RESUMEN

OBJECTIVE: To compare the efficacy and acceptability of the levonorgestrel intrauterine system and norethisterone for the treatment of idiopathic menorrhagia. DESIGN: A randomised comparative parallel group study. SETTING: Gynaecology outpatient clinic in a teaching hospital. PARTICIPANTS: Forty-four women with heavy regular periods and a measured menstrual blood loss exceeding 80 ml. METHODS: Twenty-two women had a levonorgestrel intrauterine system inserted within the first seven days of menses, and 22 women received norethisterone (5 mg three times daily) from day 5 to day 26 of the cycle for three cycles. MAIN OUTCOME MEASURES: The main outcome measure was the change in objectively assessed menstrual blood loss after three months of treatment. RESULTS: When menstrual blood loss at three months was expressed as a percentage of the control, the levonorgestrel intrauterine system reduced menstrual blood loss by 94% (median reduction 103 ml; range 70 to 733 ml), and oral norethisterone by 87% (median reduction 95 ml; range 56 to 212 ml). After three cycles of treatment 76% of the women in the levonorgestrel intrauterine system group wished to continue with the treatment, compared with only 22% of the norethisterone group. CONCLUSIONS: Both the levonorgestrel intrauterine system and oral norethisterone in this regimen provided an effective treatment for menorrhagia in terms of reducing menstrual blood loss to within normal limits. The levonorgestrel intrauterine system was associated with higher rates of satisfaction and continuation with treatment, and thus offers an effective alternative to currently available medical and surgical treatments for menorrhagia.

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PIP: The efficacy and acceptability of two new approaches to the treatment of idiopathic menorrhagia--the levonorgestrel intrauterine system and norethisterone--were compared in 45 women recruited from a gynecology outpatient clinic at a UK teaching hospital. All study participants had heavy regular periods and a measured menstrual blood loss exceeding 80 ml. 22 women were randomly assigned to have a levonorgestrel intrauterine system inserted within the first 7 days of menses and 22 women received 5 mg of norethisterone 3 times daily from day 5 to day 26 of their cycle for 3 cycles. Compared to baseline, the levonorgestrel intrauterine system reduced menstrual blood loss by 94% (median reduction, 103 ml) and oral norethisterone reduced it by 87% (median reduction, 95 ml). Recorded in both treatment groups were significant decreases in breast tenderness, mood swings, intermenstrual bleeding, and interferences in daily life caused by menstruation. After 3 treatment cycles, 64% of women in the levonorgestrel group indicated they liked the treatment "well" or "very well" and 77% elected to continue the regimen. In the norethisterone group, these rates were only 44% and 22%, respectively. Although both regimens reduced menstrual blood loss to within normal limits, the levonorgestrel intrauterine system was associated with higher satisfaction and thus offers an effective alternative to currently available medical and surgical treatments for menorrhagia.

Asunto(s)

Dispositivos Intrauterinos Medicados , Levonorgestrel/administración & dosificación , Menorragia/tratamiento farmacológico , Noretindrona/administración & dosificación , Congéneres de la Progesterona/administración & dosificación , Adulto , Femenino , Ferritinas/sangre , Hemoglobinas/análisis , Humanos , Levonorgestrel/efectos adversos , Menorragia/sangre , Menstruación , Persona de Mediana Edad , Noretindrona/efectos adversos , Satisfacción del Paciente , Congéneres de la Progesterona/efectos adversos , Resultado del Tratamiento , Hemorragia Uterina/inducido químicamente

