RESUMO
ABSTRACT Equigan is an anabolic steroid that has been developed for veterinary use and derived from endogenous sex hormone testosterone that plays a key role in the development of male reproductive tissue as well as in puberty and spermatogenesis. The current study is aimed to investigate the possible prophylactic effect of star anise extracts (SAE) on the toxicity of rat testes, sexual hormones alternations, sperm count, sperm abnormalities and testicular DNA damage by Equigan. Forty adult male rats were equally divided into four groups (1st Control group, 2nd SAE group, 3rd Equigan and 4th Equigan+SAE group). Food and fluid intakes, relative body weight, potassium, chloride, phosphorous, non-progressive and immotile sperms were significantly increased in Equigan group as compared to control group. In contrast; relative testes weight, sodium, magnesium, total calcium, testosterone, FSH, LH, PRL, sperm count, progressive motility, and viability showed a significant decrease in Equigan group as compared to control groups. The relative weight of epididymis, seminal vesicles, prostates and serum calcium ions didn't change significantly in different studied groups. Co-administration of SAE with Equigan improved the sexual toxicity, electrolyte alternations, sperm count, abnormalities and DNA damage induced by Equigan.
Assuntos
Animais , Masculino , Ratos , Extratos Vegetais/análise , Técnicas Reprodutivas , Illicium/efeitos adversos , Fenômenos Reprodutivos Fisiológicos , Espermatogênese/efeitos dos fármacos , Secreções Corporais , Fragmentação do DNA/efeitos dos fármacos , Fármacos para a Fertilidade Masculina/análise , Anabolizantes/farmacologiaRESUMO
Introducción: dentro de las técnicas de reproducción asistida de baja tecnología está la inseminación intrauterina, donde se colocan los espermatozoides dentro del útero de una mujer cerca del momento de la ovulación. Presentación del caso: se presenta el caso de una paciente de 31 años de edad, color de piel blanca, de procedencia rural (municipio Minas de Matahambre, Pinar del Río, Cuba) con el único antecedente personal de infertilidad secundaria y obstétrico de gesta 1, parto 0, aborto 1 a los 18 años, con DIU T de cobre por nueve años para lo cual fue atendida junto a su pareja en la consulta de infertilidad del policlínico universitario "Hermanos Cruz" de Pinar del Río, donde se le diagnosticó trastornos de ovulación e infección vaginal y una oligoastenospermia con varicocele izquierdo a su pareja, para lo cual llevaron tratamiento médico quirúrgico combinado. Conclusión: se logró primero la varicocelectomía y espermatogénesis con merapur (HMG), la ovulación con HMG y clomifeno, luego se realizó una fertilización de baja tecnología, con lo que se logró un embarazo, que llegó a feliz término a las 41 semanas de gestación. Por lo riesgoso de este tipo de embarazo y el resultado feliz que tuvo, se decidió publicar el caso.
Introduction: among assisted reproduction techniques of low technology is intrauterine insemination, where sperm is placed in the uterus of a woman near the time of ovulation. Case report: the case of a female 31-year-old patient, white skin, of rural origin (Minas de Matahambre Municipality, Pinar del Rio, Cuba) presents for the sole personal history of secondary infertility and obstetric geostation 1, delivery 0, abortion 1 to 18, with Copper T IUD for nine years for which she was served with her partner in the office of infertility at Hermanos Cruz university polyclinic of Pinar del Rio, where she was diagnosed disorders ovulation and vaginal infection and her partner with a left varicocele oligoasthenospermia, which led to combined surgical treatment. Conclusion: varicocelectomy was first achieved and spermatogenesis with merapur (HMG), ovulation with HMG and clomiphene, and then a low-tech fertilization took place, bringing a pregnancy, which came to fruition at 41 weeks of gestation was achieved. So this kind of risky pregnancy and was happy result, it was decided to publish the case.
RESUMO
To assess the effect of hormonal monthly injectable contraceptives upon the serum values of immunoreactive prolactin (Prl), three groups of women of reproductive age exposed to different estrogen-progestogen injectable formulation for a minimum of one year were studied. The first group (n = 10) received dihydroxyprogesterone acetophenide 150 mg and estradiol enanthate 10 mg (DHPA/E2-EN), Group 2 (n = 21) received medroxyprogesterone acetate 25 mg and estradiol cypionate 5 mg (MPA/E2-C) and Group 3 (n = 19) was exposed to norethisterone enanthate 50 mg and estradiol valerate 5 mg (NET-EN/E2-V). A group of IUD users (n = 16) served as the control group. Serum Prl and 17 beta-estradiol (E2) concentration were determined in blood samples (0 and 15 min.) on days 0 (day of last injection), 10, 20 and 30 after last contraceptive injection. The results demonstrated a slight though not significant increase (p greater than 0.05) in serum Prl in the three experimental groups as compared with the IUD control group. This increase in Prl levels observed on day 10 post-last injection never exceeded the upper limits of the normal range (20 ng/ml). Overall, the data demonstrated that the chronic administration of these estrogen/progestogen once-a-month injectable contraceptives does not affect the Prl baseline secretion in women.
