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1.
Rev. bras. ginecol. obstet ; 42(4): 194-199, Apr. 2020. tab
Article in English | LILACS | ID: biblio-1137820

ABSTRACT

Abstract Objective Changes in bleeding patterns could influence the decisions of healthcare professionals to change the levonorgestrel-releasing intrauterine system (LNG-IUS) before 7 years of use, the recommended period of extended use. We evaluated changes in the bleeding patterns of users of the 52 mg LNG-IUS at the end of use of the first (IUS-1) and during the second device (IUS-2) use. Methods We performed an audit of the medical records of all women who used two consecutive LNG-IUSs at the Family Planning clinic. We evaluated the sociodemographic/gynecological variables, the length of use, and the bleeding patterns reported in the reference periods of 90 days before removal of the IUS-1 and at the last return in use of IUS-2. We used the McNemar test to compare bleeding patterns. Statistical significance was established at p < 0.05. Results We evaluated 301 women aged (mean ± SD) 32 (±6.1) years, with lengths of use of 68.9 (±16.8) and 20.3 (±16.7) months for the IUS-1 and IUS-2, respectively. No pregnancies were reported. Bleeding patterns varied significantly among women who used the IUS-2 for ≥ 7 months to 6 years when compared the bleeding patterns reported in IUS-1 use. Eighty-nine out of 221 (40%) women maintained amenorrhea and infrequent bleeding; 66 (30%) evolved to bleeding patterns with light flow, and 66 (30%) maintained or evolved to heavy flow patterns (p = 0.012). No differences were observed among the 80 women with ≤ 6 months of use. Conclusion Changes in bleeding patterns occur during the use of LNG-IUS and should not be decisive for the early replacement of the device.


Resumo Objetivo Variações no padrão de sangramento podem afetar a decisão de troca do sistema intrauterino de levonorgestrel (SIU-LNG) antes do período de uso estendido recomendado de 7 anos. Nós avaliamos mudanças no padrão de sangramento de usuárias ao final do uso do primeiro SIU-LNG 52 mg (SIU-1) e durante o uso do segundo dispositivo (SIU-2). Métodos Revisamos os prontuários de todas as mulheres que inseriram consecutivamente o SIU-LNG no ambulatório de Planejamento Familiar. Foram avaliadas as variáveis sociodemográficas/ginecológicas, o tempo de uso, e os padrões de sangramento relatados nos períodos de referência de 90 dias antes da remoção do SIU-1 e no último retorno em uso do SIU-2. Usamos o teste de McNemar para comparar os padrões de sangramento. A significância estatística foi estabelecida em p < 0,05. Resultados Analisamos os dados de 301 mulheres com idade (média ± desvio padrão [DP]) de 32 (±6,1) anos e tempo de uso de 68,9 (±16,8) e 20,3 (±16,7) meses para o SIU-1 e SIU-2, respectivamente. Nenhuma gravidez foi relatada. Os padrões de sangramento variaram significativamente durante o uso do SIU-2 (≥ 7 meses a 6 anos) em relação ao padrão relatado no SIU-1. Oitenta e nove das 221 (40%) mulheres mantiveram amenorreia e sangramento infrequente; 66 (30%) evoluíram para padrões de sangramento com fluxo leve e 66 (30%) mantiveram ou evoluíram para padrões de fluxo intenso (p = 0,012). Não foram observadas diferenças entre as 80 mulheres que utilizavam o SIU-2 há ≤ 6 meses. Conclusão Mudanças nos padrões de sangramento ocorrem durante o uso do LNG-IUS e não devem ser decisivas para a troca precoce do dispositivo.


Subject(s)
Humans , Female , Adult , Young Adult , Levonorgestrel/administration & dosage , Levonorgestrel/adverse effects , Levonorgestrel/therapeutic use , Contraceptive Agents, Female/administration & dosage , Contraceptive Agents, Female/adverse effects , Contraceptive Agents, Female/therapeutic use , Affective Symptoms/epidemiology , Intrauterine Devices, Medicated/adverse effects , Intrauterine Devices, Medicated/statistics & numerical data , Menstruation/physiology , Retrospective Studies , Medical Audit
2.
Rev. Assoc. Med. Bras. (1992) ; 65(6): 857-863, June 2019. tab
Article in English | LILACS | ID: biblio-1012989

ABSTRACT

SUMMARY OBJECTIVE: To evaluate endocervical and vaginal environment changes in women using a levonorgestrel-releasing intrauterine system (LNG-IUS). METHODS: A quasi-experimental study included sixty women who had an LNG-IUS inserted in the Family Planning Clinic of UNICAMP between April and November of 2016. Women in reproductive age, non-pregnant, without the use of antibiotics and contraceptives seeking for LNG-IUS insertion were selected for this study. All women were evaluated with regard to vaginal and endocervical pH, vaginal and endocervical Gram-stained bacterioscopy, and Pap-smear before and two months after LNG-IUS insertion. Clinical aspects such as cervical mucus, vaginal discharge, and cervical ectopy were also observed. RESULTS: After LNG-IUS insertion, there was an increase in the following parameters: endocervical pH>4.5 (p=0.02), endocervical neutrophil amount (p<0.0001), vaginal cytolysis (p=0.04). There was a decrease in vaginal discharge (p=0.01). No statistically significant changes were found in vaginal pH, neutrophils amount in the vaginal mucosa, vaginal discharge appearance, vaginal candidiasis, bacterial vaginosis, vaginal coccobacillary microbiota, cervical mucus appearance, or cervical ectopy size. CONCLUSIONS: Short-term LNG-IUS use did not increase vulvovaginal candidiasis or bacterial vaginosis, and led to diminished vaginal discharge. Notwithstanding, this device promoted reactional changes in the vaginal and endocervical environment, without modification on cervical ectopy size.


