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New progestogens in oral contraceptives
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Citationsfrom the Literature
0.86) across the entire menstrual cycle. The authors discuss possible social and hormonal mechanisms that might underlie an ovulatory peak in coitus, as well as the relevance of their findings to current models of fecundability. hormone agonist in pulmonary lelodhyomatosis Maheux R, Samson Y; Farid NR; et al Research Center, St. Francois d’Assise Hospital, Quebec City, Que., Canada FERTIL. STERIL.; 48/2(315-317)/1987/ A patient presenting a recurrent episode of pulmonary leiomyomatosis has been treated with the LH-RH agonist buserelin at a dosage of 200 mug tid SC for 7 days, then 500 mug SC daily for a total period of 6 months. Basal serum E, was suppressed during treatment and varied between 62 and 180 pmol/ml (mean, 129.4 f 14.5). Pulmonary symptoms completely disappeared during treatment, but no objective regression of the pulmonary lesions was observed. Because of the uncertainty of response of benign metastasizing leiomyomas to castration and because of the reversibility of the medical treatment, LH-RH agonist may be preferred to surgical castration in this pathology.
lhllzatton of luteinizing hormone-releasing
Treatment of leiomyomata uteri with D-Trpeop 64uteiniztog hormone-releasing hormone Per1 V; Marquex J; Schally AV; et al Department of Obstetrics and Gynecology, Hospital Jose Joaquin Aguirre, Universidad de Chile, Santiago, Chile FERTIL. STERIL.; 48/3 (383-389)/1987/ Suppression of the secretion of gonadal steroids by chronic administration of a superactive agonist of luteiniaing hormonereleasing hormone (LH-RH) was used for treatment of leiomyomata uteri. Ten menstruating women. presented with a total of 20 uterine leiomyomas, were treated for 3 months with daily subcutaneous injections of D-Trpsup 6-LH-RH. Serum estradiol (IQ levels were suppressed rapidly in five patients and were decreased in other patients. At the end of therapy, leiomyomas regressed completely in three patients, while five patients showed a decrease of more than 40% in the volume of leiomyomas. The reduction in tumor size was correlated with the rapidity of the fall in serum E, levels. In one patient, the leiomyomata increased in size during treatment, and one woman had a poor clinical response. The agonist was well tolerated and few side effects were observed. Therapy with LHRH agonists offers an alternative in the management of some uterine leiomyomas. Metabolic effects of oral contrpceptiverr Gaspard UJ Department of Obstetrics and Gynecology, State University of Liege, Liege, Belgium AM. J. OBSTET. GYNECOL.; 157/4 II (1029-1041)/1987/
Znt J Gynecol Obstet 27
Combination oral contraceptives (OCs) are probably not an independent risk factor for cardiovascular disease but through their metabolic actions, may partly amplify the effects of known risk factors for cardiovascular disease. This review of the literature and our own data indicate that use of high-dose, progestogen-dominant OCs induces a potentially atherogenic lipoprotein profile (high or low-denisty lipoprotein-cholesterol: high density lipoprotein-cholesterol ratio), mostly attributable to the antiestrogenic action of the progestogen content of these OCs. In contrast, lower-dose combination OCs with reduced amounts of progestogens and slight estrogen dominance, either monophasic or multiphasic produce strikhrgly fewer adverse effects on lipoproteins. Moreover, the use of the low-dose, as opposed to high-dose, OCs results in almost unchanged glucose tolerance, marginally increased or unchanged insulin and ghrcagon responses to glucose, and probably unchanged levels and activity of peripheral insulin receptors. Further in-depth studies of low-dose OC formulations are mandatory to ascertain reduced metabolic risk of these OCs.
New progestogens In oraI contraceptives Runnebaum B; Rabe T Divkion of Gynecological Endorcrinology, Department of Obstretics and Gynecology, University of Heidelberg, Heidelberg, FRG AM. J. OBSTET. GYNECOL.; 15714 II (1059-1063)/1987/ The aim of using new synthetic progestogens (gestodene and norgestimate) in oral hormonal contraceptives is to find a combination that has a more beneficial effect on metabolism and endometrium than presently available formulations. Our studies with low-dose pills containing 30 mug ethinyl estradiol/ 150 mug levonorgestrel or 30 mug ethinyl estradiol/lSO mug desogestrel compared with the new pills with 35 mug ethinyl estradiol/250 mug norgestimate or 30 mug ethinyl estradiol/75 mug gestodene revealed no significant alterations of serum glucose after glucose loading. With all four combination pills, insulin levels were slightly elevated when compared with controls. Studies of the lipid metabolism showed that depending on the type and estrogen combination, progestogens have different effects on lipid metabolism. The new progestogens seem to have a more pronounced effect on triglycerides, whereas total cholesterol and high-density lipoprotein cholesterol remain almost unchanged. In general, it could be shown that low-dose oral contraceptives have little impact on lipid metabolism. Studies with low-dose monophasic preparations, including the new formulations, reveal only a low effect on blood coagulation. According to our and other data on the new progestogens in oral contraceptives available so far, it can be expected that such low-dose monophasic and triphasic combination pills will be beneficial during longtime use with respect to side effects on the cardiovascular system and control of the menstrual cycle.