Assuntos
Anticoncepcionais Orais Combinados/administração & dosagem , Prolactina/sangue , Adulto , Acetofenida de Algestona/administração & dosagem , Anticoncepcionais Orais Sintéticos/administração & dosagem , Preparações de Ação Retardada , Estradiol/administração & dosagem , Estradiol/análogos & derivados , Estradiol/sangue , Feminino , Humanos , Injeções , Dispositivos Intrauterinos de Cobre , Medroxiprogesterona/administração & dosagem , Medroxiprogesterona/análogos & derivados , Acetato de Medroxiprogesterona , Noretindrona/administração & dosagem , Noretindrona/análogos & derivados , Distribuição AleatóriaRESUMO
The disappearance of levonorgestrel from plasma after the removal of NORPLANT subdermal implants was studied in 12 women who had been treated from 5.5 to 78 months. The existence of one or two half-lives for the rate of disappearance was assessed. The influence of body weight, body fat and length of treatment upon levonorgestrel clearance was studied through stepwise regression analysis. It was found that the levonorgestrel decay rate after implant removal can be entirely accounted assuming one half-life of 42 +/- 16 h (mean +/- SD; range 13 to 62 h). Stepwise regression analysis showed that levonorgestrel half-life is positively correlated with body weight and not significantly correlated with the length of treatment or body fat. It is concluded that, after long-term administration of levonorgestrel via subdermal implants, the major part of the steroid is cleared from plasma within 96 h and that only trace amounts are detected in the following days.
Assuntos
Norgestrel/farmacocinética , Adulto , Composição Corporal , Peso Corporal , Preparações de Ação Retardada , Feminino , Meia-Vida , Humanos , LevanogestrelRESUMO
A comparative clinical trial of two combined oral contraceptives (OCs) with equivalent estrogen content, but different amounts of progestogens, was conducted at the Centro Medico Especializado em Planejamento Familiar in Rio Clara, Brazil. The study was designed to determine the differences in discontinuation rates between Norinyl 1/35 (Syntex) and Brevicon (Syntex) as well as the frequency of selected side effects which might contribute to method discontinuation. Both OCs contain 0.035 mg of ethinyl estradiol; Brevicon contains 0.5 mg and Norinyl 1/35 contains 1 mg norethindrone. Three-hundred women enrolled in the study were randomly assigned to either the Norinyl 1/35 or Brevicon OCs and follow-up visits were scheduled at 1, 4, 8 and 12 months after admission. Intermenstrual bleeding was reported by significantly more women in the Brevicon group than in the Norinyl group (p less than 0.05), and significantly more Brevicon users reported an increase in intermenstrual bleeding. At the end of the study period, no differences were found between the two OC groups in terms of discontinuation rates, but a large number of women in each group discontinued for menstrual problems. The total discontinuation rates at 11 months for both groups were extremely high: 68.2 for the Norinyl 1/35 group and 75.2 for the Brevicon users. The largest group of discontinuations were comprised of those discontinuing for menstrual problems, other personal reasons, planned pregnancy and side effects.
