1.  Title: Genetic counseling for teratogenic risk due to exposure to medications: 89 pregnancies conceived during oral contraceptive use. Author: Belli S; Mazzola S; Luongo R; Barcella L; Alushi B Source: American Journal of Medical Genetics. Part A. 2009 Jun 5; Abstract: Congenital malformations are relatively frequent (2% of the general population) but only a small proportion of them can be ascribed to medication exposure during pregnancy. Nevertheless, for the purposes of accurate prenatal diagnosis, monitoring and research, is it important to offer teratology counseling to patients exposed to drugs. There are approximately 20 medications currently on the market that have been universally acknowledged as teratogenic. At the current state of the art, exposure of early embryos to oral contraceptives is not considered teratogenic. Oral contraceptive use may be continuous (estrogen and progesterone or progesterone alone) or emergency (levonorgestrel is the only drug authorized in Italy). Like all drugs, oral contraceptives have a therapeutic failure rate, which means that a number of women on oral contraceptives conceive each year and request genetic counseling about teratogenic effects. During the period 1998-2006 at our genetics clinic we received 89 requests for counseling regarding teratogenic risk due to oral contraceptives. Our study of these patients confirms an absence of teratogenic risk for pregnancies occurring during oral contraceptive use. Teratology counseling was useful to reassure the mothers about the low risk (in the case of oral contraceptive use alone), since only 12 women chose to terminate pregnancy. Language: English Keywords: ITALY | RESEARCH REPORT | GENETICS | COUNSELING | EXPOSURE | ORAL CONTRACEPTIVES | CONTRACEPTIVE AGENTS, ESTROGEN | PROGESTERONE | LEVONORGESTREL | CONGENITAL ABNORMALITIES | RISK FACTORS | PREGNANCY | Developed Countries | Europe, Southern | Europe | Biology | Clinic Activities | Program Activities | Programs | Organization and Administration | Health | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Female | Contraceptive Agents | Progestational Hormones | Hormones | Endocrine System | Physiology | Contraceptive Agents, Progestin | Neonatal Diseases and Abnormalities | Diseases | Reproduction Document Number: 341602 |
| 2. Title: Limited knowledge on progestogen-only contraception and risk of venous thromboembolism. Author: Bergendal A; Odlind V; Persson I; Kieler H Source: Acta Obstetricia et Gynecologica Scandinavica. 2009;88(3):261-266. Abstract: Objective. To assess the current knowledge concerning progestogen-only contraception (POC) and risks of venous thromboembolism (VTE). Design and setting. Systematic review of the literature on observational and analytical studies reporting risk estimates for VTE in women exposed to POCs. Methods and main outcome measures. We performed a computerized literature search in the Pub Med, Embase, and the Cochrane Library for studies published between 1966 and February 13, 2008. Based on the evaluated studies we calculated an overall risk estimate for VTE in association with POC. Results. Four case-control studies and one cohort study were included. Of the case-control studies, three reported an increased risk and one a decreased risk of VTE. The cohort study found divergent results depending on the type of statistical analysis used. None of the results was statistically significant. The overall odds ratio for POC-associated VTE in the four case-control studies was 1.45 (95% CI=0.92-2.26). Conclusions. The risk of VTE associated with use of POCs is poorly investigated. The slightly elevated overall risk estimate might suggest an association between POC and an increased risk for VTE. The results must, however, be interpreted with caution due to the possibility of residual confounding. Well-designed studies with sufficient statistical power to evaluate risks of VTE with POC are warranted. Language: English Keywords: SWEDEN | RESEARCH REPORT | EPIDEMIOLOGY | CONTRACEPTIVE AGENTS, PROGESTIN | PROGESTERONE | THROMBOEMBOLISM | RISK FACTORS | KNOWLEDGE | Europe, Northern | Europe | Developed Countries | Public Health | Health | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Embolism | Vascular Diseases | Diseases | Sociocultural Factors Document Number: 329655 |
| 3. Title: Novel progesterone receptor modulators with gene selective and context-dependent partial agonism. Author: Berrodin TJ; Jelinsky SA; Graciani N; Butera JA; Zhang Z; Nagpal S; Winneker RC; Yudt MR Source: Biochemical Pharmacology. 2009 Jan 15;77(2):204-15. Abstract: Progesterone receptor (PR) modulators are used in contraception and post-menopausal hormone therapy, and are under clinical development for reproductive disorders such as uterine fibroids and endometriosis. Development of tissue selective PR modulators (SPRMs) with reduced side effects and improved pharmacology represents a large unmet medical need in the area of women's health. One approach to addressing this need is to focus on the two PR isoforms PR-A and PR-B. In vitro and in vivo studies have revealed both distinct as well as overlapping gene regulation and functional responses of the two PR isoforms that suggests that PR-A selective modulators may retain a desired biological profile. We have identified a chemical series of 4-(4-chlorophenyl)-substituted piperazine carbimidothioic acid esters (PCEs) that have partial PR agonist activity and selectively activate some PR-A isoform regulated genes in T47D cells. However, full microarray analysis in these cells does not predict a global isoform selective profile for these compounds, but rather a unique gene-selective profile is observed relative to steroidal progestins. Using multiplexed peptide interaction profiling and co-activator recruitment assays we find that the mechanism of partial agonism is only partly defined by the ability to recruit known co-activators or peptides but also depends on the cell and promoter context of the gene under investigation. The data demonstrate global consequences of mechanistic and functional differences that can lead to selective biological responses of novel steroid receptor modulators. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | UTERINE EFFECTS | ENDOMETRIOSIS | NEEDS | WOMEN'S HEALTH | PROGESTERONE | SCREENING | LABORATORY PROCEDURES | Developed Countries | North America | Americas | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Diseases | Economic Factors | Health | Progestational Hormones | Hormones | Endocrine System | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Laboratory Examinations and Diagnoses Document Number: 329730 |