RESUMEN

Cytokeratins 8, 18 and 19 are members of the cytoskeletal intermediate filament family found in all simple epithelia. Intermediate filaments are dynamic intracytoplasmic structures that can be influenced by a number of external factors. Norethisterone enanthate (NET-EN) is a long-acting progestogen contraceptive that has been found to arrest endometrial growth in the rat. Both Norplant and NET-EN cause bleeding problems among users which are responsible for > 50% of withdrawals with these methods. The aim of this study was to explore changes in the expression and distribution of cytokeratins 8, 18 and 19 in NET-EN- and Norplant-exposed endometrial epithelium which could be related to bleeding disturbances. Seven NET-EN and 37 Norplant endometrial biopsies were paraffin-embedded and stained immunohistochemically to evaluate cytokeratin expression and distribution. The results showed that women who had received NET-EN for 3-4 months had a cytokeratin distribution similar to that seen in the normal menstrual cycle. This is in contrast to endometrium from Norplant users in which cytokeratin expression was reduced and the epithelial cells were more rounded. No relationship between cytokeratin expression and breakthrough bleeding pattern was found. NET-EN and Norplant may act differently on endometrial epithelial cytokeratin.

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PIP: All endometrial epithelium contain the cytoskeletal intermediate filaments cytokeratins 8, 18, and 19. The aim of this study was to observe changes in the expressions of these cytokeratins in endometrial epithelial cells from Indonesian women receiving norethindrone enanthate and to compare them with the patterns of expression reported for Norplant users. Study subjects received 2 norethindrone enanthate injections (150 mg) spaced 8 weeks apart. Regardless of bleeding pattern or histopathologic finding, epithelial tissues from these 7 women stained either strongly or intensely for cytokeratin, including isolated epithelial fragments from unclassified biopsies. Surface and glandular epithelia from norethindrone enanthate users consisted of a single layer of high columnar cells, with no obvious differences between proliferative-like and secretory-like endometria. In contrast, surface epithelial tissue from 37 Norplant users showed weaker immunostaining and epithelial cells were rounded and stratified. No relationship between cytokeratin expression and breakthrough bleeding pattern was detected. These findings suggest that norethindrone enanthate and Norplant act differently on endometrial epithelial cytokeratin, with women receiving the former contraceptive agent showing a cytokeratin distribution similar to that seen in the normal menstrual cycle. The capability of norethindrone enanthate to preserve epithelial integrity may have implications for reducing the incidence of progestogen-related breakthrough bleeding.

Asunto(s)

Anticonceptivos Femeninos/farmacología , Endometrio/química , Queratinas/análisis , Levonorgestrel/farmacología , Noretindrona/análogos & derivados , Adulto , Animales , Anticuerpos Monoclonales/inmunología , Biopsia , Endometrio/efectos de los fármacos , Endometrio/patología , Femenino , Humanos , Inmunohistoquímica , Queratinas/efectos de los fármacos , Queratinas/inmunología , Ratones , Noretindrona/farmacología

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.

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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/sangre

RESUMEN

A placebo-controlled trial has shown that 15 microgram of ethinyl oestradiol is as effective as 25 microgram daily in reducing both menopausal symptoms and the urinary excretion of calcium and hydroxyproline. Norethisterone 5 mg daily also showed a significant reduction in the climacteric symptoms but was less effective than either of the ethinyl oestradiol doses.

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PIP: A small placebo-controlled double-blind study was conducted to assess the efficacy of hormone replacement therapy in relieving climacteric symptoms. Women in the study received 1 of the following treatments: 1) 15 ug ethiny l estradiol daily; 2) 25 ug ethinyl estradiol daily; 3) 5mg norethisterone daily; or 4) a placebo. There was a significant cumulative fall in climacteric symptoms for the women on the 3 active therapies but no significant change in the placebo-treated group. The 15 ug-dose of ethinyl estradiol achieved the greatest reduction in symptoms, the 25 ug-dose achieved the next best effects, and the norethisterone treatment the least change. Differences among the 3 treatments were not statistically significant. Most of the improvement was due to a reduction in hot flushes. Bone resorption was also controlled with the treatment. It is concluded that hormone replacement therapy is effective in controlling menopause-related symptoms. Since norethisterone was almost as effective as the estrogens and since it is considered by many to be a safer compound, it is concluded that progestogen replacement therapy might be the recommended mode of treatment for menopausal symptoms.