Assuntos
Anticoncepcionais Orais Hormonais , Etinilestradiol , Mestranol , Noretindrona , Adulto , Ensaios Clínicos como Assunto , Anticoncepcionais Orais Combinados/efeitos adversos , Anticoncepcionais Orais Hormonais/efeitos adversos , Combinação de Medicamentos , Etinilestradiol/efeitos adversos , Feminino , Humanos , Mestranol/efeitos adversos , Noretindrona/efeitos adversos , Fatores SocioeconômicosRESUMO
Records of the occurrence of vaginal bleeding were obtained from women using either a natural method of contraception or one of four types of hormonal contraceptive. The relationships between their bleeding patterns and a number of demographic variables were examined, with the aim of identifying subgroups of women who, if they used a particular hormonal method of contraception, would be likely to suffer more or less disruption to their bleeding pattern than the 'norm'. Within contraceptive method, bleeding patterns were more closely related to the women's geographical region of residence than to any other factor. Some of the differences between regions were consistent across contraceptive methods. European women tended to have more bleeding/spotting days than women in other regions; Latin American women had relatively short episodes and long bleeding-free intervals, whether they were using the ovulation method, combined pills or a vaginal ring. Other differences were method-specific. Women using combined pills in India or Pakistan had fewer spotting episodes than women using the same method elsewhere; those using progestogen-only pills had more. Regional variations in bleeding patterns were particularly marked among women using DMPA, and increased over time: by their fourth injection interval, 25% of European women had amenorrhea, as compared with 72% of subjects in North Africa. These findings need to be confirmed by carefully controlled studies of menstrual bleeding patterns and their acceptability in various ethnic groups. The results would be valuable in counselling new contraceptive acceptors, and could eventually guide the choice of methods for introduction into national family planning programmes.
Assuntos
Anticoncepção/métodos , Menstruação , Administração Intravaginal , África , Ásia , China , Ensaios Clínicos como Assunto , Anticoncepcionais Orais Combinados/farmacologia , Anticoncepcionais Orais Hormonais/farmacologia , Europa (Continente) , Feminino , Humanos , América Latina , Levanogestrel , Medroxiprogesterona/análogos & derivados , Medroxiprogesterona/farmacologia , Acetato de Medroxiprogesterona , Menstruação/efeitos dos fármacos , Estudos Multicêntricos como Assunto , Norgestrel/farmacologia , Índias OcidentaisRESUMO
To gain a better understanding of the mechanism of action of intrauterine devices (IUDs), a search was made for ova in the genital tracts of 115 women using no contraception and of 56 women using IUDs, all of whom volunteered for study in conjunction with surgical sterilization. Ova were recovered from tubal flushings between 48 and 120 hours after the midcycle peak of luteinizing hormone in 39% of the IUD users compared with 56% of women in the control group (0.05 less than P less than 0.10). This suggests an action of the IUD before the ovum reaches the uterus. Eggs with a microscopic appearance consistent with fertilization were recovered from the fallopian tubes of half of the women using no contraception who had intercourse within the fertile period of the reproductive cycle and from whom ova were recovered. In contrast (P less than 0.01), no eggs with this appearance were recovered in IUD users who had intercourse within the fertile period. No ova were recovered from the body of the uterus of any of the IUD users. Fertilized ova are less likely to reach the uterine cavity containing an IUD. Thus, the principal mode of IUDs is by a method other than destruction of live embryos.
Assuntos
Dispositivos Intrauterinos , Tubas Uterinas , Feminino , Humanos , Hormônio Luteinizante/sangue , Óvulo/citologiaRESUMO
Early chorionic activity was assessed in the premenstrual days by means of serum HCG beta-fraction. As control, a group of women with no contraceptive use was studied; early chorionic activity was detected in 31.8% of the cycles. In the group bearing an inert IUD the incidence was 20%, which did not differ from the control; while in the medicated IUD groups (Cu-IUD and LNG-IUD) the incidences were 4.8% and nil, respectively. Both medicated IUD groups showed a significant difference when compared with the control, as well as the inert IUD groups. The meaning of these findings, pointing out differences in the main mechanism of action between inert and medicated IUDs, is discussed.
PIP: Early chorionic activity was compared in 100 IUD users (inert device, copper IUD, and a levonorgestrel-releasing IUD) and 22 controls through measurement of the serum human chorionic gonadotropin (hCG) beta-fraction. In the control group, 7 (32%) of the 22 women had hCG beta-fraction values indicative of chorionic activity (i.e., 5mIU/ml). In the group of women wearing an inert IUD (Lippes Loop), 8 (20%) were positive for early chorionic activity. In contrast, the incidence of premenstrual chorionic activity signs was very low among women with medicated IUDs: 5% among acceptors of the copper IUD and zero among women in the levonorgestrel-releasing IUD group. In general, elevated premenstrual hCG values are indicative of failed implantation. The high incidence of hCG activity recorded among Lippes Loop acceptors in this study is consistent with the anti-implantation effect postulated for inert devices. In contrast, medicated IUDs appear to act by preventing rather than interrupting implantation and therefore should not be regarded as abortifacient contraceptive agents.