| 4. Peer Reviewed Title: Insulin sensitivity and lipid metabolism with oral contraceptives containing chlormadinone acetate or desogestrel: a randomized trial. Author: Cagnacci A; Ferrari S; Tirelli A; Zanin R; Volpe A Source: Contraception. 2009 Feb;79(2):111-6. Abstract: BACKGROUND: Second-generation and third-generation oral contraceptives containing 30 mcg or more of ethinylestradiol (EE) decrease insulin sensitivity (SI). In this study, we investigated whether SI is decreased by contraceptives containing lower doses EE or by progestins with antiandrogenic properties. STUDY DESIGN: Twenty-eight young healthy women were randomly allocated to receive 20 mcg of EE and 150 mcg of desogestrel (DSG) (n=14) or 30 mcg of EE and 2 mg of chlormadinone acetate (CMA) (n=14) for 6 months. SI and glucose utilization independent of insulin (Sg) were investigated by the minimal model method. Lipid modifications were also analyzed. RESULTS: SI decreased with EE/DSG (7.09+/-1.4 vs. 4.30+/-0.91; p=.04; n=12), but not with EE/CMA (5.79+/-0.93 vs. 6.79+/-1.1; p=.48; n=12). SI modifications observed in the two groups were significantly different (-2.79+/-1.15 vs. 1.0+/-1.38; p=.05). Sg did not vary with either treatment. The response of C-peptide to glucose increased, but significantly so only with EE/CMA (p=.01). The C-peptide/insulin response increased with both EE/DSG (p=.05) and EE/CMA (p=.04). High-density lipoprotein (HDL) cholesterol (p=.02) and triglycerides (p=.02 and p=.01) increased in both groups, but HDL/low-density lipoprotein cholesterol (p=.02), apoprotein A1 (Apo-A1) (p=.04) and Apo-A1/apoprotein B (p=.048) increased significantly only with EE/CMA. CONCLUSIONS: The present study confirms that DSG, even when associated with low EE dose, decreases SI. By contrast, EE/CMA does not deteriorate SI and induces a favorable lipid profile. Language: English Keywords: ITALY | RESEARCH REPORT | CLINICAL TRIALS | WOMEN | PROGESTERONE | DESOGESTREL | CONTRACEPTION | ORAL CONTRACEPTIVES | LIPIDS | METABOLIC EFFECTS | SIDE EFFECTS | Developed Countries | Europe, Southern | Europe | Clinical Research | Research Methodology | Demographic Factors | Population | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Family Planning | Contraceptive Methods | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 329611 |
| 5. Peer Reviewed Title: Progestogen-only contraceptive use in obese women. Author: Curtis KM; Ravi A; Gaffield ML Source: Contraception. 2009 Oct;80(4):346-54. Abstract: BACKGROUND: The objective of this systematic review is to determine whether obese women who use progestogen-only contraceptives are more likely to experience weight gain or serious adverse events as compared to nonobese users. STUDY DESIGN: We searched PubMed for all articles (in all languages) published in peer-reviewed journals from database inception through October 2008, for evidence relevant to obesity and progestogen-only contraceptives. We used standard abstract forms and grading systems to summarize and assess the quality of the evidence. RESULTS: From 579 articles, we identified nine studies fitting our selection criteria. Evidence from five studies suggests that among adult women, baseline weight or body mass index is not associated with weight gain among depot medroxyprogesterone acetate (DMPA) users (Level II-2, Fair). Evidence from three studies suggests that among adolescent women, overweight or obese DMPA users may gain more weight than normal weight DMPA users or overweight/obese nonusers (Level II-2, Fair). Evidence from one small study of Norplant users showed no differences in weight gain by baseline weight (Level II-3, Poor). We did not identify studies of other progestogen-only contraceptive methods that examined weight change by baseline weight, nor did we identify studies that reported on any serious adverse events by baseline weight. CONCLUSIONS: Adolescent DMPA users who are obese may gain more weight than normal weight users. This observation was not seen in adult DMPA users or adolescent Norplant users. Language: English Keywords: GLOBAL | LITERATURE REVIEW | ADULTS | ADOLESCENTS, FEMALE | CONTRACEPTIVE AGENTS, PROGESTIN | PROGESTERONE | DEPO-PROVERA | CONTRACEPTIVE IMPLANTS | CONTRACEPTIVE AGENTS, SIDE EFFECTS | OBESITY | BODY WEIGHT | Age Factors | Population Characteristics | Demographic Factors | Population | Adolescents | Youth | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Medroxyprogesterone Acetate | Contraceptive Methods Document Number: 342772 |
| 6. Title: [The statement of Polish Gynecological Society experts on oral use of contraceptive 75 microg desogestrel minipill in different clinical cases--state of art in 2008] Stanowisko Zespolu Ekspertow Polskiego Towarzystwa Ginekologicznego dotyczace Author: Debski R; Kotarski J; Paszkowski T; Pawelczyk L; Skrzypulec V; Tomaszewski J Source: Ginekologia Polska. 2009 Jan;80(1):63-75. Abstract: Recent epidemiologic studies indicate that use of combined oral contraception is associated with a increase in the incidence of cardiovascular disease (venous thromboembolism, pulmonary embolism, myocardial infarction and stroke). The risk of cardiovascular disease is strongly related to estrogen dose, progestogen type and other factors for example thrombogenic mutations and cigarette smoking among female over age 35. The progestogen only contraception is safe alternative to combined hormonal contraception. Progestogen only pill (POP) has different levels of action (local and/or central) which may vary from one drug to another. As for the cardiovascular disease risk, progestogens are not considered to be risk factors. Desogestrel containing POP is advised in the following cases: bad tolerance of exogenous oestrogens; in order to counteract an endogenous hyperoestrogenosis; medical, metabolic or cardiovascular contraindications to estroprogestogen contraception. Lastly, POP should be used as a prime contraception in some particular situations (breast feeding, endometriosis, adenomyosis, cigarette smoking, contraception for older women). These recommendations present the actual system of care in that population of women in Poland. Language: Polish Keywords: POLAND | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGY | ORAL CONTRACEPTIVES, COMBINED | CONTRACEPTIVE AGENTS, PROGESTIN | PROGESTERONE | CONTRACEPTIVE SAFETY | Developing Countries | Europe, Central | Europe | Research Methodology | Public Health | Health | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Female | Contraceptive Agents | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Safety Document Number: 330922 |
| 7. Title: Thrombophilic conditions in the adolescent: the gynecologic impact. Author: Dietrich JE; Yee DL Source: Obstetrics and Gynecology Clinics of North America. 2009 Mar;36(1):163-75. Abstract: As Virchow's triad suggests, a fine balance exists between the vascular wall, intravascular contents, and dynamic blood flow, such that a shift in this balance predisposes to thrombosis. Although thromboembolic events (TEs) are relatively infrequent in adolescents, the morbidity and mortality associated with TEs can be significant. Over the past 15 years, TEs and inherited and acquired thrombophilic conditions underlying them have become increasingly recognized in teens at risk, with combined hormonal contraception constituting one of the most significant of these risk factors. Therefore, managing gynecologic problems in teens who have thrombophilic conditions can be challenging. It is important to have a clear understanding about safe options available to help address adolescent gynecologic concerns in this setting and to manage situations collaboratively with a hematologist. Language: English Keywords: UNITED STATES OF AMERICA | RECOMMENDATIONS | ADOLESCENTS, FEMALE | GYNECOLOGY | THROMBOSIS | RISK FACTORS | HEREDITARY DISEASES | CONTRACEPTIVE AGENTS, FEMALE | ORAL CONTRACEPTIVES, COMBINED | BLOOD COAGULATION EFFECTS | SCREENING | PROGESTERONE | CONTRACEPTIVE METHODS | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Medicine | Health Services | Delivery of Health Care | Health | Thromboembolism | Embolism | Vascular Diseases | Diseases | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Hematological Effects | Hemic System | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Progestational Hormones | Hormones | Endocrine System Document Number: 342856 |
