October 2006). Whilst much is known about the physiological effects of the COC on Earth, there has been no discussion of the potential benefits and disadvantages of its use in space. Such a discussion must take into account the effects of spaceflight on human physiology and the fact that modern female astronauts are a highly selected, motivated and, in general, healthy group of individuals. This article aims to review the potential benefits and disadvantages of using the COC during long-duration stays in space. It begins with a discussion of the gynaecological effects of the COC. It then examines how the COC might influence the effects of spaceflight on the human musculoskeletal system. Finally, it explores ways in which the COC could affect other systems of the body in ways that are relevant to spaceflight. (excerpt)
Language: English
Keywords:
RESEARCH REPORT | RESEARCH AND DEVELOPMENT | ORAL CONTRACEPTIVES | CONTRACEPTIVE AGENTS, SIDE EFFECTS | MENSTRUATION DISORDERS | SKELETAL EFFECTS | BREAST CANCER | THROMBOEMBOLISM | SIGNS AND SYMPTOMS | PHYSIOLOGY | Technology | Economic Factors | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents | Diseases | Biology | Cancer | Neoplasms | Embolism | Vascular Diseases
Document Number: 323394

18.

Peer Reviewed

Title: Successful pregnancy outcome with the levonorgestrel-releasing intrauterine system.
Author: Pilkington A; Misfar N; Polson DW
Source: Journal of Family Planning and Reproductive Health Care. 2008;34(1):60.
Abstract: The levonorgestrel-releasing intrauterine system (IUS) is extremely effective, with pregnancy rates comparable to tubal ligation (i.e. a 5-year cumulative rate varying from 0.5 to 1.1).1 Women using the device should be fully counselled about the risks of failure and the risks of ectopic pregnancy, although those using an IUS are actually at a much lower risk of ectopic pregnancy than those not using any contraception at all. An ongoing intrauterine pregnancy with the IUS is very rare. One report confirmed that of 678 insertions only five pregnancies occurred, none of which proceeded to term with the IUS in situ. This case report describes an ongoing pregnancy with a IUS in situ. (excerpt)
Language: English
Keywords:
UNITED KINGDOM | CASE STUDIES | WOMEN | IUD | LEVONORGESTREL | PREGNANCY OUTCOMES | MENSTRUATION DISORDERS | TREATMENT | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Pregnancy | Reproduction | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 323395

19.
Peer Reviewed

Title: Reproductive health problems of female youth.
Author: Ravi R; Nair SB
Source: Journal of Family Welfare. 2008 Jun;54(1):14-23.
Abstract: Reproductive health problems are the leading cause of women's ill health and death worldwide. It is also noted that younger women are the epicenter of the reproductive problems. The present paper attempts at studying the prevalence of reproductive health problem among female youth in Kerala, showing that more than one third of female youth have reported at least one RTI/STI. Multivariate analysis reveal that age of women, religion and ever experience of pregnancy complications were found to the significant variables that determine the reproductive health problems. Regional variations in the prevalence of reproductive health problems are quite evident in the study and have emerged as a significant predictor variable. North and the Central districts comprising of Kasaragod, Wayanad, Malappuram and Thrissur, from where more female youth have reported reproductive health problems should be the focus of attention of the programmes aimed at reducing reproductive morbidity. (excerpt)
Language: English
Keywords:
INDIA | RESEARCH REPORT | PREVALENCE | YOUTH | WOMEN | EVER MARRIED | REPRODUCTIVE HEALTH | SIGNS AND SYMPTOMS | MENSTRUATION DISORDERS | SOCIOCULTURAL FACTORS | RELIGION | Asia, Southern | Asia | Developing Countries | Measurement | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Marital Status | Nuptiality | Health | Diseases
Document Number: 340182

20.