Asunto(s)

Climaterio/efectos de los fármacos , Estradiol/uso terapéutico , Noretindrona/uso terapéutico , Calcio/orina , Ensayos Clínicos como Asunto , Creatinina/orina , Método Doble Ciego , Estradiol/administración & dosificación , Femenino , Humanos , Hidroxiprolina/orina , Placebos

RESUMEN

The serum cholesterol and triglyceride concentrations of 84 postmenopausal women both before and after 2, 6 and 12 months therapy with various regimens of hormone therapy were measured. There was little alteration in mean serum cholesterol concentration with cyclical oestrogens but both sequential mestranol and norethisterone and sequential oestradiol valerate and norgestrel significantly reduced the mean serum cholesterol concentration to a level similar to that found in age-matched premenopausal women. There was a small and sometimes significant rise in serum triglyceride concentration with cyclical oestrogens. Sequential mestranol and norethisterone significantly elevated serum triglyceride levels, but sequential oestradiol valerate and norgestrel significantly depressed them. The results suggest that the progestogenic agent norgestrel has an important role to play in reducing both serum cholesterol and triglyceride levels, and that the sequential preparations, by virtue of their greater cholesterol lowering effect, should perhaps be preferred to cyclical oestrogens.

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PIP: The serum cholesterol and triglyceride concentrations of 84 postmenopausal women both before and after 2, 6 and 12 months therapy with various regimens of hormone therapy were measured. There was little alteration in mean serum cholesterol concentration with cyclical estrogens but both sequential mestranol and norethisterone and sequential estradiol valerate and norgestrel significantly reduced the mean serum cholesterol concentration to a level similar to that found in age-matched premenopausal women. There was a small and sometimes significant rise in serum triglyceride concentration with cyclical estrogens. Sequential mestranol and norethisterone significantly elevated serum triglyceride levels, but sequential estradiol valerate and norgestrel significantly depressed them. The results suggest that the progestogenic agent norgestrel has an important role to play in reducing both serum cholesterol and triglyceride levels, and that the sequential preparations, by virtue of their greater cholesterol lowering effect, should perhaps be preferred to cyclical estrogens.

Asunto(s)

Colesterol/sangre , Estrógenos/uso terapéutico , Menopausia/efectos de los fármacos , Triglicéridos/sangre , Combinación de Medicamentos , Estradiol/uso terapéutico , Estrógenos Conjugados (USP)/uso terapéutico , Estrona/uso terapéutico , Femenino , Humanos , Mestranol/uso terapéutico , Noretindrona/uso terapéutico , Norgestrel/uso terapéutico , Factores de Tiempo

RESUMEN

PIP: A 21-year-old unmarried female, with a history of periodic psychotic behavior, was admitted to the hospital after exhibiting overt psychotic symptoms. Several months of hospital observtion and a review of her earlier psychotic episodes suggested that the patient's psychotic behavior was associated with the onset of menses. The symptoms disappeared after oral contraceptives were administered on a regular basis. The patient experienced her 1st psychotic episode 1 year after menache. Several episodes during the intervening years required hospitalization. One of these episodes occurred during a period of prolonged menstrual flow. The patient's menstrual cycles were frequently irregular. During the present hospitalization the patient exhibited psychotic symptoms at the onset of 3 of her 4 menstrual cycles. She became agitated and delusional and exhibited dissociated thought patterns and autonomic symptoms. Despite the use of high doses of antipsychotic drugs, the symptoms persisted until the menstrual flow stopped 7 days later. After the 3rd episode the patient did not menstruate for 2 months. 69 days after the onset of her last menstrual flow the patient was given Provera to induce menstruation. 5 days later the menstrual flow began and Ortho-Novum 1/50 was administered. During the next 6 months she took the contraceptive regularly and remained free of any overt symptoms. The mechanism by which oral contraceptives prevent menstrual psychosis is unknown. Perhaps the estrogen decreases monoamine oxidase activity which in turn alters the level of norepinephine at the synapses.^ieng

Asunto(s)

