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Biomedical subjects

M Mall-Haefeli

Publications and source records attributed to M Mall-Haefeli.

At least 19 recordsLinked to original sources

[Clinical experience with Mercilon and Marvelon with special reference to ovarian function].

The effects of two oral contraceptive combinations either containing 0.020 mg ethynilestradiol (EE) + 0.150 mg desogestrel (Mercilon) or 0.030 mg EE + 0.150 mg desogestrel (Marvelon) were compared in two independent trials. Special attention was paid to serum levels of LH, FSH, prolactin, progesterone, testosterone, estradiol, SHBG in the first and efficacy, cycle control and tolerability in the second trial. The first trial included 71 women. Serum levels were determined in the cycle before treatment, in the third and sixth cycle of treatment and one cycle after treatment. The following difference was found: Women using the lower dosed preparation showed significantly less suppressed FSH values compared to women using Marvelon. Mean values of Estradiol and Progesterone were significantly suppressed 30% of our measurement in the lower dosed data sample showed extremely high Estradiol and Progesterone values. SHBG has increased by 200-300% and had no effect on prolactin and testosterone levels. In the second trial 781 women (5193 cycles) were evaluated. Assessment were made in the first, third and twelfth cycle of treatment. There were no marked differences between the two preparations with respect to normalisation of cycle length, bleeding duration and intensity. Differences occurred in frequencies of silent menstruation and breakthrough bleedings. They were more often by receiving 0.020 mg EE (7.7%, Mercilon) than with 0.030 mg EE (3.6%, Marvelon). With 0.020 mg EE a higher percentage of women showed body weight change. Blood pressure remained stable in both groups. Both preparations were very good tolerated with slightly more breast tenderness by taking 0.030 mg EE.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Intrauterine occlusion body (IUB). Preliminary report.

The IUB or SOF-T is a further development of the IUD with additional functions and properties. In 368 IUB insertions over a period of 48 months, there was no intrauterine pregnancy. There was a low removal rate due to bleeding, pain, infection or partial expulsion in 277 insertions performed at two university centers over an average period of 8-1/2 cycles. In 80 cases tubal occlusion was directly or indirectly proven by different methods. The improved ultrasound localisation of the IUB is possibly responsible for its effectiveness and the soft ends are probably the main reason for its improved tolerance compared to other IUDs.

Adult↗

[Prevention of pregnancy in adolescents and premenopausal females].

The norms of our society have changed in the last decades. This also concerns our general attitude towards sexuality. Professional demands on the parents, increasing material independence of adolescents, excessive exposure to external stimuli lead to sexual contacts at a very early age. Contrary to a more accelerated physical development, which manifests itself in a progressively earlier puberty, psychic development is retarded. According to numerous studies pregnancies in adolescents do not show increased somatic complications. They do, however, influence the psychic maturation of the adolescents in a negative way. Whereas the necessity for sexual education is unquestioned, the efficacy is doubtful. Knowledge of contraception and its correct use is not enough to avoid undesired pregnancies. The psychic structure of the individual may often lead to an undesired pregnancy. Therefore, we recommend for adolescents contraceptives which are reliable, without negative effect on fertility and with neglibile side-effects. The number of failures and the inconvenience realted to their use make conventional methods unacceptable. The danger of PID and the risk of later sterility contraindicate the use of IUD in adolescents. Today the method of choice is a low-dose contraceptive which contains a gestagen of the third generation. The premenopausal state is the time in which cycles become irregular and in which an increasing hormonal insufficiency is observed. Therefore, women over forty years need reliable contraception as well as hormonal substitution. Increase of cardiovascular risk was observed in women when high-dose contraceptives were given. This was obvious in the more than forty year old women taking the pill.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Contraceptive effect of low-dosage ovulation inhibitors containing various progestagen agents].

The decrease of steroid dosage in oral contraceptives resulted in a decrease of serious side effects with continued effectiveness. However, a increase in subjectively disturbing bleeding abnormalities occurred at the same time. The development of triphasic preparations was designed to eliminate these abnormal bleeding episodes by stepwise changes of the estrogen and progestagen doses. Compared to the low dosage combination preparation, triphasic preparations show often a persistence of insufficiently suppressed hormone levels in single determinations but not in mean averages of determinations. This could be an explanation for the reported pregnancies. In spite of these results, the literature reports rare failures during the administration of the triphasic preparations and additional factors could determine the contraceptive effectiveness.

