scholarly journals Observational Study for Adverse Effects and Discontinuation with Long-Term Post-Operative Hormonal Treatment for Endometriosis in Real-World Practice

2021 ◽  
Vol 36 (2) ◽  
pp. 116-124
Author(s):  
In Hye Kim ◽  
Hyungjoon Yoon ◽  
Hyun Joo Lee ◽  
Hye Kyung Noh ◽  
Jong Kil Joo ◽  
...  
Keyword(s):  
Side Effects ◽  
Oral Contraceptives ◽  
Medical Records ◽  
Ethinyl Estradiol ◽  
Hormonal Treatment ◽  
Recurrence Rates ◽  
Continuous Administration ◽  
Combined Oral Contraceptives ◽  
The Mean

Objectives: To evaluate the side effects and causes of discontinuation of either combined oral contraceptives or dienogest (DNG) used to prevent recurrence in patients with surgically confirmed endometriosis.Methods: We retrospectively analyzed the medical records of 213 women with endometriosis who had been treated with combined oral contraceptives (ethinyl estradiol 0.02 mg/drospirenone 3 mg [EE/DRSP]) or DNG 2 mg for 12 months or more. The side effects reported by the patients, laboratory parameters, causes of discontinuation of medication, and recurrence rates were evaluated one, two, three, four, and five years after starting medication (Y1, Y2, Y3, Y4, and Y5).Results: EE/DRSP were administered to 59 patients, while DNG was administered to 154 patients. The mean durations of postoperative use of EE/DRSP and DNG were 44.5 ± 22.6 months and 23.6 ± 13.5 months, respectively. The prevalence of side effects was 27.1%, 19.0%, 10.0%, 10.5%, and 7.4% in the EE/DRSP group and 29.2%, 15.7%, 14.0%, 23.1%, and 0.0% in the DNG group at Y1, Y2, Y3, Y4, and Y5, respectively. The discontinuation rates were 1.7%, 1.7%, 4.0%, 0.0%, and 7.4% at Y1, Y2, Y3, Y4, and Y5, respectively, in the EE/DRSP group and 10.4%, 3.3%, 4.0%, 3.8%, and 0.0% at the same times in the DNG group. The recurrence rates were less than 4% in both the groups.Conclusions: The side effects of commonly prescribed postoperative hormone treatments were relatively mild, and the occurrence of side effects decreased with continuous administration. Further, the long-term use of postoperative hormone treatments is likely to prevent recurrence of endometriosis after surgery.

scholarly journals Long-Term Effect of Endoscopic Sympathetic Nerve Reconstruction for Side Effects after Endoscopic Sympathectomy

2016 ◽  
Vol 65 (06) ◽  
pp. 484-490 ◽  
Author(s):  
Timo Telaranta ◽  
Tuomo Rantanen
Keyword(s):  
Side Effects ◽  
Sympathetic Nerve ◽  
Nerve Reconstruction ◽  
Endoscopic Thoracic Sympathectomy ◽  
Thoracic Sympathectomy ◽  
Long Term Effect ◽  
Primary Hyperhidrosis ◽  
The Mean

Background Endoscopic thoracic sympathectomy (ETS) is an effective treatment for primary hyperhidrosis. However, compensatory sweating (CS) may occur in many patients. Sympathetic nerve reconstruction (SNR) can be used to counteract severe CS, but the studies on the effects of SNR are few. Patients and Methods Nineteen out of 150 SNR patients were contacted by employing a long-term questionnaire. In this questionnaire, different kinds of sweating were evaluated using a four-graded symptom analysis and the visual analog scale before ETS, after ETS, and after SNR. Results The mean age of the 16 male and 3 female patients at the SNR was 32 years. The mean follow-up was 87 months. According to the long-term questionnaire, the benefit was either excellent (4 patients, 21%), good (3 patients, 15.8%), or reasonable (7 patients, 36.8%) in 14 patients (73.8%), while the benefit was questionable in 1 patient (5.3%). For three patients (15.8%), no benefit was found, and in one patient (5.3%), the situation had deteriorated. Conclusions Improvement in the side effects of ETS after SNR was found in nearly 75% of the patients. This indicates that SNR can be considered as an alternative treatment for patients with severe CS after ETS that is unresponsive to conservative treatment.

