China
Africa
Explore chapters and articles related to this topic
Contraception and termination of pregnancy
Published in David M. Luesley, Mark D. Kilby, Obstetrics & Gynaecology, 2016
Three POICs are available in the UK. They are: Depot medroxyprogesterone acetate (DMPA) 150 mg given as deep intramuscular (IM) every 12 weeks. It is the most commonly used POIC in the UK.Subcutaneous DMPA (Sayana Press) 104 mg given subcutaneously every 13 weeks. It has been available in the UK since June 2013. It is bioequivalent to IM DMPA. It is administered via Unijet which is a new delivery system and is in a pre-filled injector which needs to be shaken vigorously to ensure a uniform suspension. It can be injected into the upper anterior thigh or anterior abdomen. Rates of bone loss, amenorrhoea, weight gain and return to fertility are the same as for IM DMPA. It will be beneficial for women who are on anticoagulants as there is less likelihood of haematoma formation. Also it may be more advantageous for very obese women when there is concern that the injection may not reach the muscle.Norethisterone enanthate (NET-EN) 200 mg, licensed for short-term use. It is also given deep IM but 8-weekly.
Injectables
Published in John Guillebaud, Contraception Today, 2016
DMPA 150 mg is given every 12 or 13 weeks (sometimes less; see later), and norethisterone enantate or NET-EN (Noristerat®) 200 mg is given every 8 weeks. After the pre-loaded syringe for the former is well shaken and the ampoule for the latter, which is oily, is pre-warmed, each is given by deep intramuscular injection in the first 5 days of the menstrual cycle. First injections (of the subcutaneous injection [see the next section] as well) may also be given in special cases (see p. 160) beyond day 5, with 7 days of added precautions, if it is sufficiently certain that a conception risk has not been taken (p. 158). The injection sites, in the United Kingdom, are usually in the upper outer quadrant of either buttock, although the upper outer thigh and deltoid are also acceptable sites; these sites should not be massaged.
Information on level of drugs into breastmilk
Published in Wendy Jones, Breastfeeding and Medication, 2013
Medroxyprogesterone acetate (Depo Provera ) can be used 6 weeks after delivery and repeated every 12 weeks. It is used 5 days after delivery for mothers who do not intend to breastfeed. Norethisterone enantate (Noristerat) is not advised if the baby has symptoms of severe or persistant jaundice – repeated every 8 weeks. The etonogestrel-releasing implant (Implanon) was discontinued in 2010 but may still be in place for some women until 2013. Compatible with use during breastfeeding for majority of women. May lead to reduced breastmilk supply for some women according to anecdotal reports but not reported in large scal trials. Oral progestogen-only contraceptive pills (POPs) UK brand names: Desogestrel (Cerazette ); Ethynodiol diacetate (Femulen ); Norethisterone (Micronor, Noriday); Levonorgestrel (Norgeston)
Will Men Use Novel Male Contraceptive Methods and Will Women Trust Them? A Systematic Review
Published in The Journal of Sex Research, 2021
John J. Reynolds-Wright, Nicholas J. Cameron, Richard A. Anderson
Development of novel male contraceptive methods has been ongoing for over 50 years, and during this time many promising methods in several modalities – oral pills, injections, implants, and topical gels – have been developed yet not reached the market (Handelsman, 2003; Plana, 2017). The World Health Organization was heavily involved in the development of novel male hormonal contraceptives, with conceptual proof demonstrated by studies with testosterone enanthate (World Health Organization Task Force on Methods for the Regulation of Male Fertility, 1990, 1996) and most recently with the combination of long-acting testosterone undecanoate with norethisterone enanthate (Behre et al., 2016). This particular study was stopped early by a secondary safety monitoring panel that had concerns regarding the frequency of adverse events in the trial (particularly mood disturbance, increased libido, and injection site discomfort) and their judgment was that this outweighed the benefits of continuing at that late stage in the trial. There is a common misconception that the trial was stopped because the male participants could not accept the side effects of the drug, but that is inaccurate: only 19 men (of 301 recruited) withdrew because of side effects (Behre et al., 2016).
Effects of progestin-only contraceptives on the endometrium
Published in Expert Review of Clinical Pharmacology, 2020
Carlo Bastianelli, Manuela Farris, Vincenzina Bruni, Elena Rosato, Ivo Brosens, Giuseppe Benagiano
Back in 1982, Ludwig [41] pointed out that the effects of low dose progestational contraceptive agents not blocking ovulation, may be masked by the action of endogenous estrogens. In order to minimize this effect, he evaluated the endometrium of POP users by light and electron microscopy following long-term oral administration of NET, lynestrenol, and LNG. He also evaluated two injectable preparations: DMPA and norethisterone enanthate (NET-EN). A variety of parameters were examined: gland mitoses and tortuosity, pseudo-stratification, basal vacuolation, signs of secretion, stromal edema, pre-decidual reaction, and leukocytic infiltration. He made several general observations: in all cases the volume of the endometrium was reduced in relation to duration of treatment; no specific pattern could be attributed to individual preparations; there was an enlargement of venous vessels and, with time, there was a decrease in the size of the spiral arteries. Particularly noticeable were modifications in the glandular compartment: glands were reduced in number, their epithelium usually appeared atrophic and well-preserved glands coexisted with atrophic ones. Already after 2 months of exposure, no signs of secretory activity could be detected, but the presence of areas of pseudo-decidualization was a common finding. Initially, there was a focal infiltration of round nuclear cells, but they tended to disappear with time.
Selective progesterone receptor modulators: current applications and perspectives
Published in Climacteric, 2018
N. Chabbert-Buffet, K. Kolanska, E. Daraï, P. Bouchard
This was achieved in the Pearl III and IV studies38,39. In the Pearl III study and its extension38, it was initially thought that PAECs were the consequences of unopposed estrogen action on the endometrium. Therefore, it was decided to separate each course of UPA by a sequence of progestin: norethisterone enanthate (10 mg daily for 10 days) to limit the development of PAECs. The results of this study showed that the progestin course had no effect on the appearance of PAECs; rather these modifications disappear with time and are rarely visible 3 months after cessation of therapy. Decrease in fibroid volume reached 60–70% after treatment courses 2, 3 and 4. In addition, the pathologists involved confirmed the benign aspect of these PAECs. Therefore, PAECs are obligatory changes occurring after SPRM treatment and disappear after cessation of treatment. In addition, their reappearance does not suggest any worrisome aspect. The key is therefore the sequential administration of UPA: each course of UPA treatment for 3 months was to be followed by two normal cycles before the next cycle of treatment.