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P Collinet, X Fritel, C Revel-Delhom, M Ballester, P A Bolze, B Borghese, N Bornsztein, J Boujenah, N Bourdel, T Brillac, N Chabbert-Buffet, C Chauffour, N Clary, J Cohen, C Decanter, A Denouël, G Dubernard, A Fauconnier, H Fernandez, T Gauthier, F Golfier, C Huchon, G Legendre, J Loriau, E Mathieu-d'Argent, B Merlot, J Niro, P Panel, P Paparel, C A Philip, S Ploteau, C Poncelet, B Rabischong, H Roman, C Rubod, P Santulli, M Sauvan, I Thomassin-Naggara, A Torre, J M Wattier, C Yazbeck, M Canis
First-line investigations to diagnose endometriosis are clinical examination and pelvic ultrasound. Second-line investigations include pelvic examination performed by a referent clinician, transvaginal ultrasound performed by a referent, and pelvic MRI. It is recommended to treat endometriosis when it is symptomatic. First-line hormonal treatments recommended for the management of painful endometriosis are combined hormonal contraceptives or levonorgestrel 52mg IUD. There is no evidence to recommend systematic preoperative hormonal therapy for the unique purpose of preventing the risk of surgical complications or facilitating surgery...
March 14, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Reni Soon, Katie McGuire, Jennifer Salcedo, Bliss Kaneshiro
This pilot study assessed the feasibility of conducting a larger randomized controlled trial comparing the proportion of adolescents using a levonorgestrel intrauterine device (LNG IUD) at six months postpartum when it is inserted immediately after vaginal delivery (within 10 minutes after placental expulsion) compared to insertion four to six weeks postpartum. Pregnant adolescents (14 to 19 years) who desired a LNG IUD for postpartum contraception were randomized to insertion of the LNG IUD either within 10 minutes of delivery of the placenta or at 4-6 weeks postpartum...
March 2018: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
Riina Korjamo, Oskari Heikinheimo, Maarit Mentula
OBJECTIVE: To analyse the post-abortion effect of long-acting reversible contraception (LARC) plans and initiation on the risk of subsequent unwanted pregnancy and abortion. MATERIALS AND METHODS: retrospective cohort study of 666 women who underwent medical abortion between January-May 2013 at Helsinki University Hospital, Finland. Altogether 159 (23.8%) women planning post-abortion use of levonorgestrel-releasing intrauterine system (LNG-IUS) participated in a randomized study and had an opportunity to receive the LNG-IUS free-of-charge from the hospital...
March 14, 2018: European Journal of Contraception & Reproductive Health Care
S Geoffron, J Cohen, M Sauvan, G Legendre, J M Wattier, E Daraï, H Fernandez, N Chabbert-Buffet
The available literature, from 2006 to 2017, on hormonal treatment has been analysed as a contribution to the HAS-CNGOF task force for the treatment of endometriosis. Available data are heterogeneous and the general level of evidence is moderate. Hormonal treatment is usually offered as the primary option to women suffering from endometriosis. It cannot be used in women willing to conceive. In women who have not been operated, the first line of hormonal treatment includes combined oral contraceptives (COC) and the levonorgestrel-releasing intra uterine system (52mg LNG-IUS)...
March 10, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
D A Davey
Major advances in menopause hormone therapy (MHT) hold promise in the future of better and safer care for women at and after the menopause. The principal advances are: (1) the critical window or 'window of opportunity' in the 10 years or so after the menopause, during which the benefits of MHT in healthy women exceed any risks; (2) use of transdermal instead of oral administration of estrogen to reduce the risk of venous thromboembolism; (c) investigation of the use of oral micronized progesterone (MP) and vaginal MP to prevent endometrial hyperplasia and carcinoma without any increased risk of breast cancer and venous thromboembolism in postmenopausal women receiving estrogens; vaginal MP prevents endometrial proliferation in the short term but the long-term effects in MHT remain to be established; (4) investigation into the use of intrauterine levonorgestrel-releasing devices (LNG-IUDs), which are an attractive form of MHT in perimenopausal women, providing contraception and reducing uterine bleeding, although the risk of breast cancer with LNG-IUDs requires clarification...
March 11, 2018: Climacteric: the Journal of the International Menopause Society
Tasneem S Alaqzam, Angela C Stanley, Pippa M Simpson, Veronica H Flood, Seema Menon
STUDY OBJECTIVE: This study sought to determine the relationship of bleeding disorders to iron deficiency anemia. Additionally, this study was undertaken to examine all current treatment modalities used in a menorrhagia clinic with respect to heavy menstrual bleeding management to identify the most effective options for menstrual management in the setting of an underlying bleeding disorder. DESIGN, SETTING, PARTICIPANT, INTERVENTION, AND MAIN OUTCOME MEASURES: Retrospective chart review of adolescent <21 years with heavy menstrual bleeding attending a multidisciplinary hematology-adolescent gynecology clinic...