RESUMO OBJETIVO: Avaliar as alterações do ambiente endocervical e vaginal em mulheres usuárias de sistema intrauterino liberador de levonorgestrel (SIU-LNG). MÉTODOS: Um estudo quase-experimental incluiu 60 mulheres que inseriram o SIU-LNG na Clínica de Planejamento Familiar da UNICAMP entre abril e novembro de 2016. Mulheres em idade reprodutiva, não gestantes, sem uso de antibióticos e contraceptivos, em busca pela inserção do SIU-LNG, foram selecionadas para este estudo. Todas as mulheres foram avaliadas quanto ao pH vaginal e endocervical, bacterioscopia vaginal e endocervical por coloração de Gram, exame de Papanicolau antes e dois meses após a inserção de SIU-LNG. Aspectos clínicos como muco cervical, corrimento vaginal e ectopia cervical também foram observados. RESULTADOS: Após a inserção do SIU-LNG houve aumento nos seguintes parâmetros: pH endocervical >4,5 (p=0,02), quantidade de neutrófilos endocervicais (p<0,0001), citolise vaginal (p=0,04). Houve diminuição do conteúdo vaginal (p=0,01). Não foram encontradas alterações estatisticamente significativas no pH vaginal, na quantidade de neutrófilos na mucosa vaginal, apecto do corrimento vaginal, candidíase vaginal, vaginose bacteriana, microbiota cocobacilar vaginal, aparência de muco cervical ou tamanho da ectopia cervical. CONCLUSÃO: O uso do SIU-LNG em curto prazo não aumentou a candidíase vulvovaginal ou a vaginose bacteriana, levou à diminuição do conteúdo vaginal. No entanto, este dispositivo promoveu mudanças reacionais no ambiente vaginal e endocervical, sem modificação no tamanho da ectopia cervical.


Subject(s)
Humans , Female , Adolescent , Adult , Young Adult , Vagina/drug effects , Cervix Uteri/drug effects , Levonorgestrel/adverse effects , Contraceptive Agents, Female/adverse effects , Endometrium/drug effects , Intrauterine Devices, Medicated/adverse effects , Time Factors , Vagina/microbiology , Vagina/chemistry , Vaginal Smears , Cervix Uteri/microbiology , Statistics, Nonparametric , Endometrium/microbiology , Papanicolaou Test , Middle Aged
3.
Mem. Inst. Invest. Cienc. Salud (Impr.) ; 16(2): 100-106, Ago. 2018.
Article in Spanish | LILACS, BDNPAR | ID: biblio-998059

ABSTRACT

La normatividad legal en Colombia exige que la dispensación y administración de Cyclofem en droguerías esté apoyada por una prescripción médica. Cyclofem es un anticonceptivo inyectable de combinación de vía intramuscular (AIC) que contiene medroxiprogesterona acetato y cipionato de estradiol y presenta un 99,7% de efectividad. Este medicamento produce sangrados abundantes, prolongados e irregulares, náuseas, mareos, aumento de peso, dolor de cabeza, osteoporosis y aumenta la tolerancia a la glucosa y la resistencia a la insulina. En la ciudad de Bogotá, D.C. sólo el 0,4% de las droguerías exigen la prescripción médica para la dispensación y administración de dicho medicamento(AU)


The legal regulations in Colombia require that the dispensing and administration of Cyclofem in drugstores be supported by a medical prescription. Cyclofem is an injectable intramuscular combination contraceptive (CCI) that contains medroxyprogesterone acetate and estradiol cypionate with an effectiveness of 99.7%. This medication causes heavy, prolonged and irregular bleeding, queasiness, dizziness, weight gain, headache, osteoporosis and increases glucose tolerance and insulin resistance. Only 0.4% of the pharmacies in Bogotá D.C. demanded the presentation of the medical prescription for dispensing and intramuscular administration (I.M) of Cyclofem in accordance with the current legal regulations(AU)


Subject(s)
Humans , Female , Contraceptive Agents, Female/adverse effects , Health Risk , Pharmaceutical Trade , Prescription Drugs , Pharmacies/ethics , Colombia , Injections, Intramuscular/adverse effects
4.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 10(2): 368-373, abr.-jun. 2018. tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-908452

ABSTRACT

Objetivo: classificar usuárias de anticoncepcionais hormonais injetáveis (AHI) quanto ao uso seguro segundo critérios médicos de elegibilidade da Organização Mundial da Saúde (OMS) e verificar associação entre tipo de injetável e tempo de uso com o uso seguro. Métodos: Estudo transversal, descritivo e exploratório. A população foi composta pelas 52 usuárias de AHI. Os dados foram coletados por meio de entrevista, que seguiu formulário elaborado pelas autoras, sendo identificado fatores que contraindicassem ou indicassem o uso do método, classificando-as em categorias de 1 a 4. O Projeto foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Ceará, CAAE: 36668314.3.0000.5054. Resultados: Foram identificadas 44 (84,7%) mulheres em uso seguro e 8 (15,3%) inseguro. Usuárias há mais de um ano tiveram uma frequência maior de uso inseguro (p=0,001). Conclusão: Seguir as recomendações da OMS deve ser rotina nas consultas de enfermagem visando à proteção e segurança da mulher.


