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At least 1,351 records · Page 75Linked to original sources
PubMed1987

A new delivery system for contraceptive steroids.

Long-acting forms of contraception that take advantage of the tissue compatibility of silicone rubber, a polymer of dimethylsiloxane, have been developed. The most advanced type of subdermal contraceptive capsule contains about 36 to 40 mg of levonorgestrel and is 30 mm in length and 2.4 mm in diameter (Norplant). The set of six implants is placed under the skin of the upper arm with a 10-gauge trocar with the use of a local anesthetic. The basis for the antifertility effect of these implants is continuous, low-dose progestogen therapy without the use of estrogen. The capsules release a total of approximately 39 micrograms of levonorgestrel each day. The blood progestogen level achieved through this microabsorption delivery system is 0.25 to 0.3 ng/ml. There is a sufficient supply of steroid in the capsules to maintain this blood progestogen level for 5 to 6 years. Since the capsules can be removed at any time, this contraceptive method is voluntarily reversible. The effectiveness of these subdermal implants has been evaluated in long-term studies that have progressed for well over 5 years. Therefore one clinic visit eliminates nearly 2000 days of concern over having to remember to take a pill on schedule. There has been sufficient experience to assure that fertility recurs promptly after removal of the subdermal implants.

Clinical Trials as Topic↗
PubMed1981

Oral contraceptives and postmolar trophoblastic disease.

One hundred patients, managed for molar pregnancy at the New England Trophoblastic Disease Center, were selected at random to determine if the contraceptive method following molar evacuation influenced the incidence of postmolar trophoblastic disease. Following molar evacuation, 58 (58%) patients used oral contraceptives and 42 (42%) patients used barrier methods (foam, condom, and/or diaphragm). Postmolar trophoblastic disease developed in 11 (18.9%) patients using oral contraceptives and in 6 (14.3%) patients using barrier methods (P greater than .10). The mean human chorionic gonadotropin (hCG) regression time after molar evacuation was 7.0 weeks in patients using oral contraceptives and 7.2 weeks in patients using barrier methods. The 2 groups of patients were comparable in age, gravidity, molar histology, pretreatment hCG titers, and exposure to prophylactic chemotherapy. Oral contraceptives do not appear to increase the risk of postmolar trophoblastic tumors and therefore may be safely prescribed after molar evacuation during the entire interval of gonadotropin monitoring.

Adolescent↗
PubMed1999

A comparative study of two contraceptive vaginal rings releasing norethindrone acetate and differing doses of ethinyl estradiol.

Two combined contraceptive vaginal rings (CVR) each releasing approximately 1 mg norethindrone acetate (NET-Ac) and either 20 micrograms or 15 micrograms ethinyl estradiol over 24 h were tested at three clinic sites in Los Angeles, San Francisco, and Sydney. A total of 61 women were enrolled to use the ring on a schedule of 3 weeks in/1 week out for four treatment cycles. Serum estradiol, progesterone, norethindrone (NET), and ethinyl estradiol (EE) levels were assayed twice weekly in all four treatment cycles. Both CVR performed well, with no pregnancies occurring and only one cycle of luteal activity suggestive of ovulation (serum progesterone > 32 nmol/L) occurring with each ring (0.9% of cycles with the 1/15 ring and 1.2% of cycles with the 1/20 ring). Although there was significantly more luteal activity in women using the 1/15 CVR (5.9% compared with 1.2% of cycles), only three cycles with a marked degree of luteal activity (progesterone > 10 nmol/L) occurred among compliant women. Serum levels of NET and EE were consistently elevated during use of both rings. There was no significant difference between serum levels with the two rings because of wide interindividual variations, although both NET and EE levels tended to be higher with the 1/20 ring. However, there was a significant difference in EE levels between the women in Los Angeles and Sydney using the same dose rings. Total cholesterol, HDL, and LDL cholesterol values were not significantly changed during treatment. Triglycerides increased but remained within the normal range. Overall cycle control was good with both formulations, but there was slightly more cycle disturbance with the lower dose ring. There was no change in mean body weight during the study, and individual weight changes appeared to be idiosyncratic. Side effects were infrequent and similar to those reported with other steroidal contraceptive methods. Three women complained of vaginal discharge, one with accompanying itch and one with a vaginal Candida infection in cycle 1. Overall, both of these EE/NET-Ac rings performed well, with only minor and mainly nonsignificant differences in effect on serum EE, NET, E2, and progesterone levels and lipids, and on vaginal bleeding patterns.