Anticonceptivos Hormonales Orales/uso terapéutico , Anticonceptivos Orales/uso terapéutico , Trastornos de la Menstruación/prevención & control , Trastornos Neurocognitivos/prevención & control , Adulto , Antipsicóticos/uso terapéutico , Femenino , Humanos , Recurrencia

RESUMEN

PIP: The administration of norethisterone leads to an increase in the blood circulating volume due to the erythrocyte circulating volume and to a decrease of potassium ions in the blood serum. Total protein and protein fractions, as well as serum iron do not change essentially with norethisterone administration. The data obtained are indicative of the expediency of preventive use of norethisterone during dispensary follow-up of those patients with uterine myoma. (Authors' modified)^ieng

Asunto(s)

Atención Ambulatoria , Volumen Sanguíneo/efectos de los fármacos , Leiomioma/fisiopatología , Noretindrona/uso terapéutico , Neoplasias Uterinas/fisiopatología , Adulto , Femenino , Humanos , Leiomioma/tratamiento farmacológico , Menstruación/efectos de los fármacos , Persona de Mediana Edad , Volumen Plasmático/efectos de los fármacos , Neoplasias Uterinas/tratamiento farmacológico

RESUMEN

The authors report their results on the treatment of progressive endometrial carcinomas of cases not suitable for conventional therapy by means of long term progestogen application in high doses. It is demonstrated the effectiveness of this method of treatment if the progestogen is given in necessary doses without stopping the application. An additional short term treatment in low doses in all cases of operated endometrial carcinomas is assesed not to be useful.

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PIP: High dosage gestagen therapy is indicated for progressive endometrial carcinomas when there are recurring or metastasizing tumors or the presence of extensive tumors suggesting incomplete surgical removal. Both norethisterone acetate in dosages of 20-30 mg die and hydroxyprogesterone capronate in dosages of 1-5 gm weekly are well tolerated. Interruption of medication is to be avoided, since recurrences have been noted even after discontinuation of successful long-term therapy. In 60-70% of the patients, general and localized improvements were observed. A hemostatic effect usually occurred during the 1st week of treatment. Avoidance of local recurrence and an average survival period of 34 months after detection of lung metastasis as well as cases of complete remission speak highly for the therapy. Low dosage, short-term progesterone treatment for all cases of endometrial carcinoma is not recommended at the present time.

Asunto(s)

Adenocarcinoma/tratamiento farmacológico , Hidroxiprogesteronas/administración & dosificación , Noretindrona/administración & dosificación , Neoplasias Uterinas/tratamiento farmacológico , Adenocarcinoma/patología , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Metástasis de la Neoplasia , Recurrencia Local de Neoplasia/etiología , Neoplasias Uterinas/patología

RESUMEN

PIP: 3 preparations of 17beta-estradiol and norethisterone acetate were administered to 34 climacteric and 175 postmenopausal women to treat climacteric symptoms and symptoms of estrogen deficiency. 56 women were treated with trisekvens (Group 1), 131 with trisekvens forte (Group 2), and 22 with estrofem forte (Group 3). Triglycerides, cholesterol, calcium, sodium and potassium ions, alkaline phosphatase, creatinine, glucose, protein, albumin, haptoglobin, zinc sulphate, iron, TIBC, bilirubin, ALAT and ASAT, and follicle stimulating hormone (FSH), luteinizing hormone (LH), and low polar estrogens (LPE) were measured. All patients exhibited lowered S-cholesterols which reverted to normal after 6 months treatment. S-triglycerides were unchanged except in Group 1 patients where there was a slight increase after 24 months use (p .01). Serum FSH and LH decreased during treatment and this decrease was most pronounced in Groups 2 and 3. Serum LPE levels increased in Group 1, for climacteric women, to normal luteal values and in postmenopausal women to proliferation values. In groups 2 and 3, serum LPG for postmenopausal women reached luteal values. Climacteric symptoms disappeared with therapy and there was an improvement in symptoms caused by estrogen deficiency. 34 patients discontinued treatment, 14 changing to another preparation. These preparations were well tolerated with few side effects.^ieng

