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Reproductive health care for adolescents with developmental delay
Published in Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo, Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Elisabeth H. Quint, Susan D. Ernst
No single therapy has been found to be always successful in treating cyclical behavior disorders.57 The usual first-line treatments, such as dietary and lifestyle changes, can be difficult to administer to teens with DD. In women who may not be able to communicate their feelings, behaviors may be an outlet for pain. The first line of treatment for women with DD is an NSAID in adequate doses to start on the day of start of the behavior, which was found to be successful in 65% of 45 adult patients with cyclical behavior changes.53 If that approach is unsuccessful, ovulation suppression may be tried. Several studies suggest that an oral contraceptive with drospirenone may be helpful.58 Selective serotonin reuptake inhibitors (SSRIs) have not been used for this indication in teens with DD but are among the first-line therapy in the general population with severe PMS and PMDD.59
Combined oral contraceptive methods
Published in Sarah Bekaert, Alison White, Integrated Contraceptive and Sexual Healthcare, 2018
Sarah Bekaert, Alison White, Kathy French, Kevin Miles
The third-generation progestogens desogestrel, drospirenone and gestodene may be considered for women who experience progestogenic side effects (such as acne, headache, depression, weight gain, breast symptoms and breakthrough bleeding) as they, combined with ethinyloestradiol, are more oestrogen dominant. Women should be advised that desogestrel and gestodene may be associated with an increased risk of venous thromboembolism (VTE),1-3 although there is recent evidence suggesting second-generation progestogens do not have these associated risks.4,5
Adverse reactions and the proliferation of risk
Published in Kevin Dew, Public Health, Personal Health and Pills, 2018
Geampana notes that there has been a long history of epidemiological studies identifying links between oral contraceptives and blood clots, as well as other serious health conditions. Drug agency reviews of Drospirenone found that it was associated with a 1.5–3 times higher risk of blood clots than other contraceptive pills. The FDA and medical associations used a number of strategies to downplay this concern. One was identifying potential methodological flaws in the epidemiological studies that came up with negative findings. Another was to emphasise that, even with its higher risk profile, taking the drug was less likely to cause blood clots than pregnancy. This sets up a very simple dichotomy for women: with their risky bodies, taking a drug is less risky than getting pregnant. Geampana notes that comparisons between Drospirenone and other less risky oral contraceptives was downplayed, and that all the other potential side effects from oral contraceptives (such as migraines, weight gain, loss of libido) were not mentioned at all by these agencies when responding to the controversy. In sum, we can suggest that, as women’s bodies are constructed as being naturally and inevitably sites or risk, therefore more risks can be taken with those bodies as compared to the male body.
Hormonal and natural contraceptives: a review on efficacy and risks of different methods for an informed choice
Published in Gynecological Endocrinology, 2023
Andrea R. Genazzani, Tiziana Fidecicchi, Domenico Arduini, Andrea Giannini, Tommaso Simoncini
Some progestin-only pills (POPs) have a lower ovulation inhibition capacity than that obtained with CHCs containing the same progestin. However, they maintain the progestogenic effect on cervical mucus and sperm viability. On the contrary, desogestrel- and drospirenone-containing pills have a sufficient progestin dose to efficiently inhibit ovulation, also reducing the incidence of breakthrough bleedings that may occur with other POPs [52, 53]. Non-oral progestin-only contraceptives include injectable progestins, subdermal implant, and intrauterine devices (IUD); they were developed to avoid the one-per-day pill administration. Depot medroxyprogesterone acetate should be injected every three months, subdermal implants last three years, while IUDs should be replaced every three to five years, according to the type used. Thanks to their long life, they ensure greater compliance, with good safety profile and no effects on hemostatic parameters [54].
Effects of spironolactone on dysmenorrhoea: a case report
Published in Journal of Obstetrics and Gynaecology, 2022
Mariko Nakahara, Mika Tanaka, Kanako Murata, Yuko Matsuda, Yasuka Miyakuni, Fuyuko Nagai, Kentaro Miyai
SPL has progestational activity in rabbits and rhesus monkeys (Schane and Potts 1978). Drospirenone is a unique progestogen derived from SPL and has a pharmacologic profile similar to that of endogenous progesterone (Genazzani et al. 2007). Drospirenone reportedly has anti-inflammatory, anti-angiogenic, and anti-neurogenic effects on endometriotic stromal cells that are mediated by progesterone receptors (Makabe et al. 2017). Here, SPL demonstrated similar efficacy to drospirenone for dysmenorrhoea. SPL is predominantly used in clinical practice as a potassium-sparing diuretic; however, its anti-androgenic effects have led to its use in other areas, such as in the treatment of hirsutism in women, particularly when associated with polycystic ovary syndrome (PCOS). It can also result in undesirable effects, such as menstrual disorders (Carone et al. 2017). Our patient’s menstrual bleeding improved and her menstrual cycle remained regular.
A rare complication of combined oral contraceptives (COCs): optic neuritis
Published in Journal of Obstetrics and Gynaecology, 2021
As a result of these mechanisms, flow-mediated vasodilatation can be antagonised when progesterone is added to the structure (Miner et al. 2011). Thus, with the same mechanism, drospirenone, can affect the eye structure by inhibiting the effects of oestrogen (Wiegratz and Kuhl 2006). Madendag et al. (2017) compared 24 healthy women taking a monophasic third-generation COC (3 mg drospirenone and 0.03 mg ethinylestradiol) for contraception only for at least one year to a control group of 24 healthy women who were not taking a COC. They evaluated the effect of oral COCs on choroidal thickness (CT) and the retinal nerve fibre layer (RNFL). They found that RNFL and CT were significantly thinner in the study group versus the control group. Third-generation progestins are more advanced than first-generation progestins, but in the long-term use of COCs, progestins may antagonise oestrogen activity, leading to ocular complications.