| 8. Peer Reviewed Title: Profile of the progesterone derivative chlormadinone acetate - pharmocodynamic properties and therapeutic applications. Author: Druckmann R Source: Contraception. 2009 Apr;79(4):272-81. Abstract: Chlormadinone acetate (CMA) is a derivative of progesterone (17alpha-acetoxy-6-chloro-4,6-pregnadiene-3,20-dione), first synthesized in 1961 and is used as an orally effective progestogen in hormone replacement therapy (HRT), and in combination with ethinyl estradiol (EE) in contraception since 1999. Chlormadinone acetate has a strong progestogenic effect - about one-third higher than that of progesterone - and may vary depending on the previous effect of an estrogen, i.e., estrogens may promote the formation of progesterone receptors and proliferation of the endometrium. Like progesterone, it is anti-estrogenic and has no partial androgenic effect (at the doses used for contraception and HRT). In contrast to progesterone, it has a slight glucocorticoid effect, a pronounced anti-androgenic effect and no anti-mineralocorticoid effect. No pregnancy-maintaining effect of CMA has been demonstrated in humans. The anti-androgenic effect of CMA is presumed to be the result of both its binding to androgen receptors - competitively inhibiting the effect of endogenous testosterone and dihydrotestosterone - and the competitive inhibition of 5alpha-reductase. In this respect, dosing of CMA is crucial; agonistic effects are observed when doses are increased from those optimal for an antagonistic effect. Chlormadinone acetate has a strong anti-gonadotropic effect, through negative feedback on gonadotropin secretion, and has been used for more than 20 years alone for contraception in arterial risk patients. The clinical and metabolic tolerability of CMA has been demonstrated in numerous clinical studies with duration of treatment of up to 2.5 years. The more recent application of CMA as an oral contraceptive in combination with EE (Neo Eunomin, Belara) has proven highly successful, with studies reporting excellent contraceptive efficacy, high tolerability and adherence due to a good side effect profile and positive effects on preexisting dysmenorrhea, skin and hair conditions. Language: English Keywords: FRANCE | RESEARCH REPORT | ORAL CONTRACEPTIVES | CONTRACEPTIVE AGENTS, PROGESTIN | PROGESTERONE | CONTRACEPTIVE EFFECTIVENESS | Developed Countries | Europe, Western | Europe | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Female | Contraceptive Agents | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology Document Number: 341633 |
| 9. Title: Laryngeal aerodynamics associated with oral contraceptive use: Preliminary findings. Author: Gorham-Rowan M; Fowler L Source: Journal of Communication Disorders. 2009 May 21; Abstract: The purpose of this study was to examine possible differences in laryngeal aerodynamic measures during connected speech associated with oral contraceptive (OC) use. Eight women taking an OC, and eight others not taking an OC, participated in the study. Three trials of syllable /p/repetitions were obtained using a circumferentially vented face mask and small translabial tube. All participants were recorded on or near days 7 and 14 of their menstrual cycle. Subglottal pressure (P(SG)) and average airflow rates were obtained to determine laryngeal airway resistance. Glottal airflow measures of peak flow, minimum flow, alternating flow, as well as relative sound level (RSL) were obtained. P(SG) was obtained from the pressure peak associated with/p/. All airflow parameters and RSL were obtained from the vowel portion. No significant differences were found related to day of recording or OC use, indicating that OC use does not significantly affect laryngeal airflow regulation. LEARNING OUTCOMES: The reader will better understand the effects of hormones and oral contraceptives on the female voice, as well as the specific changes in vocal function that may occur in conjunction with the use of oral contraceptives. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CONTROL GROUPS | WOMEN | ORAL CONTRACEPTIVES | CONTRACEPTIVE AGENTS, SIDE EFFECTS | MENSTRUAL CYCLE | ESTROGENS | PROGESTERONE | ORAL EFFECTS | EDEMA | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents | Menstruation | Reproduction | Hormones | Endocrine System | Physiology | Biology | Progestational Hormones | Signs and Symptoms | Diseases Document Number: 341750 |
| 10. Peer Reviewed Title: Levonorgestrel enhances spermatogenesis suppression by testosterone with greater alteration in testicular gene expression in men. Author: Lue Y; Wang C; Cui Y; Wang X; Sha J; Zhou Z; Xu J; Wang C; Hikim AP; Swerdloff RS Source: Biology of Reproduction. 2009 Mar;80(3):484-92. Abstract: Prior studies have demonstrated that combined treatment of testosterone with a progestin induces a more rapid and greater suppression of spermatogenesis than testosterone treatment alone. We hypothesized that the suppressive effects of the combination of testosterone undecanoate (TU) injections plus oral levonorgestrel (LNG) on spermatogenesis may be mediated through a greater perturbation of testicular gene expression than TU alone. To test this hypothesis, we performed open testicular biopsy on 12 different adult healthy subjects: 1) four healthy men as controls; 2) four men 2 wk after TU treatment; and 3) four men 2 wk after TU + LNG administration. RNA isolated from biopsies was used for DNA microarray using the Affymetrix Human Genome U133 Plus 2.0 oligonucleotide microarrays. Gene expression with >or=2-fold changes (P < 0.05) compared with control was analyzed using the National Institutes of Health Database for Annotation, Visualization, and Integrated Discovery 2008 resource. The TU treatment altered the gene expression in 109 transcripts, whereas TU + LNG altered the gene expression in 207 transcripts compared with control. Both TU and TU + LNG administration suppressed gene expression of insulin-like 3; cytochrome P450, family 17, subfamily A1 in Leydig cells; and inhibin alpha in Sertoli cells; they increased proapoptotic transcripts BCL2-like 14, insulin-like growth factor-binding protein 3; and they decreased X-linked inhibitor of apoptosis protein. In comparison with TU treatment alone, TU + LNG treatment upregulated insulin-like 6 and relaxin 1, and downregulated RNA-binding protein transcripts. We conclude that TU + LNG administration induces more changes in testicular gene expression than TU alone. This exploratory study provided a novel and valuable database to study the mechanisms of action of hormonal regulation of spermatogenesis in men and identified testicular-specific molecules that may serve as potential targets for male contraceptive development. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | MEN | MALE CONTRACEPTION | PROGESTERONE | SPERMATOGENESIS | TESTIS | TESTOSTERONE | CONTRACEPTION RESEARCH | LEVONORGESTREL | Developed Countries | North America | Americas | Demographic Factors | Population | Contraception | Family Planning | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Reproduction | Genitalia, Male | Genitalia | Urogenital System | Androgens | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents Document Number: 341724 |
