contraceptives--postcoital and Breast-Neoplasms

Review of recent data from clinical trials and descriptions of endometrial morphology with administration of selective progesterone receptor modulators (SPRMs).. Recent reports concerning administration of SPRMs, specifically the efficacy of ulipristal acetate in reducing fibroid size and rapid control of menstrual blood loss, have renewed clinical interest in this class of compound. Histological data from studies with SPRMs report that this class of drugs is associated with progesterone receptor modulator-associated endometrial changes. Data on mechanisms of action are lacking. The antagonistic progesterone effect of SPRMs has shown promising results in animal studies with endometriosis. Sex steroid receptor effects of PRMs outside the reproductive tract raise the potential for use in neurology and oncology, and although there are several randomized trials in these areas, there are limited small studies published to date.. The SPRM ulipristal acetate is an effective treatment for preoperative treatment of fibroids and a reliable emergency contraceptive. This class of compounds holds the potential for long-term effective medical management of fibroids and may have utility in the management of other sex steroid-dependent conditions.

Topics: Breast Neoplasms; Contraceptives, Postcoital; Endometriosis; Female; Hormone Antagonists; Humans; Leiomyoma; Menorrhagia; Norpregnadienes; Quality of Life; Receptors, Progesterone; Uterine Neoplasms

Over the last couple of decades a reduction of estrogen by at least 80% in combined oral contraceptives (OCs) and much research have resulted in effective and safe contraception. We still do not know longterm effects of OCs however. OCs may protect against endometrial and ovarian cancer. A link between current OC use and liver cancer exists in areas where liver cancer is rare. An association between OC use and cervical cancer disappears when researchers control for sexual activity and barrier method use. Some research shows OC use increases the risk of breast cancer, while other research does not. There does appear to be an increased risk of breast cancer developing in women younger than 46 years of age and who have used OCs for at least 10 years. Women who have a preexisting cardiovascular condition and/or smoke should not use OCs. OC progestogens may impair glucose metabolism in healthy women, but just for 6 months. Women with diabetes mellitus can use OCs, but may need to increase insulin intake. OCs can cause hypertension in 4-5% of healthy women and worsen hypertension in about 9-16% of hypertensive women. Progestogen-only OCs have fewer systemic side effects than combined OCs, but often cause menstrual changes. Their long term effects are not yet known. Injectables containing a progestogen cause few, if any, adverse effects. The subdermal implant, Norplant, tends to cause menstrual disturbances, but is safe and effective. Progestogen - only vaginal rings are as effective as progestogen-only OCs, but menstrual irregularities are common. Failure rates for combined vaginal rings match those of combined OCs. Long-term effects of vaginal rings are not known. Postcoital contraception does not cause serious side effects, but may cause vomiting and menstrual irregularities. A levonorgestrel-releasing IUD is effective and reduces menstrual blood loss, sometimes resulting in amenorrhea. Hormonal injections in men are unlikely in the near future.

Topics: Breast Neoplasms; Cardiovascular Diseases; Contraceptive Agents, Male; Contraceptives, Oral, Combined; Contraceptives, Oral, Hormonal; Contraceptives, Postcoital; Drug Implants; Female; Humans; Male; Progestins; Risk Factors

Topics: Abnormalities, Drug-Induced; Arrhythmias, Cardiac; Breast Neoplasms; Contraception; Contraceptive Devices; Contraceptives, Oral, Synthetic; Contraceptives, Postcoital; Estradiol Congeners; Female; Humans; Intrauterine Devices; Lactation; Male; Pelvic Inflammatory Disease; Pregnancy; Pregnancy, Ectopic; Progesterone; Progesterone Congeners; Prospective Studies; Spermatocidal Agents; Thromboembolism; Time Factors; Uterine Cervical Neoplasms

Topics: Age Factors; Breast Neoplasms; Contraceptives, Postcoital; Drug Approval; Female; Health Services Accessibility; Humans; Levonorgestrel; Multiple Sclerosis; Nonprescription Drugs; Politics; United States; United States Food and Drug Administration

Oral, injectable, and implantable contraceptives offer women safe, effective, and reversible fertility regulation. In some cases, their use also confers important noncontraceptive benefits. By individualizing counseling and recommendations based on relevant behavioral and medical considerations, clinicians can maximize their patients' success with hormonal contraceptives. Even in women with relative contraindications to the use of hormonal contraceptives, the risks associated with pregnancy may be sufficiently great so as to warrant their use.

