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Combined methods
Published in Suzanne Everett, Handbook of Contraception and Sexual Health, 2020
The combined oral contraceptive pill contains the hormones oestrogen and progestogen. The synthetic forms of these found in combined contraceptive methods are ethinylestradiol and progestogens in the form of gestodene, desogestrel, drospirenone, levonorgestrel and norethisterone.
Probabilities in Medicine
Published in Dien Ho, A Philosopher Goes to the Doctor, 2019
The failure to understand health statics among laypersons, journalists, and policy-makers can be equally if not more distressing. In 1995, the U.K.’s Committee on Safety of Medicines warned that the use of third-generation birth-control pills that contain gestodene or desogestrel have a risk for venous thromboembolism that is twice as high as that of earlier generations. Thousands of women stopped taking oral contraceptives leading to a significant increase of abortions and unplanned births. However, if one digs deeper into the statistics, the risk of a woman developing venous thromboembolism without being on birth-control pills is 1 in 7,000, while for women on the birth-control pills, the risk is 2 in 7,000. Although the relative risk was in fact twice as high, the absolute risk of developing venous thromboembolism was still remarkably small. Given the harm caused by the abrupt cessation of oral birth-control, a mis-comprehension of the statistics (and the warning issued) led to poor public health and clinical decisions.
Contraception
Published in James M. Rippe, Lifestyle Medicine, 2019
COCs all contain an estrogen and progestin component. Most current COCs in the United States contain ethinyl estradiol (EE) as the estrogen component in a 10–35 mcg dosage. COCs have varying numbers of active pills and placebo pills. The progestin component is one of eight different progestins. Third-generation progestins, desogestrel, norgestimate, and gestodene, have lower androgenic activity, allowing for less acne and hirsutism. The newest group of progestins, the fourth generation, is drospirenone, which is a derivative of spironolactone. It also has significant antiandrogenic activity and is beneficial for androgenic states, such as acne, hirsutism, and polycystic ovary syndrome.9 The primary mechanism of action of COCs is due to the progestin component, which results in ovulation suppression through negative feedback on the hypothalamic-pituitary system. Additionally, the progestin component results in thickening of cervical mucus, which prevents sperm penetration and slows tubal motility. The thin, asynchronous endometrium created inhibits implantation.7
Oculo-auriculo-vertebral spectrum and maternal drug ingestion: cause or coincidence?
Published in Hearing, Balance and Communication, 2023
Joana Raquel Costa, Miguel Bebiano Coutinho, Teresa Soares, Luís Meireles
Fluoxetine intake during pregnancy was observed in 3 cases. One case throughout the first trimester of pregnancy and the second case during the first and second trimester. In two cases, a history of Gestational Diabetes requiring insulin in the third trimester was found. The use of Hormonal Contraceptives with oestrogen and progesterone components during the first trimester of pregnancy has been reported in 4 cases: Perlutan® – algestone acetophenide + oestradiol enanthade; Provera® – medroxyprogesterone acetate; and Harmonet® – ethinylestradiol + gestodene (2 cases). In two cases, a history of Hypothyroidism requiring Levothyroxine intake was reported. Also in two cases, history of intake of Isotretinoin during the first trimester of pregnancy for the treatment of acne has been described. Other drugs reported were: Domperidone (until the fifth week of gestation); Enalapril; Acyclovir (in the seventh week for herpes zoster) and Pseudoephedrine/Triprolidine.
Effects of anatomical location on in vivo percutaneous penetration in man
Published in Cutaneous and Ocular Toxicology, 2020
Jordan L. Bormann, Howard I. Maibach
A contraceptive patch containing ethinyl oestradiol and gestodene was tested at three location sites: upper outer arm, buttocks, and abdomen. There was no significant difference in percutaneous absorption at any of the sites (Table 8)37. Stanczyk et al.38 found less absorption at the abdomen compared to back and buttocks of a low-dose ethinyl oestradiol patch (Table 8). However, therapeutically, all three patch application sites were similar. Abrams et al.22 collected absorption data on a patch containing ethinyl oestradiol and norelgestromin also showing decreased absorption of both hormones, yet still within therapeutic range (Table 8). Yet another study regarding 17-B-oestradiol absorption showed 88% of the AUC0-last for an abdominal patch location compared to the buttock (Table 8)39.
A comprehensive review of hormonal and biological therapies for endometriosis: latest developments
Published in Expert Opinion on Biological Therapy, 2019
Fabio Barra, Giovanni Grandi, Matteo Tantari, Carolina Scala, Fabio Facchinetti, Simone Ferrero
Another multicenter RCT compared a 12-month treatment with COC (EE 0.03 mg and gestodene 0.75 mg) with TRP (3.75 mg intramuscular every month) given for 4 months followed by COC (EE 0.03 mg and gestoden 0.75 mg) for other 8 months. A significant improvement in dysmenorrhea and non-menstrual pain at 12-month follow-up was observed without inter-group differences by receiving both treatments [53]. A double-blind RCT evaluated the efficacy of a 48-week treatment with LEU (11.25 mg every 3 months) with the addition of NETA (5 mg every day), as add-back therapy, in comparison with continuous COC (35 mg EE and 1 mg NETA). Both drugs provided a significant improvement in pain from baseline without significant difference [54]. In 2010, a Cochrane review included 27 studies comparing GnRH-agonists versus danazol in patients with endometriosis; no significant difference was reported between the two treatments in improving dysmenorrhea, deep dyspareunia and non-cyclic pelvic pain [47].