| 11. Title: [Contraception in women with special problems] Kontrazeption bei Problemfallen. Author: Mueck A; Neulen J; Thaler C; Birkhauser M; Braendle W Source: therapeutische Umschau. Revue therapeutique. 2009 Feb;66(2):117-28. Abstract: Thromboembolic, cardiovascular and cerebrovascular events are age-dependent. They are extremely rare in young women. In contrast to the progestogen-only pills, oral contraceptives (OC) increase the risk of venous thrombosis. However, decisive ist the genetic predisposition. In healthy non-smokers of less than 35 years of age, the risk to suffer from a myocardial infarction or a cerebrovascular accident is not increased by OC. Risk factors play a major role in the etiology of cardiovascular dieases. A detailed personal and family history is therefore mandatory before OC are prescribed. Very rarely, blood pressure is increased by OC. Although the incidence of such an increase is very low, blood pressure has to be measured regularly in pill users. Inspite of a current opinion, weight increase is rare in OC users. It depends mainly on the individual predisposition. An increased water retention can be reduced by a combined OC containing a progestagen with an antimineralocorticoid activity. Changes in insulin and blood sugar induced by low-dose OC are minimal so that they have no clinical relevance. OC do not increase the incidence of diabetes. Adrenal and thyroid function are not influenced by OC, there is no increased incidence of prolactinomas. Asthma is no contraindication against OC. If there is a cycle-dependent aggravation of the disease, OC might be beneficial. OC have no side-effects on the eye or the ear. In women suffering from lupus erythematodes having no renal participation, no increased antiphospholipid-antibodies and showing a stable or inactve disease, low-dose OC might be used. Language: German Keywords: RESEARCH REPORT | RISK FACTORS | ORAL CONTRACEPTIVES | CARDIOVASCULAR EFFECTS | HEART DISEASES | CONTRACEPTIVE AGENTS, PROGESTIN | PROGESTERONE | CONTRACEPTIVE SAFETY | Biology | Contraceptive Methods | Contraception | Family Planning | Physiology | Diseases | Contraceptive Agents, Female | Contraceptive Agents | Progestational Hormones | Hormones | Endocrine System | Safety | Public Health | Health Document Number: 329570 |
| 12. Title: Mirena(R) (Levonorgestrel intrauterine system): A successful novel drug delivery option in contraception. Author: Rose S; Chaudhari A; Peterson CM Source: Advanced Drug Delivery Reviews. 2009 May 12; Abstract: This manuscript serves as a review of Mirena(R), the levonorgestrel intrauterine system (LNG IUS) as a very successful drug delivery system. The LNG IUS has a very high contraceptive efficacy rate, and low rates of patient discontinuation. In addition to its contraceptive benefits, most users experience a decrease in menstrual bleeding over the five years of use. LNG IUS has also been used for management of menorrhagia, dysmenorrhea, adenomyosis, and endometrial hyperplasia in some cases. The LNG IUS provides long term efficacy, high rates of compliance, rapid return to fertility, and minimal adverse effects during use. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | IUD | PROGESTERONE | MENORRHAGIA | ENDOMETRIAL EFFECTS | IUD, COPPER RELEASING | CONTRACEPTION | LEVONORGESTREL | CONTRACEPTIVE USE-EFFECTIVENESS | Developed Countries | North America | Americas | Contraceptive Methods | Family Planning | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Menstruation Disorders | Diseases | Endometrium | Uterus | Genitalia, Female | Genitalia | Urogenital System | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Effectiveness Document Number: 341256 |
| 13. Title: Impact of combined and progestogen-only contraceptives on bone mineral density. Author: Sarfati J; de Vernejoul MC Source: Joint, Bone, Spine. 2009 Mar;76(2):134-8. Abstract: Sex steroids are major determinants of bone mass, and hormonal contraceptives may affect bone mineral density (BMD) in women. Combination contraceptives probably have no impact on BMD, except perhaps when started within 3 years after the menarche. Progestogen-only contraceptives are being increasingly used. Injectable medroxyprogesterone acetate, a potent inhibitor of gonadotropin release, can induce bone loss, most notably in young women. Other progestogens are used in lower doses that have weaker antigonadotropin effects. Levonorgestrel and etonorgestrel implants have unclear effects on BMD but are probably safe. The impact of high- and low-dose oral progestogens on BMD has not been investigated, although no adverse effects would be expected. Language: English Keywords: FRANCE | RESEARCH REPORT | IMPACT | WOMEN | PROGESTERONE | ESTROGENS | ORAL CONTRACEPTIVES, COMBINED | SKELETAL EFFECTS | Developed Countries | Europe, Western | Europe | Communication | Demographic Factors | Population | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning Document Number: 341723 |
| 14. Peer Reviewed Title: Progesterone-only and non-hormonal contraception in the breast cancer survivor: Joint review and committee opinion of the Society of Obstetricians and Gynaecologists of Canada and the Society of Gynecologic Oncologists of Canada No. 179, July 2006. Source: International Journal of Gynecology and Obstetrics. 2008 Jun;101(3):309-318. Abstract: The objective was to examine the relationship between progestin-only contraception and breast cancer, and to make recommendations regarding contraception for the breast cancer survivor. The outcome was incidence of breast cancer among users of progestin-only contraception. PubMed and Medline databases were searched using the terms "breast cancer" and "progesterone," "contraception," "depot medroxyprogesterone acetate," "Micronor," "Mirena," and "subdermal implant." The citations were limited to the English language. References were searched for other relevant articles. The quality of evidence is described using the classification of the Canadian Task Force on the Periodic Health Exam. Benefits, Harms, and Costs: Providing reliable contraception and non-contraceptive benefits to breast cancer survivors versus breast cancer recurrence risk. Summary Statements: 1. Progesterone and progestins can have a proliferative, antiproliferative, or neutral effect on breast tissue, depending on the type, timing, and dose of progestin used. (I). 2. Use of depot medroxyprogesterone acetate (DMPA) does not increase the risk of breast cancer in the general population. (II-2). 3. Although not as well-studied as the combined contraceptive pill, progestin-only pills do not appear to increase the risk of breast cancer in the general population. (II-2). 4. There is insufficient evidence to comment on risk or recurrence risk of breast cancer with contraceptive implants in the general population (II-2) or among breast cancer survivors. (III). 5. The limited data available suggest that the levonorgestrel-releasing intrauterine system (LNG-IUS) does not seem to increase breast cancer risk in the general population. (II-2). 6. Sterilization and the copper intrauterine device (IUD) are the most reliable non-hormonal contraceptive methods. (II-1). 7. Other non-hormonal methods may also be appropriate given decreased fertility with advancing age and after chemotherapy. (III). 8. Further research into progestin-only contraception inthe breast cancer survivor is needed. (III). Recommendations: 1. DMPA use in a breast cancer survivor can be considered in circumstances where contraceptive or non-contraceptive benefits outweigh any unknown potential increase in recurrence risk. (III-C). 2. Use of progestin-only pills in a breast cancer survivor may be considered in a situation where known benefits outweigh any unknown potential increase in recurrence risk. (III-C). 3. Use of the LNG-IUS in the breast cancer survivor can be considered if the unique contraceptive or non-contraceptive benefits outweigh the risk of an unknown effect on recurrence. (III-C). 4. Non-hormonal contraceptive methods should be used as first-line options in the breast cancer survivor. (author's) Language: English Keywords: CANADA | RESEARCH REPORT | LITERATURE REVIEW | INCIDENCE | WOMEN | BREAST CANCER | CONTRACEPTIVE METHODS | LOW-DOSE PROGESTINS | PROGESTERONE | North America, Northern | Americas | Developed Countries | Measurement | Research Methodology | Demographic Factors | Population | Cancer | Neoplasms | Diseases | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology Document Number: 326725 |