Assuntos
Córion/efeitos dos fármacos , Gonadotropina Coriônica/sangue , Anticoncepcionais Femininos/efeitos adversos , Dispositivos Intrauterinos de Cobre/efeitos adversos , Dispositivos Intrauterinos Medicados/efeitos adversos , Norgestrel/efeitos adversos , Adulto , Anticoncepcionais Femininos/administração & dosagem , Feminino , Humanos , Levanogestrel , Norgestrel/administração & dosagemRESUMO
In women, IUDs produce alterations of the uterine environment in terms of a pronounced foreign body reaction. This biological response may interfere with steps of the reproductive process that normally take place before the ovum reaches the uterine cavity. In order to discuss this hypothesis on the mechanism of action of IUDs, this review is focussed on 1) detection in urine and blood of substances alleged to be specifically produced by the embryo, 2) migration of gametes in the female genital tract, and 3) microscopic features of ova recovered from the genital tract.
PIP: This review delves into the mode of action of IUDs in greater detail than the commonly held theory that IUDs prevent implantation: it discusses whether IUDs affect fertilization, gamete migration or development of fertilized ova. In order to determine whether IUDs prevent fertilization, noninvasive methods of detecting fertilization, or very early pregnancy tests, would be necessary. Two approaches are to assay an alleged immunosuppressive early pregnancy factor, and to design extremely sensitive assays for trophoblastic gonadotrophin (hCG). In fertile cycles, such studies found a 6 to 57% incidence of fertilized ova that did not result in pregnancy. Comparable studies in IUD users sought a transient rise in hCG. Some researchers have seen a fleeting hCG with standard assays, but one laboratory using a new immunoradiometric assay found hCG in only 0.9% of cycles in IUD users. Following sperm or egg migration in women is possible by flushing the vagina and endocervix, or the tubes during surgery. Normally sperm can reach the oviduct in 2 hours and remain viable as long as 85 hours. With an IUD in place, several searches recovered no sperm in the tubes, presumably they were phagocytosed. Copper IUDs especially reduced numbers of sperm, and those found often had heads decapitated from tails. Ovum migration in IUD wearers was not appreciably affected through the oviduct, but few eggs were found in the uterus, again far fewer were found in copper IUD users. Looking at ova that were detected in IUD users, none were developing normally, the rest were classified as either abnormal or uncertain. Ova from copper IUD users were distinctive for being without vitellus and surrounded by macrophages. This preliminary research as a whole suggests that IUDs affect events prior to implantation, specifically ovum development in the tubes, sperm migration, and ovum transport in the uterus.
Assuntos
Implantação do Embrião , Fertilização , Dispositivos Intrauterinos , Feminino , Humanos , GravidezRESUMO
Four-hundred-twenty-six women, aged 18 to 36, completed a four-cycle comparative, randomized, single-blind (observer blind), multicenter study of a new graduated estrogen formulation with three constant-dosed combination oral contraceptives containing the same synthetic steroid compounds. The products studied were Loestrin 1/20, Loestrin 1.5/30, Norlestrin 1/50, and a new graduated estrogen product, Estrostep. A total of 1,850 cycles were completed and analyzed for efficacy, side effects, metabolic changes, and cycle control. Four pregnancies occurred during the course of the study. None of the pregnancies occurred in the group receiving Estrostep. The new formulation produced the lowest rate of breakthrough bleeding (BTB) compared with the other three products. All four combination oral contraceptives resulted in an increase in high-density lipoprotein cholesterol (HDL-C). The levels of HDL-C were greatest with Estrostep.