Quantitation of Albumin and Alpha-1-Acid Glycoprotein in Human Cervical Mucus

1991 ◽  
Vol 10 (2) ◽  
pp. 137-139 ◽  
Author(s):  
I.G. Salas Herrera ◽  
R.M. Pearson ◽  
P. Turner
Keyword(s):  
Oral Contraceptives ◽  
Genital Tract ◽  
Female Genital Tract ◽  
Cervical Mucus ◽  
Combined Oral Contraceptives ◽  
Acid Glycoprotein ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Female Genital

1 Concentrations of albumin and alpha-1-acid glycoprotein (AGP) in human cervical mucus have been measured by a radial immunodiffusion technique. 2 The cervical mucus samples were obtained from women on combined oral contraceptives (Group A) and from women not taking this medication (Group B). In group A the mean level of albumin was 75.6 (range 22-198) mg 1-1 and for AGP 6.5 (range 3-12) mg 1-1. In group B the mean level of albumin was 72.9 (range 22-148) mg 1-1 and for AGP 6.6 (range 3-14) mg 1 -1. 3 The levels of albumin and AGP in cervical mucus were less than 1% of the concentration in serum and were not affected by combined oral contraceptives. 4 The clinical and toxicological consequences of these observations, in terms of the disposition of drugs and other chemicals in the female genital tract, await elucidation.

Combined oral contraceptives and treatment of new coronavirus infection (COVID-19): aspects of drug interactions

2021 ◽  
Vol 19 (1) ◽  
pp. 149-158
Author(s):  
O.A. Limanova ◽  
◽  
L.E. Fedotova ◽  
O.A. Gromova ◽  
◽  
...  
Keyword(s):  
Drug Interactions ◽  
Oral Contraceptives ◽  
Ethinyl Estradiol ◽  
Antihypertensive Drugs ◽  
Efficacy And Safety ◽  
Antiinflammatory Drugs ◽  
Combined Oral Contraceptives ◽  
Chlormadinone Acetate ◽  
Coronavirus Infection ◽  
Oral Hypoglycemic Drugs

This article discusses the problem of drug interactions between combined oral contraceptives on the example of Belara® (30 μg of ethinyl estradiol + 2 mg of chlormadinone acetate; Gedeon Richter, Hungary) and medications recommended for the treatment of new coronavirus infection (COVID-19) and concomitant disorders at the pharmacodynamic and pharmacokinetic levels with an assessment of the efficacy and safety of therapy for females. We described safe, potentially dangerous, and dangerous combinations of these drugs. Key words: new coronavirus infection (CAVID-19), combined oral contraceptives, antiviral drugs, antibacterial drugs, antiinflammatory drugs, anticoagulants, migraine drugs, antihypertensive drugs, oral hypoglycemic drugs, essential micronutrients, pharmacodynamic and pharmacokinetic interactions

More Contraindications to the Pill

PEDIATRICS ◽  
1980 ◽  
Vol 66 (4) ◽  
pp. 644-645
Author(s):  
Janet P. Realini
Keyword(s):  
Oral Contraceptives ◽  
Animal Studies ◽  
Ethinyl Estradiol ◽  
Combined Oral Contraceptives ◽  
Excellent Review ◽  
Ovulation Inhibition ◽  
Relative Potencies

I read with interest the excellent review by Drs Greydanus and McAnarney.1 Several of their points concerning combined oral contraceptives deserve discussion, however. The relative potencies of the progestins and estrogens contained in oral contraceptives are controversial. Progestin potency is difficult to measure reliably, and comparisons among progestins can be misleading.2 While animal studies have suggested that mestranol is a weaker estrogen than ethinyl estradiol, a study of human ovulation inhibition suggested that ethinyl estradiol may be weaker than mestranol.3

SPECIAL REQUIREMENTS FOR TOXICITY TESTING OF ORAL COMPOUNDS ADMINISTERED CONTINUOUSLY OR CYCLICALLY

1974 ◽  
Vol 77 (1_Suppla) ◽  
pp. S387-S408 ◽  
Author(s):  
G. A. Overbeek ◽  
H. W. Hornstra ◽  
E. B. van Julsingha ◽  
J. P. Mumford ◽  
I. Zayed
Keyword(s):  
Side Effects ◽  
Oral Contraceptives ◽  
Predictive Value ◽  
Animal Studies ◽  
Toxicity Testing ◽  
Prolonged Treatment ◽  
Safety Studies ◽  
Short And Long Term ◽  
Dose Levels

ABSTRACT The authors feel that several reasons exist for considering contraceptives as a special class of drugs, which therefore require special safety studies. Apart from the usual short and long term studies, particular attention should be paid to the reversibility of the induced infertility, and to its possible consequences for subsequent offspring. A possible risk of damage to the foetus is partially outweighed by the low risk of pregnancy during the treatment periods with oral contraceptives. The procedures used in the Organon laboratories are briefly described. Principles on which we base the choice of dose levels and the duration of the various studies are discussed. The paucity of available data from toxicity studies in animals has prevented the presentation of a summary allowing an appraisal of the predictive value of the current methods in toxicology. Nevertheless, a few examples are given which demonstrate the need for more predictive methods. The present lack of knowledge on side effects in humans after prolonged treatment with oral contraceptives has created a feeling of uneasiness. This in its turn has resulted in some excessive regulatory requirements for very long term animal studies. In our opinion, the predictive value of these studies is extremely low because of the inadequacy of the available animal models. More value can be attached to the monitoring of side effects in humans and efforts in this direction should be increased. The Organon system of monitoring the side effects of its marketed preparations is briefly described. It is not considered feasible to standardize regulatory toxicity requirements for the time being, which should not prevent us from aiming at reasonable, more generally accepted methods of study.

