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Biomedical subjects

J Toivonen

Publications and source records attributed to J Toivonen.

62 records · Page 4Linked to original sources

The use of a contraceptive vaginal ring governed by the pattern of individual uterine bleeding.

Contraceptive vaginal rings (CVR) releasing levonorgestrel and estradiol were used for contraceptive purposes in eight women. They were instructed to remove the CVR for five days only, in the case of bleeding. Three selected subjects were followed by plasma sampling during the first 60 days of treatment. Plasma concentrations of levonorgestrel, progesterone, estradiol and gonadotropins were determined. All subjects kept bleeding records and were controlled clinically in the course of treatment. The subjects were protected an average of 163 days by the CVR. Three subjects used the CVR 170--180 days without removing it and two subjects had to remove the CVR only once. Two subjects experienced quite regular bleedings, and metrorrhagic bleeding was present in one case. No pregnancies were observed during the follow-up period of 1304 days. Clinical examination revealed no pathological findings. The vaginal mucosa tolerated the treatment well. Out of those subjects who were followed by plasma sampling, pituitary suppression was more marked in the subject with continuous use of CVR.

Adult↗

Bleeding and ovulation control with use of a small contraceptive vaginal ring releasing levonorgestrel and estradiol.

Levonorgestrel and estradiol releasing contraceptive vaginal rings (CVR) with an outer diameter of 50 mm were used by twenty women. The treatment was given in three-week cycles followed by one treatment-free week. The treatment was planned to cover six cycles. All subjects kept records of bleeding and were controlled clinically in the course of treatment. Three subjects were followed by blood sampling. Plasma levonorgestrel, estradiol, progesterone and gonadotropins were determined. The subjects experienced no difficulties in using the CVR and 90 per cent continued the treatment through the whole experimental period of six months. One subject discontinued after three cycles because of irregular bleedings and one subject after five cycles because of urinary discomfort. Regular bleedings were observed only in three subjects and in nine cases the bleeding started with the CVR in situ during the last days of the three-week treatment period. Breakthrough bleeding occurred in the remaining eight subjects. The subjective side-effects were as follows: weight gain in four subjects, oedema in one subject and urinary discomfort in one subject. Pituitary function was not generally suppressed as judged by plasma gonadotropins. Out of the three subjects studied, two experienced ovulatory plasma progesterone concentrations.

Body Weight↗

Intravaginal contraception with the synthetic progestin, R2010.

Four women used polysiloxane vaginal rings of core design containing 50 mg of norgestrienone (17 alpha-ethynyl-17 beta-hydroxy-estra-4,9,11,trien-3-one). The treatment was given in three-week cycles, leaving one treatment-free week between the cycles. The patterns of bleeding were registered and plasma norgestrienone (R2010), estradiol, progesterone, and gonadotropins were determined. Altogether twelve cycles were studied. The patterns of bleeding were unsatisfactory; only one subject had regular bleedings, and two of these were preceded by a luteal phase. The mean plasma concentration of norgestrienone (R2010) produced by the rings was 0.9 ng/ml. Ovulation was observed in 25% of cycles studied. Some follicular activity was present in every subject as judged by estradiol peaks. Excluding LH peaks in subjects who ovulated, mild pituitary suppression was achieved by this treatment. The only side-effect complained of was acne in one subject. The ring was regarded as easy to use.

Adult↗

Pituitary and gonadal function during the use of norgestrelestradiol vaginal rings.

Four women used polysiloxane contraceptive rings (CVR) impregnated with d-Norgestrel and estradiol for contraceptive purposes. The treatment was given in three-week cycles, leaving one treatment-free week between the cycles. Subjects were followed by blood sampling twice a week for three or four treatment cycles. Plasma concentrations of d-Norgestrel, estradiol, progesterone, and gonadotropins were determined by radioimmunoassay. The bleeding patterns were very acceptable. One subject experienced acne and weight gain, but no other side-effects were observed. Furthermore, no local irritation was found during the follow-up period of six or seven months. The individual variation in the mean plasma concentrations of d-norgestrel was between 3.2 and 1.1 ng/ml. Apart from one case, the highest individual levels were observed at the beginning of the first treatment cycle. Plasma estradiol was low during the treatment, but in some cases low post-insertion peaks were observed. No ovulatory progesterone values were found. Plasma LH was generally suppressed, but FSH was not. During the treatment-free week increasing concentrations of both LH and FSH were found, indicating an activation of pituitary function.

Adult↗