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Biomedical subjects

V Odlind

Publications and source records attributed to V Odlind.

At least 37 records · Page 2Linked to original sources
PubMed1997

Intrauterine administration of levonorgestrel 5 and 10 microg/24 hours in perimenopausal hormone replacement therapy. A randomized clinical study during one year.

OBJECTIVE: To investigate the clinical effects especially with regard to histopathology and bleeding patterns by levonorgestrel (5- or 10 microg/24 h) released from an intrauterine system (IUS) in combination with estradiol valerate (2 mg) given daily or transdermal estradiol (50 microg/24 h) in perimenopausal women. DESIGN: A prospective randomized single blind comparison during twelve months. SUBJECTS: One hundred and twelve perimenopausal women with vaso-motor symptoms. OUTCOME MEASURES: Histopathological assessment of the endometrium, ultrasonographic measurement of endometrial thickness, bleeding patterns, and acceptability. RESULTS: A total of 108 women started the study and 12 discontinued. The most common reason for discontinuation was frequent bleeding (six women). Thus, 96 (89%) women were followed for twelve months. In both the 5- and 10 microg levonorgestrel IUS groups the endometrium in all women but one was non-proliferative after twelve months and no case of hyperplasia was found. Irregular bleeding was reported during the first months of treatment but decreased after six months. At the end of the study 62% in the 5 microg- and 61% in the 10 microg group were amenorrhoic. The effects on bleeding patterns did not differ between the two levonorgestrel dosages. CONCLUSION: Continuous combined HRT was well accepted in perimenopausal women when the progestogen was given in an IUS. IUS's releasing 5- or 10 microg/24 h levonorgestrel seemed to minimize the progestogenic side effects and proved to be sufficient for effective prevention of endometrial stimulation by estrogen treatment in HRT in perimenopausal women.

Administration, Cutaneous↗
PubMed1997

Induced abortion--a global health problem.

Every year around 500,000 women are estimated to die from pregnancy-related causes, the majority in the developing world and many as a consequence of unsafe abortion. Around 25 per cent of maternal deaths in Asia and 30-50 per cent of maternal deaths in Africa and Latin America occur as a result of induced abortion. Data on abortion related maternal morbidity is less reliable than mortality but suggests that for every maternal death 10-15 women suffer significant pregnancy-related morbidity, i.e. infertility, genito-urinary problems and/or chronic pain. Induced abortion occurs in practically every society in the world but only 40 per cent of the women in the world live in countries where abortion is legally free. A permissive legislation is an important prerequisite for medically safe and early abortion. Oppositely, with a restrictive law, abortion is difficult to obtain, costly and possibly unsafe, in particular to the least affluent women in the society. Induced abortion in a developed country with legal and easy access to services is a safe procedure with hardly any mortality and very low morbidity. The best strategy to reduce the number of unsafe abortions is prevention of unwanted pregnancy. The consequences of unsafe abortion on women's health need to be acknowledged by everybody in the society in order to improve abortion care. It is necessary to adjust legal and other barriers to medically safe abortion in order to follow the declaration at the UN conference on population in Cairo, 1994, which stated that abortion, wherever legal, should be safe. It is also necessary to introduce preventive measures where abortions are performed, i.e. good and easily accessible family planning services.

Abortion, Induced↗
PubMed1996

Modern intra-uterine devices.

Modern intrauterine devices (IUDs) provide effective, safe and long-term contraception and could be recommended to most women. The mechanism of action of an IUD is still not fully understood, but most recent research suggests that copper-IUDs as well as hormone-releasing intrauterine systems (IUSs) prevent conception. In women in mutually monogamous relationships the risk of PID is low and related to the insertion procedure. IUD/IUS use should be discouraged if there is a suspicion of increased risk of sexually transmitted disease. The risk of ectopic pregnancy is extremely low if modern, highly effective IUDs/IUSs are used. Copper-IUDs increase menstrual blood loss by around 50%, whereas hormone-releasing IUSs substantially reduce menstrual blood loss. Careful patient selection and counselling are the most important tools in order to provide acceptable and safe IUD use.

Female↗
PubMed1996

Increased use of condoms among female university students: a 5-year follow-up of sexual behavior.

OBJECTIVE: To ascertain any changes in sexual behavior and attitudes as an indication of the impact of intensified information activities aiming at decreasing the risk of spread of sexually transmitted diseases among university students. METHODS: In 1989 questionnaires were offered to 275 consecutive female students visiting the Student Health Center. Identical questionnaires were mailed to 200 randomly selected women registered at Uppsala University. The study was repeated in 1994. The study was carried out in Uppsala, a city in Sweden with 27,000 university students. RESULTS: At the Student Health Center 241 (88%) participated in the study in 1989 and 262 (95%) in 1994. Corresponding figures in the postal survey were 137 (69%) in 1989 and 151 (76%) in 1994. Compared with the findings in 1989, in 1994 the sexual behavior was unchanged in terms of mean age at first intercourse (17.6 years), median number of life partners (3-4) and median number of sexual partners during the last 12 months (1), but the awareness of sexually transmitted diseases had increased. Their attitudes to using condoms had become more positive and the actual use of a condom had also increased both at the first intercourse and when changing partner, from 40 to 60%. Concerns about safety of oral contraceptives decreased significantly. CONCLUSIONS: This follow-up shows that awareness of sexually transmitted diseases and condom use had increased between 1989 and 1994, possibly as a result of intensified information efforts.

Adolescent↗
PubMed1996

Long-term experience of a levonorgestrel-releasing intrauterine system.