Adolescent↗
PubMed1988

Epidemiological studies of natural family planning.

The prevalence of the use of natural family planning (NFP) can be estimated from sample surveys of married women in the reproductive ages (MWRA). Surveys in developed and developing countries during the past decade indicate that the prevalence of NFP use varies from 0 to 11%. In addition, if one considers NFP use in relation to other contraceptive methods, the percentage of all current contraceptors who use NFP varies from 1 to 35%. This suggests that NFP is an important method in certain countries. Pregnancy rates for NFP vary widely, but most reliable studies report 1-year life-table pregnancy rates between 10 and 25/100 woman-years. The Billings ovulation method consistently has higher pregnancy rates than the sympto-thermal method and NFP users generally have among the highest pregnancy rates compared to other methods. The major safety issue concerning NFP is the risk of adverse pregnancy outcomes associated with aged gametes. There are suggestions from a number of investigations that conceptions distant from ovulation have a higher risk of spontaneous abortion and a higher proportion of male births. The findings with respect to birth defects or multiple pregnancies are less consistent, although some studies have reported an increased risk of chromosomal anomalies.

Abortion, Spontaneous↗
PubMed1990

Cardiovascular death among women under 40 years of age using low-estrogen oral contraceptives and intrauterine devices in Finland from 1975 to 1984.

From 1975 to 1984, there were 1,585,000 women-years of oral contraceptive use and 1,975,000 women-years of copper-bearing intrauterine device use in Finland. During this 10-year period, 20 women between 15 and 39 years of age died of pulmonary embolism, 41 of coronary heart disease, and 311 of intracranial hemorrhage. The diagnoses were confirmed in 89% at necropsy examination. The contraceptive method used by patients was determined in 84% by means of inquiry sent to family planning clinics. Among the 20 patients who died of pulmonary embolism, four died while taking the pill, which gives a relative risk of 1.2 (95% confidence limits, 0.37 to 3.62; p = 0.78). The corresponding values for death from myocardial infarction and intracranial hemorrhage were 0.19 (95% confidence limits, 0.05 to 0.70; p = 0.01) and 0.36 (95% confidence limits, 0.18 to 0.70; p = 0.03), respectively. None among the copper intrauterine device users under the age of 40 years died of pulmonary embolism during 1,383,000 women-years of intrauterine device use. The relative risk of death from intracranial hemorrhage among intrauterine device users was 1.18 (95% confidence limits, 0.70 to 1.99, p = 0.25).

Adolescent↗
PubMed1986

Five years' experience with levonorgestrel-releasing IUDs.

Two levonorgestrel-releasing IUDs and a copper-releasing IUD of the same shape were studied in a randomized comparative study over five years. The levonorgestrel-releasing IUDs released 20 micrograms or 30 micrograms per day. The Pearl index during the 10,600 woman-months of LNG-IUD use was 0.11. The control device releasing copper had a Pearl index of 1.6. The amount and duration of menstrual bleeding was greatly reduced, leading to a high incidence of oligo- or amenorrhea. The continuation rate in this pioneer trial was 53 per 100 users for the levonorgestrel-releasing IUD (LNG-IUDs) and 50 per 100 users for the copper-releasing IUD (Nova T). The removal rates for reasons other than amenorrhea were not significantly different. Discontinuation because of amenorrhea occurred during the first two years, the cumulative termination rate for this reason was 11.6 per 100 users at five years. The LNG-IUDs removed for investigation after five years of use revealed that the devices contained about 40 percent of the original load. The effective lifespan of the device has been demonstrated by this study to be five years; the residual steroid gives an additional safety period of two more years. The LNG-IUD is a highly effective reversible contraceptive method, which strongly reduced the amount and duration of bleeding. During the first two months there is scanty but frequent spotting which, like the high incidence of oligo- and/or amenorrhea, requires counselling of health personnel and women using LNG-IUDs.

Adult↗
PubMed1984

IUD-induced changes in cervical secretion content of albumin, IgG and complement C3c.

Cervical secretion albumin, IgG, complement C3c, spinnbarkeit and amount of wet weight mucus recovered were analyzed in a group of 13 women using IUD as a contraceptive method and the results were compared to those obtained in a control group. Significant differences were obtained when concentrations and amounts of soluble proteins in the respective groups were compared, but spinnbarkeit and amount of wet weight mucus recovered were not affected by the presence of the IUDs.

Adult↗