RESUMEN
A multicenter, prospective, open-label postmarketing surveillance study examined to what extent 2-month oral hormone replacement therapy (estradiol valerate and levonorgestrel; Klimonorm) could produce changes in psychosomatic well-being, self esteem and cognitive capabilities in 78 peri- and postmenopausal women. The women included were 42-58 years of age and had approached the physician due to climacteric symptoms. The following tests were used: Kupperman index, Menopause Rating Scale (MRS II), General Depression Scale (ADS), Zerssen's Symptom List (B-L), Frankfurt Self-Concept Scales (FSAL, FSAP, FSEG, FSSW), Digit Symbol Substitution Test (DSST), d2 Test of Attention and Number Square Test. The results showed a clear improvement in subjective psychosomatic well-being and improvements to a lesser extent in the concentration and cognitive capabilities in women in the third treatment cycle.
Asunto(s)
Climaterio/efectos de los fármacos , Cognición/efectos de los fármacos , Estradiol/análogos & derivados , Terapia de Reemplazo de Hormonas/psicología , Levonorgestrel/uso terapéutico , Posmenopausia/efectos de los fármacos , Premenopausia/efectos de los fármacos , Autoimagen , Administración Oral , Adulto , Depresión/tratamiento farmacológico , Combinación de Medicamentos , Estradiol/uso terapéutico , Femenino , Humanos , Persona de Mediana Edad , Posmenopausia/psicología , Premenopausia/psicología , Vigilancia de Productos Comercializados , PsicometríaRESUMEN
The political changes in the GDR and the unity of Germany give the women the possibility of deciding for tubal sterilization as a method of contraception that was restrictively used in the GDR. This investigation analysis the psychosocial and medical factors influencing the women in their decision for sterilization. 103 women were interviewed with a questionnaire before they underwent tubal sterilization in a great medical center in Sachsen-Anhalt. The findings known in the literature regarding the satisfied after sterilization were discussed. However the sterilization is an intervention that should be thought over carefully.
Asunto(s)
Comparación Transcultural , Esterilización Tubaria/estadística & datos numéricos , Aborto Inducido/estadística & datos numéricos , Adulto , Conducta Anticonceptiva , Femenino , Alemania , Conocimientos, Actitudes y Práctica en Salud , Humanos , Persona de Mediana Edad , Paridad , Esterilización Tubaria/psicologíaRESUMEN
Fifty eight fertile female volunteers between 20 to 45 years were enrolled in a clinical trial to evaluate the efficacy and tolerance of the progestin dienogest (17 alpha-cyanomethyl-17 beta-hydroxyestra-4,9-dien-3-one, VEB Jenapharm Jena GDR) as a postcoital contraceptive. An oral dose of 2 mg dienogest was administered immediately after each coitus. The 58 women reported 872 intercourses during 302 cycles. Frequency of ingestion was on average 3 times per cycle. Pregnancy occurred in 14 women corresponding to a Pearl-index of 55.6. The observed pregnancy rate referring to all intercourses was 1.6 per cent. The incidence of expected pregnancies in relation to the coital exposures was 4.04 per cent. As a result the risk of pregnancy was reduced 2.5 times by dienogest. Menstrual disorders occurred in 18.9 per cent in regard of the total numbers of cycles. The results and an overview of literature suggest that neither dienogest nor other progestins are suitable as a sole contraceptive method when used as a postcoital agent. They are only indicated as a risk-reducing method after so-called "contraceptive emergencies".