March 7, 2018: Journal of Pediatric and Adolescent Gynecology
Christian Friedrich, Matthias Berse, Stefan Klein, Beate Rohde, Joachim Höchel
It is known that a small fraction of orally administered norethisterone is metabolically converted to ethinylestradiol. This exploratory, open-label, nonrandomized study was conducted to investigate the systemic exposure to ethinylestradiol after intramuscular administration of norethisterone enantate in comparison with the exposure to ethinylestradiol after administration of a standard combined oral contraceptive. Sixteen healthy premenopausal women received an oral contraceptive (ethinylestradiol 30 μg/levonorgestrel 150 μg) once daily for 21 days and-after a 1-week washout period-a single intramuscular dose of 200 mg norethisterone enantate...
March 9, 2018: Journal of Clinical Pharmacology
Patricia Barrionuevo, Mohammed Nabhan, Osama Altayar, Zhen Wang, Patricia J Erwin, Noor Asi, Kathryn A Martin, M Hassan Murad
Background: Several pharmacologic treatments for hirsutism are used in practice; however, their relative efficacy is unclear. Methods: We searched MEDLINE, EMBASE, and CENTRAL through January 2017 for randomized controlled trials (RCTs) with follow-up of at least 6 months that evaluated antiandrogens, insulin sensitizers, and oral contraceptives in women with hirsutism. Independent pairs of reviewers selected and appraised trials. Random-effects network meta-analysis was used to compare individual drugs and classes...
March 7, 2018: Journal of Clinical Endocrinology and Metabolism
M Sauvan, N Chabbert-Buffet, M Canis, P Collinet, X Fritel, S Geoffron, G Legendre, J-M Wattier, H Fernandez
OBJECTIVE: To provide clinical practice guidelines for the management of painful endometriosis in women without infertility. METHODS: Systematic review of the literature literature since 2006, level of evidence rating, external proofreading and grading of the recommendation grade by an expert group according to HAS methodology. RESULTS: Combined hormonal contraceptives (COP) and the levonorgestrel-releasing intra-uterin system (LNG-IUS) are recommended as first-line hormonal therapies for the treatment of painful endometriosis (grade B)...
March 3, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Sharon L Achilles, Michele N Austin, Leslie A Meyn, Felix Mhlanga, Zvavahera M Chirenje, Sharon L Hillier
BACKGROUND: Data evaluating the impact of contraceptives on the vaginal microbiome are limited and inconsistent. OBJECTIVE: We hypothesized that women initiating copper intrauterine device use would have increased bacterial vaginosis and bacterial vaginosis-associated microbes with use compared to women initiating and using hormonal contraceptive methods. STUDY DESIGN: Vaginal swabs (N=1047 from 266 participants seeking contraception) for Nugent score determination of bacterial vaginosis (BV) and quantitative polymerase chain reaction analyses for assessment of specific microbiota were collected from asymptomatic, healthy women aged 18-35 in Harare, Zimbabwe who were confirmed to be free of non-study hormones by mass spectrometry at each visit...
March 2, 2018: American Journal of Obstetrics and Gynecology
Sridhar Vajapeyam, Kirsten Ecklund, Robert V Mulkern, Henry A Feldman, Jennifer M O'Donnell, Amy D DiVasta, Clifford J Rosen, Catherine M Gordon
PURPOSE: Dehydroepiandrosterone (DHEA)+estrogen/progestin therapy for adolescent girls with anorexia nervosa (AN) has the potential to arrest bone loss. The primary aim of this study was to test the effects of DHEA+estrogen/progestin therapy in adolescent girls with AN on bone marrow in the distal femur using magnetic resonance imaging (MRI) and spectroscopy. METHODS: Seventy adolescent girls with AN were enrolled in a double blind, randomized, placebo-controlled trial at two urban hospital-based programs...
February 26, 2018: Bone
Brett L Worly, Tamar L Gur, Jonathan Schaffir
OBJECTIVE: We performed a systematic review to look for an association between progestin-only contraception and depression. METHODS: We searched PubMed, Ovid and Web of Science for English-language articles including progestin-only contraception and depression from database inception to September 2016. We evaluated study quality with the procedures guiding reviews for the United States Preventive Services Task Force and the Cochrane Risk of Bias Tools. We included studies that evaluated progestin-only contraception and depression, focusing on externally validated depression measures...
February 20, 2018: Contraception
Ellen Laan, Yvette Zimmerman, Rik H W van Lunsen, Hanneke M M Termeer, Nicole Appels, Bart C J M Fauser, Herjan J T Coelingh Bennink
OBJECTIVES: To evaluate the effect of combined oral contraceptives (OCs) on sexual function, either alone or together with DHEA. STUDY DESIGN: An exploratory randomized, double-blind, placebo-controlled, comparative, crossover study was conducted in 81 OC users. Subjects discontinued their OC for one cycle before being randomized for 10cycles to a 30μg ethinyl estradiol (EE)/levonorgestrel (LNG) OC or a 30μg EE/drospirenone (DRSP) OC, along with daily use of 50mg dehydroepiandrosterone (DHEA) or placebo during 5 OC cycles before crossing over from DHEA to placebo or the reverse for another 5cycles...