15.  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 |
| 16. Title: Birth spacing and maternal risk of invasive epithelial ovarian cancer in a Swedish nationwide cohort. Author: Baik I; Lambe M; Liu Q; Chie L; Cnattingius S; Mucci LA; Riman T; Ekbom A; Adami HO; Hsieh CC Source: Cancer Causes and Control. 2008 Dec;19(10):1131-7. Abstract: OBJECTIVE: Pregnancies reduce the risk of ovarian cancer, and among multiparous women, levels of circulating progesterone might be higher during pregnancies with wider birth spacing. We hypothesized that childbirth with wider birth spacing might reduce maternal risk of invasive epithelial ovarian cancer more than births with narrower spacing. METHODS: We conducted a case-control study nested in a nationwide cohort of Swedish women from 1961 to 2001. We selected five individually age-matched controls for each case of invasive epithelial ovarian cancer, and analysis for the effect of birth spacing was performed for 5,341 cases and 29,047 controls. We applied unconditional logistic regression analyses adjusting for age, ages at childbirth, educational level, area of residence, and gender of offspring. RESULTS: Relative risk of invasive epithelial ovarian cancer associated with each one-year increase in average birth spacing is 1.00 (95% CI = 0.98-1.01) among all women and 0.99 (0.98-1.01) among those born before 1935 and less likely to have used oral contraceptives. Further analyses on the biparous and triparous women did not find a consistent association between birth spacing and the risk of ovarian cancer. CONCLUSIONS: Birth spacing is unlikely to be a major determinant underlying the protective effects of childbirth on ovarian cancer risk. Language: English Keywords: SWEDEN | RESEARCH REPORT | CASE STUDIES | BIRTH SPACING | PROGESTERONE | OVARIAN CANCER | RISK FACTORS | Europe, Northern | Europe | Developed Countries | Studies | Research Methodology | Family Planning | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Cancer | Neoplasms | Diseases Document Number: 330103 |
| 17. Peer Reviewed Title: Dioxin may promote inflammation-related development of endometriosis. Author: Bruner-Tran KL; Yeaman GR; Crispens MA; Igarashi TM; Osteen KG Source: Fertility and Sterility. 2008 May;89 Suppl 3:1287-1298. Abstract: Laboratory and population-based studies suggest that exposure to environmental toxicants may be one of several triggers for the development of endometriosis. We discuss evidence that modulation of the endometrial endocrine-immune interface could mechanistically link toxicant exposure to the development of this disease. (author's) Language: English Keywords: UNITED STATES OF AMERICA | TENNESSEE | RESEARCH REPORT | WOMEN | ENDOMETRIOSIS | EXPOSURE | TOXICITY | ENVIRONMENTAL POLLUTION | PROGESTERONE | LEUKOCYTOSIS | Developed Countries | North America | Americas | Demographic Factors | Population | Diseases | Risk Factors | Biology | Physiology | Environmental Degradation | Environment | Progestational Hormones | Hormones | Endocrine System | Hematological Effects | Hemic System Document Number: 327229 |
| 18. Peer Reviewed Title: Contraceptive applications of progesterone receptor modulators. Author: Chabbert-Buffet N; Ouzounian S; Kairis AP; Bouchard P Source: European Journal of Contraception and Reproductive Health Care. 2008 Sep;13(3):222-30. Abstract: Currently developed progesterone receptor modulators (PRMs) are steroid-derived compounds with mild or potent antiprogestin activity. PRMs may exert a contraceptive activity by different mechanisms such as blockade of ovulation and endometrial desynchronization. Their potential clinical applications are manifold and are very promising in major public health areas, including emergency contraception, long term oestrogen-free contraception (administered alone, or in association with a progestin-only pill to improve bleeding patterns), endometriosis and myoma treatment. The mechanisms of their anti-ovulatory effects and of the endometrial modifications elicited during long term PRM treatment are still not fully elucidated. In future clinical applications, PRMs will be administered orally, via intrauterine systems or vaginal rings. Language: English Keywords: BELGIUM | RESEARCH REPORT | WOMEN | PROGESTERONE | CONTRACEPTION | BLEEDING | UTERINE EFFECTS | CONTRACEPTIVE AGENTS, PROGESTIN | VAGINAL RING | Developed Countries | Europe, Western | Europe | Demographic Factors | Population | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Family Planning | Signs and Symptoms | Diseases | Uterus | Genitalia, Female | Genitalia | Urogenital System | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Methods Document Number: 329698 |
| 19. Title: [Treatment of metrorrhagia, breakthrough bleeding and spotting under contraceptives] Metrorragies sous contraceptifs : attitude therapeutique. Author: Gompel A Source: Journal De Gynecologie, Obstetrique Et Biologie De La Reproduction. 2008 Dec;37 Suppl 8:S356-64. Abstract: Breakthrough bleeding and spotting are common side effects of contraceptives. These side effects may decrease the compliance and thus it is important to try to alleviate them. All the combined estrogen progestin contraceptives may be associated with abnormal bleeding. It is important to try to understand the mechanisms of these troubles and readapt the composition of the pill. It is difficult to edict recommendations to be used systematically but generally higher estrogens (and progestogens) containing pills are less associated with bleeding. Progestins also are associated with bleeding problems and the combination of estrogens may help if they are possible. Mirena can help in women with menorraghia but still breakthrough bleeding and spotting may occur. There is not one answer and the solution has to be found for each woman sometimes empirically. Language: French Keywords: GLOBAL | SUMMARY REPORT | WOMEN | BLEEDING | CONTRACEPTIVE AGENTS, SIDE EFFECTS | CONTRACEPTIVE AGENTS, ESTROGEN | CONTRACEPTIVE AGENTS, PROGESTIN | PROGESTERONE | Demographic Factors | Population | Signs and Symptoms | Diseases | Contraceptive Agents | Contraception | Family Planning | Contraceptive Agents, Female | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology Document Number: 342048 |