Hemangiopericytoma of the Nasal Cavity: A Review of 15 Cases over a 40-Year Period

1992 ◽  
Vol 6 (6) ◽  
pp. 203-209 ◽  
Author(s):  
Kenneth V. Hughes ◽  
Michael C. Bard ◽  
Jean E. Lewis ◽  
Jan L. Kasperbauer ◽  
George W. Facer
Keyword(s):  
Local Recurrence ◽  
Nasal Cavity ◽  
Paranasal Sinuses ◽  
Clinical Course ◽  
Recurrence Rates ◽  
Long Term Follow Up ◽  
Vascular Origin ◽  
The Mean

Hemangiopericytomas are rare tumors of vascular origin most commonly found in the extremities or retroperitoneal area. When they originate from the nasal cavity and paranasal sinuses, they tend to be less aggressive and generally do not metastasize. The term “hemangiopericytoma-like lesion” has been coined for sinonasal hemangiopericytomas that display more benign histologic and growth characteristics than do those located elsewhere. Fifteen cases of hemangiopericytoma of the nasal cavity and paranasal sinuses were reviewed over the period 1951 to 1990; included are follow-up data on cases reported earlier from this institution. The clinical course, management, and outcome was evaluated and correlated with the histologic characteristics of the tumors. The recurrence rate in our series was 13.3%; the mean follow-up was 11 years. No patients died of their disease or had evidence of metastatic disease. This clinicopathologic review suggests that sinonasal hemangiopericytomas should not be classified as “hemangiopericytoma-like” lesions; rather, they should be expected to have significant local recurrence rates with low rates of distant metastasis and mortality. Long-term follow-up is essential as there can be local recurrence after many years.

scholarly journals Effectiveness of Hormone Based Therapies (Spironolactone and Combined Oral Contraceptives in the Management of Acne Vulgaris in Women: A Systematic review and meta-analysis

2021 ◽  
pp. 42
Author(s):  
Keyword(s):  
Systematic Review ◽  
Oral Contraceptives ◽  
Meta Analysis ◽  
Acne Vulgaris ◽  
Mean Difference ◽  
Cochrane Library ◽  
Combined Oral Contraceptives ◽  
Female Patients ◽  
The Mean ◽  
Control Therapy

Background: Acne vulgaris (AV) is a chronic inflammatory disease of the pilosebaceous follicular unit that often occurs. Acne is a skin disorder that is not life-threatening but is mostly complained of because it is aesthetically disruptive, which can cause significant psychological problems for sufferers. The management of acne vulgaris in female patients has its challenges. There are many histories of failed therapy using conventional therapy, such as with antibiotics or isotretinoin, and female patients have a predisposition to the condition of androgen excess. Also, the increasing awareness about limiting the use of antibiotics to prevent resistance in dermatological cases, including acne vulgaris, encourages other treatment options in the female patient population, one of which is hormone-based therapy. A systematic review and meta-analysis were performed of randomized clinical trials assessing the effects of Hormone Based Therapies (Spironolactone and Combined Oral Contraceptives) in the management of Acne Vulgaris in Women. Methods: Medline Pubmed, Scopus, Cochrane Library, the reference list, conference proceedings, researchers in the field of eligible studies were searched. Ten studies (n=1906 sub-jects) were included in qualitative analysis, of which two studies (n=1842 subjects) were included in the meta-analysis. The age of the participant was greater than 14 years old. Intervention using combined oral contraceptives (n=8) or oral spironolactone (n=2). Duration of intervention (minimum six months for COC and three months for SL) and out-comes of mean difference number of acne vulgaris lesions before and after treatment. Results: Pooling of data using random-effects model found a significant difference in the mean difference in the number of lesions after treatment in the group receiving hormone-based therapy (spironolactone and combined oral contraceptives) and those receiving control therapy (p = 0.005). The overall mean difference was -0.890 ± 0.316. A negative value indicating the number of lesions after hormone-based therapy (spironolactone and combined oral contraceptives) was significantly lower than those receiving control therapy (p = 0.005). Conclusion: From the results of the systematic review and meta-analysis conducted, it can be concluded that in the group given hormone-based therapy (spironolactone and Combined Oral Contraceptives), there was a decrease in the total number of acne vulgaris lesions compared to before treatment, and the mean difference in the number of lesions was significantly lower after getting hormone-based therapy (spironolactone and combined oral contraceptives) compared with controls.

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