Objective: to classify users of injectable hormonal contraceptives (AHI) in accordance with the safe use according to medical eligibility criteria of the World Health Organization (WHO) and assess the association between type of injection and use of time with safe use. Methods: Cross-sectional, descriptive and exploratory study. The population was composed by 52 users of AHI. Data were collected through interviews, which followed form developed by the authors, and identified factors that contraindicate or indicate the use of the method, classifying them into categories from 1 to 4. The project was approved by the Ethics Committee of the University Federal do Ceará, CAAE: 36668314.3.0000.5054. Results: Were identified 44 (84.7%) women in safe use and 8 (15.3%) in unsafe use. Users with over a year of use had a higher frequency of unsafe use (p=0.001). Conclusion: Following WHO recommendations should be routine in nursing consultation to the protection and safety of women.


Objetivo: clasificar las usuarias de anticonceptivos hormonales inyectables (AHI) segundo criterio de elegibilidad médica de la Organización Mundial de la Salud (OMS) y evaluar la asociación entre el tipo de inyección y el uso del tiempo con uso seguro. Métodos: Estudio transversal, descriptivo y exploratorio. La población fue compuesta por 52 usuarias de AHI. Los datos fueron colectados a través de entrevistas desarrollada por las autoras, e identificó los factores que contraindican o indiquen el uso del método, clasificándolos en categorías 1 a 4. El proyecto fue aprobado por el Comité de Ética de Investigación de la Universidad Federal do Ceará, CAAE: 36668314.3.0000.5054. Resultados: Se identificaron 44 (84,7%) mujeres en el uso seguro y 8 (15,3%) no seguro. Las usuarias más de un año habían una mayor frecuencia de uso inseguro (p=0,001). Conclusión: El uso de las recomendaciones de la OMS debe ser rutinario en la consulta de enfermería.


Subject(s)
Female , Humans , Adolescent , Young Adult , Adult , Middle Aged , Contraceptive Agents, Female , Contraceptive Agents, Female/adverse effects , Contraceptive Agents, Female/standards , Brazil , Contraceptive Prevalence Surveys
5.
Braz. j. med. biol. res ; 51(6): e7575, 2018. graf
Article in English | LILACS | ID: biblio-889102

ABSTRACT

Because of weight gain, women often discontinue hormonal contraception, especially depot medroxyprogesterone acetate (DMPA). Our objective was to conduct a systematic review of studies describing dietary intake or eating behavior in DMPA users to understand whether the use of DMPA is associated with changes in dietary habits and behaviors leading to weight gain. We searched the PubMed, POPLINE, CENTRAL Cochrane, Web of Science, and EMBASE databases for reports published in English between 1980 and 2017 examining dietary intake or eating behavior in healthy women in reproductive age and adolescents using DMPA (150 mg/mL). Of the 749 publications screened, we excluded 742 due to duplicates (96), not addressing the key research question (638), not reporting dietary intake data (4), and not evaluating the relationship of body weight and dietary or eating behaviors (4). We identified seven relevant studies, including one randomized placebo-controlled trial, one non-randomized paired clinical trial, and five cohort studies. The randomized trial found no association and the other reports were inconsistent. Findings varied from no change in dietary intake or eating behavior with DMPA use to increased appetite in the first six months of DMPA use. Few studies report dietary intake and eating behavior in DMPA users and the available data are insufficient to conclude whether DMPA use is associated with changes in dietary habits or behavior leading to weight gain.


Subject(s)
Humans , Female , Energy Intake/drug effects , Weight Gain/drug effects , Medroxyprogesterone Acetate/adverse effects , Contraceptive Agents, Female/adverse effects , Feeding Behavior/drug effects , Body Mass Index , Clinical Trials as Topic
6.
Ciênc. saúde coletiva ; 22(1): 43-52, jan. 2017.
Article in Portuguese | LILACS | ID: biblio-839903

ABSTRACT

Resumo Norplant® é a marca do primeiro implante hormonal subdérmico contraceptivo registrado no mundo, desenvolvido nos laboratórios do Population Council, organização internacional direcionada ao tema da fertilidade e crescimento populacional. O artigo revisita a trajetória deste contraceptivo no Brasil desde sua chegada, através de pesquisas clínicas, até sua proibição em 1986 pelo órgão brasileiro responsável por medicamentos na ocasião. Sua circulação gerou controvérsias relacionadas a práticas de pesquisa, efeitos colaterais e usos políticos do método. Este artigo concentra sua análise nas divergências relacionadas com as práticas de pesquisa. Utilizou-se a técnica de análise de controvérsia, revisitando as versões dos envolvidos, investigando suas compreensões e os efeitos que este objeto produziu em suas redes. O Norplant® provocou deslocamentos e associações entre grupos da sociedade, autoridades do Estado, cientistas e médicos, indústria, produtos farmacêuticos, procedimentos de pesquisas, instrumentos burocráticos, usuárias de contraceptivos. Estilos de pensamento médico científicos foram sacudidos e novas formas de pensar autonomia científica começaram a ser discutidas no país.


