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Levonorgestrel

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https://www.readbyqxmd.com/read/27925651/model-based-dose-selection-for-intravaginal-ring-formulations-releasing-anastrozole-and-levonorgestrel-intended-for-the-treatment-of-endometriosis-symptoms
#1
Isabel Reinecke, Marcus-Hillert Schultze-Mosgau, Rüdiger Nave, Heinz Schmitz, Bart A Ploeger
Pharmacokinetics (PK) of anastrozole (ATZ) and levonorgestrel (LNG) released from an intravaginal ring (IVR) intended to treat endometriosis symptoms were characterized, and the exposure-response relationship focusing on the development of large ovarian follicle-like structures was investigated by modeling and simulation to support dose selection for further studies. A population PK analysis and simulations were performed for ATZ and LNG based on clinical phase 1 study data from 66 healthy women. A PK/PD model was developed to predict the probability of a maximum follicle size ≥30 mm and the potential contribution of ATZ beside the known LNG effects...
December 7, 2016: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27913230/effects-of-combined-oral-contraceptives-depot-medroxyprogesterone-acetate-and-the-levonorgestrel-releasing-intrauterine-system-on-the-vaginal-microbiome
#2
J Paul Brooks, David J Edwards, Diana L Blithe, Jennifer M Fettweis, Myrna G Serrano, Nihar U Sheth, Jerome F Strauss, Gregory A Buck, Kimberly K Jefferson
OBJECTIVES: Prior studies suggest that the composition of the vaginal microbiome may positively or negatively affect susceptibility to sexually transmitted infections (STI) and bacterial vaginosis (BV). Some female hormonal contraceptive methods also appear to positively or negatively influence STI transmission and BV. Therefore changes in the vaginal microbiome that are associated with different contraceptive methods may explain, in part, effects on STI transmission and BV. STUDY DESIGN: We performed a retrospective study of 16S rRNA gene survey data of vaginal samples from a subset of participants from the Human Vaginal Microbiome Project at Virginia Commonwealth University...
November 29, 2016: Contraception
https://www.readbyqxmd.com/read/27913229/a-single-arm-phase-iii-study-exploring-the-efficacy-and-safety-of-lng-ius-8-a-low-dose-levonorgestrel-intrauterine-contraceptive-system-total-content-13-5-mg-in-an-asia-pacific-population
#3
Guangsheng Fan, Sukho Kang, Mulan Ren, Edith Weisberg, Eeva Lukkari-Lax, Katrin Roth, SoYoung Shin
OBJECTIVE: To evaluate the efficacy and safety of a low-dose levonorgestrel intrauterine system with total content 13.5 mg (average approx. 8 μg/24 h over the first year; LNG-IUS 8; Jaydess®) in an Asia-Pacific population. STUDY DESIGN: An open-label, single-arm Phase III study conducted at 25 centers in China, Australia, and Korea assessed LNG-IUS 8 use over 3 years in nulliparous and parous women (N=1114) aged 18-40 years with regular menstrual cycles (21-35 days)...
November 29, 2016: Contraception
https://www.readbyqxmd.com/read/27901412/oral-progestogens-versus-levonorgestrel-releasing-intrauterine-system-for-treatment-of-endometrial-intraepithelial-neoplasia
#4
Mary L Marnach, Kristina A Butler, Michael R Henry, Catherine E Hutz, Carrie L Langstraat, Christine M Lohse, Petra M Casey
BACKGROUND: Limited therapeutic guidelines exist regarding medical therapy, ideal dosing, duration of therapy, or recommendations for timing of endometrial reassessment for women with endometrial intraepithelial neoplasia (EIN) who desire fertility preservation or who are not optimal surgical candidates. We aimed to determine the effectiveness of oral progestogens (OP) versus the levonorgestrel-releasing intrauterine system (LNG IUS) in the medical treatment of EIN. METHODS: We retrospectively identified women with EIN at our institution from 2007 through 2014 and compared the outcomes of those treated with OP versus LNG IUS...
