ortho-evra and etonogestrel

To evaluate the efficacy and tolerability of a contraceptive vaginal ring and transdermal patch in the treatment of endometriosis-associated pain.. Patient preference cohort study.. Academic center.. Two-hundred and seven women with recurrent moderate or severe pelvic pain after conservative surgery for symptomatic endometriosis.. Continuous, 12-month treatment with a vaginal ring supplying 15 mcg of ethinyl E and 120 mcg of etonogestrel per day or a transdermal system delivering 20 mcg of ethinyl E and 150 mcg norelgestromin per day.. Satisfaction with treatment.. One-hundred and twenty-three women preferred the ring, and 84 preferred the patch. Forty-four ring users (36%) and 51 patch users (61%) withdrew. Thirty-six of 79 subjects (46%) in the ring group and 14 of 33 (42%) in the patch group shifted from continuous to cyclic use because of irregular bleeding. Pain symptoms were reduced by both treatments, with the ring being more effective than the patch in patients with rectovaginal lesions. According to an intention-to-treat analysis, 88 of 123 ring users (72%) and 40 of 84 patch users (48%) were satisfied with the treatment received.. Patients who preferred the ring were significantly more likely to be satisfied and to comply with treatment than those who chose the patch. Both systems were associated with poor bleeding control when used continuously.

Topics: Administration, Cutaneous; Adolescent; Adult; Choice Behavior; Contraceptive Agents, Female; Contraceptive Devices, Female; Desogestrel; Drug Combinations; Endometriosis; Ethinyl Estradiol; Female; Humans; Menstruation Disturbances; Norgestrel; Pain Measurement; Patient Satisfaction; Uterine Diseases; Young Adult

To compare the bleeding patterns, satisfaction and tolerability of 3 different contraceptive in an extended regimens in the service of Family Planning of the North Central Hospital of PEMEX.. Healthy, adult women with desire of contraception for one year (N 120) were randomly assigned to receive oral contraceptive drospirenone/ethinyl E2 (group1), the norelgestromin/ethinyl E2 transdermal patch (group 2) and vaginal ring etonogestrel/ ethinyl E2 (group 3) in an extended regimen (42 consecutive days, 1 hormone-free week). Study assessments were conducted at scheduled visits at the time of initial screening, at baseline after 1, 3, 6, and 12 months. Subjects recorded menstrual associated symptoms bleeding data and completed satisfaction questionnaires. Subjects and investigators provided overall assessments of the regimens.. Extended use of 3 different contraceptive resulted in fewer bleeding days in every group (66.6%, 55% and 58.3% P 0.0024), and less mastalgia and menstrual pain. Subjects were highly satisfied with three regimens (93.3%, 96.6% and 91.6% P 0.00421). Although not mayor adverse events were reported with this regimen, there was an increase in spotting days; it decreased with each successive cycle of therapy. Efficacy and safety were similar to those reported for traditional cycle.. Extended-contraceptive regimen delays menses and reduces bleeding, a profile that may be preferred by women who seek flexibility with their contraceptive method.

Topics: Administration, Cutaneous; Adolescent; Adult; Androstenes; Breast Diseases; Contraceptive Devices, Female; Contraceptives, Oral, Combined; Contraceptives, Oral, Hormonal; Desogestrel; Drug Combinations; Dysmenorrhea; Ethinyl Estradiol; Female; Headache; Humans; Menstrual Cycle; Norgestrel; Patient Acceptance of Health Care; Prospective Studies; Time Factors; Uterine Hemorrhage; Young Adult

Topics: Administration, Cutaneous; Contraceptive Agents, Female; Contraceptive Devices, Female; Desogestrel; Drug Combinations; Drug Implants; Drug Monitoring; Ethinyl Estradiol; Female; Humans; Intrauterine Devices, Medicated; Levonorgestrel; Norgestrel; Safety; Treatment Outcome

Combined hormonal contraceptives (CHCs) place women at increased risk of venous thromboembolic events (VTEs) and arterial thrombotic events (ATEs), including acute myocardial infarction and ischemic stroke. There is concern that three recent CHC preparations [drospirenone-containing pills (DRSPs), the norelgestromin-containing transdermal patch (NGMN) and the etonogestrel vaginal ring (ETON)] may place women at even higher risk of thrombosis than other older low-dose CHCs with a known safety profile.. All VTEs and all hospitalized ATEs were identified in women, ages 10-55 years, from two integrated health care programs and two state Medicaid programs during the time period covering their new use of DRSP, NGMN, ETON or one of four low-dose estrogen comparator CHCs. The relative risk of thrombotic and thromboembolic outcomes associated with the newer CHCs in relation to the comparators was assessed with Cox proportional hazards regression models adjusting for age, site and year of entry into the study.. The hazards ratio for DRSP in relation to low-dose estrogen comparators among new users was 1.77 (95% confidence interval 1.33-2.35) for VTE and 2.01 (1.06-3.81) for ATE. The increased risk of DRSP was limited to the 10-34-year age group for VTE and the 35-55-year group for ATE. Use of the NGMN patch and ETON vaginal ring was not associated with increased risk of either thromboembolic or thrombotic outcomes.. In new users, DRSP was associated with higher risk of thrombotic events (VTE and ATE) relative to low-dose estrogen comparator CHCs, while the use of the NGMN patch and ETON vaginal ring was not.

Topics: Adolescent; Adult; Androstenes; Arteries; California; Child; Contraceptive Agents, Female; Desogestrel; Drug Combinations; Estrogens; Ethinyl Estradiol; Female; Hospitalization; Humans; Incidence; Middle Aged; Myocardial Infarction; Norgestrel; Proportional Hazards Models; Risk Factors; Stroke; Tennessee; Thromboembolism; Time Factors; Venous Thromboembolism; Washington; Young Adult

Young women under the age of 16 years require special consideration when requesting contraception. Such young women can give voluntary consent, which enables prescription and supply providing that the practitioner has determined that the minor is sufficiently mature to understand the details of the method and its use. All reversible methods may be appropriate but it is necessary to provide information in a form that is fully understood. For women with pre-existing medical conditions including obesity, the benefits and risks of the use of individual methods needs to be weighed against the risks of pregnancy for that woman.

Topics: Adolescent; Adult; Anemia; Breast Diseases; Cardiovascular Diseases; Condoms; Contraception; Contraceptive Agents, Female; Contraindications; Desogestrel; Diabetes Mellitus; Drug Combinations; Drug Implants; Epilepsy; Ethinyl Estradiol; Female; Heart Valve Diseases; Humans; Hypertension; Inflammatory Bowel Diseases; Injections; Intrauterine Devices; Levonorgestrel; Liver Diseases; Lupus Erythematosus, Systemic; Medroxyprogesterone Acetate; Migraine Disorders; Norethindrone; Norgestrel; Obesity; Patient Preference; Pregnancy; Progestins; Stroke; Young Adult