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Progestogen use and breast cancer
Published in Barry G. Wren, Progress in the Management of the Menopause, 2020
Although many epidemiological studies have been conducted to assess the relationship between ERT and breast-cancer risk, only a few of them specifically address the role of the progestins. This relates to the rather recent coprescription of progestins with estrogens for menopausal therapy, especially in the United States where most of the large epidemiological surveys were conducted. Also, one must bear in mind that the progestins prescribed for hormone replacement therapy (HRT) differ from country to country, and their effects also differ according to the category to which they belong. In the United States, most of the prescriptions of progestins relate to medroxyprogesterone acetate (MPA), while in Europe derivatives of progesterone are preferred for HRT, such as micronized progesterone (MP), dydrogesterone (DDG), chlormadinone acetate (CIA) derived from 170H-progesterone, or nomegestrol acetate (NOM Ac) derived from 19-norprogesterone.
Reproductive System and Mammary Gland
Published in Pritam S. Sahota, James A. Popp, Jerry F. Hardisty, Chirukandath Gopinath, Page R. Bouchard, Toxicologic Pathology, 2018
Justin D. Vidal, Charles E. Wood, Karyn Colman, Katharine M. Whitney, Dianne M. Creasy
Diffuse cystic endometrial hyperplasia, with or without mucometra, is a common observation in dogs related to repeated progestogenic stimulation that can be exacerbated by a previous estrogenic influence. Administration of progestogenic or combined estrogenic + progestogenic oral contraceptives, progestin estrus inhibitors (e.g., medroxyprogesterone acetate, megestrol acetate, or chlormadinone acetate), or other agents resulting in prolonged increases in serum progesterone, invariably induces cystic endometrial hyperplasia in the dog (El Etreby 1979; Johnson 1989; Murakoshi et al. 2000; Sahara et al. 1994; Sokolowski and Zimbelman 1973; Von Berky and Townsend 1993).
Development of palliative medicine in the United Kingdom and Ireland
Published in Eduardo Bruera, Irene Higginson, Charles F von Gunten, Tatsuya Morita, Textbook of Palliative Medicine and Supportive Care, 2015
39 Handa VL, Bachus KE, Johnston WW et al. Vaginal administration of low-dose conjugated estrogens: Systemic absorption and effects on the endometrium. Obstet Gynecol 1994;84:215-218. 40 Sekido N, Kawai K, Akaza H, Koiso K. Chlormadinone acetate withdrawal syndrome under combined androgen blockade for advanced prostate cancer. Jpn J Clin Oncol 1995;25:164-167.
Primary choice of estrogen and progestogen as components for HRT: a clinical pharmacological view
Published in Climacteric, 2022
In our recommendations (Table 6) we have considered the different tolerability of the various progestogens. For example, progesterone and its derivatives present a mostly higher tolerability and are mostly neutral in their metabolic and vascular effects (higher doses are possible to ensure endometrial safety) in contrast to norethisterone and its derivatives, and also considering the lower endometrial efficacy especially of progesterone with the consequence that higher doses are possible, even though this is certainly not needed in all patients. Especially high dosages of progesterone have been used in reproductive medicine (e.g. 800 mg/day) without a high frequency of side effects (with the exception of bloating due to mineralocorticoid metabolites), the strong sedative effect not being a disadvantage for HRT (if applied during evening). For the progestogen challenge test, in earlier years we often used oral NETA (1–2 mg/day) due to its strong endometrial efficacy, but in our countries this is no longer available. Alternatively, chlormadinone acetate (4–6 mg/day), dienogest (2–4 mg/day) or dydrogesterone (10 mg/day) can be recommended. For this test we would not like to recommend progesterone.
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
In 1967, Martinez-Manautou et al. [37] presented their first experience with what became known as the ‘Minipill’ (or progestin-only pill, POP), a new method aimed at producing a local antifertility effect by modifying both the endometrium and the cervical mucus, without suppressing the hypothalamic-pituitary-ovarian axis. They used daily 0.5 mg chlormadinone acetate (CMA), first from day 5 to 25, and later without interruption, with encouraging results. In a further report, Martinez-Manautou [38] summarized information, based on 1070 biopsies, on the endometrial effects of the new method; a secretory endometrium was observed in 67.4 and 79.7% of all samples, depending on timing. This suggested no major interference with glandular development.
Oral administration of l -carnitine improves the clinical outcome of fertility in patients with IVF treatment
Published in Gynecological Endocrinology, 2018
Yuko Kitano, Shu Hashimoto, Hiroshi Matsumoto, Takayuki Yamochi, Masaya Yamanaka, Yoshiharu Nakaoka, Aisaku Fukuda, Masayasu Inoue, Tomoaki Ikeda, Yoshiharu Morimoto
Single embryo transfer was performed in 96 patients under fresh or vitrified-warmed hormone replacement cycles between January 2013 and December 2015. For fresh cycles, a single embryo was transferred 3 days after oocyte pick-up in patients with endometrial thickness >8 mm on the day of hCG injection. Daily doses of 6 mg of chlormadinone acetate (Lutoral®; Shionogi & Co., Ltd., Osaka, Japan) were maintained until a pregnancy test. Chlormadinone acetate was administered until 8 weeks of gestation after confirmation of pregnancy. Progesterone (Progeston depot® 125 mg; Fuji Pharma Co., Ltd., Toyama, Japan) was injected intramuscularly on the day of ET with two additional injections after confirming pregnancy.