Assuntos
Etinilestradiol/farmacologia , Noretindrona/análogos & derivados , Noretindrona/farmacologia , Adolescente , Adulto , Amenorreia/induzido quimicamente , HDL-Colesterol/metabolismo , LDL-Colesterol/metabolismo , Ensaios Clínicos como Assunto , Anticoncepcionais Orais Combinados/efeitos adversos , Anticoncepcionais Orais Combinados/farmacologia , Combinação de Medicamentos , Etinilestradiol/efeitos adversos , Feminino , Humanos , Noretindrona/efeitos adversos , Gravidez , Hemorragia Uterina/induzido quimicamenteRESUMO
PIP: In May 1986, a small number of Norplant contraceptive implants were made available in Profamilia family planning centers in Bogota, Cali, Medellin, and Pereira, Colombia. The Norplant system provides women with highly effective and long acting contraceptive protection through 6 small silicone tubes containing levonorgestrel. Levonorgestrel impedes the production of ova by the ovaries, causes the endometrium to atrophy, and thickens the cervical mucus,hindering passage of sperm. The high effectiveness rate of 98% is due to the combination of the 3 effects. The Norplant tubes are inserted under the skin in any part of the body using a special needle. The inner part of the arm is usually preferred. A small amount of local anesthetic is used for the procedure, which requires only a few minutes in a doctor's office. The method is effective for 5 years, after which it can be replaced or permanently removed to allow pregnancy or a change of method. If the woman wishes to have another child before the 5 years are over, the system is removed and fertility is usually restored in the first few months. As with any other drug or hormone, it is prudent to assess the woman's state of health for contraindications and to provide periodic follow-up.^ieng
Assuntos
Anticoncepção , Anticoncepcionais Femininos , Diagnóstico , Serviços de Planejamento Familiar , Hormônios , Levanogestrel , Substâncias para o Controle da Reprodução , América , Anestesia , Biologia , Colômbia , Anticoncepcionais , Países Desenvolvidos , Países em Desenvolvimento , Sistema Endócrino , América Latina , Fisiologia , América do Sul , TerapêuticaRESUMO
PIP: Contraceptive hormonal injectable action of medroxy-progesterone acetate ciprionate estradiol (MPACE) in the reproductive system of female rats was studied. The female rats were selected in 2 groups: A and B, castrated and non castrated, respectively, and according to dose numbers in 6 subgroups: A0, A1, A2, A3, A4, A5 and B0, B1, B2, B3, B4, B5. Karyometric studies of nuclei from uterine epithelial tunica mucosa endometrial glands, myometrium, exocervix and vaginal epithelium were made. For each subgroup females were selected and 3 slides analyzed for each 1, which means 9 observations per subgroup. From uterine epithelial tunica mucosa, endometrial glands, and myometrium kariometric, 20 nuclei were measured per slide, in a total of 60. When dealing with vaginal and exocervical epithelia, 120 nuclei were measured as both are stratified epithelia. Karyometric studies were made in 15,120 nuclei and the results statistically analyzed. Nearly a 2-fold increase in nuclear volume was observed in female rats at the estrual phase as compared with castrated female controls. A higher significant MPACE effect was found in cells covering uterine epithelial tunica mucosa, endometric glands, and myometrium. The MPACE action on the exocervix and vaginal cells was not significant. As statistically assessed, the MPACE combination showed a predominance of the estrogenic portion with an increase of nuclear volumes but this action was balanced by the progestagenic fraction, as mitoses were unusual.^ieng
Assuntos
Animais de Laboratório , Anticoncepção , Anticoncepcionais Femininos , Doença , Endométrio , Estudos de Avaliação como Assunto , Serviços de Planejamento Familiar , Genitália Feminina , Hormônios , Injeções , Acetato de Medroxiprogesterona , Substâncias para o Controle da Reprodução , Pesquisa , Sistema Urogenital , Útero , Biologia , Anticoncepcionais , Economia , Sistema Endócrino , Genitália , Fisiologia , TecnologiaRESUMO
PIP: In 1978, Centro de Pesquisas de Assitencia Integrada a Mulher e a Crianca (CPAIMC) in Rio de Janeiro began to offer interval sterilizations in an attempt to increase the access of poor women to sterilization services. By the end of 1984, the program had provided in excess of 19,000 sterilizations, making CPAIMC Brazil's largest single source of voluntary interval sterilization. Despite the program's success, CPAIMC was concerned that obstacles still existed in the poor woman's path to sterilization access. A study was conducted by Family Health International (FHI) in collaboration with the Pathfinder Fund and CPAIMC's Department of Information, Evaluation and Research to locate possible barriers. The study indicated that less than half of the women who requested sterilization between June 1 and August 31, 1983 actually had the procedure. During that period, 1256 women requested sterilization at the CPAIMC clinic. Of these, 925 were approved, and 639 were scheduled for surgery. Only 559 were actually sterilized within 3 months of receiving approval. 