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Certainty? Maybe, Maybe Not: 1950 to 2000
Published in John K. Crellin, A Social History of Medicines in the Twentieth Century, 2020
The "improvements" noted were nonestrogen or low-dose estrogen products—the latter in fact having been used more widely in Britain than in the United States and Canada in the 1960s.197 Uncertainties, however, remained, as reflected in 1970 when Time magazine told readers about a new progestogen-only product: Chlormadinone differs from conventional forms of the Pill in two vital respects: 1) it consists simply of a synthetic analogue of the hormone progesterone and contains none of the estrogen that has been implicated in clotting disorders among Pill users ... 2) it is taken every day of the year, and not on the 21 -days-on, seven-days-off schedule of other forms of the Pill. Like the other versions—and, in fact like all other potent medications—chlormadinone has its drawbacks. The failure rate, judged by unwanted pregnancies, is slightly higher than with other pills, and some women complain of irregular menstrual bleeding.198 This cautious optimism, reflecting authoritative medical opinion at the time, was fair comment given the existing state of knowledge.199
Progestogen use and breast cancer
Published in Barry G. Wren, Progress in the Management of the Menopause, 2020
Although many epidemiological studies have been conducted to assess the relationship between ERT and breast-cancer risk, only a few of them specifically address the role of the progestins. This relates to the rather recent coprescription of progestins with estrogens for menopausal therapy, especially in the United States where most of the large epidemiological surveys were conducted. Also, one must bear in mind that the progestins prescribed for hormone replacement therapy (HRT) differ from country to country, and their effects also differ according to the category to which they belong. In the United States, most of the prescriptions of progestins relate to medroxyprogesterone acetate (MPA), while in Europe derivatives of progesterone are preferred for HRT, such as micronized progesterone (MP), dydrogesterone (DDG), chlormadinone acetate (CIA) derived from 170H-progesterone, or nomegestrol acetate (NOM Ac) derived from 19-norprogesterone.
Primary choice of estrogen and progestogen as components for HRT: a clinical pharmacological view
Published in Climacteric, 2022
In our recommendations (Table 6) we have considered the different tolerability of the various progestogens. For example, progesterone and its derivatives present a mostly higher tolerability and are mostly neutral in their metabolic and vascular effects (higher doses are possible to ensure endometrial safety) in contrast to norethisterone and its derivatives, and also considering the lower endometrial efficacy especially of progesterone with the consequence that higher doses are possible, even though this is certainly not needed in all patients. Especially high dosages of progesterone have been used in reproductive medicine (e.g. 800 mg/day) without a high frequency of side effects (with the exception of bloating due to mineralocorticoid metabolites), the strong sedative effect not being a disadvantage for HRT (if applied during evening). For the progestogen challenge test, in earlier years we often used oral NETA (1–2 mg/day) due to its strong endometrial efficacy, but in our countries this is no longer available. Alternatively, chlormadinone acetate (4–6 mg/day), dienogest (2–4 mg/day) or dydrogesterone (10 mg/day) can be recommended. For this test we would not like to recommend progesterone.
Oral administration of l -carnitine improves the clinical outcome of fertility in patients with IVF treatment
Published in Gynecological Endocrinology, 2018
Yuko Kitano, Shu Hashimoto, Hiroshi Matsumoto, Takayuki Yamochi, Masaya Yamanaka, Yoshiharu Nakaoka, Aisaku Fukuda, Masayasu Inoue, Tomoaki Ikeda, Yoshiharu Morimoto
For hormone replacement cycles, the endometrium was prepared as described previously [22] by incremental doses of oral estradiol valerate (Progynova®; Bayer Schering Pharma Co., Ltd., Zürich, Switzerland) from 1 to 4 mg for 2 weeks following administration of GnRH agonist (600 μg/day, Suprecur® nasal solution 0.15%; Mochida Pharmaceutical Co., Ltd., Tokyo, Japan) for 3 weeks. A total of 6 mg per day of chlormadinone acetate was administered after confirming that the endometrial thickness was >8 mm by ultrasonography. Daily doses of 3 mg of estradiol valerate and 6 mg of chlormadinone acetate were maintained until a pregnancy test. A single vitrified-warmed blastocyst was transferred on the fifth day of chlormadinone acetate administration.
Effects of progestin-only contraceptives on the endometrium
Published in Expert Review of Clinical Pharmacology, 2020
Carlo Bastianelli, Manuela Farris, Vincenzina Bruni, Elena Rosato, Ivo Brosens, Giuseppe Benagiano
In 1967, Martinez-Manautou et al. [37] presented their first experience with what became known as the ‘Minipill’ (or progestin-only pill, POP), a new method aimed at producing a local antifertility effect by modifying both the endometrium and the cervical mucus, without suppressing the hypothalamic-pituitary-ovarian axis. They used daily 0.5 mg chlormadinone acetate (CMA), first from day 5 to 25, and later without interruption, with encouraging results. In a further report, Martinez-Manautou [38] summarized information, based on 1070 biopsies, on the endometrial effects of the new method; a secretory endometrium was observed in 67.4 and 79.7% of all samples, depending on timing. This suggested no major interference with glandular development.