Abstract Norplant® is the brand name of the world's first registered subdermal hormonal contraceptive implant, developed by the laboratories of the Population Council, an international organisation working in the area of fertility and population growth. The article revisits the trajectory of this contraceptive in Brazil from its arrival through clinical trials to its eventual ban in 1986 by the Brazilian regulatory agency responsible for approving medications at the time. Its circulation generated controversies related to research practices, side effects and political uses of the drug as a birth control method. This article focuses its analysis on the divergences related to research practices. It uses a controversy analysis technique, reviewing the versions of those involved, investigating their understandings and the effects that this object generated in their networks. Norplant® provoked displacements and associations between civil society groups, State authorities, scientists and physicians, industry, pharmaceutical products, research procedures, bureaucratic instruments, and the female users of the contraceptives. Scientific styles of medical thought were shaken up and new forms of thinking about scientific autonomy began to be discussed in the country.


Subject(s)
Humans , Female , Biomedical Research/standards , Contraceptive Agents, Female/administration & dosage , Drug Approval , Levonorgestrel/administration & dosage , Biomedical Research/ethics , Brazil , Contraceptive Agents, Female/adverse effects , Drug Implants , Ethics, Research , Levonorgestrel/adverse effects , Politics
7.
Rev. chil. obstet. ginecol ; 79(6): 459-465, 2014. tab
Article in Spanish | LILACS | ID: lil-734791

ABSTRACT

Antecedentes: Las enfermedades reumatológicas (ER) se presentan con mayor frecuencia en mujeres en edad fértil. Es durante este período que muchas mujeres consultan por trastornos de los flujos rojos, dismenorrea y prevención del embarazo. Objetivo: Realizar una puesta al día del uso de anticoncepción hormonal (AH) en mujeres jóvenes con ER, especialmente en las portadoras de lupus eritematoso sistémico (LES) y artritis reumatoide (AR). Método: Se revisó la literatura en Pubmed para los términos AH en ER, con especial énfasis en guías clínicas y ensayos clínicos aleatorizados. Resultados: El uso de AH en pacientes con LES inactivo o con actividad leve no ha mostrado un empeoramiento de la enfermedad. Tampoco existe evidencia categórica que demuestre un mayor riesgo trombótico en aquellas con anticuerpos antifosfolípidos negativos, para las cuales se recomienda el uso de cualquier tipo de AH. En pacientes con AR no se ha demostrado asociación del uso de AH y aumento de la actividad de la enfermedad. Además la interacción farmacológica entre AH y medicamentos reumatológicos es mínima. Existe escasa evidencia del uso de AH en mujeres menores de 18 años con ER. Conclusión: Basado en la evidencia disponible las pacientes con ER con anticuerpos antifosfolípidos negativos podrán utilizar AH según los criterios de la OMS, lo que abre las puertas a mayores alternativas terapéuticas y prevención de embarazo para estas adolescentes y mujeres jóvenes con ER.


Background: Rheumatologic diseases (RD) are most common in women of childbearing age. It is during this period that many women consult for menstrual disorders, dysmenorrhea and pregnancy prevention. Objective: To update the use of hormonal contraception (HC) in young women with RD. Method: Literature was reviewed in PubMed for HC and RD terms, with special emphasis on clinical guidelines and randomized clinical trials. Results: The use of HC in patients with inactive or mild activity systemic lupus erythematosus has not shown a worsening of the disease. Also, there is no evidence demonstrating greater thrombotic risk in those with negative antiphospholipid antibodies, for which the use of any type of HC is recommended. In patients with rheumatoid arthritis an association between use of HC and increases disease activity has not been demonstrated. In addition, there is minimal drug interaction between HC and rheumatologic drugs. There is little evidence of the use of HC in women less than 18 years with RD. Conclusion: Based on the available evidence the patients with RD and negative antiphospholipid antibodies could use HC according to WHO criteria, which leads to greater therapeutic alternatives and pregnancy prevention for these adolescents and young women with RD.


Subject(s)
Humans , Female , Contraceptives, Oral, Hormonal/adverse effects , Arthritis, Rheumatoid/physiopathology , Lupus Erythematosus, Systemic/physiopathology , Contraceptive Agents, Female/adverse effects , Rheumatic Diseases/physiopathology
8.
Audiol., Commun. res ; 18(4): 233-239, out.-dez. 2013. tab
Article in Portuguese | LILACS | ID: lil-697611

ABSTRACT

OBJETIVO: Identificar se há diferença na amplitude das emissões otoacústicas de mulheres que utilizam e que não utilizam contraceptivo hormonal. MÉTODOS: Participaram da pesquisa 30 mulheres, sendo 15 que utilizam o método contraceptivo hormonal e 15 que não o utilizam, todos sem queixa auditiva e com audição dentro dos padrões de normalidade. A coleta de dados foi realizada por meio das emissões otoacústicas transientes e pelas emissões otoacústicas produto de distorção. RESULTADOS: Não houve diferença entre os valores de amplitude das emissões otoacústicas produto de distorção para as frequências de 1 kHz, 1,4 kHz, 2,8 kHz, 4 kHz e 6 kHz, na orelha direita, nos grupos estudados. Na frequência de 2 kHz houve tendência à diferença entre os valores de amplitude das emissões otoacústicas produto de distorção, comparando-se o grupo de mulheres que não usam contraceptivo hormonal e o grupo das que usam. Na orelha esquerda, não houve diferença entre os valores de amplitude das emissões otoacústicas produto de distorção para as frequências de 1 kHz, 1,4 kHz, 2 kHz, 2,8 kHz, 4 kHz e 6 kHz, nos dois grupos analisados. CONCLUSÃO: Não foram observadas diferenças na amplitude das emissões otoacústicas produto de distorção pelo uso de contraceptivo hormonal, nos grupos estudados.