Asunto(s)

Climaterio/efectos de los fármacos , Estradiol/uso terapéutico , Menopausia/efectos de los fármacos , Noretindrona/uso terapéutico , Colesterol/sangre , Estrógenos/sangre , Femenino , Hormona Folículo Estimulante/sangre , Estudios de Seguimiento , Humanos , Hormona Luteinizante/sangre , Persona de Mediana Edad , Triglicéridos/sangre

RESUMEN

The binding capacity of plasma testosterone-estradiol-binding globulin (TeBG) and testosterone (T) levels were measured in four women with proved polycystic ovaries and three women with a clinical diagnosis of polycystic ovarian disease before, during, and after administration of norethindrone, 2 mg., and mestranol, 0.1 mg. (N + M)...

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PIP: The response of the binding capacity of plasma testosterone-estradiol-binding globulin (TeBG) to 2 mg norethindrone and .1 mg mestranol in polycystic ovarian disease was investigated. TeBG and testosterone levels were measured in 4 women with proved polystic ovaries and 3 women with a clinical diagnosis of polystic ovarian disease before, during, and after norethindrone plus mestranol treatment. TeBG was increased within 4 days after treatment was begun. TeBG was significantly elevated (p less than .05) and testosterone was significantly suppressed (p less than .05) relative to pretreatment levels by 9-12 days after treatment was started. Both levels remained markedly different from pretreatment levels during the 12-day posttreatment period. All 7 women responded to treatment with a decrease in plasma levels of both total and free testosterone.

Asunto(s)

Proteínas Portadoras/sangre , Mestranol/farmacología , Noretindrona/farmacología , Síndrome del Ovario Poliquístico/sangre , Unión Proteica/efectos de los fármacos , Estradiol/sangre , Estrona/sangre , Femenino , Hormonas Esteroides Gonadales/fisiología , Mestranol/uso terapéutico , Noretindrona/uso terapéutico , Síndrome del Ovario Poliquístico/tratamiento farmacológico , Prednisona/sangre , Testosterona/sangre , Tiroxina/fisiología , Factores de Tiempo

RESUMEN

PIP: The therapeutic value of norethisterone acetate in the treatment of scleroderma (progressive systemic sclerosis) was evaluated in 9 patients completing at least 6 months of treatment. 2 patients reported some benefit during treatment, and 1 claimed improvement after treatment. Only occasional improvement was indicated by skin elasticity tests (6 patients), skin biopsy (4 patients), calorimetry (8 patients) and respiratory function tests (9 patients). There was no urinary glycosaminoglycan excretion response to treatment, except in 1 patient who showed a considerable decrease. There were several occurrences of side effects, including hypertension, venous thrombosis, and transient cerebral vascular disturbance. It is concluded that norethisterone acetate is of dubious value in treating scleroderma and, because of side effects, its use is not recommended.^ieng

Asunto(s)

Estudios de Evaluación como Asunto , Hipertensión , Noretindrona/uso terapéutico , Investigación , Esclerodermia Sistémica/tratamiento farmacológico , Piel , Trombosis , Adulto , Anciano , Biología , Coagulación Sanguínea , Anticoncepción , Anticonceptivos , Anticonceptivos Femeninos , Anticonceptivos Orales , Enfermedad , Embolia , Servicios de Planificación Familiar , Femenino , Humanos , Persona de Mediana Edad , Fisiología , Tromboembolia , Enfermedades Vasculares

RESUMEN

PIP: It was ascertained and confirmed statistically in 96 women that Lysenyl shortens the period of hemorrhage after insertion of an IUD; depot Agofollin, Lysenyl, and in particular Ascorutin reduce the intensity of hemorrhage. In women with hemorrhage in the middle and 2nd half of the cycle, with the IUD in situ, a combination of Lysenyl and Ascorutin proved most useful. More severe cases were treated with Norethisterone. It was recommended in more severe cases to treat, in addition to the above preparations, with hormones - in the 1st half of the cycle with estrogens and in the 2nd half with norsteroids.^ieng