Title: Mirena intrauterine system in the treatment of menstrual disorders: a survey of UK patients' experience, acceptability and satisfaction.
Author: Robinson R; China S; Bunkheila A; Powell M
Source: Journal of Obstetrics and Gynaecology. 2008 Oct;28(7):728-31.
Abstract: Our study investigated the personal experience and satisfaction of patients with menstrual disorders treated with the Mirena intrauterine system in secondary care. A retrospective questionnaire was sent to all 1,100 women treated with a Mirena intrauterine system in the Menstrual Disorders Clinic between 1995-2003 at the Queens' Medical Centre, Nottingham, England. A total of 1,056 (96%) women responded and were included in the study. The majority (73%) of women continued to use the Mirena. The women reported a decrease in the heaviness, frequency and pain associated with their period. The commonest side-effect experienced was spotting (19%). Women ranked their satisfaction on a scale of 1-10, with a mean score of 7.07/10. The majority of women are satisfied with the Mirena as a treatment for menstrual disorders. Less than 5% of the women required subsequent operative treatment for menstrual disorders following treatment with the Mirena.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | CLIENTS | MENSTRUATION DISORDERS | IUD | SATISFACTION | USER COMPLIANCE | Developed Countries | Europe, Western | Europe | Program Activities | Programs | Organization and Administration | Diseases | Contraceptive Methods | Contraception | Family Planning | Psychological Factors | Behavior
Document Number: 330474

21.

Title: Variation in the menstrual characteristics in adolescents of West Bengal.
Author: Sanyal S; Ray S
Source: Singapore Medical Journal. 2008 Jul;49(7):542-50.
Abstract: INTRODUCTION: Like other biological phenomena, menstrual characteristics also vary with different age groups, socioeconomic status, and lifestyles. This study aimed to find out the variation in the menstrual characteristics among adolescents of different age groups, and the significant predictors of a menstrual outcome. METHODS: 260 adolescent Bengali-speaking Hindu girls of three different age groups (early, middle and late adolescence) were selected from the district of 24 Parganas (North), West Bengal, India. Data on the socioeconomic conditions and menstrual characteristics were collected via a pre-tested questionnaire. RESULTS: Significant differences exist between these three age groups in characteristics such as irregularity in the cycle, skipping of the cycle, duration of menstrual discharge, absenteeism from school because of pain and discomfort related to menstruation, and the prevalence of white discharge. Logistic regression showed that socioeconomic variables such as the occupations of the parents and educational levels of the parents and the subjects have a significant relationship with some menstrual outcomes (irregularity in the menstrual cycle, premenstrual problems, and duration of menstrual discharge) and with consultation of doctors due to some morbid conditions. Some of the other menstrual characteristics such as duration of menstrual discharge, number of days of peak discharge and absence of pain at the time of menstrual discharge, can be significantly predicted by age group of the individuals and other menstrual features. CONCLUSION: Menstrual characteristics vary among the adolescents of different age groups, and some of the menstrual characteristics can be predicted by some socioeconomic factors and other menstrual variables.
Language: English
Keywords:
INDIA | RESEARCH REPORT | CLINICAL RESEARCH | KAP SURVEYS | STATISTICAL REGRESSION | ADOLESCENTS, FEMALE | PARENTS | MENSTRUATION | AGE FACTORS | SOCIOECONOMIC FACTORS | MENSTRUATION DISORDERS | PAIN | EDUCATIONAL STATUS | TIME FACTORS | OCCUPATIONS | Developing Countries | Asia, Southern | Asia | Research Methodology | Surveys | Sampling Studies | Studies | Data Analysis | Adolescents | Youth | Population Characteristics | Demographic Factors | Population | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Reproduction | Economic Factors | Diseases | Signs and Symptoms | Socioeconomic Status | Population Dynamics | Human Resources
Document Number: 328998

22.