Topics: Breast Neoplasms; Cardiovascular Diseases; Contraceptive Agents, Female; Contraceptives, Oral, Hormonal; Contraceptives, Postcoital; Female; Humans; Levonorgestrel; Liver Neoplasms; Medroxyprogesterone Acetate; Risk Factors; Uterine Cervical Neoplasms

Anti-estrogenic effects of yuehchukene were observed in rat uterotrophic, mice vaginal smear and MCF-7 cell growth assays. Whereas yuehchukene per se was estrogenic in these bioassay models, the co-administration of yuehchukene and an optimal dose of 3,17 beta-estradiol (estradiol) could attenuate the maximum estrogenic response due to estradiol alone. The anti-estrogenic effect of yuehchukene in rat uterine hypertrophy was corroborated by a parallel attenuation of ornithine decarboxylase activity in these tissues. Yuehchukene binds to rat, mice and MCF-7 cell estrogen receptors with a relative binding affinity of 1/150 to 1/300. This binding affinity was positively related to estrogenicity as determined by uterotrophic assay and MCF-7 cell growth. However, this estrogenic effect did not correlate with the degree of competitive receptor binding by a weaker agonist. Indole-3-carbinol and methylbutadienylindole could induce ethoxyresorufin O-deethylase and estradiol-2-hydroxylase in rat liver and MCF-7 cells. It is postulated that the 'free' indole moiety of yuehchukene could possess similar induction activity. Thus yuehchukene may have a dual pharmacological function. While the intact molecule is a weak estrogen, the 'free' indole moiety in yuehchukene may induce an enhancement of estradiol-2-hydroxylase, thus terminating the biological activity of the endogenous estrogen pool. There is obvious benefit in attenuating the estrogen level in post-menopausal breast cancer patients without going directly to the use of tamoxifen or aromatase inhibitor. Yuehchukene may serve this purpose. In this context, the pharmacological evaluation of a hydroxylated yuehchukene analogue and the anti-estrogenic effect of methylbutadienylindole acid-condensation products are now being studied in earnest.

Topics: Alkaloids; Animals; Binding, Competitive; Breast Neoplasms; Cell Division; Contraceptives, Postcoital; Estradiol; Estrogen Antagonists; Estrogens; Female; Humans; Hypertrophy; Indoles; Mice; Ornithine Decarboxylase; Ovariectomy; Rats; Rats, Sprague-Dawley; Receptors, Estrogen; Steroid Hydroxylases; Tumor Cells, Cultured; Uterus; Vagina; Vaginal Smears

Science and modern medicine accord us many advantages, e.g., contraceptive drugs, but many people still do not use them. Contraceptive drugs include oral contraceptives and injectables. OCs are very effective and are associated with minor side effects (e.g., mood changes, breast tenderness, nausea, and changes in weight, mild headache, and spotting between periods), perhaps explaining why they are one of the most often used contraceptive in essentially every country. Women who smoke; are 35 years old; or either have or have a family history of hypertension, diabetes, cardiovascular disease and use OCs are at higher risk of a cardiovascular episode. On the other hand, OCs protect against ovarian and endometrial cancers. Research does not yet confirm or disprove their effect on breast cancer development. OCs appear not to be linked to breast cancer through age 59. Yet, studies of women 45 years old suggest that OCs increases the breast cancer risk in these women who had their first menses before age 13 and used OCs for a long time before their first pregnancy. OCs may facilitate growth of breast tumors that other causes activated, and therefore, do not likely increase the overall risk. Researchers recognize the death of knowledge about breast cancer development, so they call for more research, including basic molecular, cellular, and biochemical studies. In Nigeria, breast cancer is rare, while deaths due to pregnancy and childbirth are common, indicating that OC use can prevent many female deaths. Prolonged breast feeding; later age at first menses; earlier age at menopause; earlier age at first full-term pregnancy larger families; low fat, high fiber diets; and thinness, all of which are common in developing countries, have a protective effect against breast cancer. Further, women in developing countries begin OC use later than women in developed countries.