| 20. Title: Effects of pre- and postmenopausal use of exogenous hormones on receptor content in normal human breast tissue: a randomized study. Author: Hallberg G; Persson I; Naessen T; Magnusson C Source: Gynecological Endocrinology. 2008 Aug;24(8):475-80. Abstract: OBJECTIVE: To examine the effects of exposure to endogenous and exogenous hormones on estrogen receptor-alpha (ERalpha) and progesterone receptor (PR) levels in normal human breast tissue. METHODS: In a randomized study of women scheduled for mammary reduction plasty (n = 81), ERalpha and PR content in breast parenchyma was analyzed in premenopausal (n = 49) and postmenopausal (n = 16) women. Premenopausal women were randomized to surgery in the follicular or luteal phase of the menstrual cycle or after oral contraceptive treatment for 2 months. Postmenopausal women were randomized to sequential or estrogen-only therapy for 2 months prior to surgery. RESULTS: ERalpha content was higher in parous than in nulliparous (p = 0.009) premenopausal women and displayed a positive association with age (r(s) = 0.51, p = 0.0002). Compared with premenopausal women in the follicular phase, postmenopausal women had higher ERalpha content (p = 0.040) whereas premenopausal women on oral contraception had lower ERalpha (p = 0.048) and PR (p = 0.007) content. Smokers had lower PR content than non-smokers (p = 0.02). CONCLUSION: In the present study ERalpha content was higher in parous than in non-parous women and associated with premenopausal age. Short-term oral contraceptives yielded lower ERalpha and PR contents. Postmenopausal estrogen/progestogen combined therapy yielded lower PR content than estrogen-only therapy. Language: English Keywords: SWEDEN | RESEARCH REPORT | WOMEN | MENOPAUSE | SURGERY | BREAST EXAM | ORAL CONTRACEPTIVES | PROGESTERONE | ESTROGENS | EXPOSURE | CANCER | Europe, Northern | Europe | Developed Countries | Demographic Factors | Population | Reproduction | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physical Examinations and Diagnoses | Examinations and Diagnoses | Contraceptive Methods | Contraception | Family Planning | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Risk Factors | Neoplasms | Diseases Document Number: 329582 |
| 21. Title: Cardiovascular effects of medroxyprogesterone acetate and progesterone: a case of mistaken identity? Author: Hermsmeyer RK; Thompson TL; Pohost GM; Kaski JC Source: Nature Clinical Practice. Cardiovascular Medicine. 2008 Jul;5(7):387-95. Abstract: Heart disease presentation can differ between the sexes because nonobstructive coronary disease and angina unrelated to exercise are considerably more prevalent in women than in men. When the outcomes of large, randomized, controlled trials failed to demonstrate cardiac risk protection, many women and their physicians abandoned hormone replacement therapy as primary or secondary prevention for cardiovascular disease. We are concerned that the apparent blanket condemnation of steroids has not sufficiently distinguished between the cardiovascular actions of estrogen, progesterone and the synthetic progestin medroxyprogesterone acetate. The actions of active metabolites of progestins are not well understood and in some cases have not been explored. We intend to present what is known and what is not known about progesterone per se versus medroxyprogesterone acetate, particularly with regard to cardiovascular effects. This Review considers the mounting evidence that progesterone improves cardiovascular function and proposes its mechanism of action-restoration of a threshold level of progesterone as preventive of microvascular cardiac ischemia-and compares oral and transdermal routes of administration. We hope to stimulate research to determine whether progesterone, with or without estrogen, has a role in reducing cardiovascular risk and treating cardiovascular disease including myocardial ischemia in postmenopausal women. Language: English Keywords: UNITED STATES OF AMERICA | SUMMARY REPORT | WOMEN | HEART DISEASES | SEX FACTORS | PROGESTERONE | CONTRACEPTIVE AGENTS, PROGESTIN | CARDIOVASCULAR EFFECTS | Developed Countries | North America | Americas | Demographic Factors | Population | Diseases | Population Characteristics | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning Document Number: 328471 |
| 22. Title: Endometrial structural and inflammatory changes with exogenous progestogens. Author: Hickey M; Salamonsen LA Source: Trends In Endocrinology and Metabolism. 2008 Jul;19(5):167-74. Abstract: Safe and effective contraception is an international public health priority. The long-acting progestogen-only contraceptives are used by over 20 million women worldwide but their main drawback is abnormal uterine bleeding. Such bleeding arises owing to structural and inflammatory changes which compromise endometrial microvascular and epithelial integrity. The molecular and structural changes that lead to the vessel and surface epithelial fragility, and hence the side effect of abnormal uterine bleeding commonly seen with exogenous progestogen use, might be lessened by short-term treatments shown to shorten bleeding episodes. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | WOMEN | BLEEDING | CONTRACEPTIVE AGENTS, PROGESTIN | PROGESTERONE | ENDOMETRIAL EFFECTS | VASCULAR DISEASES | Developed Countries | Oceania | Demographic Factors | Population | Signs and Symptoms | Diseases | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Endometrium | Uterus | Genitalia, Female | Genitalia | Urogenital System Document Number: 328378 |
| 23. Title: Menstrual cycle and oral contraceptive use do not modify postexercise heat loss responses. Author: Kenny GP; Leclair E; Sigal RJ; Journeay WS; Kilby D; Nettlefold L; Reardon FD; Jay O Source: Journal of Applied Physiology. 2008 Oct;105(4):1156-65. Abstract: It is unknown whether menstrual cycle or oral contraceptive (OC) use influences nonthermal control of postexercise heat loss responses. We evaluated the effect of menstrual cycle and OC use on the activation of heat loss responses during a passive heating protocol performed pre- and postexercise. Women without OC (n = 8) underwent pre- and postexercise passive heating during the early follicular phase (FP) and midluteal phase (LP). Women with OC (n = 8) underwent testing during the active pill consumption (high exogenous hormone phase, HH) and placebo (low exogenous hormone phase, LH) weeks. After a 60-min habituation at 26 degrees C, subjects donned a liquid conditioned suit. Mean skin temperature was clamped at approximately 32.5 degrees C for approximately 15 min and then gradually increased, and the absolute esophageal temperature at which the onset of forearm vasodilation (Th(vd)) and upper back sweating (Th(sw)) were noted. Subjects then cycled for 30 min at 75% Vo(2 peak) followed by a 15-min seated recovery. A second passive heating was then performed to establish postexercise values for Th(vd) and Th(sw). Between 2 and 15 min postexercise, mean arterial pressure (MAP) remained significantly below baseline (P < 0.05) by 10 +/- 1 and 11 +/- 1 mmHg for the FP/LH and LP/HH, respectively. MAP was not different between cycle phases. During LP/HH, Th(vd) was 0.16 +/- 0.24 degrees C greater than FP/LH preexercise (P = 0.020) and 0.15 +/- 0.23 degrees C greater than FP/LH postexercise (P = 0.017). During LP/HH, Th(sw) was 0.17 +/- 0.23 degrees C greater than FP/LH preexercise (P = 0.016) and 0.18 +/- 0.16 degrees C greater than FP/LH postexercise (P = 0.001). Postexercise thresholds were significantly greater (P < or = 0.001) than preexercise during both FP/LH (Th(vd), 0.22 +/- 0.03 degrees C; Th(sw), 0.13 +/- 0.03 degrees C) and LP/HH (Th(vd), 0.21 +/- 0.03 degrees C; Th(sw), 0.14 +/- 0.03 degrees C); however, the effect of exercise was similar between LP/HH and FP/LH. No effect of OC use was observed. We conclude that neither menstrual cycle nor OC use modifies the magnitude of the postexercise elevation in Th(vd) and Th(sw). Language: English Keywords: CANADA | RESEARCH REPORT | WOMEN | MENSTRUATION | BODY TEMPERATURE | FITNESS | ESTROGENS | PROGESTERONE | North America, Northern | Americas | Developed Countries | Demographic Factors | Population | Reproduction | Physiology | Biology | Health | Hormones | Endocrine System | Progestational Hormones Document Number: 328846 |