November 30, 2016: Journal of Women's Health
https://www.readbyqxmd.com/read/27898258/estradiol-therapy-and-breast-cancer-risk-in-perimenopausal-and-postmenopausal-women-a-systematic-review-and-meta-analysis
#5
Zhilan Yang, Ying Hu, Jing Zhang, Liangzhi Xu, Rujun Zeng, Deying Kang
OBJECTIVE: To investigate the association between estradiol therapy and incidence of breast cancer, taking into consideration of different types of combined progestogen, the duration of exposure and the type of regimen. METHOD: A systematic review and meta-analysis. RESULT: A total of 14 studies were included in our study. In estradiol-only therapy analysis, meta-analysis resulted a pooled OR =0.90, 95% CI (0.40, 2.02) from the RCTs and pooled OR = 1...
November 29, 2016: Gynecological Endocrinology
https://www.readbyqxmd.com/read/27896507/levonorgestrel-releasing-intrauterine-systems-versus-oral-cyclic-medroxyprogesterone-acetate-in-endometrial-hyperplasia-therapy-a-meta-analysis
#6
Jin-Sung Yuk, Jae Yen Song, Jung Hun Lee, Won I Park, Hyeong Sik Ahn, Hyun Jung Kim
BACKGROUND: This study aimed to compare the levonorgestrel-releasing intrauterine system (LNG-IUS) with oral cyclic medroxyprogesterone acetate (MPA) in endometrial hyperplasia therapy using randomized controlled trials (RCTs). METHODS: The study searched MEDLINE, EMBASE, CENTRAL, and other databases. All regression outcomes were calculated for dichotomous outcomes in terms of relative risk (RR) and 95% confidence intervals (CIs) using a Mantel-Haenszel random effects model...
November 28, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27896473/experience-with-oral-emergency-contraception-since-the-otc-switch-in-germany
#7
Marion Kiechle, Miriam Neuenfeldt
PURPOSE: In March 2015, the oral emergency contraceptives levonorgestrel (LNG) and ulipristal acetate (UPA) were released from prescription-only status in Germany. The main research question is to analyse whether the OTC status of oral emergency contraceptives has an influence on the patterns of use. METHODS: All information is based on searches for public domain sources on emergency contraception. Searches were made for scientific publications, statistics, and surveys...
November 28, 2016: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/27892938/dendritic-cell-function-and-pathogen-specific-t-cell-immunity-are-inhibited-in-mice-administered-levonorgestrel-prior-to-intranasal-chlamydia-trachomatis-infection
#8
Nirk E Quispe Calla, Rodolfo D Vicetti Miguel, Ao Mei, Shumin Fan, Jocelyn R Gilmore, Thomas L Cherpes
The growing popularity of levonorgestrel (LNG)-releasing intra-uterine systems for long-acting reversible contraception provides strong impetus to define immunomodulatory properties of this exogenous progestin. In initial in vitro studies herein, we found LNG significantly impaired activation of human dendritic cell (DCs) and their capacity to promote allogeneic T cell proliferation. In follow-up studies in a murine model of intranasal Chlamydia trachomatis infection, we analogously found that LNG treatment prior to infection dramatically reduced CD40 expression in DCs isolated from draining lymph nodes at 2 days post infection (dpi)...
November 28, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27884916/usual-medical-treatments-or-levonorgestrel-ius-for-women-with-heavy-menstrual-bleeding-long-term-randomised-pragmatic-trial-in-primary-care
#9
Joe Kai, Lee Middleton, Jane Daniels, Helen Pattison, Konstantinos Tryposkiadis, Janesh Gupta
BACKGROUND: Heavy menstrual bleeding (HMB) is a common, chronic problem affecting women and health services. However, long-term evidence on treatment in primary care is lacking. AIM: To assess the effectiveness of commencing the levonorgestrel-releasing intrauterine system (LNG-IUS) or usual medical treatments for women presenting with HMB in general practice. DESIGN AND SETTING: A pragmatic, multicentre, parallel, open-label, long term, randomised controlled trial in 63 primary care practices across the English Midlands...