Peer Reviewed

Title: Genital tuberculosis: An important cause of Asherman's syndrome in India.
Author: Sharma JB; Roy KK; Pushparaj M; Gupta N; Jain SK
Source: Archives of Gynecology and Obstetrics. 2008 Jan;277(1):37-41.
Abstract: The objective was to demonstrate the association between genital endometrial tuberculosis and Asherman's syndrome. A total of 28 women who underwent hysteroscopy with or without laparoscopy for suspected Asherman's syndrome from symptoms (amenorrhoea or oligomenorrhoea, and or primary or secondary infertility) and who were found to have genital tuberculosis on endometrial biopsy (histopathology or culture) or positive polymerase chain reaction (PCR) on endometrial aspirate or positive findings of tuberculosis on laparoscopy or hysteroscopy were enrolled in this retrospective study. The mean age and parity were 26.5 years and 0.3, respectively. There was past history of TB in 67.8% women. All women had menstrual dysfunction, with oligomenorrhoea and hypomenorrhoea in 16 (57%) women and amenorrhoea in 12 (42.8%). All women had primary (n = 19, 67.8%) or secondary (n = 9, 32%) infertility. On hysteroscopy, there were various grades of adhesions in all women, with grade I in 17.8%, grade II in 28.5%, grade III in 28.5% and grade IV in 17.5% women. Only four women (14.3%) had open ostia, while others had bilateral (28.5%) or unilateral (21.3%) blocked ostia or inability to see ostia (28.5%). On laparoscopy performed on 18 women, there were varying grades of adhesions in 16 (88.8%) women, with beading (33.3%), tubercles (33.3%), caseation (11.1%) and tubo-ovarian masses (11.1%). The diagnosis of genital TB was made by histopathology (tuberculous granuloma) on endometrial biopsy in 28.6%, positive culture in 3.6%, positive polymerase chain reaction (PCR) in 46.4% and observation of tubercles, beading or caseation on laparoscopy in 17.8% or shaggy cavity with caseation on hysteroscopy in 3.6% women. Genital tuberculosis appears to be an important and common cause of Asherman's syndrome in India, causing oligomenorrhoea or amenorrhoea with infertility. (author's)
Language: English
Keywords:
INDIA | RESEARCH REPORT | RETROSPECTIVE STUDIES | WOMEN | TUBERCULOSIS, FEMALE GENITAL | HYSTEROSCOPY | LAPAROSCOPY | MENSTRUATION DISORDERS | INFERTILITY | PHYSICAL EXAMINATIONS AND DIAGNOSES | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Demographic Factors | Population | Tuberculosis | Infections | Diseases | Endoscopy | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction
Document Number: 314002

23.

Title: Problems related to menstruation amongst adolescent girls.
Author: Sharma P; Malhotra C; Taneja DK; Saha R
Source: Indian Journal of Pediatrics. 2008 Feb;75(2):125-129.
Abstract: The objective was to study the types and frequency of problems related to menstruation in adolescent girls and the effect of these problems on daily routine. Girls in the age group 13-19 years who had had menarche for at least one year at the time of study. 198 adolescents girls have been studied. Data was collected by personal interviews on a pre-tested, semi-structured questionnaire. The questions covered menstrual problems, regularity of menses in last three cycles of menstruation and the effect of these problems on the daily routine. Analysis was done using SPSS version 12. Percentages were calculated for drawing inferences. More than a third (35.9%) of the study subjects were in the age group 13-15 years followed by 17-19 years, 15-17 years respectively. Mean age of study participants was calculated to be 16.2 years. Dysmenorrhea (67.2%) was the commonest problem and (63.1%) had one or the other symptoms of Pre-menstrual syndrome (PMS). Other related problems were present in 55.1% of study subjects. Daily routine of 60% girls was affected due to prolonged bed rest, missed social activities/commitments, disturbed sleep and decreased appetite. 17.24% had to miss a class and 25% had to abstain from work. Mothers and friends were the most common source of information on the issue. Screen adolescent girls for menstruation related problems and provide them with counseling services and relevant information on possible treatment options. Besides, there is a need to emphasize on designing menstrual health programmes for adolescents. (author's)
Language: English
Keywords:
INDIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | ADOLESCENTS, FEMALE | MENSTRUATION | MENSTRUAL CYCLE | MENSTRUATION DISORDERS | DYSMENORRHEA | PREMENSTRUAL TENSION | Developing Countries | Asia, Southern | Asia | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproduction | Diseases
Document Number: 325042

24.