Citationsfrom the Literature
0.86) across the entire menstrual cycle. The authors discuss possible social and hormonal mechanisms that might underlie an ovulatory peak in coitus, as well as the relevance of their findings to current models of fecundability. hormone agonist in pulmonary lelodhyomatosis Maheux R, Samson Y; Farid NR; et al Research Center, St. Francois d’Assise Hospital, Quebec City, Que., Canada FERTIL. STERIL.; 48/2(315-317)/1987/ A patient presenting a recurrent episode of pulmonary leiomyomatosis has been treated with the LH-RH agonist buserelin at a dosage of 200 mug tid SC for 7 days, then 500 mug SC daily for a total period of 6 months. Basal serum E, was suppressed during treatment and varied between 62 and 180 pmol/ml (mean, 129.4 f 14.5). Pulmonary symptoms completely disappeared during treatment, but no objective regression of the pulmonary lesions was observed. Because of the uncertainty of response of benign metastasizing leiomyomas to castration and because of the reversibility of the medical treatment, LH-RH agonist may be preferred to surgical castration in this pathology.
lhllzatton of luteinizing hormone-releasing
Treatment of leiomyomata uteri with D-Trpeop 64uteiniztog hormone-releasing hormone Per1 V; Marquex J; Schally AV; et al Department of Obstetrics and Gynecology, Hospital Jose Joaquin Aguirre, Universidad de Chile, Santiago, Chile FERTIL. STERIL.; 48/3 (383-389)/1987/ Suppression of the secretion of gonadal steroids by chronic administration of a superactive agonist of luteiniaing hormonereleasing hormone (LH-RH) was used for treatment of leiomyomata uteri. Ten menstruating women. presented with a total of 20 uterine leiomyomas, were treated for 3 months with daily subcutaneous injections of D-Trpsup 6-LH-RH. Serum estradiol (IQ levels were suppressed rapidly in five patients and were decreased in other patients. At the end of therapy, leiomyomas regressed completely in three patients, while five patients showed a decrease of more than 40% in the volume of leiomyomas. The reduction in tumor size was correlated with the rapidity of the fall in serum E, levels. In one patient, the leiomyomata increased in size during treatment, and one woman had a poor clinical response. The agonist was well tolerated and few side effects were observed. Therapy with LHRH agonists offers an alternative in the management of some uterine leiomyomas. Metabolic effects of oral contrpceptiverr Gaspard UJ Department of Obstetrics and Gynecology, State University of Liege, Liege, Belgium AM. J. OBSTET. GYNECOL.; 157/4 II (1029-1041)/1987/
Znt J Gynecol Obstet 27
Combination oral contraceptives (OCs) are probably not an independent risk factor for cardiovascular disease but through their metabolic actions, may partly amplify the effects of known risk factors for cardiovascular disease. This review of the literature and our own data indicate that use of high-dose, progestogen-dominant OCs induces a potentially atherogenic lipoprotein profile (high or low-denisty lipoprotein-cholesterol: high density lipoprotein-cholesterol ratio), mostly attributable to the antiestrogenic action of the progestogen content of these OCs. In contrast, lower-dose combination OCs with reduced amounts of progestogens and slight estrogen dominance, either monophasic or multiphasic produce strikhrgly fewer adverse effects on lipoproteins. Moreover, the use of the low-dose, as opposed to high-dose, OCs results in almost unchanged glucose tolerance, marginally increased or unchanged insulin and ghrcagon responses to glucose, and probably unchanged levels and activity of peripheral insulin receptors. Further in-depth studies of low-dose OC formulations are mandatory to ascertain reduced metabolic risk of these OCs.
New progestogens In oraI contraceptives Runnebaum B; Rabe T Divkion of Gynecological Endorcrinology, Department of Obstretics and Gynecology, University of Heidelberg, Heidelberg, FRG AM. J. OBSTET. GYNECOL.; 15714 II (1059-1063)/1987/ The aim of using new synthetic progestogens (gestodene and norgestimate) in oral hormonal contraceptives is to find a combination that has a more beneficial effect on metabolism and endometrium than presently available formulations. Our studies with low-dose pills containing 30 mug ethinyl estradiol/ 150 mug levonorgestrel or 30 mug ethinyl estradiol/lSO mug desogestrel compared with the new pills with 35 mug ethinyl estradiol/250 mug norgestimate or 30 mug ethinyl estradiol/75 mug gestodene revealed no significant alterations of serum glucose after glucose loading. With all four combination pills, insulin levels were slightly elevated when compared with controls. Studies of the lipid metabolism showed that depending on the type and estrogen combination, progestogens have different effects on lipid metabolism. The new progestogens seem to have a more pronounced effect on triglycerides, whereas total cholesterol and high-density lipoprotein cholesterol remain almost unchanged. In general, it could be shown that low-dose oral contraceptives have little impact on lipid metabolism. Studies with low-dose monophasic preparations, including the new formulations, reveal only a low effect on blood coagulation. According to our and other data on the new progestogens in oral contraceptives available so far, it can be expected that such low-dose monophasic and triphasic combination pills will be beneficial during longtime use with respect to side effects on the cardiovascular system and control of the menstrual cycle.