RESUMEN
Fifty-one hirsute women were randomly treated for nine months with ethinyl estradiol 35 ug plus norethindrone 0.4 mg or 30 ug ethinyl estradiol plus 1.5 mg norethindrone acetate if they needed contraception or spironolactone 200 mg daily if they did not. Metabolic evaluations in response to therapy demonstrated triglyceride elevations with the two oral contraceptives but not with spironolactone. While systolic blood pressure was lower with spironolactone, fasting insulin levels were higher as opposed to either low-dose oral contraceptive preparation. Ethinyl estradiol 30 ug plus 1.5 mg norethindrone acetate lowered 3-alpha-diol glucuronide levels, yet ethinyl estradiol 35 ug plus norethindrone 0.4 mg and spironolactone were more effective in lowering Ferriman-Gallwey Scores. Treatment strategies for hirsute women need to consider metabolic consequences as well as efficacy.
PIP: 51 hirsute women were randomly treated for 9 months with ethinyl estradiol (EE) 35 mcg + norethindrone 0.4 mg or 30 mcg EE + 1.5 mg norethindrone acetate if contraception was necessary or spironolactone 200 mg daily if it was not. Metabolic evaluations in response to therapy demonstrated triglyceride elevations with the 2 oral contraceptives (OCs) but not with spironolactone. While systolic blood pressure was lower with it, fasting insulin levels were higher as opposed to either low-dose OC preparation. EE 30 mcg + 1.5 mg norethindrone acetate lowered 3-alpha-diol-glucuronide levels; however, E 35 mcg + norethindrone 0.4 mg and spironolactone were more effective in lowering Ferriman-Gallwey scores. Treatment strategies for hirsute women need to consider metabolic consequences as well as efficacy.
Asunto(s)
Etinilestradiol/uso terapéutico , Hirsutismo/sangre , Hirsutismo/tratamiento farmacológico , Noretindrona/uso terapéutico , Espironolactona/uso terapéutico , Análisis de Varianza , Androstano-3,17-diol/análogos & derivados , Androstano-3,17-diol/sangre , Presión Sanguínea/efectos de los fármacos , Peso Corporal/efectos de los fármacos , HDL-Colesterol/sangre , Etinilestradiol/efectos adversos , Femenino , Humanos , Insulina/sangre , Noretindrona/efectos adversos , Espironolactona/efectos adversos , Testosterona/sangreRESUMEN
A Lippes type intrauterine device (IUD) was modified to be used for immediate postpartum insertion. In 114 patients in whom the modified IUD was inserted immediately after delivery, expulsion rates at six months averaged approximately 30%. Expulsion rates were significantly different, at p less than 0.05, for women in whom the IUD was inserted digitally (19.5 +/- 5.6% at 6 months) compared to those in whom it was inserted using surgical forceps (39.6 +/- 7.1%). Furthermore, expulsion rates were higher for inexperienced inserters (p less than 0.01). We conclude that: 1) this modification of an otherwise standard IUD has a continued high expulsion rate, and 2) the technique of insertion has significant impact upon the likelihood of expulsion.
PIP: A Lippes loop IUD was modified to be used for immediate postpartum insertion. In 114 patients in whom the modified IUD was inserted immedicately after delivery, expulsion rates at 6 months averaged approximately 30%. Expulsion rates were significantly different at P0.05 for women in whom the IUD was inserted digitally (19.5 +or- 5.6% at 6 months) compared to those in whom it was inserted using surgical forceps (39.6 +or- 7.1%). Furthermore, expulsion rates were higher for inexperienced inserters (P0.01). The authors conclude that: 1) this modification of an otherwise standard IUD has a continued high expulsion rate, and 2) the insertion technique has significant impact on the likelihood of expulsion.