The levonorgestrel-releasing intrauterine system is a highly effective, long-acting, safe and reversible method of contraception, which offers additional health effects through its effects on menstruation. Long-term clinical studies have suggested a protective effect on pelvic inflammatory disease, have demonstrated that it is highly acceptable to the majority of women requesting effective contraception, and have shown that it may be used at any time throughout the fertile period and beyond.

Contraceptive Agents, Female↗
PubMed1995

Ovarian function after seven years' use of a levonorgestrel IUD.

Fifteen women with regular menstrual periods and seven amenorrheic women who had been using a levonorgestrel-releasing (LNg) IUD for more than seven years were studied. For controls, eight women using TCu380Ag IUDs for more than seven years were studied during two complete menstrual cycles. Ovarian function was assessed with hormonal determination and ultrasound examinations. The regularly menstruating women were studied for two complete menstrual cycles and the amenorrheic women for eight weeks. In the regularly menstruating LNg-IUD users, according to progesterone levels, 93% of the cycles were ovulatory but just 58% of these 'ovulatory' cycles showed normal follicular growth and rupture. Follicular cysts and luteinization of regressing follicles were observed in 42% of the 26 'ovulatory' cycles studied. SHBG capacity was decreased in the LNg-IUD users compared with the TCu380Ag users. Progesterone levels were lower in the LNg-IUD users compared with the TCu380Ag users but this difference was not statistically significant. Preovulatory estradiol and LH levels were lower in the LNg-IUD users than in the TCu380Ag users. These differences were not statistically significant. For the amenorrheic women, five had follicular cysts that disappeared spontaneously within 45 days. Two women showed follicular development and rupture. The presence of good cervical mucus was observed in 69% of the ovulatory cycles studied in the LNg-IUD users. This indicates that effects on cervical mucus cannot be the main mechanism of action of the LNg-IUDs. It is concluded that LNg-IUDs may exert a contraceptive effect in many different ways, such as inhibition of ovulation, endometrial changes preventing implantation, alteration of physical and chemical properties of cervical mucus affecting sperm transport and subtle disturbances in hypothalamic pituitary ovarian function, resulting in alterations of follicular development and rupture.

Adult↗
PubMed1995

Intrauterine administration of levonorgestrel in two low doses in HRT. A randomized clinical trial during one year: effects on lipid and lipoprotein metabolism.

OBJECTIVE: To investigate the effects on lipid and lipoprotein metabolism of two doses (5- or 10 micrograms/24 h) of levonorgestrel released from an intrauterine device (IUD) in combination with orally administered estradiol (2 mg estradiol valerate) in perimenopausal women. DESIGN: A 1-year prospective randomized single blind clinical trial. SETTING: Department of Obstetrics and Gynaecology, Ostra Hospital, Göteborg, Sweden. SUBJECTS: Fifty-one perimenopausal women with climacteric symptoms. OUTCOME MEASURES: Cholesterol in serum and in lipoprotein fractions; high-density lipoprotein (HDL), low-density lipoprotein (LDL). Triglycerides in serum and in very low-density lipoprotein. RESULTS: In both treatment groups significant elevations in HDL-cholesterol of similar magnitude were observed after 1 month and these changes were maintained during the 12 month observation period. In both treatment groups an initial significant decrease of LDL-cholesterol was observed and the decrement was maintained after 12 months. Serum levels of cholesterol decreased significantly in both groups after 1 month and were maintained after 12 months in the levonorgestrel-IUD (LNG-IUD) 5 micrograms group. However, the initial reduction of serum cholesterol in the LNG-IUD 10 micrograms group did not differ from baseline after 12 months. Serum triglyceride levels fluctuated during the observation period. No significant changes occurred. CONCLUSION: Continuous combined HRT with intrauterine administration of levonorgestrel, 5- or 10 micrograms/24 h, in perimenopausal women was observed to increase HDL-cholesterol and to decrease LDL-cholesterol compared with pretreatment values. The low doses of levonorgestrel did not reverse the beneficial effects on lipid metabolism usually seen after estradiol administration.

Administration, Oral↗
PubMed1994

Levonorgestrel-releasing and copper-releasing (Nova T) IUDs during five years of use: a randomized comparative trial.

A 20 micrograms/24 hours levonorgestrel-releasing intrauterine contraceptive device (LNG-IUD) has, in an open randomized multicenter study, been compared to the copper-releasing device Nova T during 5 years of use; 1821 women had the LNG-IUD and 937 women had the Nova T inserted. The 5-year cumulative gross pregnancy rate was 5.9% for Nova T and 0.5% for the LNG-IUD. The local effect of levonorgestrel in the uterine cavity causes reduction of menstrual blood loss and development of oligo-amenorrhea, and the termination rates because of heavy and/or prolonged menstrual flow were significantly (P < 0.001) lower among LNG-IUD users. However, the gross termination rate because of amenorrhea was 6.0 in this group. Hb increased during use of the LNG-IUD and decreased during Nova T use, and the difference between the devices was statistically significant. The incidence of pelvic inflammatory disease (PID) was low in LNG-IUD users regardless of age, whereas in the Nova T group, the PID rate was increased among the youngest women, which makes the difference between the devices significant (P < 0.01). The gross termination rate for reasons considered to be hormonal was 12.1 in the LNG-IUD group compared to 2.0 in the Nova T group (P < 0.001). The LNG-IUD is a long-acting reversible contraceptive method for 5 years with a pregnancy rate comparable to female sterilization. The incidence of PID is low even in young women. In addition, the positive health effects such as decreased menstrual blood loss and increased blood haemoglobin concentration make the LNG-IUD a favorable combination of hormonal and intrauterine contraception.

Adult↗