1 possible reason why women were not receiving the surgery was that the women requesting sterilization actually were not highly motivated to obtain the service. Yet, study results indicate this probably was not the reason. During initial interviews at the clinic, many women said they had thought very carefully about being sterilized, and more than 40% reported deciding to have a tubal ligation before their last pregnancy. Almost 3/4 of the women reported that they did not plan their last pregnancy, and almost 2/3 indicated that the pregnancy was unwanted. About 63% were contracepting, and many were using effective methods. More than half of the non-contraceptors were not using a method because they had just ended a pregnancy and were not sexually active. As a group, the women requesting sterilization were highly motivated to avoid having more children. Age and number of children were the most important criteria used by the clinic to determine a woman's eligibility for sterilization. Women who were at least 30 years old and who had 3 or more living children usually were approved for surgery. During the study period, a woman who did not use oral contraceptives, an IUD, or injectables was required to receive a Depo-Provera injection on the 5th to 8th day of her menstrual cycle before surgery was scheduled. This requirement was aimed at reducing the incidence of pregnancies among sterilized women. The number of clinic visits necessary to complete the requirements for sterilization apparently made the difference. Women who needed the Depo-Provera injection had to make more visits and were less likely to follow through to obtain the sterilization. As a result of the CPAIMC study, the clinic has changes its procedure for scheduling sterilization surgery. It is likely that even relatively small changes in service provision may yield significant increases in family planning prevalence and thus increase the coverage and quality of health care in Brazil.^ieng
Assuntos
Estudos de Avaliação como Assunto , Acessibilidade aos Serviços de Saúde , Motivação , Pobreza , Esterilização Reprodutiva , Esterilização Tubária , Fatores Etários , América , Comportamento , Coeficiente de Natalidade , Brasil , Países Desenvolvidos , Países em Desenvolvimento , Economia , Serviços de Planejamento Familiar , Hormônios , América Latina , Acetato de Medroxiprogesterona , Organização e Administração , Paridade , População , Características da População , Avaliação de Programas e Projetos de Saúde , Psicologia , Substâncias para o Controle da Reprodução , População Rural , Classe Social , Fatores Socioeconômicos , América do SulRESUMO
Two hundred and sixty-eight Jamaican women were interviewed and asked about their views on various types of contraceptives. During the interviews they were given an outline of a woman's body and asked to draw the female reproductive system. Worries about altered menstruation, irreversible sterility and other consequences of contraception contributed to underutilization of services. Recommendations for improved services and public education are made.
Assuntos
Anticoncepção , Serviços de Planejamento Familiar , Conhecimentos, Atitudes e Prática em Saúde , Dispositivos Anticoncepcionais Masculinos , Anticoncepcionais Orais , Feminino , Humanos , Dispositivos Intrauterinos , Jamaica , Medroxiprogesterona/análogos & derivados , Acetato de Medroxiprogesterona , Esterilização TubáriaRESUMO
Preliminary results of a study of the possible relationship of depot-medroxy-progesterone acetate (DMPA) to invasive cervical cancer are presented. The findings are based on data from three participating centres in Thailand and one in Mexico. A relative risk for cervical cancer of 1.2 was observed in women who had ever used DMPA; this was not statistically significant. No consistent increase in risk with duration of use was observed, although a relative risk of 2 was found in women who had used DMPA for more than 5 years. This observed increase in risk was confined to women who were aged under 46 years or who had first been exposed to DMPA before 30 years of age. These findings are based on small numbers of subjects, and may not represent a causal relationship.
Assuntos
Anticoncepcionais Femininos/efeitos adversos , Medroxiprogesterona/análogos & derivados , Neoplasias do Colo do Útero/induzido quimicamente , Preparações de Ação Retardada , Feminino , Humanos , Medroxiprogesterona/efeitos adversos , Acetato de Medroxiprogesterona , México , Risco , Tailândia , Neoplasias do Colo do Útero/epidemiologiaRESUMO
PIP: The clinical trial of a longacting levonorgestrel implant, Norplant, as a reversible method of contraception in 2 outpatient clinics of 2 hospitals in Colombia, has had very promising results. In almost 400 acceptors, with thus far more than 2600 woman-months, the pregnancy rate has been nil. Results of the 1st 300 cases are summarized, illustrating 2 sites of insertion--the inner region of the left arm and the left scapular region, both of which present some advantages. Secondary effects and other parameters are analyzed, including irregular bleeding and amenorrheas. Finally, some comments are made in relation to site, extraction, acceptability, and future use of the method. (author's) modified^ieng