PURPOSE: To verify differences of otoacoustic emissions responses in women using and not using hormonal contraception. METHODS:Participated in this study 30 female individuals, 15 using a hormonal contraceptive method and 15 that do not use hormonal contraception. All without hearing complaints and hearing within normal limits. Data collection was performed by: transient otoacoustic emissions and distortion product otoacoustic emissions. RESULTS: There was no difference between the amplitude of distortion product otoacoustic emissions for frequencies 1 kHz, 1.4 kHz, 2.8 kHz, 4 kHz and 6 kHz in the right ear between the groups. The frequency of 2 kHz tended to the difference between the amplitude of distortion product otoacoustic emissions between the group of women not using hormonal contraception and use. In the left ear there was no difference between the amplitude of distortion product otoacoustic emissions for frequencies 1 kHz, 1.4 kHz, 2 kHz, 2.8 kHz, 4 kHz and 6 kHz between the groups. CONCLUSION: No differences were observed in the amplitude of distortion product otoacoustic emissions by use of hormonal contraceptives.


Subject(s)
Humans , Female , Contraceptive Agents, Female/adverse effects , Ear, Inner , Hair Cells, Auditory , Otoacoustic Emissions, Spontaneous/drug effects , Contraceptives, Oral, Hormonal , Evoked Potentials, Auditory/drug effects , Menstrual Cycle , Menstruation Disturbances , Ovulation , Tinnitus
9.
Femina ; 39(7): 373-378, jul. 2011.
Article in Portuguese | LILACS | ID: lil-613325

ABSTRACT

Devido aos efeitos adversos dos contraceptivos hormonais, algumas mulheres são privadas de seus benefícios, que se estendem além da contracepção. Especialmente em adolescentes, é preocupante o impacto dos hormônios sobre o osso. Buscando reunir evidências nesse sentido, três revisores independentes fizeram buscas nas bases de dados Medline, Lilacs, Ibecs, Scielo e Cochrane, utilizando descritores relacionados à contracepção e densidade óssea. Foram critérios de inclusão: revisões sistemáticas e estudos com nível de evidência A e B. Foram excluídos estudos com contraceptivos utilizados para fins terapêuticos e não contraceptivos. Das 66 publicações encontradas, foram selecionados 15 estudos, e evidenciou-se que compostos com progesterona isolada de depósito e possivelmente os de baixa dose estrogênica têm impacto negativo na fase do pico de massa óssea. Contudo, o efeito esteve restrito à idade de iniciação e ao tempo de uso, havendo recuperação após interrupção da contracepção. Não há evidências de relação entre uso de contraceptivos e fraturas. O aconselhamento contraceptivo deve considerar o efeito negativo que a progesterona isolada de depósito e a baixa dose estrogênica podem ter sobre a massa óssea na adolescência, considerando que tal efeito é reversível e limitado ao tempo de uso


Due to the adverse effects of hormonal contraceptives, some women are deprived of the benefits they provide that extend beyond contraception. In adolescents, the main concern is the impact hormones can have on their bone structure. Three independent reviewers researched the databases Medline, Lilacs, Ibecs, Scielo and Cochrane, by using descriptions related to contraception and bone density. The inclusion criteria were: systematic reviews and studies with levels of evidence A and B. Contraceptives used for therapeutic purposes, other than contraception itself, were excluded from the study. Of the 66 publications found, 15 studies were selected. Compounds isolated from progesterone deposit, and possibly the low-dose estrogen, have a negative impact on the stage the bone mass peaks, but the effect was restricted to the age of initiation and the time of use, with recovery after discontinuation of contraception. There is no evidence of a relationship between the use of contraceptives and bone fractures. The negative effects that the deposit of progesterone and low-dose estrogen may have on bone mass should be taken into account when adolescents engage in the use of contraceptives ? bearing in mind that said effects are reversible and limited to the time of use


Subject(s)
Humans , Female , Adolescent , Adolescent , Medroxyprogesterone Acetate/administration & dosage , Medroxyprogesterone Acetate/adverse effects , Contraceptive Agents, Female/adverse effects , Bone Density , Medroxyprogesterone Acetate/pharmacology , Contraceptives, Oral, Combined/administration & dosage , Delayed-Action Preparations , Estrogens/administration & dosage , Bone and Bones , Bone and Bones/metabolism
10.
Article in English | WPRIM | ID: wpr-152846

ABSTRACT

Various synthetic progestogens that are used as contraceptives have been reported to influence lipid and lipoprotein fractions differently. Depo-medroxyprogesterone acetate (DMPA), a synthetic progestogen, is used by Nepalese women as a contraceptive agent. Our study aims to determine the effects of long-term use of DMPA on lipid metabolism. We performed this study on 60 healthy Nepalese women who had been using DMPA for more than 2 yr and age- and weight-matched control subjects who were not using hormonal contraceptives. Fasting blood samples were collected from the subjects for the estimation of total cholesterol (TC) and triglyceride (TG) levels, and the levels of high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were estimated using the Friedewald's equation. TC and LDL-C levels in DMPA users were significantly higher than those in non-users. Our study concluded that DMPA use induces lipid metabolism changes that can increase the risk of cardiovascular diseases.