Adolescent↗

[Comparative socioeconomic, anamnestic and psychological studies of patients with uterine myoma and uterine prolapse].

30 female patients with the diagnosis of "uterus myomatosus" and a control group of also 30 women with the diagnosis "descensus uteri et vaginae" were examined by a standardized questionnaire containing socio-economic, anamnestic and psychological data. To get information about their personality the "Freiburger Persönlichkeitsinventar" (Freiburg Personality Inventory), half-form A, was administered at the end of the interview. The age limits were 35 and 55 years. The main socio-economic results are the following: during childhood and adolescence the myom-patients lived mainly near towns (p less than 0,01). The women of this group have better relationships to their husbands than the descensus-patients (p less than 0,01) and the husbands of the myom-patients are more often (p less than 0,01) of the same age or younger than their women. 18 out of the 30 women of the myom-group (i.e. more than 50%) said that their wish to become a mother has not been fulfilled while this answer was given by none of the 30 descensus-patients (p less than 0,01). The question is discussed in how far the uterus-myom can be understood as a somatic expression of the frustrated wish to get a child, as a "compensatory growth". Beside this, the authors are aware of the fact that other aspects, f.e. hormonal factors, may be important.

Adult↗

[Advantages and risks of hormonal contraception].

Among modern contraceptive methods hormonal contraceptive agents, due to their reliability, are preferred. Nevertheless, it has to be considered that these steroidal hormones and their metabolites do not only possess an ovulation inhibitory effect, but that they also influence other systems, such as carbohydrate and lipid metabolism, blood clotting, fluid balance, plasma proteins as well as the entire hormonal system. These multiple side effects have positive and negative influences. By reducing the doses of estrogens and progestagens occurrence of unpleasant adverse reactions has been decreased. Some years ago, the estrogen content of oral contraceptive preparations was considered to be noxious while a favourable effect was attributed to the progestagen content. The results of biochemical studies yielded a better understanding of the effect of steroidal hormones on lipid metabolism. Fertility problems occurring after discontinuation of oral contraceptive treatment are mainly observed in women who, prior to use of oral contraceptive agents have already been suffering from functional cycle disturbances. Ovulation inhibitory preparations may also be given to adolescent girls with immature cycles. As the juvenile endocrine system is adaptable, after cessation of the ovulation inhibitory effect, the cycle returns to pretreatment patterns. It may now even be possible to administer hormonal contraceptive agents to treat endocrine disturbances.

Adult↗

[Clinical and biochemical results during the treatment with marvelon, a new oral contraceptive (author's transl)].

Marvelon was tolerated without side effects by 338 women during 2,104 cycles. Although some errors of administration were made by patients there were no pregnancies. In contradistinction to other low dosage combination oral contraceptives this new oral contraceptive has a good control of the menstrual cycle. The incidence of clinical side effects was low. An over-suppression syndrome after the discontinuation of the treatment was not observed. Hormonal assays were done in order to investigate the difficult problems of oligomenorrhoea in adolescents with oral contraception. A marked inhibition of ovulation evident by low values of pituitary ovarian hormones was found. When the treatment was discontinued the majority of the patients showed ovulation in the first post-treatment cycle.

Adolescent↗

[Internal medicine problems regarding contraception. Part I].

The increasing distaste for the "pill' is mainly due to uncritical comments disseminated by the mass media and to the rational and irrational anxieties of women. The doses of steroidal hormones in today's hormonal contraceptive agents are only a small fraction of the amounts used in the past. Consequently, the occurrence of adverse reactions is much smaller; thus, tendency to thromboembolism has decreased by more than 25% with ovulation inhibitors containing only 50 gamma of EE, and thrombotic incidents are very rare if the so-called "micropill" (30 gamma EE) is given. Hypertension is observed in 1--2.5%, but can be detected by regular blood pressure control. Glucose tolerance is dependent on the estrogen dose and the type of gestagen used. By choosing contraceptive agents with low estrogen doses in combination with a gestagen of the pregnane type, or with the so-called "minipill", the danger of glucose deterioration can be avoided. Plasma triglycerides are markedly increased. The risk of hepatic complications increases with the duration of treatment. Jaundice seems to be mainly due to C17-alkyl substituted steroids. A correlation has been assumed between episodes of pancreatitis and increased lipoprotein concentrations due to treatment with oral contraceptive agents. In contrast, they have a protective effect in rheumatoid arthritis. The absolute and relative contraindications for oral contraceptive agents are listed.

Adolescent↗