RESUMEN
PIP: Medroxyprogesterone acetate injections (Depo-Provera) were given to 625 women at 3 monthly intervals involving 693 episodes. Ages at entry to the study ranged from 15-51 years with the majority in their 20s and a mean age of 30. Length of exposure ranged from 3-168 cycles. 4 women have received more than 160 continuous cycles of DMPA. Of the medication-induced reasons for discontinuing DMPA, bleeding was the most common with an incidence of 10.5% followed by depression (1.4%), weight gain (1.4%), and loss of libido (1.6%). No patient ceased treatment because of headaches, recurrent vaginal infections, mastalgia, nausea, chloasma, hypertension, or other vascular illnesses. The 59 women who move away or were lost to follow-up accounted for 405 cycles of treatment. The solitary unplanned pregnancy occurred in a 28-year-old obese woman who had previously had other method failures, once with an IUD and once with oral contraceptives (OCs). No association was found with carcinoma of the cervix. Of 80 women ceasing treatment to become pregnant, only 1 women has required the assistance of chlomiphene and conceived 2 years after ceasing DMPA. Amenorrhea was the side effect most appreciated by the women using DMPA. Due to the problem of irregular bleeding, it is wise to warn prospective patients about the lack of bleeding control that they have 1 chance in 10 of having relative menorrhagia. Women using OC subject to frequent vaginal moniliasis had a marked reduction in episodes after switching to DMPA. Chloasma, 1 of the minor stigmas of OC, was not induced in any of the patients. DMPA is a safe and efficient reversible method of contraception for women who have various gynecological conditions or problems associated with using OCs.^ieng
Asunto(s)
Anticonceptivos Femeninos , Medroxiprogesterona/análogos & derivados , Adolescente , Adulto , Anticonceptivos Femeninos/efectos adversos , Preparaciones de Acción Retardada , Femenino , Humanos , Inyecciones , Medroxiprogesterona/efectos adversos , Acetato de Medroxiprogesterona , Persona de Mediana Edad , EmbarazoRESUMEN
The frequency of cervical cytology screening in a group of 1966 women in an Australian setting is presented. Of women "at risk" of carcinoma of the cervix, 91-8% have had at least one previous cervical Papanicolaou (Pap) smear examination. Of the women who had never had a previous smear examination, 19-8% were taking oral contraceptives and 58% were parous.
Asunto(s)
Cuello del Útero/patología , Tamizaje Masivo/estadística & datos numéricos , Neoplasias del Cuello Uterino/prevención & control , Adulto , Anciano , Australia , Femenino , Humanos , Persona de Mediana Edad , Paridad , EmbarazoRESUMEN
PIP: A letter in response to the withdrawal of Serial C from the commercially available oral contraceptive range is presented. Its usage as a pharmaceutical benefit far exceeded the quantity required if it had been used solely for the restricted indications on its listing. The author's compromise, enabling a patient to receive estrogenic effect utilizing only 50 mcg of ethinyl estradiol, has to date a total failure rate of only 9 pregnancies in 12,000 completed cycles. Indiscriminate use of high doses of unopposed estrogen in unsupervised premenopausal and postmenopausal women may lead to complications in susceptible subjects, however, this should not lead to rejection of the benefits of estrogen therapy to those women clinicaly deemed to benefit from such treatment.^ieng
Asunto(s)
Anticonceptivos Orales Combinados/efectos adversos , Anticonceptivos Secuenciales Orales/efectos adversos , Anticonceptivos Orales/efectos adversos , Estrógenos/efectos adversos , Femenino , HumanosRESUMEN
A 12-week double-blind trial involving 50 patients from a suburban general practice showed a highly significant loss of weight in the group taking 2 mg of mazindol (Sanorex) per day.
Asunto(s)
Indoles/uso terapéutico , Mazindol/uso terapéutico , Obesidad/tratamiento farmacológico , Adulto , Ensayos Clínicos como Asunto , Medicina Familiar y Comunitaria , Humanos , PlacebosAsunto(s)
Anticonceptivos Secuenciales Orales/administración & dosificación , Anticonceptivos Orales/administración & dosificación , Etinilestradiol/administración & dosificación , Megestrol/administración & dosificación , Ovulación/efectos de los fármacos , Australia , Combinación de Medicamentos , Evaluación de Medicamentos , Femenino , HumanosRESUMEN
Various progestogens were given to postmenopausal and premenopausal women. The first group consisted of 46 postmenopausal patients and in the postmenopausal atrophic smear, 17 acetoxyprogestogens produced no effect. However, the administration of two 19 nortestosterone derivatives, ethynodiol diacetate and norethisterone increased the Karyopyknotic Index and degree of proliferation of the epithelium, presumably due to their estrogenic metabolites. Low grade hypotrophic smears, consisting of parabasal and intermediate cells, reacted by a decrease in the size of the intermediate cells associated with clumping, and a disappearance from the smear of parabasal cells. In the case of ethynodiol diacetate, its estrogenic effect of elevating the Karyopyknotic Index occurred before the progestogenic effect of clumping and fusing of the intermediate cells. The second group consisted of 370 women using an oral form of sequential contraception, based on administration of 0.05 mg ethinyl estradiol daily for three weeks followed by a combined oral contraceptive containing the same amount of estrogen with varying progestogens for a further week. The anti-estrogenic effect of the various progestogens was then compared by their ability to lower the Karyopyknotic Index. This levelled out after four or five tablets. The most potent progestogen was d-norgestrel in the lowest dose of 0.25 mg and this compound exerted a greater effect than 4 mg norethisterone, 1 mg ethynodiol diacetate or 4 mg megestrol acetate.