Asunto(s)

Dispositivos Intrauterinos/efectos adversos , Hemorragia Uterina/tratamiento farmacológico , Aminas/uso terapéutico , Ácido Ascórbico/uso terapéutico , Ergolinas/uso terapéutico , Alcaloides de Claviceps/uso terapéutico , Femenino , Humanos , Maleatos/uso terapéutico , Rutina/uso terapéutico , Hemorragia Uterina/etiología

RESUMEN

PIP: 18 French women with bone metastases of breast cancer were treated with norethisterone 60 mg per day (except 1 woman given 20 mg daily) for 2 months or until the end of the remission from 1969-1972. The patients ranged from 39-84 years (mean 57.7). In 16 breast cancer had 0een diagnosed 6 months to 16 years before (mean 43 months). Calcemia was less than 102 mg per 1; calcuria was above 250 mg per 24 hours in 3. The bone lesions were lytic in 13 and mixed in 5. Progestagens were the first treatment for bone metastases in 10; others had ovariectomy, androgens, cortisone, chemotherapy, adrenalectomy, and hypophysectomy. Since the response of these metastases is difficult to evaluate, the authors chose criteria of disappearance of pain and stabilization of radiographic lesions. In 6 patients pain was relieved within 2-4 weeks, and lesions stabilized or recalcified in 2. In 5 of the 6 erythrocyte sedimentation rate became normal in 2 months; calcemia normalized in 1; calcuria decreased in 4. Remission lasted 3-9 months (mean 5.6). After remission, androgens were effective in 3 or 4. In 6, norethisterone was stopped because it was ineffective. 6 others had to stop for intolerance: vomiting in 1, jaundice in 2, hypercalcemia in 3.^ieng

Asunto(s)

Neoplasias Óseas/tratamiento farmacológico , Neoplasias de la Mama/tratamiento farmacológico , Noretindrona/uso terapéutico , Adulto , Anciano , Sedimentación Sanguínea , Neoplasias Óseas/complicaciones , Neoplasias de la Mama/complicaciones , Calcio/sangre , Calcio/orina , Femenino , Humanos , Persona de Mediana Edad , Metástasis de la Neoplasia , Dolor/etiología , Pronóstico , Remisión Espontánea , Factores de Tiempo

RESUMEN

PIP: Serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), plasma plasma testosterone and androstenedione, were determined daily in 5 women with mild to hirsutism and polycystic sclerotic ovaries, and in 2 normal controls. Blood was sampled daily for 10 days before and 10 days during administration of diethylstilbestrol 3 mg daily or norethindrone acetate 5 mg daily, during Cycle Days 2-12 in controls. FSH was significantly (p = .05 or less) decreased in 4 patients by diethylstilbestrol, and in the vehicle for serum triglyceride, pre-beta lipoprotein, was not significantly elevated in any subjects. Though the mechanism of these pills' effect on serum lipids is not known, although it appeared to increase in 4 patients and 1 control during stimulation. must produce caution in evaluating long-term oral contraceptive administration.^ieng

Asunto(s)

Dietilestilbestrol/administración & dosificación , Hormona Folículo Estimulante/sangre , Hirsutismo/sangre , Hormona Luteinizante/sangre , Noretindrona/administración & dosificación , Síndrome del Ovario Poliquístico/sangre , Testosterona/sangre , Adulto , Androstenodiona/sangre , Femenino , Humanos , Trastornos de la Menstruación/sangre , Ovario/efectos de los fármacos , Ovario/metabolismo