Peer Reviewed

Title: Frequency and management of breakthrough bleeding with continuous use of the transvaginal contraceptive ring: a randomized controlled trial.
Author: Sulak PJ; Smith V; Coffee A; Witt I; Kuehl AL
Source: Obstetrics and Gynecology. 2008 Sep;112(3):563-71.
Abstract: OBJECTIVE: To assess bleeding patterns with continuous use of the transvaginal contraceptive ring. METHODS: We did a prospective analysis of daily menstrual flow during a 21/7 cycle followed by 6 months of continuous use and institution of a randomized protocol to manage breakthrough bleeding/spotting. Seventy-four women completed the baseline 21/7 phase and were randomized equally into two groups during the continuous phase. Group 1 was instructed to replace the ring monthly on the same calendar day with no ring-free days. Group 2 was instructed to use the same process, but if breakthrough bleeding/spotting occurred for 5 days or more, they were to remove the ring for 4 days, store it, and then reinsert that ring. RESULTS: Sixty-five women completed the continuous phase with reduced average flow scores in the continuous phase compared with the 21/7 phase (P<.02). Most patients had no to minimal bleeding during continuous use, with group 2 experiencing a statistically greater percentage of days without breakthrough bleeding or spotting (95%) compared with group 1 (89%) (P=.016). Instituting a 4-day hormone-free interval was more (P<.001) effective in resolving breakthrough bleeding/spotting than continuing ring use. CONCLUSION: A reduction in bleeding occurred during continuous use with replacement of the transvaginal ring compared with baseline 21/7 use. Continuous vaginal ring use resulted in an acceptable bleeding profile in most patients, reduction in flow, reduction in pelvic pain, and a high continuation rate.
Language: English
Keywords:
TEXAS | RESEARCH REPORT | CLINICAL TRIALS | PROSPECTIVE STUDIES | COMPARATIVE STUDIES | WOMEN | VAGINAL RING | BLEEDING | MENSTRUATION DISORDERS | COMPLICATIONS | TREATMENT | PAIN | PELVIS | United States of America | North America | Americas | Developed Countries | Clinical Research | Research Methodology | Studies | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Signs and Symptoms | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Anatomy | Biology
Document Number: 329054

25.

Title: Prospective follow-up of menstrual disorders in adolescence and prognostic factors.
Author: Wiksten-Almstromer M; Hirschberg AL; Hagenfeldt K
Source: Acta Obstetricia et Gynecologica Scandinavica. 2008;87(11):1162-8.
Abstract: OBJECTIVE: Clinical follow-up of menstrual status and eating behavior in grown-up women diagnosed with menstrual disturbance in adolescence. DESIGN: Prospective follow-up study six years after the initial study. SETTING: A youth clinic that is part of the school health system in Stockholm. POPULATION: Eighty-seven women diagnosed with secondary amenorrhea or oligomenorrhea in adolescence. METHODS: Subjects underwent gynecological examination, evaluation of eating behavior and endocrine status. MAIN OUTCOME MEASURES: Menstrual status and eating behavior changes. RESULTS: Menstrual disturbances were still present in 62% of the subjects not using hormonal contraception, 59% of which fulfilled the criteria for polycystic ovary syndrome (PCOS). The frequency of persistent menstrual disturbance was significantly more common in women with previous oligomenorrhea than secondary amenorrhea. The occurrence of eating disorders was decreased by half to 31% in women diagnosed with secondary amenorrhea at the initial study, whereas it was unchanged (40%) in women with previous oligomenorrhea. Recovery from anorectic behavior, primarily in the group of secondary amenorrhea, significantly predicted resumption with menses. CONCLUSION: Menstrual disturbances and eating disorders were still frequent after six years in a follow-up of women who had menstrual disturbance in adolescence. PCOS was the main cause explaining persistent menstrual disorder, whereas recovery of anorectic eating disorders predicted resumption of menses. The findings call for a continued follow-up of women diagnosed with menstrual disturbance in their teens.
Language: English
Keywords:
SWEDEN | RESEARCH REPORT | FOLLOW-UP STUDIES | ADOLESCENTS, FEMALE | MENSTRUATION | MENSTRUATION DISORDERS | DIET | BODY WEIGHT | Europe, Northern | Europe | Developed Countries | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproduction | Diseases | Nutrition | Health | Physiology | Biology
Document Number: 329343

