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Drugs at work
Published in Peri J. Ballantyne, Kath Ryan, Living Pharmaceutical Lives, 2021
Pharmaceuticals have become modern solutions to occupational stressors or high-risk situations faced by military enlistees in several ways. For example, menstrual suppression using combined oral contraceptives has been promoted for enlisted women – who in 2019 made up 14.6% of total military personnel in the United States (US Medicine, 2019). In a study designed to describe and assess enlisted women’s views of menstrual suppression, most participants expressed a guarded interest along with concern about the short- and long-term safety profile and side effects of combined oral contraceptives (Trego, 2007). Their risks mimic those of traditional oral contraceptives – stroke or blood clots, with increased risk with age, smoker status or hypertension (National Women’s Health Network, 2015). Possible long-term outcomes of menstrual suppression are unknown, and the potential benefit of menstruation to women’s health (see Howes, 2010) could render its suppression disadvantageous.
Transgender care in adolescents
Published in Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo, Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Stephanie Cizek, Gylynthia Trotman
Surgical methods of menstrual suppression include endometrial ablation and hysterectomy. However, endometrial ablation is not recommended in adolescents, due to the high failure rate, the overall lack of data in adolescents, and the increased risks if subsequent pregnancy occurs. Hysterectomy is discussed separately as part of surgical management for gender dysphoria; however, if considered solely for the purpose of menstrual suppression, it is not recommended due to the comparatively high risk of morbidity and mortality compared to other available methods.29
Gynaecological disorders in children
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
Lisa M Allen, Rachel F Spitzer
Hysterectomy is not required for vaginal obstructions from either a transverse septum or partial vaginal agenesis where continuity of the outflow tract can be reliably re-established. The appropriate surgical management of the rare case of cervical agenesis is more controversial. Traditionally, hysterectomy is offered. More recently uterovaginal anastomosis has been reported successfully in several small case series. Referral of these infrequent anomalies for management at centres of excellence is recommended to optimise outcomes. There is no indication to remove the ovaries when performing hysterectomy in young women with müllerian anomalies. When managing any outflow tract obstruction, menstrual suppression can be prescribed to control pain symptoms while awaiting definitive surgery. Menstrual suppression can be achieved with continuous combined hormonal contraceptives, depo-medroxyprogesterone acetate or gonadotropin-releasing hormone agonists with addback combined hormonal replacement.
“I LOVE This”: An Exploration of How Self-Objectification Predicts Support for Menstrual Suppression
Published in Women's Reproductive Health, 2021
Qualitative responses indicate that many women were hesitant to try or had concerns about the long-term effects of the practice of menstrual suppression. Much of their concern centered on the uncertainty of how it would affect future fertility, which supports the quantitative data that indicate less interest in menstrual suppression among women who believe it is important to care for children. Some women indicated that, although menstrual suppression is of no interest to them, they can see its utility in certain circumstances, and they also believe it is a woman’s choice. A small percentage of women did indicate a positive reaction to the practice of menstrual suppression; some cited menstruation as a “useless” bodily process or indicated the convenience of being able to ‘skip’ a menstrual bleed. Indeed, the women in this sample who had engaged in menstrual suppression indicated that it was for reasons of convenience or the reduction of unpleasant menstrual symptoms.
“Just because I don't bleed, doesn't mean I don't go through it”: Expanding knowledge on trans and non-binary menstruators
Published in International Journal of Transgender Health, 2020
The available research focuses on the use of hormonal contraception technologies including depot medroxyprogesterone acetate and levonorgestrel intrauterine devices as effective menstrual suppression techniques, utilized to achieve therapeutic amenorrhea and therefore alleviate any associated gender dysphoria (Akgul et al., 2019; Chrisler et al., 2016; Kanj et al., 2019; Schwartz et al., 2019). Gonadotropin-releasing hormone agonists, commonly called puberty blockers, are also discussed in the literature as a tool to suppress puberty, menarche and alleviate gender dysphoria associated with its onset (Pradhan & Gomez-Lobo, 2019; Schwartz et al., 2019). Often menstrual suppression is discontinued upon initiation of gender-affirming hormone therapy regimens, specifically testosterone, which can be used to achieve amenorrhea on its own (Akgul et al., 2019). Those with incomplete menstrual suppression on testosterone may continue to use these, or try progesterone therapies, to achieve and maintain amenorrhea (Boudreau & Mukerjee, 2019; Schwartz et al., 2019).