December 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27863271/comparison-of-combined-hormonal-vaginal-ring-and-low-dose-combined-oral-hormonal-pill-for-the-treatment-of-idiopathic-chronic-pelvic-pain-a-randomised-trial
#10
Khushboo Priya, Shalini Rajaram, Neerja Goel
OBJECTIVE: To compare the efficacy and acceptability of combined hormonal vaginal ring with combined oral hormonal pill in women with idiopathic chronic pelvic pain. STUDY DESIGN: Randomised prospective interventional trial conducted in 60 women with idiopathic chronic pelvic pain. Women were randomised into two groups of 30 each. In each group, treatment was given for 84 days using either combined vaginal ring or combined oral hormonal pill. Hormonal vaginal ring releases 15mcg of ethinyl estradiol and 120mcg of the etonogestrel per day while the hormonal pill contained 30mcg of ethinyl estradiol and 150mcg of levonorgestrel...
November 8, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27861709/contraceptive-use-in-the-nordic-countries
#11
Ingela Lindh, Finn Egil Skjeldestad, Kristina Gemzell-Danielsson, Oskari Heikinheimo, Helena Hognert, Ian Milsom, Øjvind Lidegaard
The aim was to compare contraceptive use in the Nordic countries and to assess compliance with recommendations from the European Medicines Agency regarding the use of combined oral contraceptives (COC) containing low dose estrogen and levonorgestrel, norethisterone or norgestimate MATERIAL AND METHODS: Data on hormonal contraceptive prescriptions and sales figures for copper intrauterine devices (Cu-IUD) were obtained from national databases and manufacturers in Denmark, Finland, Iceland, Norway and Sweden 2010-2013 RESULTS: Contraceptive use was highest in Denmark (42%) and Sweden (41%), followed by Finland (40%)...
November 12, 2016: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/27836586/intrauterine-contraception-after-medical-abortion-factors-affecting-success-of-early-insertion
#12
Elina Pohjoranta, Satu Suhonen, Maarit Mentula, Oskari Heikinheimo
OBJECTIVE: To assess the success and factors affecting early intrauterine device (IUD) provision after first trimester medical termination of pregnancy (MTOP). STUDY DESIGN: Subgroup analysis of a randomized contraceptive trial assessing the long-term effects of early provision of intrauterine contraception following abortion. Altogether, 606 women undergoing MTOP were included and followed for 3 months. The intervention group (n=307) was offered an IUD (either the levonorgestrel-releasing intrauterine system or copper-IUD) at a follow-up visit 1-4 weeks after MTOP...
November 9, 2016: Contraception
https://www.readbyqxmd.com/read/27836505/a-randomized-clinical-trial-on-the-effects-of-progestin-contraception-in-the-genital-tract-of-hiv-infected-and-uninfected-women-in-lilongwe-malawi-addressing-evolving-research-priorities
#13
Athena P Kourtis, Lisa Haddad, Jennifer Tang, Lameck Chinula, Stacey Hurst, Jeffrey Wiener, Sascha Ellington, Julie A E Nelson, Amanda Corbett, Kristina De Paris, Caroline C King, Mina Hosseinipour, Irving F Hoffman, Denise J Jamieson
Hormonal contraception is central in the prevention of unintended pregnancy; however there are concerns that certain methods may increase the risk of HIV acquisition and transmission. Hormonal contraceptives may modify the genital mucosa in several ways, however the mechanisms are incompletely understood. Few studies have examined genital HIV shedding prospectively before and after initiation of hormonal contraception. The effects of hormonal contraception on genital HIV shedding in the setting of antiretroviral therapy (ART) are also unknown...
November 9, 2016: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/27833182/appreciation-for-analysis-of-how-levonorgestrel-works-and-reservations-with-the-use-of-meloxicam-as-emergency-contraception
#14
COMMENT
A Patrick Schneider, Christopher Kubat, Christine M Zainer
This paper is a response to Dr. Kathleen Raviele's recent article on her critical analysis of the use of levonorgestrel given to women postsexual assault and her suggestion that the use of Meloxicam may be an ethical alternative.
February 2016: Linacre Quarterly
https://www.readbyqxmd.com/read/27833181/does-levonorgestrel-emergency-contraceptive-have-a-post-fertilization-effect-a-review-of-its-mechanism-of-action
#15
REVIEW
Rebecca Peck, Walter Rella, Julio Tudela, Justo Aznar, Bruno Mozzanega
BACKGROUND: Recent studies have identified that levonorgestrel administered orally in emergency contraception (LNG-EC) is only efficacious when taken before ovulation. However, the drug does not consistently prevent follicular rupture or impair sperm function. OBJECTIVE: The present systematic review is performed to analyze and more precisely define the extent to which pre-fertilization mechanisms of action may explain the drug's efficacy in pregnancy avoidance...