Assuntos
Comportamento , Comportamento Contraceptivo , Anticoncepção , Anticoncepcionais Femininos , Estudos de Avaliação como Assunto , Hormônios , Incidência , Levanogestrel , Aceitação pelo Paciente de Cuidados de Saúde , Substâncias para o Controle da Reprodução , Projetos de Pesquisa , Pesquisa , Comportamento Sexual , Estatística como Assunto , Fatores Etários , Amenorreia , América , Antropometria , Biologia , Peso Corporal , Colômbia , Anticoncepcionais , Demografia , Países Desenvolvidos , Países em Desenvolvimento , Diagnóstico , Doença , Dismenorreia , Escolaridade , Sistema Endócrino , Serviços de Planejamento Familiar , Fertilidade , Cefaleia , Hemorragia , América Latina , Ciclo Menstrual , Menstruação , Distúrbios Menstruais , Manifestações Neurológicas , Paridade , Fisiologia , População , Características da População , Dinâmica Populacional , Reprodução , Sinais e Sintomas , América do SulRESUMO
PIP: Cyproterone acetate (Androcur), a potent progestagin and antigonadotropin, has been widely used in Europe in treatment of hirsutism, seborrhea, and alopecia. A formulation combining an estrogen, ethinyl estradiol (EE), to neutralize the progestational action and consequent amenorrhea of Androcur is marketed under the name of DIANE. 3 different treatment protocols were tested: 1) continuous administration of Androcur at doses varying from 25-150 mgr with rests every 3 months 2) high dose combination of 50 mgr Androcur and .05 mgr of EE in 21 day cycles and 3) low dose combinations of 2 mgr Androcur and .05 mgr of EE in 21-day cycles (DIANE). 54 patients who received the DIANE combined low dose treatment were compared. 7 of them had previously received the cyproterone acetate in variable doses of 25-150 mgr/day for 3-10 cycles, 16 had previously taken cyproterone acetate in variable doses of 50-150 mgr/day for 3-14 cycles, followed by the high dose combined method for 3-12 cycles and DIANE for 1-7 cycles, and 15 patients had previously received the high dose combined method for 2-22 cycles followed by DIANE for 3-7 cycles. Among the 54 patients there were 10 cases of idiopathic hirsutism, 11 of suprarenal hirsutism, 25 of ovarian hirsutism, 2 of iatrogenic hirsutism, 24 of acne, 37 of seborrhea, and 10 of alopecia. No pregnancies were reported in patients exposed to risk of pregnancy who took a total of 96 cycles of DIANE or 55 cycles of the high dose combination. Continuous dose cyproterone acetate is usually associated with amenorrhea. The high dose combination induces amenorrhea in up to 20% of cases, while with DIANE the principal change is a diminution in the amount of bleeding. Cyproterone acetate alone or associated with androgens is the preferred treatment for androgenic manifestations. The therapeutic regimen should be adapted to the predominance, time of evolution and severity of symptoms. For moderate or serious hirsutism, the treatment should be continuous administration of high doses of cyproterone acetate for 6 months followed by the combined method at high doses according to the type of initial response. When acne and seborrhea predominate, the combined low-dose method is used, because even though the high dose continuous method gives better results, the secondary effects do not justify its use. The high dose continuous method can be chosen if the low dose combined method fails. The high dose combined method is preferred for alopecia, with the low dose combined method used for maintenance.^ieng
Assuntos
Alopecia , Acetato de Ciproterona , Doença , Etinilestradiol , Doenças do Cabelo , Hirsutismo , Antagonistas de Hormônios , Hormônios , Substâncias para o Controle da Reprodução , Pele , Terapêutica , Acne Vulgar , Biologia , Anticoncepção , Anticoncepcionais , Anticoncepcionais Femininos , Anticoncepcionais Orais Hormonais , Sistema Endócrino , Serviços de Planejamento Familiar , Fisiologia , Sinais e SintomasRESUMO
PIP: Oral contraceptives (OCs) have been distributed through a community-based distribution (CBD) program in Matamaros, Mexico under the auspices of the Centro pro Orientacion Familiar (COFAC). Family Health International (FHI) has provided technical assistance enabling COFAC to conduct a Reproductive Risk Factors Survey to determine if any substantial group of women were placed at a greater risk of death or serious health damage because of this program than if the program had not existed, and, if so, how might such women be protected. The health of CBD acceptors was compared with that of women accepting OC from other sources and women who had never taken OC, using parameters ranging from anemia to cardiovascular disorders. The objective was to investigate the behavior of women who may have serious contraindications to OC and/or pregnancy. About 500 women were interviewed in their homes by specially trained nurses with a questionnaire supplemented by some simple, objective measurements. For validation, a complete medical history was taken and physical examination given for a subsample in the COFAC clinic. Some 40 separate reproductive health indicators were developed from