26.
Title: Evaluation of extended and continuous use oral contraceptives.
Author: Wright KP; Johnson JV
Source: therapeutics and Clinical Risk Management. 2008 Oct;4(5):905-11.
Abstract: Oral contraceptives are classically given in a cyclic manner with 21 days of active pills followed by 7 days of placebo. In the past 4 years, new oral contraceptives have been introduced which either shorten the placebo time, lengthen the active pills (extended cycle), or provide active pills every day (continuous). These concepts are not new; extended and continuous pills were first studied in the 1960s and 1970s and have been provided in an off-label manner by gynecologists to treat menstrual disorders, such as menorrhagia and dysmenorrhea, and gynecologic disorders, such as endometriosis. Now that extended and continuous combined oral contraceptives are available for all patients, it is critical for providers to understand the physiology, dosing, side effects, and benefits of this form of oral contraceptive. This article reviews the history and the potential uses of the new continuous combined oral contraceptive.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | ORAL CONTRACEPTIVES | ADMINISTRATION AND DOSAGE | CONTRACEPTIVE AGENTS, SIDE EFFECTS | MENSTRUATION DISORDERS | RISK FACTORS | EVALUATION | Developed Countries | North America | Americas | Contraceptive Methods | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Agents | Diseases | Biology
Document Number: 330138

28.

Title: Light exposure, melatonin secretion, and menstrual cycle parameters: An integrative review.
Author: Barron ML
Source: Biological Research For Nursing. 2007 Jul;9(1):49-69.
Abstract: Dysfunction in menstrual physiology has pronounced effects on quality of life, involving mood changes, body image, infertility, and pregnancy complications. Light exposure may affect menstrual cycles and symptoms through the influence of melatonin secretion. The purpose of this systematic review is to determine the current state of knowledge about the effects of light and melatonin secretion on menstrual phase and cycle alterations. A brief overview of the influence of melatonin on human physiology is included. There is evidence of a relationship between light exposure and melatonin secretion and irregular menstrual cycles, menstrual cycle symptoms, and disordered ovarian function. In women with a psychopathology such as bipolar disorder or an endocrinopathy such as polycystic ovary syndrome, there seems to be greater vulnerability to the influence of light-dark exposure. Research on the complex role of light-dark exposure in menstrual physiology has implications for treatment of menstrual-associated disorders. (author's)
Language: English
Keywords:
UNITED STATES OF AMERICA | LITERATURE REVIEW | WOMEN | MENSTRUAL CYCLE | PREMENSTRUAL TENSION | MENSTRUATION DISORDERS | QUALITY OF LIFE | PSYCHOLOGICAL FACTORS | Developed Countries | North America | Americas | Demographic Factors | Population | Menstruation | Reproduction | Diseases | Social Welfare | Economic Factors | Behavior
Document Number: 322223

29.