| 24. Title: The bradykinin-degrading aminopeptidase P is increased in women taking the oral contraceptive pill. Author: La Corte AL; Carter AM; Turner AJ; Grant PJ; Hooper NM Source: Journal of the Renin - Angiotensin-aldosterone System. 2008 Dec;9(4):221-5. Abstract: INTRODUCTION: The renin-angiotensin and kininogen-kinin hormonal systems are critically involved in regulating blood pressure and are candidates in contributing to oral contraceptive pill (OCP)-induced hypertension.Angiotensin-converting enzyme (ACE) and aminopeptidase P (AP-P) are key enzymes in these systems and are both involved in the degradation of the vasodilator bradykinin. METHODS: Circulating ACE and AP-P levels were measured by activity assay using selective fluorogenic peptide substrates in plasma samples from the Leeds Family Study. In addition, the effect of progesterone on the expression of AP-P and ACE was examined in cells. RESULTS: Women on the OCP had higher age-adjusted plasma AP-P (mean [95% confidence interval]) (0.27 [0.23-0.32] nmol/min/ml (n = 53)) compared with women not on the OCP (0.17 [0.16-0.19] nmol/min/ml (n = 133), p < 0.001) or males (0.19 [0.17-0.20] nmol/min/ml (n = 209), p<0.001).There were no differences in the age-adjusted plasma ACE levels among the three groups. In HepG2 cells, progesterone treatment increased the AP-P protein and mRNA expression, whereas no effect of progesterone treatment was observed for ACE. CONCLUSION: Increased AP-P may result in increased breakdown of bradykinin.These data suggest that progesterone-induced increases in AP-P may contribute to the development of OCP-induced hypertension in susceptible Women. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | WOMEN | PROGESTERONE | TREATMENT | HYPERTENSION | ORAL CONTRACEPTIVES | BLOOD PRESSURE | Developed Countries | Europe, Western | Europe | Demographic Factors | Population | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Vascular Diseases | Diseases | Contraceptive Methods | Contraception | Family Planning | Hemic System Document Number: 329634 |
| 25. Peer Reviewed Title: Effect of oral contraceptives on vascular endothelial growth factor, Cox-2 and aromatase expression in the endometrium of uteri affected by myomas and associated pathologies. Author: Maia H Jr; Casoy J; Pimentel K; Correia T; Athayde C; Cruz T; Coutinho EM Source: Contraception. 2008 Dec;78(6):479-85. Abstract: BACKGROUND: The study was conducted to evaluate vascular endothelial growth factor (VEGF), Cox-2 and aromatase expression in the endometrium of uteri with myomas and other associated pathologies. STUDY DESIGN: Hysteroscopy was performed in 118 women of reproductive age with myomas and menorrhagia, 40 of whom were using a pill containing 75 mcg gestodene+30 mcg ethinylestradiol. Aromatase p450, VEGF and Cox-2 expression was detected using immunohistochemistry. Fisher's Exact Test and the Mann-Whitney test were used in the statistical analysis, with significance established at p<.05. RESULTS: In patients with myomas and menorrhagia, associated pathologies such as adenomyosis, endometrial polyps and endometriosis were found in 32%, 12% and 17% of cases, respectively. Aromatase, Cox-2 and VEGF expression was greater during the proliferative phase compared to the luteal phase of the cycle or following oral contraceptive use. CONCLUSION: Endogenous progesterone or combined oral contraceptives are potentinhibitors of VEGF, aromatase and Cox-2 expression in the endometrium of patients with myomas and menorrhagia. Language: English Keywords: BRAZIL | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | GENETIC TECHNIQUES | WOMEN IN DEVELOPMENT | ORAL CONTRACEPTIVES | ENDOMETRIAL EFFECTS | UTERINE CANCER | MENORRHAGIA | ENDOMETRIOSIS | PREVALENCE | SIDE EFFECTS | PROGESTERONE | ORAL CONTRACEPTIVES, COMBINED | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Economic Development | Economic Factors | Contraceptive Methods | Contraception | Family Planning | Endometrium | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Cancer | Neoplasms | Diseases | Menstruation Disorders | Measurement | Treatment | Progestational Hormones | Hormones | Endocrine System Document Number: 330522 |
| 26. Title: Risk factors of cardiovascular disease among the oral contraceptive users in Kermanshah City of Iran [letter] Author: Malek-Khosravi S Source: JPMA. Journal of the Pakistan Medical Association. 2008 Aug;58(8):473-4. Abstract: This letter to the editor discusses risk factors associated with oral contraceptive use in Kermanshah City of Iran. It recommends a new generation oral contraceptive (OCP) with fewer side effects and attentiveness to the cardiovascular risk factors when prescribing OCPs. Language: English Keywords: IRAN | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | ORAL CONTRACEPTIVES, SIDE EFFECTS | ORAL CONTRACEPTIVES, CONTRAINDICATIONS | RISK FACTORS | PROGESTERONE | ORAL CONTRACEPTIVES, COMBINED | ORAL CONTRACEPTIVES, LOW-DOSE | TIME FACTORS | AGE FACTORS | CARDIOVASCULAR EFFECTS | HYPERTENSION | Middle East | Developing Countries | Research Methodology | Economic Development | Economic Factors | Contraceptive Safety | Safety | Public Health | Health | Biology | Progestational Hormones | Hormones | Endocrine System | Physiology | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Population Dynamics | Demographic Factors | Population | Population Characteristics | Vascular Diseases | Diseases Document Number: 329155 |
| 27. Title: ER, PR and Ki-67 expression status in granulomatous and chronic non-specific endometritis. Author: Mishra K; Wadhwa N; Guleria K; Agarwal S Source: Journal of Obstetrics and Gynaecology Research. 2008 Jun;34(3):371-378. Abstract: Aim: To study the changes in the histological pattern, distribution and intensity of sex steroid receptors (estrogen and progesterone) and cell proliferation by Ki-67 expression by semi-quantitative scores in granulomatous and chronic non-specific endometritis in the premenstrual phase. Methods: A retrospective study was conducted on 20 cases of granulomatous endometritis, 10 of chronic non-specific endometritis and 30 age matched (+or- 2 years) controls with no endometrial lesions. Morphological changes were noted on histological examination and semi-quantitative scoring of Estrogen Receptor (ER), Progesterone Receptor (PR) and Ki-67 expression was done by immunohistochemistry. Results: There was significantly higher ER, PR and Ki-67 expression in endometrial glandular and stromal cells in inflamed endometria as compared with the controls (all P-values < 0.02) regardless of the character of the inflammation. The cases with morphology not conforming to the secretory phase at which biopsy was takenhad significantly higher ER, PR and Ki-67 expression in both endometrial and stromal cells indicating a lag in the endometrial maturation (all P-values < 0.02). Interestingly, all parameters except PR expression in glandular cells had a significantly higher expression even in cases with secretory morphology indicating disturbances in local milieu. Conclusion: Endometrial inflammation interferes with local expression of ER, PR and Ki-67. This may contribute to infertility regardless of other factors and other endometrial dysfunctional states. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | CLINICAL RESEARCH | RETROSPECTIVE STUDIES | WOMEN IN DEVELOPMENT | ENDOMETRITIS | HORMONE RECEPTORS | CHRONIC DISEASES | HISTOLOGY | GRANULOMAS | ESTROGENS | PROGESTERONE | GENETICS | INFERTILITY | TUBERCULOSIS, FEMALE GENITAL | Asia, Southern | Asia | Developing Countries | Research Methodology | Studies | Economic Development | Economic Factors | Reproductive Tract Infections | Infections | Diseases | Membrane Proteins | Physiology | Biology | Signs and Symptoms | Hormones | Endocrine System | Progestational Hormones | Reproduction | Tuberculosis Document Number: 327383 |