Subject(s)
Adult , Cardiovascular Diseases/etiology , Cholesterol/blood , Cholesterol, HDL/analysis , Cholesterol, LDL/analysis , Contraceptive Agents, Female/adverse effects , Female , Humans , Lipid Metabolism/drug effects , Medroxyprogesterone Acetate/adverse effects , Nepal , Risk Factors , Triglycerides/blood
12.
Periodontia ; 18(1): 55-63, 2008. ilus, tab, graf
Article in Portuguese | LILACS, BBO | ID: lil-544193

ABSTRACT

Com o objetivo de avaliar a influência da ação dos contraceptivos hormonais sobre os tecidos periodontais, realizou-se uma pesquisa, considerando a relevância de alguns aspectos: a duração de uso e o tipo da droga utilizada, a concentração dos hormônios sexuais presentes, o grau de higiene bucal e a presença de fatores de risco locais associados. A amostra foi constituída por 60 mulheres, entre 17 e 47 anos de idade, sendo 30 mulheres representando o grupo teste (usuárias da droga) e 30 fazendo parte do grupo controle (não-usuárias). Os dados foram coletados por meio de roteiro de entrevista e de exame clínico utilizando os índices IPC e IHO-S. Os resultados obtidos mostraram que o uso de contraceptivos hormonais não influenciou na ocorrência da doença periodontal. As péssimas condições de higiene bucal, associadas à presença de cálculo, apresentaram-se de forma homogênea na população estudada. O tempo de uso de contraceptivos hormonais, bem como diferenças nos tipos e concentrações hormonais de estrógeno e progesterona não representaram grandes mudanças na condição periodontal das mulheres da droga.


Subject(s)
Humans , Female , Adolescent , Adult , Contraceptive Agents, Female/adverse effects , Hormones/adverse effects , Periodontal Diseases
13.
Medical Forum Monthly. 2008; 19 (2): 22-28
in English | IMEMR | ID: emr-88728

ABSTRACT

Increasing population growth rate in developing countries like Pakistan is a major problem requiring fertility control. The introduction of injectable hormonal contraceptives has increased the number of women practicing contraception and compliance as well. To assess the frequency of menstrual disorders with depot medroxy progesterone acetate. This descriptive study was carried out in Obstetrics and Gynaecology Unit I, in collaboration with Reproductive Health Services, Master Training Centre, Nishtar Hospital Multan during the period from July 2005 to December 2006. One hundred and fifty non-pregnant women of reproductive age were selected and after complete history, examination and investigations, all women suitable for DPMA were included. In our Study the main complaint was menstrual disturbance. More than one fifth of the clients i.e. 32 [21%] enjoyed normal menstrual patterns. Sixty two [41%] ladies developed amenorrhoea by the end of one year. Seventeen [12%] cases complained of irregular vaginal bleeding and 39 [26%] had heavy regular periods. One hundred and thirty three [89%] patients revealed complete satisfaction with the product while 17 [11%] complained about discomfort due to menstrual problems. Out of these seventeen, nine discontinued as menstrual irregularities had handicapped their life so there were 141 [94%] patients who continued while 6% discontinued. Despite bleeding disturbances caused by DPMA, high continuation rates showed that this contraceptive method is acceptable to women


Subject(s)
Humans , Female , Progesterone/analogs & derivatives , Contraceptive Agents, Female/adverse effects , Amenorrhea
14.
Medicina (B.Aires) ; 67(5): 481-490, sep.-oct. 2007.
Article in Spanish | LILACS | ID: lil-489373

ABSTRACT

La contracepción de emergencia puede evitar el embarazo luego de un coito sin medidas contraceptivas o cuando éstas fallan. Se recomienda el levonorgestrel, un gestágeno sintético, en dosis única de 1.5 mg (alternativamente en dos dosis de 0.75 mg espaciadas 12 h). Su eficacia es moderada, pues impide aproximadamente 80% de los embarazos. La eficacia es mayor cuanto más precozmente se administre, pero puede darse hasta 5 días post-coito. La tolerancia es similar o superior a la de otros preparados empleados con igual propósito. Los efectos adversos comprenden náuseas, vómitos, cefalea, tensión mamaria y alteraciones transitorias en la siguiente menstruación. Se desconoce si el levonorgestrel aumenta la probabilidad de embarazo ectópico cuando el tratamiento fracasa. No se recomienda su empleo como contraceptivo habitual. Cuando se administra antes del pico preovulatorio de LH, el levonorgestrel generalmente bloquea o retrasa la ovulación. Puede asimismo afectar la migración de los espermatozoides en el tracto genital femenino e, indirectamente, la fertilización. Pese a haberse postulado reiteradamente, no existe evidencia de un efecto antiimplantatorio. El conocimiento del método es muy variable en diferentes sociedades, pero aun donde es bien conocido permanece subutilizado. Se ha propuesto proveer levonorgestrel por adelantado para promover su uso. En ensayos clínicos, tal provisión no afectó adversamente el comportamiento sexual ni el empleo de otros contraceptivos, pero tampoco redujo el número de embarazos o abortos. En consecuencia, el empleo de levonorgestrel debe considerarse un método de respaldo que no reemplaza el uso de contraceptivos más eficaces.


