ABSTRACT
A patient with non-mosaic Turner syndrome and normal fertility had four documented pregnancies, two of which were carried to term. Although her fertility history can be considered normal, she did not have spontaneous sexual maturation or menarche, and bilateral streak gonads were identified on laparotomy for tubal ligation. A review of the literature on non-mosaic Turner syndrome and reproductive function indicates that there are several theories to account for the extreme variety of ovarian function in such patients, but not enough data are yet available to form a conclusion.
Subject(s)
Fertility/drug effects , Pregnancy Complications/physiopathology , Turner Syndrome/physiopathology , Adult , Contraceptives, Oral, Combined/administration & dosage , Diethylstilbestrol/therapeutic use , Dimethisterone/administration & dosage , Ethinyl Estradiol/administration & dosage , Female , Fetal Death , Humans , Karyotyping , Medroxyprogesterone/analogs & derivatives , Medroxyprogesterone/therapeutic use , Medroxyprogesterone Acetate , Mosaicism , Ovary/pathology , Ovary/ultrastructure , Pregnancy , Pregnancy Complications/surgery , Sterilization, Tubal , Turner Syndrome/drug therapy , Turner Syndrome/surgeryABSTRACT
Six patients who took oral contraceptive agents for 5 to 18 years developed endometrial neoplasia. Endometrial adenocarcinoma occurred in 4 of these patients and severe adenomatous hyperplasia occured in 2. Five of the 6 patients took sequential agents; 1 patient used a combined agent. An additional patient who took Premarin and Provera sequentially developed adenocarcinoma of the endometrium. Eighteen cases of endometrial adenocarcinoma and 7 cases of adenomatous hyperplasia in patients with long-term sequential oral contraceptive use have previously been reported by others. Progestogens may not be completely protective against the endometrial cancer-causing potential of the estrogens, especially in the sequential regimens.
Subject(s)
Adenocarcinoma/chemically induced , Contraceptives, Oral, Synthetic/adverse effects , Contraceptives, Oral/adverse effects , Uterine Neoplasms/chemically induced , Adult , Contraceptives, Oral, Sequential/administration & dosage , Contraceptives, Oral, Sequential/adverse effects , Contraceptives, Oral, Synthetic/administration & dosage , Dimethisterone/administration & dosage , Dimethisterone/adverse effects , Drug Combinations , Estrogens, Conjugated (USP)/administration & dosage , Estrogens, Conjugated (USP)/adverse effects , Ethinyl Estradiol/administration & dosage , Ethinyl Estradiol/adverse effects , Female , Humans , Hyperplasia , Medroxyprogesterone/administration & dosage , Medroxyprogesterone/adverse effects , Middle Aged , Norgestrel/administration & dosage , Norgestrel/adverse effects , Time FactorsSubject(s)
Breast Neoplasms/drug therapy , Carcinoma in Situ/drug therapy , Estrogens/therapeutic use , Progesterone/therapeutic use , Uterine Neoplasms/drug therapy , Administration, Oral , Adrenal Cortex Hormones/therapeutic use , Dimethisterone/administration & dosage , Dimethisterone/therapeutic use , Drug Therapy, Combination , Ethynodiol Diacetate/administration & dosage , Ethynodiol Diacetate/therapeutic use , Female , Humans , Hydroxyprogesterones/administration & dosage , Hydroxyprogesterones/therapeutic use , Injections, Intramuscular , Medroxyprogesterone/administration & dosage , Medroxyprogesterone/therapeutic use , Neoplasm Metastasis , Norethindrone/administration & dosage , Norethindrone/therapeutic use , Norpregnanes/administration & dosage , Norpregnanes/therapeutic use , Progesterone/administration & dosage , Prolactin/physiology , Recurrence , Uterine Neoplasms/surgery , UterusSubject(s)
