Drugs online research references
Hum Reprod. 1990 Apr;5(3):279-81.
Detection and management of pathological, non-palpable, cystic adnexal masses.
Anderson RE, Serafini PC, Paulson RJ, Sauer MV, Marrs RP.
Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles.
Ten patients with normal bimanual pelvic examinations were found to have small, non-palpable adnexal cysts by transvaginal ultrasound examination. After failing to respond to a course of observation and suppressive therapy with combination oral contraceptives, surgical evaluation was performed. In each case, histological examination returned a pathological diagnosis (endometrioma, serous cystadenoma, mature cystic teratoma, inflammatory cyst). This series suggests that transvaginal ultrasonography may be used to detect adnexal pathology before it is clinically apparent. A scheme for management of this clinical entity is proposed.
PIP: 10 women being evaluated for infertility by intravaginal ultrasonography had small, non-palpable cystic adnexal masses, which after conservative management proved pathological. The women ranged from 22-35 years old, with infertility of 1-4 years' duration. The ultrasound exams were performed with the ADR 4000 or Ultramark IV with 3.5 mHz vaginal probe. Women were re-examined with ultrasound after 1 month's observation, then after each of 3 cycles of treatment with either Ortho-Novum 1/35 (norethindrone 1 mg, ethinyl estradiol 35 mcg) or Ovral (norgestrel 0.5 mg, ethinyl estradiol 50 mcg) combined oral contraceptives. After this period of suppression, 6 of the masses had grown, 3 were unchanged, and 1 was slightly smaller. After diagnostic laparoscopy and laparotomy, there were no functional cysts, but 6 endometriomas, 2 serous cystadenomas, 1 inflammatory cyst, and 1 mature cystic teratoma. This preliminary series suggests that small cysts seen on vaginal ultrasound be followed with observation, then with suppression for at least 2 cycles of combines, not triphasic, oral contraceptives. The prevalence of non-palpable pathologic cysts needs to be determined.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2141030&dopt=Abstract
word match triphasil online literature
Am J Obstet Gynecol. 1990 Oct;163(4 Pt 2):1388-93.
Oral contraceptives, lipoproteins, and atherosclerosis.
Adams MR, Clarkson TB, Shively CA, Parks JS, Kaplan JR.
Department of Comparative Medicine, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27103.
A nonhuman primate model was developed to study the effects of oral contraceptives on lipoproteins and atherosclerosis. Cynomolgus macaques were selected because of their susceptibility to diet-induced atherosclerosis and because their reproductive physiology, menstrual cycle, and circulating sex hormone patterns are similar to those of human females. The first study compared a vaginal ring containing levonorgestrel and estradiol with an oral contraceptive containing norgestrel and ethinyl estradiol. A second study compared two oral combinations: norgestrel-ethinyl estradiol and ethynodiol diacetate-ethinyl estradiol. As predicted, use of all the contraceptives led to lowering of high-density lipoprotein cholesterol levels. However, contrary to what might be expected, use of the ethinyl estradiol-containing oral contraceptives did not lead to an increase in the prevalence or extent of atherosclerosis. We concluded that ethinyl estradiol neutralized the atherogenic influence of the progestin component of oral contraceptives.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2220963&dopt=Abstract
word match triphasil online literature
Clin Ther. 1990 Sep-Oct;12(5):447-55.
Clinical significance of the androgenicity of progestins in hormonal therapy in women.
Linn ES.
Department of Obstetrics and Gynecology, Saint Joseph Hospital, Evanston, Illinois.
Optimal efficacy has been achieved in both oral contraception and postmenopausal replacement therapy. The current challenge is to minimize the side effects and metabolic impact of the administered hormones in both oral contraceptives and hormone replacement agents. When the dose of estrogen in oral contraceptives was reduced the risk of thromboembolism decreased, but the androgenic side effects of the progestin became increasingly apparent. The addition of progestins to hormone replacement therapy reduces the risk of endometrial cancer associated with unopposed estrogen, but their androgenicity offsets the favorable effects of estrogen on lipid metabolism. Androgens not only cause troublesome clinical side effects but also induce changes in blood levels of lipoproteins that have been associated with an increased risk of atherogenesis and coronary heart disease, as well as alterations in glucose and insulin levels. Both the side effects and the adverse effects on lipoprotein and glucose metabolism can be reduced by the use of less androgenic progestins.
PIP: In order to offset the undesirable clinical effects of progestins in oral contraceptives (OCs) or in hormone replacement therapy, effort has been made to reduce the amount of progestin used and to use progestins with lower androgenicity. It is pointed out that the androgenicity is related to the structural relationship between progestins and 19-nortestosterone. Based on the relative binding affinities (RBAs) for rat prostatic androgen receptors and for sex hormone binding globulin (SHBG), it has been noted that levonorgestrel, which is the active isomer of norgestrel, has twice the androgenicity of norethisterone. There have been research results which confirm OCs with progestins with reduced androgenicity; research shows norethindrone in Ortho-Novum 7/7/7 and levonorgestrel in Triphasil both minimize the effect on lipid metabolism. Another study shows only those more androgenic progestins reduce HDL. The newest low dose progestins in OCs are norgestimate, desogestrel, and gestodene. The action of progestins is on lipid and carbohydrate metabolism.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2268868&dopt=Abstract
word match triphasil online literature
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