Emergency contraception may avoid pregnancy after unprotected intercourse or when regular contraceptive measures fail. Levonorgestrel, a synthetic gestagen, is recommended for emergency contraception as a single 1.5-mg dose or, alternatively, two 0.75-mg doses taken 12 h apart. Its efficacy is moderate, preventing about 80% of pregnancies. Efficacy is higher the earlier after unprotected intercourse the drug is taken, but it may be administered up to 5 days post-coitum. Tolerance is similar to, or better than, those of other oral emergency contraceptives. Adverse effects include nausea, vomiting, headache, breast tenderness and transient alteration of menstrual bleeding pattern. It is not known whether levonogestrel increases the risk of ectopic pregnancy when the treatment fails. Its use as an ongoing contraceptive method is discouraged. When given before the preovulatory LH peak, levonorgestrel blocks or delays ovulation. It may also affect sperm migration in the female reproductive tract and have an effect on fertilization. Although it has been often postulated, there is no evidence for an anti-implantatory effect. Acquaintance with the method is quite variable among different societies, but it remains underutilized even where it is well known. Advance provision of the drug has been proposed as a way to promote its use. In clinical trials, advance provision did not adversely modify sexual or regular contraceptive behavior, but it did not reduce pregnancy or abortion rate either. Therefore, emergency contraception with levonorgestrel should be regarded as a backup method which is not a substitute for the continued use of more effective contraceptive methods.


Subject(s)
Humans , Female , Pregnancy , Contraception, Postcoital , Contraceptive Agents, Female/administration & dosage , Contraceptives, Oral, Synthetic/administration & dosage , Levonorgestrel/administration & dosage , Ovulation/drug effects , Clinical Trials as Topic , Contraceptive Agents, Female/adverse effects , Contraceptives, Oral, Synthetic/adverse effects , Fallopian Tubes/drug effects , Fertilization/physiology , Intrauterine Devices , Levonorgestrel/adverse effects , Pregnancy, Ectopic/etiology
15.
J. bras. pneumol ; 32(4): 367-370, jul.-ago. 2006. ilus
Article in Portuguese | LILACS | ID: lil-452333

ABSTRACT

Relata-se o caso de uma mulher de 25 anos com síndrome de Churg-Strauss, cujos sintomas surgiram aos dezesseis anos, logo após o início do uso de contraceptivo oral. O quadro clínico evoluiu rapidamente com asma persistente grave, polipose nasal, rinite perene obstrutiva, eosinofilia periférica e tecidual, e mononeurite. A síndrome de Churg-Strauss é uma doença que exige suspeita precoce, diagnóstico preciso, tratamento agressivo e monitoramento periódico, devendo ser considerada no diagnóstico diferencial de asma persistente moderada e grave. O caso relatado chama a atenção para possível participação hormonal e surgimento em idade precoce.


We report the case of a 25-year-old woman with Churg-Strauss syndrome, the symptoms of which had first appeared soon after she began taking oral contraceptive at the age of sixteen. The clinical profile evolved rapidly to severe persistent asthma, nasal polyposis, perennial obstructive rhinitis, eosinophilia (peripheral/tissue) and mononeuritis. Churg-Strauss syndrome is the type of disease that demands early detection, accurate diagnosis, aggressive treatment and periodic monitoring. It should be considered in the differential diagnosis of moderate and severe persistent asthma. The case reported calls attention to possibility that there is a hormonal component and that the disease can present early onset.


Subject(s)
Adult , Female , Humans , Asthma/diagnosis , Churg-Strauss Syndrome/diagnosis , Contraceptive Agents, Female/adverse effects , Biopsy , Churg-Strauss Syndrome/chemically induced , Churg-Strauss Syndrome/drug therapy , Diagnosis, Differential , Severity of Illness Index , Tomography, X-Ray Computed
17.
Rev. chil. obstet. ginecol ; 71(3): 170-173, 2006. tab
Article in Spanish | LILACS | ID: lil-464953

ABSTRACT

Objetivo: El propósito de la investigación fue evaluar la evolución a un año los efectos adversos en una cohorte de pacientes con implante subdérmico de desogestrel. Método: Se incluyeron pacientes portadoras de implante que tenían como mínimo tres meses de uso, previo consentimiento informado. Se realizaron 4 mediciones en forma trimestral, registrándose los efectos más frecuentes referidos por la paciente. El análisis incluyó porcentajes, promedios e intervalos de confianza al 95 por ciento. Resultados: Se estudiaron 50 pacientes, los efectos adversos presentados con mayor frecuencia en el primer trimestre fueron alteraciones del ciclo 48 por ciento, mastalgia 46 por ciento, amenorrea 40 por ciento, mareo 40 por ciento, cefalea 40 por ciento, náuseas 30 por ciento, acné 28 por ciento, aumento de peso 26 por ciento y dolor local 10 por ciento. Se observó al final del tercer trimestre reducción de la cefalea, mastalgia y mareo (p<0,05); para el cuarto trimestre las náuseas y las alteraciones del ciclo (p<0,05). El 11,1 por ciento de las pacientes desertaron del método al final del estudio. Se observó que el uso del desogestrel tuvo un valor estadísticamente significativo para el control de la dismenorrea (p<0,05) al final del cuarto trimestre de uso. Conclusión: Los implantes de desogestrel tienen efectos adversos importantes en los primeros meses de uso para disminuir la mayoría de ellos al final del primer año.