this data. Findings indicated that the CBD program in Matamoros did not introduce any new source of danger to women of reproductive age. As a generality across the 40 indicators, CBD acceptors were as healthy as acceptors from other sources and were somewhat more likely to have consulted a physician. Current OC users were healthier than never users, after controlling for age and parity. The fact of regular contact with neighborhood promotoras (promoters), backed up by the COFAC medical center, represented an additional source of safety not previously available. The promoters were responsible for promotion of family planning, including sale at a subsidized price of OCs and contraceptive foam, and were trained in the use of a checklist for possible contraindications to OC. The CBD program introduced an important public health benefit by reducing unwanted pregnancy with its attendant dangers. Survey results failed to support the view that physician prescription as a requirement for OC use would be a useful public health measure in that setting.^ieng
Assuntos
Anticoncepção , Anticoncepcionais Femininos , Anticoncepcionais Orais , Atenção à Saúde , Saúde , Aceitação pelo Paciente de Cuidados de Saúde , Características da População , Substâncias para o Controle da Reprodução , América , América Central , Anticoncepcionais , Países Desenvolvidos , Países em Desenvolvimento , Serviços de Planejamento Familiar , Planejamento em Saúde , América Latina , México , América do Norte , Organização e Administração , Saúde Pública , PesquisaRESUMO
Norplant subdermal implants containing levonorgestrel were used for contraception and compared with the Copper T, Model T Cu 200, during 42 months of use in an open study in Chile, the Dominican Republic, and Finland. Among 324 women enrolled for the implant regimen, there were no pregnancies in the 1st 2.5 years, and 2 by the end of 42 months. 1st segment net and gross cumulative pregnancy rates were 0.7 and 1.2/100 respectively, at 3.5 years. Cumulative pregnancy rates for the T Cu 200 group were 2.9, net and 3.5/100, gross at 42 months. More than 1/2 of the implant acceptors, 51.6/100 were continuing use at 3.5 years, somewhat above the continuation rate of the T Cu acceptors, 43.5/100, but not significantly so.
Assuntos
Anticoncepção , Anticoncepcionais Femininos , Estudos de Avaliação como Assunto , Dispositivos Intrauterinos de Cobre , Dispositivos Intrauterinos , Levanogestrel , Aceitação pelo Paciente de Cuidados de Saúde , Taxa de Gravidez , Substâncias para o Controle da Reprodução , Pesquisa , América , Coeficiente de Natalidade , Região do Caribe , Chile , Comportamento Contraceptivo , Anticoncepcionais , Demografia , Países Desenvolvidos , Países em Desenvolvimento , Diagnóstico , República Dominicana , Europa (Continente) , Serviços de Planejamento Familiar , Fertilidade , Finlândia , América Latina , América do Norte , População , Dinâmica Populacional , Países Escandinavos e Nórdicos , América do SulRESUMO
Chlamydia trachomatis is a common cause of sexually transmitted disease in adolescent girls. Of 366 adolescent patients screened, 15.3% were found to have chlamydial endocervical infections, with an infection rate of 23.3% in blacks, 14.3% in Hispanics, and 10.3% in whites (P = 0.01, excess for blacks). Of Chlamydia-positive patients, 63.6% had a diagnosis of lower genital tract infection, compared with 35.4% of Chlamydia-negative patients (P = 0.004). Oral contraceptive users had a higher prevalence of infection (23.8%) compared with those using a barrier method (16.2%) or with nonusers (9.3%) (P = 0.004). Inflammatory changes on Papanicolaou smears were associated with chlamydial infection (P = 0.0001). Other variables identified as risk factors for chlamydial infection included both a younger age at first intercourse (P = 0.02) and more years of sexual activity (P = 0.02). Chronologic, menarchal, and gynecologic age, biologic age of the cervix, the number of sexual partners in the last month and during a lifetime, and parity were not found to be associated with recovery of Chlamydia.
PIP: Chlamydia trachomatis is a common cause of sexually transmitted disease in adolescent girls. Of 366 adolescent patients screened, 15.3% were found to have chlamydial endocervical infections, with an infection rate of 23.3% in blacks, 14.3% in Hispanics, and 10.3% in whites (P=0.01, excess for blacks). Of Chlamydia-positive patients, 63.6% had a diagnosis of lower genital tract infection, compared with 35.4% of Chlamydia-negative patients (P=0.004). Oral contraceptive users had a higher prevalence of infection (23.8%) compared with those using a barrier method (16.2%) or with nonusers (9.3%) (P=0.004). Inflammatory changes on Papanicolaou smears were associated with chlamydial infection (P=0.0001). Other variables identified as risk factors for chlamydial infection included both a younger age at 1st intercourse (P=0.02) and more years of sexual activity (P=0.02). Chronologic, menarchal, and gynecologic age, biologic age of the cervix, number of sexual prtners in the last month, and during a lifetime, and parity were not found to be associated with recovery of Chlamydia.