Peer Reviewed

Title: Effectiveness of the levonorgestrel-releasing intrauterine system in the treatment of adenomyosis diagnosed and monitored by magnetic resonance imaging.
Author: Bragheto AM; Caserta N; Bahamondes L; Petta CA
Source: Contraception. 2007 Sep;76(3):195-199.
Abstract: This study was conducted to evaluate the effect of the levonorgestrel-releasing intrauterine system (LNG-IUS) on adenomyotic lesions diagnosed and monitored by magnetic resonance imaging (MRI). LNG-IUS was inserted during menstrual bleeding in 29 women, 24 to 46 years of age, with MRI-diagnosed adenomyosis associated with menorrhagia and dysmenorrhea. Clinical evaluations were carried out at baseline and at 3 and 6 months postinsertion. MRI was performed at baseline and at 6 months postinsertion and was used to calculate junctional zone thickness (in mm), to define the junctional zone borders, to identify the presence of high-signal foci on T2-weighted images and to calculate uterine volume (in mL). A significant reduction of 24.2% in junctional zone thickness was observed (p less than .0001); however, no significant decrease in uterine volume was observed (142.6 mL vs. 136.4 mL; p = .2077) between baseline and the 6-month evaluation. A significant decrease in pain score was observed at 3 and 6 months after insertion (p less than .0001); however, six women continued to report pain scores less than 3 at 6 months of observation. At 3 months of use, the most common bleeding pattern was spotting, and at 6 months of observation, oligomenorrhea was the most common pattern observed, although spotting was present in one third of the women. The insertion of an LNG-IUS led to a reduction in pain and abnormal bleeding associated with adenomyosis. MRI was useful for monitoring response of adenomyotic lesions to the LNG-IUS. (author's)
Language: English
Keywords:
GLOBAL | RESEARCH REPORT | PROSPECTIVE STUDIES | CLINICAL RESEARCH | WOMEN | GYNECOLOGIC DISEASES | MENSTRUATION DISORDERS | SIGNS AND SYMPTOMS | EXAMINATIONS AND DIAGNOSES | TESTING | Studies | Research Methodology | Demographic Factors | Population | Genital Effects, Female | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement
Document Number: 313802

30.

Title: Premenopausal factors influencing premature ovarian failure and early menopause.
Author: Chang SH; Kim CS; Lee KS; Kim H; Yim SV
Source: Maturitas. 2007 Sep;58(1):19-30.
Abstract: We conducted this study to examine premenopausal risk factors associated with premature ovarian failure (POF) and early menopause (EM) among Korean women. A 73% of total women aged 30-69 at four districts in the KMCC(Korean Multi-center Cancer Cohort)was participated in this study during 2002-2003. We selected 137 POF and 281 EM cases who had menopause before age 40 and at age 40-44, respectively, and 1318 normal menopause (NM) controls that experienced menopause at age 45-60, and among them, selected idiopathic POF (n = 84) and EM (n = 261) after excluding surgical/medical menopause. We collected the information of premenopausal lifestyle and reproductive risk factors. Multivariate and polytomous logistic regression were used to estimate POF and EM risk and to differentiate POF and EM risk using ordinal and nominal scale. Cigarette smoking was associated with an increased risk of idiopathic POF (OR = 1.82 [1.03-3.23]), whereas oral contraceptive use was associated with a reduced risk of natural EM (OR = 0.62 [0.43-0.90]). Idiopathic POF risk by both factors differed from idiopathic EM risk (p-nominal < 0.05). Factors related to ovulation, such as later menarche, irregular menstruation and longer breast feeding cumulatively reduced the risk of natural EM and POF (p-ordinal < 0.05). In analysis including medical and surgical menopause, lung tuberculosis, hysterectomy, past cancers, and lower number of deliveries before menopause were associated with POF. Our findings indicate that etiology in POF development may partly differ from that in EM. (author's)
Language: English
Keywords:
REPUBLIC OF KOREA | RESEARCH REPORT | CLINICAL RESEARCH | MULTIVARIATE ANALYSIS | WOMEN IN DEVELOPMENT | MENOPAUSE | AGE FACTORS | OVARIAN EFFECTS | RISK FACTORS | LIFE STYLE | TOBACCO USE | CONTRACEPTIVE USAGE | MENARCHE | BREASTFEEDING | MENSTRUATION DISORDERS | Asia, Eastern | Asia | Developed Countries | Research Methodology | Data Analysis | Economic Development | Economic Factors | Reproduction | Population Characteristics | Demographic Factors | Population | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Behavior | Contraception | Family Planning | Menstruation | Infant Nutrition | Nutrition | Health | Diseases
Document Number: 319657


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