| 28. Title: Stimulation of epithelial repair is a likely mechanism for the action of mifepristone in reducing duration of bleeding in users of progestogen-only contraceptives. Author: Morison NB; Kaitu'u-Lino TJ; Fraser IS; Salamonsen LA Source: Reproduction. 2008 Aug;136(2):267-74. Abstract: Many women using progestogen (P)-only contraceptives experience uterine bleeding problems. In clinical trials, a single low dose of mifepristone, given to Implanon users at the beginning of a bleeding episode reduced the number of bleeding days by approximately 50% compared with controls. In this study, a single dose of mifepristone was administered to etonogestrel (ENG)-exposed pseudo-pregnant mice, 5 days after artificial decidualization was induced when the endometrium showed signs of bleeding. Control mice received vehicle alone. Mice were culled 12-, 18-, 24- and 48-h post-treatment. In the continued presence of ENG, a single dose of mifepristone stimulated tissue breakdown followed by very rapid repair: most treated tissues were fully restored to the pre-decidualized state by 48 h post-treatment. During repair, proliferating cells (Ki67 immunostained) were localized to a band of cells around the basal area in breaking down tissues and to the repairing luminal epithelium and glands. Progesterone receptor-positive cells were largely localized to the basal area of the breaking down tissue in treated mice compared with decidual cells in controls. Oestrogen receptor-positive cells were observed in the repairing luminal epithelium and glands compared with the decidua and the basal region in control tissues. It is concluded that mifepristone treatment stimulates rapid restoration of luminal epithelial integrity: such action may be a key event in reducing the number of bleeding days observed in women using Implanon who were treated with a single dose of mifepristone. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | CLINICAL TRIALS | WOMEN | CONTRACEPTIVE AGENTS, PROGESTIN | PROGESTERONE | ORAL CONTRACEPTIVES | BLEEDING | RU-486 | ADMINISTRATION AND DOSAGE | TREATMENT | Developed Countries | Oceania | Clinical Research | Research Methodology | Demographic Factors | Population | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Contraceptive Methods | Signs and Symptoms | Diseases | Hormone Antagonists | Drugs | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 329605 |
| 29. Title: Endogenous and exogenous female sex hormones and renal electrolyte handling: effects of an acute sodium load on plasma volume at rest. Author: Sims ST; Rehrer NJ; Bell ML; Cotter JD Source: Journal of Applied Physiology. 2008 Jul;105(1):121-7. Abstract: This study was conducted to investigate effects of an acute sodium load on resting plasma volume (PV) and renal mechanisms across the menstrual cycle of endurance-trained women with natural (NAT) or oral contraceptive pill (OCP) controlled cycles. Twelve women were assigned to one of two groups, according to their usage status: 1) OCP [n = 6, 29 yr (SD 6), 59.4 kg (SD 3.2)], or 2) NAT [n = 6, 24 yr (SD 5), 61.3 kg (SD 3.6)]. The sodium load was administered as a concentrated sodium chloride/citrate beverage (164 mmol Na(+)/l, 253 mosmol/kgH(2)O, 10 ml/kg body mass) during the last high-hormone week of the OCP cycle (OCP(high)) or late luteal phase of the NAT cycle (NAT(high)) and during the low-hormone sugar pill week of OCP (OCP(low)) or early follicular phase of the NAT cycle (NAT(low)). The beverage ( approximately 628 ml) was ingested in seven portions across 60 min. Over the next 4 h, PV expanded more in the low-hormone phase for both groups (time-averaged change): OCP(low) 6.1% (SD 1.1) and NAT(low) 5.4% (SD 1.2) vs. OCP(high) 3.9% (SD 0.9) and NAT(high) 3.5% (SD 0.8) (P = 0.02). The arginine vasopressin increased less in the low-hormone phase [1.63 (SD 0.2) and 1.30 pg/ml (SD 0.2) vs. 1.82 (SD 0.3) and 1.57 pg/ml (SD 0.5), P = 0.0001], as did plasma aldosterone concentration ( approximately 64% lower, P = 0.0001). Thus PV increased more and renal hormone sensitivity was decreased in the low-hormone menstrual phase following sodium/fluid ingestion, irrespective of OCP usage. Language: English Keywords: NEW ZEALAND | RESEARCH REPORT | WOMEN | ESTROGENS | PROGESTERONE | SIDE EFFECTS | ESTRADIOL | ORAL CONTRACEPTIVES | ORAL CONTRACEPTIVES, SIDE EFFECTS | Developed Countries | Oceania | Demographic Factors | Population | Hormones | Endocrine System | Physiology | Biology | Progestational Hormones | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning | Contraceptive Safety | Safety | Public Health Document Number: 328376 |
| 30. Title: Comparative effects of oral conjugated equine estrogens and micronized 17beta-estradiol on breast proliferation: a retrospective analysis. Author: Wood CE; Clarkson TB; Chen H; Veenstra TD; Xu X; Scott L; Cline JM Source: Menopause. 2008 Sep-Oct;15(5):890-8. Abstract: OBJECTIVE: To evaluate the effects of oral conjugated equine estrogens (CEE) and micronized 17beta-estradiol (E2) on breast proliferation in a postmenopausal primate model. DESIGN: Data from nine studies were analyzed retrospectively. The primary outcome measure was breast epithelial proliferation determined by immunolabeling for the Ki67 antigen. Other measures included progesterone receptor expression and endometrial thickness (as surrogate markers of systemic estrogen exposure) and urinary estrogen metabolite profile. All CEE doses were given at the human equivalent of 0.625 mg/day (n = 281), whereas E2 was given at the human equivalent of 1.0 mg/day or less (n = 131). RESULTS: Oral CEE resulted in a modest overall increase in breast epithelial proliferation of 75% that reached significance at P < 0.05 compared with placebo in one of four parallel-arm studies. In contrast, oral E2 resulted in a more substantial increase in breast epithelial proliferation of 259% (all studies) to 330% (parallel-arm studies only) that reached significance at P < 0.05 in all five E2 studies evaluated. Breast epithelial expression of progesterone receptor, a widely used marker of estrogen receptor activity, and endometrial thickness showed similar increases after treatment with CEE and E2 (P < 0.05 in all available studies). Relative amounts of urinary methoxyestrogens and the 2-hydroxyestrogen-to-16alpha-hydroxyestrone ratio were higher after CEE compared with E2 treatment (P < 0.05 for all). CONCLUSIONS: This retrospective analysis of oral estrogen effects in postmenopausal macaques suggests that standard doses of CEE may result in less estrogen-induced epithelial proliferation in the breast compared with E2. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | LITERATURE REVIEW | CLINICAL RESEARCH | LABORATORY ANIMALS | WOMEN | ESTROGENS | ESTRADIOL | ORAL CONTRACEPTIVES | MENOPAUSE | ANTIGENS | PROGESTERONE | BREAST CANCER | SIDE EFFECTS | HORMONE REPLACEMENT THERAPY | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Hormones | Endocrine System | Physiology | Biology | Contraceptive Methods | Contraception | Family Planning | Reproduction | Immunologic Factors | Immunity | Immune System | Progestational Hormones | Cancer | Neoplasms | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 329630 |
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