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DRCPG MCQs for Circuit A 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
The Mirena coil or the levonorgestrel-releasing intrauterine system (IUS) is licensed to be used for 5 years at a time in the UK. It does not have a product licence yet for control of menorrhagia, but it does have this added advantage. The local effect of the Mirena coil causes thickening of the cervical mucus, endometrial atrophy and partial ovulation suppression. It is not advisable in patients with a history of PID and does not increase the risk of ectopic pregnancy. By acting as a contraceptive device with 99% efficacy, the risk is lower.
Obstetrics and Gynaecology
Published in Seema Khan, Get Through, 2020
The Mirena coil or the levonorgestrel-releasing intrauterine system (IUS) is licensed to be used for 5 years at a time in the UK. It has a product licence for control of menorrhagia. The local effect of the Mirena coil causes thickening of the cervical mucus, endometrial atrophy and partial ovulation suppression. It is not advisable in patients with a past history of PID and does not increase the risk of ectopic pregnancy. By acting as a contraceptive device with 99% efficacy, the risk is lower.
The twentieth century
Published in Michael J. O’Dowd, The History of Medications for Women, 2020
Over 20 years later it became apparent that anti-prostaglandin agents could reduce excess menstrual blood loss and in the 1980s mefenamic acid became a regular treatment for abnormal uterine hemorrhage. Westrom and Bengtsson (1970) and Nilsson and Rybo (1971) treated menorrhagia with tranexamic acid and reported a significant reduction in menstrual blood loss. The fibrinolytic inhibitors became rhe mainstay of therapy although the combined oral contraceptive and continuous or intermittent progesterone treatment were much used. In the late 1990s the Mirena intrauterine progesterone contraceptive was found helpful. Although it is not possible to compare directly the clinical studies of early and later anti-menorrhagic drugs, there is no doubt that drug treatment has not been entirely satisfactory at either end of the century and many women have had to endure operative intervention with endometrial ablation or hysterectomy.
Contraceptive access experiences and perspectives of Mexican-origin youth: a binational qualitative study
Published in Sexual and Reproductive Health Matters, 2023
Ashley Mitchell, Abigail Gutmann-Gonzalez, Claire D. Brindis, Martha J. Decker
Another participant reported receiving the Depo shot, but when asked if this was their preferred method, she explained: “No, before they had told me about a new one that came out, the Mirena, but there at the hospital … they didn't put it in because I was discharged later. First, they asked me if I was the one who was going to get it, I said yes, but then they never came, and I didn't get anything in the end.” (Guanajuato Interviewee)This participant described the additional effort required to make up for the lost opportunity, first seeking an injection at their local health centre and considering finding another provider who would place an IUD “to better protect myself.” While this participant was aware of the choices and benefits of contraception, and advocated for her preference, she was denied access at specific times and locations.
Levonorgestrel-releasing intrauterine system effects on metabolic variables in PCOS
Published in Gynecological Endocrinology, 2023
Limei Ji, Lanying Jin, Ming jun Shao, Min Hu, JIan Xu
Any effective treatment that delivers a hormone locally and is associated with a lower systemic level is likely to be more acceptable to the patient as the side effects would be more tolerable. The Mirena intrauterine system (Schering Health, Berlin, Germany) delivers levonorgestrel (Lng) locally at a steady rate of 20 mg/24 h and offers the added advantage of a single administration for a possible duration of 5 years. Thus far, only one study [8] has evaluated the performance of the Mirena intrauterine system was not associated with relevant changes in clinical or metabolic markers in women without comorbidities with PCOS; however, the follow-up period was short. The aim of our study was to evaluate the effect of the Mirena intrauterine system in women with PCOS followed up over a period of 24 months by comparing the levels of various reproductive hormones and metabolic indices from baseline and to women without PCOS.
Preoperative CA125 as a risk factor for symptom recurrence of adenomyosis after ultrasound-guided high-intensity focused ultrasound ablation surgery
Published in International Journal of Hyperthermia, 2022
Ying Tang, Yang Ming-tao, Ru-mei Xiang, Wei Xu, Ruo-yi Zhang, Ming-bo Weng, Fang-xiang Tang, Hui-quan Hu, Fan Xu, Jun Li, Qiuling Shi
Our results were in agreement with the finding of Sheth S [22], high preoperative CA125 level suggesting larger the adenomyotic lesions volume, especially in the outer lesion of myometrium, higher the chance of its coexistance with adhesion and endometrisis in patients of adenomyosis. On this occasion, patients might be in a high level of inflammation. When preoperative CA125 level of adenomyosis patients was more than 35 U/mL, especially more than 58.7 U/mL, the symptom recurrence rate of adenomyosis was high, especially combined with severe dysmenorrhea, hyperintensity on T2WI and massive grayscale change during FUAS procedure. On this occasion, a sufficient sonication energy and average sonication power without causing safety troubles was suggested to decrease the opportunity to relapse. Besides, combined treatment with GnRH-a or mirena might be a beneficial choice for decreasing the recurrence. Given the pathogenesis of adenomyosis, FUAS alone might not guarantee therapeutic effect and prevent symptom recurrence in patients with adenomyosis, especially diffuse adenomyotic lesions with high preoperative CA125 level [8]. Therefore, 3-6 cycles of GnRH-a after FUAS were administered, and treatment combined with mirena after 4-6 cycles of injection was recommended if patients had no desire to get pregnant in short time.