contraceptives--postcoital and Menorrhagia

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

The aim of this chapter is to review the worldwide use of intrauterine devices (IUDs) for contraception and the long-term contraceptive efficacy and safety of copper-bearing IUDs. The TCu380A and Multiload Cu375 have a very low failure rate (0.2-0.5%) over 10 years. The main concerns of the use of IUDs are risk of pelvic inflammatory diseases and increased menstrual blood loss and irregular bleeding. Factors associated with an increase in risk of pelvic inflammatory diseases are discussed. Preventive measures can be taken with careful screening of eligible IUD users, technical training and adequate service facilities for provision of IUDs. Levonorgestrel-releasing IUDs have the benefit of reducing menstrual blood loss in addition to high contraceptive efficacy. The copper IUD is the most effective method for emergency contraception. It can prevent over 95% of unwanted pregnancies within 5 days of unprotected intercourse.

Topics: Contraceptives, Postcoital; Female; Humans; Intrauterine Devices, Copper; Menorrhagia; Oligomenorrhea; Pelvic Inflammatory Disease; Reproductive Medicine; Treatment Outcome

Emergency contraception was introduced in Nigeria over two decades ago, but few women have used this method even in emergency situations because of the side effects. To find an acceptable levonorgestrel regimen for emergency contraception in our community, the two-dose regimen 0.75-mg levonorgestrel 12 h apart (group A) and the single dose 1.5-mg levonorgestrel (group B) were studied in 1118 volunteers. Mild side effects such as nausea, vomiting, lower abdominal pains, menorrhagia, dizziness, headache, and breast tenderness were reported. Significantly more women in the high-dose group reported headache, breast tenderness, and heavy menstrual flow. Eleven pregnancies (1.0%) were reported (7 in group A and 4 in group B). The crude relative risk of pregnancies was similar in the two groups (RR = 0.71, 95% CI = 0.32-1.55; p > 0.05) [corrected]. On the other hand, the estimated effectiveness rate of 86.80% in group A was significantly lower than the 92.99% for group B (p < 0.05). The pregnancy rates increased with delay in starting treatment and if further acts of unprotected sexual intercourse took place after treatment. It was concluded that both regimens were effective and safe.

Topics: Abdominal Pain; Adult; Contraceptives, Postcoital; Double-Blind Method; Female; Headache; Humans; Levonorgestrel; Menorrhagia; Nausea; Nigeria; Placebos; Pregnancy; Safe Sex; Vomiting

Topics: Administration, Oral; Adolescent; Adult; Contraceptives, Postcoital; Diethylstilbestrol; Drug Evaluation; Estrogens; Ethinyl Estradiol; Female; Humans; Menorrhagia; Nausea; Pregnancy; Time Factors; Vomiting

Topics: Animals; Breast Diseases; Contraceptives, Postcoital; Embryo Implantation; Estrogens; Female; Haplorhini; Humans; Menorrhagia; Pain; Time Factors; Vomiting