RESUMEN

PIP: Ovarian morphological changes with injectable contraceptives and the ir relation to cycle control were studied to determine any differences between amenorrheic cases and those with normal cycles. 27 women received either 200 mg norethisterone enanthate every 84 days or 150 mg medroxyprogesterone every 3 months. 16 of the women suffered from ameno rrhea, 4 of whom received estrogens for induction of bleeding. Endometrial biopsies and vaginal smears were taken. Laparotomies were performed for sterilization at which time ovarian biopsies were obtained. Corpora lutea were not detected in any of the cases. Those with acceptable cycles revealed Graafian follicles in all stages of development and more follicular cysts than in the controls. Amenorrheic cases revealed no developing follicles and scanty and atrophic cysts, with marked cortical and perifollicular fibrosis. After estrogen the 4 cases showed the amenorrheic picture and ovarian congestion.^ieng

Asunto(s)

Amenorrea , Cuerpo Lúteo , Endometrio , Histología , Acetato de Medroxiprogesterona , Noretindrona , Ovario , Investigación , Vagina , Biología , Anticoncepción , Anticonceptivos , Anticonceptivos Femeninos , Enfermedad , Servicios de Planificación Familiar , Genitales , Genitales Femeninos , Inyecciones , Ciclo Menstrual , Trastornos de la Menstruación , Ovulación , Fisiología , Sistema Urogenital , Útero , Vaginitis

RESUMEN

PIP: 123 women took NOR 50 (1 mg norethindrone and .05 mg mestranol, combined) for a total of 1779 cycles, ranging from 1-42 months. The chief indication was contraception, but some also had menstrual irregularity (47 cases), menorrhagia (54), dysmenorrhea (41), chronic pain (11), premenstrual syndrome (13), and acne (3). There were no pregnancies, and all gynecological complaints were cured except 1 case of pain and 1 of acne. Side effects included 4 who stopped for nausea and vomiting, 28 who had transient nausea, 50 with metrorragia (according to the author, probably due to forgotten pills in severe cases), 29 with amenorrhea, 27 with breast pain, 7 with loss of libido, 1 with cholasma. The author remarked that the dimunution of menstrual flow and the improvement to those with fibroids was striking.^ieng

Asunto(s)

Anticonceptivos Orales , Mestranol , Noretindrona , Adulto , Anticonceptivos Orales/uso terapéutico , Femenino , Enfermedades de los Genitales Femeninos/tratamiento farmacológico , Humanos , Persona de Mediana Edad

RESUMEN

PIP: Norethindrone was administered continuously in daily doses of .35 mg to 74 women suffering from menstrual disorders for 576 cycles. The cases included 39 women suffering from dysmenorrhea (treated for 296 cycles) and 35 women suffering from premenstrual tension (treated for 280 cycles). The symptoms improved or disappeared in 87.2% of the dysmenorrhea cases, and in 93.9% of the premenstrual tension cases; the percentages by number of cycles studied were 90.3% and 95.0%, respectively. Only 1 case of dysmenorrhea worsened. The findings are regarded as conclusive and demonstrating the usefulness of norethindrone in the treatment of these disorders.^ieng

Asunto(s)

Dismenorrea , Trastornos de la Menstruación , Noretindrona , Síndrome Premenstrual , Investigación , Anticoncepción , Anticonceptivos , Anticonceptivos Femeninos , Anticonceptivos Orales , Enfermedad , Servicios de Planificación Familiar

RESUMEN

PIP: Ablacton, and andro-estro-progestagen hormone combination, was administered to 59 postpartum and postcurettage patients to suppress lactation: primary inhibition was attempted in 40 cases and secondary in 19. In primary suppression, results were excellent in 83.5% of the cases, good in 10.0% and bad in 2.5%. In secondary suppression, results were excellent in all cases. The suppression of lactation was total and permanent. Tolerance to medication was very good. Because of the very small number of cases and the type of study, the study is limited to this single product.^ieng

Asunto(s)

Estradiol/farmacología , Lactancia/efectos de los fármacos , Noretindrona/farmacología , Periodo Posparto/efectos de los fármacos , Testosterona/farmacología , Femenino , Humanos , Embarazo

