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Endocrine Disorders, Contraception, and Hormone Therapy during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Danazol is usually prescribed for only a three to six-month course. A patient who becomes pregnant while taking the medication may not be diagnosed until a considerable fetal exposure has occurred because the drug is expected to cause amenorrhea. Therefore, physicians should be aware of the risk of female genital ambiguity occurring in the offspring of women who are prescribed this drug.
DRCOG OSCE for Circuit B Answers
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Medical treatment for endometriosis includes the combined oral contraceptive (coc) pill (taken three packets a time with a week's gap), progestogens (Provera) to induce a pseudopregnant state, danazol, gestrinone, GnRH agonists such as Zoladex injections ± add-back therapy, and the Mirena IUS (experimental). Patients on danazol must be warned of the potential androgenic and anti-oestrogenic side-effects such as greasy hair, acne, irreversible voice deepening, hot flushes, etc. Therapy is discontinued after 6 months to reduce the risk of osteoporosis. Patients on Zoladex should be warned of vasomotor side-effects. Therapy is discontinued after 6 months to reduce the risk of osteoporosis.
The twentieth century
Published in Michael J. O’Dowd, The History of Medications for Women, 2020
The next treatment of note was that of ‘pseudomenopause’. Greenblatt and associates (1971) introduced danazol which brought about a hormonal state similar to chronic anovulation. As a result, the endometriosis implants atrophied. Danazol bound itself to the progestin, androgen and glucocorticoid receptors. Its net effect was the creation of a high-androgen, low-estrogen environment that was detrimental to endometrial growth. Unfortunately the side-effects of danazol were common and primarily due to its androgenic properties. Despite this, the patients who persisted with treatment reported that danazol was effective in alleviating endometriosis-associated pain. A number of other steroid and anti-steroid treatments have been used, including gestrinone, tamoxifen and the synthetic RU486.
Pregnancy-associated aplastic anemia: a case-based review
Published in Expert Review of Hematology, 2021
José Carlos Jaime-Pérez, Mariana González-Treviño, David Gómez-Almaguer
The first-line treatment for AA is bone marrow transplantation [30,31]; however, HSCT is contraindicated during pregnancy due to the conditioning regimen’s toxic effects on the fetus [5]. The effectiveness of danazol for AA has been confirmed in several reports [32] but it may be harmful to the fetus, especially a female fetus in which it can cause virilization [33]. According to BCSH guidelines CsA is recommended for pregnant patients needing recurring transfusions; however, there is controversial data supporting that CsA alone is effective in AA [4,5,15,16,18,20,25,29,30]. GM-CSF has also been used in combination with CsA in pregnant women with AA with no response [4]. Furthermore, erythropoietin and eltrombopag have been used in pregnant women with myelodysplastic syndrome and immune thrombocytopenia [34,35]; however, there is insufficient data to determine a drug-associated risk of adverse fetal development using these drugs. Our case C received CsA and erythropoietin during pregnancy and it did not appear to offer an advantage over support therapy alone.
The role of pharmacotherapy in the treatment of endometriosis across the lifespan
Published in Expert Opinion on Pharmacotherapy, 2020
Kaia Schwartz, Natalia C. Llarena, Jenna M. Rehmer, Elliott G. Richards, Tommaso Falcone
Data specific to the postoperative management of deeply infiltrating endometriosis (DIE) are limited; however, some studies have reported improvements in recurrence rates with postoperative medical treatment [45]. In a prospective cohort study of 500 women who underwent rectal shaving for DIE involving the bowel, the recurrence of pelvic pain occurred in 13% of women treated with continuous COCs or progestins compared to 20% of those who were not treated. The lowest recurrence rate was among women who became pregnant after surgery and immediately began continuous progestins after delivery (2%) [46]. Danazol may also have a role in postoperative suppression for women with DIE, though its utility is limited by side effects; danazol is not frequently prescribed in its oral form. A randomized trial of 60 patients evaluated danazol 200 mg 3 times daily for 6 months after laparoscopy and demonstrated significant improvements in postoperative pain compared to placebo [47]. A second-look laparoscopy at 6 months showed a reduction in the size of recurrent endometriotic implants after danazol treatment. While androgenic side effects are common in oral danazol treatment, including acne and weight gain, recent studies of vaginal or intrauterine danazol have reported substantial improvements in pain associated with DIE with no systemic side effects [48].
Drug-induced arterial hypertension – a frequently ignored cause of secondary hypertension: a review
Published in Acta Cardiologica, 2018
Camelia Cristina Diaconu, Giorgiana Nicoleta Dediu, Mihaela Adela Iancu
Studies on women taking oral contraceptives have shown that hypertension is 2–3 times more frequent than in control subjects [3]. Women with a family history of arterial hypertension or a personal history of pregnancy-induced hypertension have increased risk, as well as smokers, obese, or diabetic women [4]. This increased risk of hypertension associated with oral contraceptives is explained by the natrium retention, with increased volemia due to the effects on mineralocorticoid receptors, or by increased serum concentrations of angiotensinogen [5]. The risk of hypertension increases parallel with the doses used. Estrogen replacement treatment in post-menopausal women may slightly increase the blood pressure values. Also, treatment with oestrogens for prostatic cancer in men may be associated with increased risk of hypertension. Danazol is a semisynthetic androgen drug recommended for women with endometriosis or for patients with hereditary angioedema; this drug produce natrium and water retention, with elevations of blood pressure values [6].