February 25, 2018: Contraception
Meiqiu Lu, Xin Yang
BACKGROUND: Glanzmann's Thrombasthenia (GT) is an inherited genetic disorder caused by defects in the platelet membrane glycoproteins IIb/IIIA, and is associated with heavy menstrual bleeding (HMB). HMB is a common complication in female patients, and many adolescent girls with this disease have issues with HMB beginning at menarche. The available treatment modalities including anti-fibrinolytics, nonsteroidal anti-inflammatory drugs (NSAIDs) and hormonal therapies though are effective, their associated side effects, limited efficacy and the poor compliance is a challenge in management of HMB...
February 27, 2018: BMC Women's Health
Wojciech Wrona, Anna Stępniak, Piotr Czuczwar
Uterine fibroids are considered to be the most frequently occurring tumours in females. The majority of fibroids do not require any treatment. When symptomatic, the major ailments include abnormal uterine bleeding, painful menstruation, pelvic pressure or pain, urinary problems, constipation, infertility, and recurrent pregnancy loss. Surgery remains a mainstay of symptomatic uterine fibroids therapy; however, minimally-invasive techniques and pharmacological management have become more available. The levonorgestrel intrauterine system (LNG-IUS) is a T-shaped device with a vertical stem containing a reservoir of levonorgestrel and is widely known for its contraception effect...
December 2017: Przeglad Menopauzalny, Menopause Review
Mie Jareid, Jean-Christophe Thalabard, Morten Aarflot, Hege M Bøvelstad, Eiliv Lund, Tonje Braaten
OBJECTIVE: Women with ovarian cancer have poor survival rates, which have proven difficult to improve; therefore primary prevention is important. The levonorgestrel-releasing intrauterine system (LNG-IUS) prevents endometrial cancer, and recent studies suggested that it may also prevent ovarian cancer, but with a concurrent increased risk of breast cancer. We compared adjusted risks of ovarian, endometrial, and breast cancer in ever users and never users of LNG-IUS. METHODS: Our study cohort consisted of 104,318 women from the Norwegian Women and Cancer Study, 9144 of whom were ever users and 95,174 of whom were never users of LNG-IUS...
February 23, 2018: Gynecologic Oncology
Tracey A Wilkinson, Sally Rafie, Porsche D Clark, Aaron E Carroll, Elizabeth Miller
PURPOSE: Since restrictions on nonprescription sales were removed in 2013, levonorgestrel emergency contraception (EC) should be available without a prescription at pharmacies for consumers of all genders and ages. Using mystery callers, we assessed variations in availability of and access to EC. METHODS: In 2015-2016, three sets of mystery callers (two female physicians, two adolescent females, and two adolescent males) each called all licensed retail pharmacies in five U...
February 21, 2018: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Omar M Shaaban, Ahmed M Abbas, Hanaa R Mahmoud, Entsar M Yones, Ahmed Mahmoud, Mahmoud S Zakherah
OBJECTIVE: The current study aims to evaluate the effect of the use of single packet of levonorgestrel emergency contraceptive pills (LNG-ECPs) during breastfeeding on the health and development of the nursing infant. MATERIALS AND METHODS: The current study was an ancillary observational cohort study carried out in a university hospital. We counseled all women delivered and planning birth-space and breastfeed for at least 1 year for participation during postpartum hospital stay...
February 20, 2018: Journal of Maternal-fetal & Neonatal Medicine
K M Sinning, D C Jude, J L Yoost
STUDY OBJECTIVE: To quantify the "normal" adolescent experience after IUD insertion, in order to provide appropriate counseling for future adolescents. DESIGN: Prospective cohort study. SETTING: Marshall University Department of Obstetrics and Gynecology generalist and adolescent gynecology clinics. PARTICIPANTS: Nulliparous adolescents age 13-18 and parous adults ≥18 years receiving a levonorgestrel intrauterine system (LNG-IUS)...
February 17, 2018: Journal of Pediatric and Adolescent Gynecology
Ching-Jung Lin, Teh-Fu Hsu, Yen-Hou Chang, Ben-Shian Huang, Ling-Yu Jiang, Peng-Hui Wang, Yi-Jen Chen
OBJECTIVE: To evaluate whether a maintenance levonorgestrel-releasing intrauterine system is effective for preventing the recurrence of postoperative adenomyosis-related symptoms. MATERIALS AND METHODS: From January 2005 through December 2014, a retrospective study including 133 patients with symptomatic adenomyosis undergoing conservative uterine-sparing surgery followed by gonadotropin-releasing hormone agonist treatment was conducted. We excluded the 18 patients who did not meet the inclusion criteria...
February 2018: Taiwanese Journal of Obstetrics & Gynecology
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