RESUMEN

PIP: A tablet of .35 mg of norethindrone was administered daily and continuously for 6 complete cycles to 30 patients suffering from premenstrual tension syndrome and 5 suffering from functional sterility related to a deficiency of the corpus luteum. In the case of premenstrual tension, particularly good results were obtained in reducing pelvic pains, mastalgia, and headache, especially when related to disorders of the estrogen metabolism. In the sterility cases, 2 patients out of 5 responded to the treatment: 1 was in the 7th month of pregnancy at the time of writing and 1 suffered a spontaneous abortion from unknown causes in the 3rd month of pregnancy. It is concluded that this is a promising treatment, especially for premenstrual disorders.^ieng

Asunto(s)

Infertilidad , Noretindrona , Síndrome Premenstrual , Investigación , Aborto Espontáneo , Anticoncepción , Anticonceptivos , Anticonceptivos Femeninos , Enfermedad , Servicios de Planificación Familiar , Trastornos de la Menstruación , Embarazo , Congéneres de la Progesterona , Reproducción

RESUMEN

PIP: This paper outlines methods of therapy utilizing newer combinations of estrogens and progestins. The specific agent and length of treatment depends on the extent of disease, severity of symptoms, presence of infertility and response to pseudopregnancy. Structural formulas for 19 synthetic preparations are shown. Of 36 patients with proven endometriosis in which pseudopregnancy was induced by the use of these newer agents, satisfactory objective in 82%. Pregnancy occurred later in 6 of 10 patients who had previously been infertile and wished to become pregnant. The optimum maintenance dose is 4-6 mg of chlormadinone acetate or ethnodiol diacetate with .2 mg of mestranol and 5-10 mg of megestrol acetate with .2 mg of ethniyl estradiol. Dosage is increased only when break through bleeding occurs. Gain in weight occurred in almost 1/2 of the patients. The decidual reaction was just as great as that produced formerly by large doses of Enovid. In a more recent study 60 patients were treated with Norlestrin, 20 with Lyndiol and 20 with Ovral. Satisfactory objective and subjective remissions were obtained in 89%. Pregnancy has occurred subsequently in 17 to 43 patients who desired pregnancy. All infants have been normal. The optimum maintenance doses seem to be 10-15 mg if Norlestrin, 2.5-5 mg Lyndiol or .5-1 mg of Ovral. The most common side effect was weight gain in 35%. These agents may be used prior to conservative surgery in order to soften areas of fibrotic endometriosis or to pinpoint areas otherwise overlooked. The length of preoperative treatment depends on the extent of disease, 6 weeks being usual. The indication for prolonged pseudopregnancy is recurrent endometriosis following surgery, also proven vaginal endometriosis. Subsequent to conservative surgery, 12 to 24 weeks of therapy are given in order to inhibit ovulation and prevent reactivation of any remaining areas of endometriosis. Tables show commercial combinations and dosage regimens. Nausea, break through bleeding, breast soreness, acne, water retention, isoninia, irritability, lethargy, headaches or development of leiomyomas are side effects to be dealt with by modifying the treatment. Thromboembolic disease has not been a complication in over 500 patients but should be looked for as it has been reported by others. The effect of long-term use of these drugs has been shown to be entirely reversible without subsequent deleterious effects. Severe hepatic disease or previous mammary carcinoma are contraindications. Excessive side effects may necessitate other treatment but the newer drugs reduce this chance. The diagnosis of endometriosis should first be proven.^ieng

Asunto(s)

Anticonceptivos Femeninos , Anticonceptivos Orales , Etinilestradiol , Linestrenol , Acetato de Medroxiprogesterona , Mestranol , Metrorragia , Náusea , Noretindrona , Noretinodrel , Seudoembarazo , Tromboembolia , Coagulación Sanguínea , Anticoncepción , Anticonceptivos , Anticonceptivos Orales Combinados , Anticonceptivos Hormonales Orales , Sistema Digestivo , Enfermedad , Embolia , Servicios de Planificación Familiar , Hemorragia , Inyecciones , Ciclo Menstrual , Menstruación , Reproducción , Signos y Síntomas , Enfermedades Vasculares