February 2016: Linacre Quarterly
https://www.readbyqxmd.com/read/27818117/-induced-abortion-guidelines-for-clinical-practice%C3%A2-%C3%A2-text-of-the-guidelines-short-text
#16
C Vayssière, A Gaudineau, L Attali, K Bettahar, S Eyraud, P Faucher, P Fournet, D Hassoun, M Hatchuel, C Jamin, B Letombe, T Linet, M Msika Razon, A Ohanessian, H Segain, S Vigoureux, N Winer, S Wylomanski, A Agostini
OBJECTIVE: Develop recommendations for the practice of induced abortion. MATERIALS AND METHODS: The Pubmed database, the Cochrane Library and the recommendations from the French and foreign Gyn-Obs societies or colleges have been consulted. RESULTS: The number of induced abortions (IA) has been stable for several decades. There are a lot of factors explaining the choice of abortion when there is an unplanned pregnancy (UPP). Early initiation and choice of contraception in connection to the woman's life are associated with lower NSP...
November 3, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27799149/dtb-select-11-november-2016
#17
(no author information available yet)
Impact of hepatic enzyme-inducing drugs on levonorgestrel EHC ● New clinical rule to improve antibiotic prescribing to children ● The impact of nursery sickness policies on the treatment of conjunctivitis ● Patient safety alert for acute kidney injury ● Do strategies to reduce polypharmacy improve patient-relevant outcomes? ● When is a health app a medical device? ● Automated feedback reduces high-risk prescribing in primary care ● Quantifying resting heart rate as a predictor of disease.
October 31, 2016: Drug and Therapeutics Bulletin
https://www.readbyqxmd.com/read/27785169/non-prescription-dispensing-of-emergency-oral-contraceptives-recommendations-from-the-german-federal-chamber-of-pharmacists-bundesapothekerkammer
#18
Martin Schulz, Ralf Goebel, Claudia Schumann, Petra Zagermann-Muncke
BACKGROUND: Emergency hormonal contraceptives (EHC) are contraceptives used to prevent unintended pregnancy following unprotected sexual intercourse (USI) or contraceptive failure. The EHCs available without a prescription include medicines containing levonorgestrel (LNG) in more than 80 countries and, recently, based on an EU-switch ellaOne®, which contains ulipristal acetate (UPA). EHCs work by stopping or delaying ovulation. Those containing LNG can be used up to 72 hours after USI or contraceptive failure, while UPA can be used up to 120 hours...
July 2016: Pharmacy Practice
https://www.readbyqxmd.com/read/27785107/levonorgestrel-releasing-intrauterine-systems-for-long-acting-contraception-current-perspectives-safety-and-patient-counseling
#19
REVIEW
Dustin J Costescu
Unintended pregnancy is a significant global problem. In 2008, there were over 100 million unplanned pregnancies worldwide, representing approximately 41% of global conceptions. Family planning strategies in many countries are shifting from increasing the uptake of contraception among nonusers to increasing the uptake of the most effective methods among users of less effective methods. One of the most effective and acceptable methods of contraception is the levonorgestrel-releasing intrauterine system (LNG IUS); however, its uptake varies widely by country...
2016: International Journal of Women's Health
https://www.readbyqxmd.com/read/27771476/non-oral-combined-hormonal-contraceptives-and-thromboembolism-a-systematic-review
#20
Naomi K Tepper, Monica V Dragoman, Mary E Gaffield, Kathryn M Curtis
BACKGROUND: Combined hormonal contraceptives (CHCs), containing estrogen and progestin, are associated with an increased risk of venous thromboembolism (VTE) and arterial thromboembolism (ATE), compared with non-use. Few studies have examined whether non-oral formulations (including the combined hormonal patch, combined vaginal ring, and combined injectable contraceptives) increase the risk of thrombosis compared with combined oral contraceptives (COCs). OBJECTIVES: To examine the risk of VTE and ATE among women using non-oral CHCs compared to women using COCs...
October 19, 2016: Contraception
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