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Africa
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Ailments and Diseases
Published in James Sherifi, General Practice Under the NHS, 2023
Despite the widespread availability of free contraception in the UK, the incidence of abortion continued to rise from 8 per 1,000 women aged 15–44 in 1970, to peak at 18.2 in 2008.14 Rates have since levelled off, partly due to the licensing in 2000, of mifepristone with misoprostol for medical termination of pregnancy up to nine weeks. Levonorgestrel, Levonelle, a palatable, safe, and effective post-coital contraception was initially only available on prescription but quickly moved to prescription-free purchase from chemists.
Endocrine Disorders, Contraception, and Hormone Therapy during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
No epidemiologic studies have been published regarding malformations in the offspring of women who became pregnant with a Norplant system in place. Levonorgestrel is the progestin component in many oral contraceptive preparations.
Contraception
Published in S Paige Hertweck, Maggie L Dwiggins, Clinical Protocols in Pediatric and Adolescent Gynecology, 2022
Oral levonorgestrel 1.5 mg (Plan B® One Step®, Next Choice® One Dose®, My Way®)Previously divided into two doses, however similar efficacy with one-dose regimenTake as soon as possible up to 5 days (120 hours) after unprotected sexAvailable over the counter without age restrictionsMost common side effects: Nausea, irregular bleedingEfficacy decreased by as much as 33% in patients who are overweight or obese
Treatment of women with BRCA mutation
Published in Climacteric, 2023
The influence of a levonorgestrel intrauterine system (LNG-IUS) on the breast is controversial [12]. Although a large observational study indicates an increased risk of breast cancer in the general population [11], the results do not really add up scientifically. With oral contraception there is an increase in breast cancer with long duration of use. In LNG-IUS users, there is an increase of risk of 20% virtually immediately. This is not logical taking tumor biology into account. Subsequently this increased risk does not change any more with longer duration of LNG-IUS use, which is again not logical from the tumor biology point of view. The only substantial information we have is the study where breast cancer histology and behavior were compared in a large set of breast cancers detected in copper intrauterine device and LNG-IUS users [13]. Histology, tumor size and extent of node involvement were the same in both groups. The results did not differ when intrauterine device use was initiated in relation with the tumor detection, nor did the duration of use matter. Both groups had a higher risk of breast cancer compared to controls, indicating that women opting for intrauterine devices are probably at higher risk, suggesting that this is the reason to choose contraception with the lowest possible hormonal burden.
The levonorgestrel-releasing intrauterine device induces endometrial decidualisation in women on tamoxifen
Published in Journal of Obstetrics and Gynaecology, 2019
Sarah Philip, Anthony H. Taylor, Justin C. Konje, Marwan Habiba
Levonorgestrel is a synthetic 19-nortestosterone progestin derivative that is widely used in contraception and postmenopausal hormone therapy. The LNG-IUS releases 20 µg of levonorgestrel per 24 h into the uterine cavity. The local effect predominates but maximum serum levonorgestrel concentrations are reached within a few hours following insertion, and are maintained at 150–200 pg per ml (Lahteenmaki et al. 2000). The LNG-IUS, via the effects of locally delivered levonorgestrel, may prevent tamoxifen-induced polyps (Gardner et al. 2009). Gardner et al. reported that all women in whom the LNG-IUS was fitted (n = 40) showed histological evidence of a decidualised endometrium at the end of an average of 27.9 months of use. The authors linked the inhibition of polyp formation to the ‘progestogenic antagonism’ of tamoxifen effects (Gardner et al. 2009). Chan et al. (2007) also reported a reduction in polyps in LNG-IUS users, and that the endometrium at 12 months was predominantly atrophic.
Selective progesterone receptor modulators: current applications and perspectives
Published in Climacteric, 2018
N. Chabbert-Buffet, K. Kolanska, E. Daraï, P. Bouchard
Today mifepristone, despite its proven efficacy as an EC18, is available for this indication only in China, Vietnam, Russia, and Armenia, while UPA (EllaOne 30 mg) is available world-wide, often over the counter. Tolerance of levonorgestrel and UPA is good22, with the main side-effects of headache, dysmenorrhea, intermenstrual bleeding and nausea described in 9% of cases. The frequency of adverse effects after taking 30 mg UPA or 1.5 mg levonorgestrel is comparable19. There are no contraindications to levonorgestrel or UPA use for EC, except for hypersensitivity to the compound or its excipient and ongoing pregnancy16. No metabolic side-effects have been demonstrated with UPA23 or levonorgestrel. Different aspects of hormonal EC still need improvement or evaluation, however.