Subject(s)
Humans , Female , Adult , Drug Implants , Desogestrel/administration & dosage , Desogestrel/adverse effects , Contraceptive Agents, Female/administration & dosage , Contraceptive Agents, Female/adverse effects , Cohort Studies , Confidence Intervals , Menstrual Cycle , Dose-Response Relationship, Drug , Longitudinal Studies , Time Factors
18.
Article in English | IMSEAR | ID: sea-39168

ABSTRACT

OBJECTIVE: To determine adverse events and discontinuation of Implanon in healthy Thai women between 16 and 45 years of age. DESIGN: Prospective descriptive study. SETTING: Family Planning Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University. SUBJECTS: Ninety-two female volunteers with eligible criteria, no contraindication for hormonal contraceptive and wished to have long-term contraception were recruited. MAIN OUTCOME MEASURES: Determination of adverse events was done three months after Implanon insertion. Discontinuation of Implanon use was reviewed during the study period of one year RESULTS: Amenorrhea (40.2%) and infrequent bleeding (39.1%) were the most menstrual adverse events. While most non-menstrual adverse events were headache/dizziness (27.2%) and lower abdominal pain (23.9%). Severe non-menstrual side effect was rare (1-2%). Seven subjects (7.6%) discontinued using Implanon during the one year period of study. CONCLUSION: Implanon demonstrated a high continue rate at the first year of insertion. It produced similar adverse events like other progestin-only contraceptives. Counseling before insertion is important for increased client satisfaction and a higher continuation rate.


Subject(s)
Adolescent , Adult , Contraceptive Agents, Female/adverse effects , Desogestrel/adverse effects , Female , Humans , Middle Aged
19.
Article in English | WPRIM | ID: wpr-160613

ABSTRACT

An 8-year-old female Yorkshire Terrier was presented for investigation of reduced appetite, and occasional vomiting. She has been treated with medroxyprogesterone acetate (MPA) from past 3 year-old age for contraception. Abdominal sonography showed abnormal enlargement of uterus, and ovariohysterectomy was performed. Main gross findings of uterus were enlarged lesions in two areas of the left horn, which had thickened wall and yellowish sticky material in the lumen. Histopathologically, cystic endometrial hyperplasia (CEH) and endometritis were present in the thickened area. In this case, CEH and endometritis may be attributed to prolonged treatment of MPA. It was concluded that further study is needed to clarify the association of MPA treatment with age, its pathogenesis and abnormal uterine changes in dogs.


Subject(s)
Animals , Contraceptive Agents, Female/adverse effects , Dog Diseases/chemically induced , Dogs , Endometrial Hyperplasia/chemically induced , Endometritis/chemically induced , Female , Medroxyprogesterone Acetate/adverse effects
20.
West Indian med. j ; 53(6): 406-412, Dec. 2004.
Article in English | LILACS | ID: lil-410093

ABSTRACT

Most low-resource settings depend on hormonal contraceptives for their family planning programmes and cervical cancer occurs in higher frequency in these populations. To determine whether hormonal contraception use increases cervical carcinoma in-situ (CIS) risk, a case-control study was conducted in the Kingston and St Andrew Corporate area of Jamaica, using 119 cases from the Jamaica Tumour Registry and 304 population controls matched on year of Papanicolaou (Pap) smear and clinic where Pap smear was obtained. While CIS cases were more likely to have 'ever used' combined oral contraceptives (COC) (OR = 1.4, 95 CI: 0.8, 2.5), depo-medroxyprogesterone acetate (DMPA) use was similar. Compared to women who never used hormonal contraceptives, the risk of CIS was elevated in: women who had used COCs five years or more (OR = 2.1, 95 CI: 1.0, 4.6), women who first used COC for less than 10 years prior to the interview (OR = 1.8, 95 CI: 0.9, 3.7) and women who were 18 to 24 years old when they first used COCs (OR = 1.8, 95 CI: 0.9, 3.4). Similarly, compared to women who never used DMPA, the risk of CIS was elevated in: women using DMPA five years or more (OR = 1.9, 95 CI: 0.7, 4.8), women reporting use within a year prior to interview (OR = 2.8, 95 CI: 0.7, 10.7) and women who initiated use of DMPA when they were 20 and 24 years old (OR = 1.4, 95 CI: 0.7, 3.1). These results suggest that if hormonal contraceptive use confers any risk of CIS, it is confined to long-term users. Increased risk in some groups, however, warrant further study


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , /adverse effects , Contraceptive Agents, Female/adverse effects , Cervical Intraepithelial Neoplasia , Uterine Cervical Neoplasms/chemically induced , Case-Control Studies , Cervical Intraepithelial Neoplasia , Contraceptives, Oral, Combined , Jamaica/epidemiology , Uterine Cervical Neoplasms/epidemiology , Risk Factors , Time Factors
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