Asunto(s)
Anticonceptivos Hormonales Poscoito , Anticonceptivos Poscoito , Nandrolona/análogos & derivados , Adulto , Ensayos Clínicos como Asunto , Femenino , Humanos , Ciclo Menstrual/efectos de los fármacos , Persona de Mediana Edad , Nandrolona/administración & dosificación , Nandrolona/efectos adversos , EmbarazoRESUMEN
To examine levonorgestrel as a postcoital contraceptive, 77 women received an oral dose of 0.4 mg per coitus for 1011 cycles and 27 women were administered 0.75 mg per coitus for 226 cycles. In the first dose group seven women became pregnant (Pearl's index 8.3), while two pregnancies resulted in the second group, one of the latter because of faulty drug intake (uncorrected Pearl's index 10.6; corrected Pearl's index 5.3). Menstrual irregularities (chiefly break-through bleedings and oligomenorrhea) were observed in 84.4% and 88.9% of the women, respectively. The number of cycle disorders increased with increasing intake rate and diminished when the drug was applied in excess of six months. The experiments undertaken to test the mechanisms of action indicated an influence on both cervical factor and endometrium, whereas the occurrence of LH-peaks and biphasic basal body temperature patterns suggested the presence of ovulations. Application of levonorgestrel for postcoital contraception failed to be a reliable routine method of hormonal contraception because of insufficient efficacy and considerable menstrual irregularities. The drug should be administered only after unprotected sexual intercourse as might happen, to women with very low frequency of intercourse, or in periods of reduced fertility.
Asunto(s)
Anticonceptivos Hormonales Poscoito/uso terapéutico , Anticonceptivos Poscoito/uso terapéutico , Norgestrel/uso terapéutico , Adolescente , Adulto , Anticonceptivos Orales Combinados/efectos adversos , Anticonceptivos Orales Combinados/uso terapéutico , Anticonceptivos Hormonales Poscoito/efectos adversos , Esquema de Medicación , Implantación del Embrión/efectos de los fármacos , Femenino , Hormona Folículo Estimulante/sangre , Humanos , Levonorgestrel , Hormona Luteinizante/sangre , Menstruación/efectos de los fármacos , Norgestrel/efectos adversos , Embarazo , RiesgoRESUMEN
PIP: The gynecologic department of the Magdeburg Medical Academy has a special clinic where adolescents can come for sex, contraception, and abortion counseling. Current life-style has increased sexual behavior among adolescents; age of menarche comes earlier (12.6 yrs); cohabitation occurs at an earlier age. With increase in heterosexual activities comes increase in unwanted pregnancy and venereal diseases. The clinic engages in personal and group counseling on all aspects of sex life, family life and planning, and contraceptive methods. In the past 10 years 18,000 adolescents between the ages of 14 and 17 have been counseled. Of these, 610 subjects were counseled in the contraceptive clinic. Timely use of contraceptives by adolescents is still inadequate: only 12.8% of these girls used contraception before 1st sexual relations (10.5% hormonal, 2.3% diaphragm); 12.6% had a pregnancy before 1st contraceptive use of which 88.3% had an abortion. The question of side effects of oral contraceptives in adolescents concerns: 1) growth suppression - this is not likely because growth after menarche is usually no more than about 6 cm; 1) thromboembolism - there are few predisposing factors in adolescents, except in those who smoke; and 3) endocrinological problems - it is important that a stable biphasic ovulatory cycle exists; the risk of postpill amenorrhea must be considered. The minipill (progestin only) is prescribed to those with menstrual irregularities; sequential contraceptives (Ovosiston) to those with stable biphasic cycles before age 16; combination contraceptives (Minisiston) to those with stable cycles after age 16. With contraindications to the pill, the use of IUDs is considered after careful history taking in relation to earlier endometritis and/or adnexitis. Other methods such as rhythm methods or mechanical barriers are also considered. The most important aspect in contraceptive and sexual counseling of adolescents is an open and individualized approach.^ieng
Asunto(s)
Anticoncepción , Consejo , Servicios de Planificación Familiar , Educación Sexual , Adolescente , Adulto , Factores de Edad , Femenino , Alemania Oriental , Humanos , MasculinoRESUMEN
The experiences of out-of-school sexual education with about 5000 youths in the district of Magdeburg are reported. The joining of a strange educator, e. g. a physician, in sexual-ethical education is always unfavourable when this is the only form of influence on youths. But at present it is still necessary to do so because of the lack of a sufficient and continuous sexual education at school. It is important here to take part in the discussion of the problems: "friendship-love-sexuality". Discussions are more effective than lectures in the usual sense. But a special course of the talk must be observed and the youths must also get the possibility of single talks. Altogether the cycle should consist of 2 discussions: -juvenile partnership -marriage and family planning.