contraceptives--postcoital and Uterine-Hemorrhage

Currently developed progesterone receptor modulators (PRMs) are steroid-derived compounds with mild or potent antiprogestin activity. PRMs may exert a contraceptive activity by different mechanisms such as blockade of ovulation and endometrial desynchronization. Their potential clinical applications are manifold and are very promising in major public health areas, including emergency contraception, long term oestrogen-free contraception (administered alone, or in association with a progestin-only pill to improve bleeding patterns), endometriosis and myoma treatment. The mechanisms of their anti-ovulatory effects and of the endometrial modifications elicited during long term PRM treatment are still not fully elucidated. In future clinical applications, PRMs will be administered orally, via intrauterine systems or vaginal rings.

Topics: Contraceptive Agents, Female; Contraceptives, Oral, Hormonal; Contraceptives, Oral, Synthetic; Contraceptives, Postcoital; Female; Humans; Mifepristone; Ovulation; Receptors, Progesterone; Uterine Hemorrhage

The objectives of the present study were to evaluate the efficacy and side effects and the benefits and limitations of inserting Multiload intrauterine device (IUD) for emergency contraception. A total of 1013 women requesting emergency contraception was recruited, among whom 843 were parous women and 170 nulliparous women. Multiload Cu-375 SL IUD was inserted within 120 h after unprotected intercourse. A urine test for pregnancy was performed before IUD insertion to rule out pregnancy. Participants were followed-up until 1 week after the expected day of the next menstruation. Pregnancy test or ultrasound scanning were performed if menstruation did not return. Efficacy of preventing unplanned pregnancy was calculated. Efficacy and side effects were compared between the parous and nulliparous groups. The results showed that there were two pregnancies, one in each group. The pregnancy rate was 0.2 per 100 women. The efficacy rate of preventing unwanted pregnancy in the parous group was 98.1% and in the nulliparous group 92.4%. The difference was not significant. Removal of IUD because of pain and bleeding was 2.5% in parous women, but was more in the nulliparous group (10.6%). After the return of menstruation, 95.7% of parous women and 80% of nulliparous women maintained the IUD for contraception. There were two complete expulsions and three partial expulsions of the IUD, but there was no significant changes in menstruation and bleeding pattern, nor was infection or trauma observed. It was concluded that IUD insertion is a safe and effective method for emergency contraception for both parous and nulliparous women. One of the advantages of using an IUD is its long-term contraceptive effect, if the women prefer to continue its use.

Topics: Contraceptives, Postcoital; Female; Humans; Intrauterine Devices, Copper; Pain; Parity; Pregnancy; Safe Sex; Time Factors; Uterine Hemorrhage

Topics: Adult; Clinical Trials as Topic; Contraceptives, Oral; Contraceptives, Postcoital; Ethinyl Estradiol; Ethinyl Estradiol-Norgestrel Combination; Female; Humans; Menstruation; Menstruation Disturbances; Norgestrel; Time Factors; Uterine Hemorrhage

Multiple trials by the World Health Organization have established levonorgestrel as the gold standard in hormonal emergency contraception (EC). However, changes in menstrual patterns following EC have been observed; thus, we undertook this prospective study to identify and determine the characteristics of these changes.. Women requesting EC at either any of two hospitals --1 family planning unit and 12 pharmacies in Yaoundé, Cameroon were enrolled if they had a history of regular menstrual cycles over the previous 3 months and if they agreed to follow-up until the end of the subsequent menstrual cycle. Pretreatment menstrual patterns were compared with those of the EC treatment cycle and the cycle after EC.. In a set of 232 participants (mean age, 25 years), we observed 34 (14.7%) cases of incident intermenstrual bleeding and statistically significant changes in menstrual cycle length, menstrual period length and menstrual appearance compared to baseline patterns that differed according to whether EC was taken well before, close to or well after the expected ovulation for that cycle. The majority of these changes disappeared in the following cycle.. Levonorgestrel EC is associated with significant but transient changes in menstrual patterns in a significant proportion of users.

Topics: Adolescent; Adult; Contraceptives, Postcoital; Female; Humans; Levonorgestrel; Menstrual Cycle; Menstruation; Prospective Studies; Regression Analysis; Time Factors; Uterine Hemorrhage

Topics: Adolescent; Adult; Contraception, Postcoital; Contraceptives, Postcoital; Female; Humans; Levonorgestrel; Medical Records; Menstrual Cycle; Menstruation Disturbances; Pregnancy; Uterine Hemorrhage

We evaluated the efficacy and side effects of immediate postcoital administration of levonorgestrel 0.75 mg used repeatedly for contraception. A total of 295 healthy women with infrequent coitus were enrolled at 6 study sites. Each woman took levonorgestrel 0.75 mg by mouth immediately after intercourse during 6 months as her only method of contraception. We collected data on side effects and acceptability and calculated the Pearl index failure rates over 133 woman-years of use by standard methods. The Pearl index failure rate was 6.8 (95% CI 3.1-12.9) pregnancies per 100 woman-years of use. The overall probability of pregnancy per treated coital act was 1.4 per 1000. Approximately one-third of participants discontinued the study within 6 months (mainly for bleeding problems). Menstrual complaints were reported by 70% of women. Other complaints included (in decreasing order) nausea, breast tenderness, weakness, dizziness, headache, abdominal bloating, loss of libido, depression, and vomiting. High-dose levonorgestrel pills are unsuitable for regular postcoital contraception.

Topics: Adult; Contraceptives, Postcoital; Female; Humans; Levonorgestrel; Menstruation Disturbances; Pregnancy; Treatment Failure; Uterine Hemorrhage

Topics: Abortion, Legal; Contraceptives, Postcoital; England; Female; Humans; Infections; Intraoperative Complications; Menstruation Disturbances; Postoperative Complications; Pregnancy; Pregnancy, Ectopic; Progestins; Prostaglandins; Rh-Hr Blood-Group System; Sterilization, Reproductive; Uterine Hemorrhage; Uterus; Vacuum Extraction, Obstetrical; Wales

Topics: Adolescent; Adult; Amenorrhea; Biopsy; Body Weight; Contraceptives, Oral; Contraceptives, Postcoital; Demography; Endometrium; Female; Humans; Lactation; Menstruation; Norgestrel; Norpregnadienes; Pregnancy; Progestins; Uterine Hemorrhage; Vaginal Smears