Topics: Africa; Africa South of the Sahara; Africa, Western; Ambulatory Care Facilities; Biology; Birth Rate; Breast Neoplasms; Communication; Contraception; Contraceptive Agents; Contraceptive Agents, Female; Contraceptives, Oral; Contraceptives, Postcoital; Counseling; Demography; Developing Countries; Disease; Endometrial Neoplasms; Evaluation Studies as Topic; Family Planning Services; Fertility; Health Planning; Injections; Neoplasms; Nigeria; Organization and Administration; Ovarian Neoplasms; Parity; Population; Population Dynamics; Progesterone Congeners; Research; Risk Factors

RU-486's primary use as an abortifacient stirs controversy in the US. Changes in US policy have opened the door for RU-486 to be made available for research. The Population Council plans on conducting a multicenter clinical trial of RU-486 involving at least 2000 women. This is the first step to obtaining possible approval from the Food and Drug Administration. RU-486 alone has an effectiveness rate of inducing abortion between 80 and 90%. When taken 36 to 48 hours before a prostaglandin (PG) analogue, the rate climbs to about 95%. Possible side effects of RU-486 and the analogue are bleeding, abdominal pain, and cardiovascular problems (rare). More than 100,000 women in France have undergone the RU-486/PG analogue regimen. RU-486 also has contraceptive qualities. If taken every day during the week before ovulation, it prevents ovulation. 12 days of RU-486 administration followed by 10 days of administration of a synthetic progestin also suppresses ovulation. Taking RU-486 during the last 10 to 12 days of the menstrual cycle alters the endometrium, thereby preventing implantation. A single dose of RU-486 during the late luteal phase is about 80% effective at bringing on menses. The aforementioned effects of Ru-486 demonstrate that it may be an effective postcoital contraceptive. Besides, RU-486 has fewer side effects than other postcoital contraceptive regimens. Further, RU-486 softens and dilates the cervix, thus it can be used to induce labor and ease delivery. Evidence suggests that RU-486 may be used to treat hormone-dependent breast tumors, Cushing's syndrome, meningiomas, and endometriosis.

Topics: Abortifacient Agents; Abortion, Induced; Americas; Biology; Breast Neoplasms; Contraception; Contraceptive Agents; Contraceptive Agents, Female; Contraceptives, Postcoital; Developed Countries; Disease; Embryo Implantation; Endocrine System; Endometrium; Europe; Family Planning Services; France; Genitalia; Genitalia, Female; Hormone Antagonists; Hormones; Labor Stage, First; Menstruation; Mifepristone; Neoplasms; North America; Ovulation; Physiology; Therapeutics; United States; Urogenital System; Uterus

Topics: Breast Neoplasms; Cardiovascular Diseases; Contraceptives, Oral, Hormonal; Contraceptives, Postcoital; Female; Humans; Liver Neoplasms; Uterine Neoplasms

Topics: Abnormalities, Drug-Induced; Breast Neoplasms; China; Contraceptives, Oral; Contraceptives, Oral, Combined; Contraceptives, Postcoital; Delayed-Action Preparations; Female; Genital Neoplasms, Female; Humans; Megestrol; Norethindrone; Research

Topics: Adenocarcinoma; Animals; Breast Neoplasms; Contraceptives, Oral; Contraceptives, Postcoital; Diethylstilbestrol; Dogs; Drug Interactions; Estrogens; Female; Haplorhini; Humans; Male; Mammary Neoplasms, Experimental; Mice; Neoplasms, Experimental; Pituitary Neoplasms; Pregnancy; Pregnancy Complications; Progestins; Rats; Urogenital Neoplasms; Uterine Cervical Neoplasms; Vaginal Neoplasms

Topics: Acne Vulgaris; Adult; Alopecia; Animals; Breast Neoplasms; Chlormadinone Acetate; Contraception; Contraceptives, Oral; Contraceptives, Postcoital; Cyproterone; Delayed-Action Preparations; Dermatitis, Seborrheic; Dogs; Estrogens; Ethinyl Estradiol; Female; Hirsutism; Humans; Injections, Intramuscular; Norgestrel; Progestins