Estradiol Congeners/pharmacology , Follicle Stimulating Hormone/metabolism , Hypothalamus/drug effects , Luteinizing Hormone/metabolism , Progesterone Congeners/pharmacology , Administration, Oral , Chlormadinone Acetate/administration & dosage , Chlormadinone Acetate/pharmacology , Dimethisterone/administration & dosage , Dimethisterone/pharmacology , Drug Combinations , Ethinyl Estradiol/administration & dosage , Ethinyl Estradiol/pharmacology , Female , Humans , Mestranol/administration & dosage , Mestranol/pharmacology , Norgestrel/administration & dosage , Norgestrel/pharmacologySubject(s)
C-Reactive Protein/metabolism , Contraception , Pregnancy , Adult , Blood Protein Electrophoresis , Chlormadinone Acetate/administration & dosage , Contraceptives, Oral , Dimethisterone/administration & dosage , Female , Humans , Intrauterine Devices , Latex , Lynestrenol/administration & dosage , Maternal-Fetal Exchange , Megestrol/administration & dosage , Mestranol/administration & dosage , Microspheres , Norethindrone/administration & dosage , Pregnancy Complications/metabolismSubject(s)
Androstanes/adverse effects , Contraceptives, Oral/adverse effects , Ethinyl Estradiol/adverse effects , Progestins/adverse effects , Affective Symptoms/drug therapy , Candidiasis, Vulvovaginal/chemically induced , Contraceptives, Oral/administration & dosage , Dimethisterone/administration & dosage , Dimethisterone/adverse effects , Ethinyl Estradiol/administration & dosage , Female , Headache/drug therapy , Humans , Menstruation Disturbances/chemically induced , Menstruation Disturbances/drug therapy , Pregnancy , Time FactorsSubject(s)
Adrenal Glands/drug effects , Androstanes/adverse effects , Contraceptives, Oral/adverse effects , Hydrocortisone/blood , Pregnanes/adverse effects , Progestins/adverse effects , Androstanes/administration & dosage , Contraceptives, Oral/administration & dosage , Dimethisterone/administration & dosage , Dimethisterone/adverse effects , Ethinyl Estradiol/administration & dosage , Ethinyl Estradiol/adverse effects , Female , Humans , Ketosteroids/administration & dosage , Ketosteroids/adverse effects , Megestrol/administration & dosage , Megestrol/adverse effects , Pregnancy , Pregnanes/administration & dosage , Progestins/administration & dosage , Time FactorsSubject(s)
Androstanes/administration & dosage , Contraceptives, Oral/administration & dosage , Ethinyl Estradiol/administration & dosage , Pregnanes/administration & dosage , Progestins/administration & dosage , Adolescent , Adult , Age Factors , Breast/drug effects , Cardiovascular System/drug effects , Central Nervous System/drug effects , Contraceptives, Oral/adverse effects , Contraceptives, Oral/pharmacology , Digestive System/drug effects , Dimethisterone/administration & dosage , Dimethisterone/adverse effects , Dimethisterone/pharmacology , Epithelium/drug effects , Ethinyl Estradiol/adverse effects , Ethinyl Estradiol/pharmacology , Female , Humans , Megestrol/administration & dosage , Megestrol/adverse effects , Megestrol/pharmacology , Menstruation/drug effects , Middle Aged , Parity , Respiratory System/drug effects , Skin/drug effects , Vagina/drug effectsABSTRACT
PIP: A study on sequential ovulation inhibiting pill, 5048-1Z(Oracon), with the following preparation --16 white tablets, each containing .1 mg ethinyl estradiol and 5 colored tablets each with the same does of ethinyl estradiol plus 25 mg dimethisterone--is presented. Another group of patients received a more potent and newer orally effective progestin, megestrol acetate, the tablets being the same except instead of 25 mg dimethisterone in the last 5 tablets there were 5 mg of megestrol acetate. A third group received the megestrol acetate formulation but the dose was reduced to 2.5 mg and then to 2 mg megestrol acetate. The sequential regimen more closely resembles the physiologic hormonal pattern. The Oracon preparation with 25 mg dimethisterone was effective in fertility control. The formulation with megestrol acetate in both dose forms was found to be effective for the inhibition of ovulation and control of conception. Breakthrough bleeding and missed menstrual periods were uncommon with the sequential regimen.^ieng
