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https://www.readbyqxmd.com/read/28639461/hormonal-contraception-and-breast-cancer-what-more-do-we-need-to-know
#1
Jo Marsden
Most women use hormonal contraception for more than 30 years and for many, this may involve exposure in their older reproductive years when baseline breast cancer risk rises steeply. Overall, the risk of breast cancer diagnosis with exposure to hormonal contraception is very small and outweighed by its contraceptive benefits but despite this, there are still outstanding questions for all methods used in clinical practice due to paucity of available evidence, lack of which should not be taken to imply safety...
January 1, 2017: Post Reproductive Health
https://www.readbyqxmd.com/read/28624570/effects-of-intrauterine-contraception-on-the-vaginal-microbiota
#2
Christine M Bassis, Jenifer E Allsworth, Heather N Wahl, Daniel E Sack, Vincent B Young, Jason D Bell
OBJECTIVES: There have been conflicting reports of altered vaginal microbiota and infection susceptibility associated with contraception use. The objectives of this study were to determine if intrauterine contraception altered the vaginal microbiota and to compare the effects of a copper intrauterine device (Cu-IUD) and a levonorgestrel intrauterine system (LNG-IUS) on the vaginal microbiota. STUDY DESIGN: DNA was isolated from the vaginal swab samples of 76 women using Cu-IUD (n=36) or LNG-IUS (n=40) collected prior to insertion of intrauterine contraception (baseline) and at 6 months...
June 14, 2017: Contraception
https://www.readbyqxmd.com/read/28618723/evaluation-of-quality-of-life-and-cost-effectiveness-of-definitive-surgery-and-the-levonorgestrel-intrauterine-system-as-treatment-options-for-heavy-menstrual-bleeding
#3
Cevdet Adigüzel, Sevtap Seyfettinoğlu, Deniz Aka Satar, Sefa Arlier, Eda Eskimez, Fatma Kaya, Hakan Nazik
BACKGROUND/AIM: This study aimed to compare the levonorgestrel intrauterine system (LNG-IUS) with abdominal hysterectomy (TAH) and total laparoscopic hysterectomy (TLH) as first-line treatments for heavy menstrual bleeding (HMB). MATERIALS AND METHODS: Ninety-eight patients aged 20-55 years who complained of regular heavy menstrual bleeding were enrolled in the study. The TAH group included 29 patients, the LNG-IUS group included 34, and the TLH group included 35...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28617060/levonorgestrel-releasing-intrauterine-system-lng-ius-12-for-prevention-of-pregnancy-for-up-to-five-years
#4
Anita L Nelson
A new five-year low dose, smaller-framed, levonorgestrel-releasing intrauterine contraceptive system (LNG-IUS 12) has been introduced to complement the currently available systems. Areas Covered: This article will provide an overview of this new intrauterine system - its composition and its mechanisms of action as well as the results of the Phase II and III clinical trials of its efficacy, safety and tolerability. Expert Commentary: This new LNG-IUS 12 provides five-year contraceptive protection a pregnancy rate (less than 1%) in first year of use, which puts it into the top tier with the existing LNG-IUS 20 products; however, the LNG-IUS 12 does not have the high rates of amenorrhea often seen with the higher dose devices...
June 19, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28590560/routine-provision-of-intrauterine-contraception-at-elective-cesarean-section-in-a-national-public-health-service-a-service-evaluation
#5
Rebecca Heller, Anne Johnstone, Sharon T Cameron
INTRODUCTION: We conducted a prospective health service evaluation to assess the feasibility and acceptability of routinely offering insertion of intrauterine contraception (IUC) at cesarean section in a maternity setting in the UK. MATERIAL AND METHODS: One month before scheduled cesarean section, women were sent information about postpartum contraception including the option of insertion of IUC at cesarean. Women choosing IUC (copper intrauterine device or levonorgestrel intrauterine system) were followed up in person at six weeks; telephone contact was made at three, six and 12 months postpartum...
June 7, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28586411/incidence-and-treatment-of-heavy-menstrual-bleeding-in-general-practice
#6
Marian J van den Brink, Anne Linde Saaltink, Feikje Groenhof, Boudewijn J Kollen, Marjolein Y Berger, Yvonne Lisman-van Leeuwen, Janny H Dekker
Background.: Heavy menstrual bleeding (HMB) is a common problem in women of reproductive age. In 2008, the Dutch guideline for general practitioners (GPs) was revised to recommend the levonorgestrel intrauterine system (LNG-IUS) as a first-choice treatment for HMB. However, GP prescribing practices have not been studied in depth. Objectives.: To investigate the incidence and initial treatment of HMB in general practice, and to identify if there were changes in prescribing practices after the revision of the national guideline in 2008...
June 6, 2017: Family Practice
https://www.readbyqxmd.com/read/28586290/non-contraceptive-benefits-of-intrauterine-levonorgestrel-administration-why-not
#7
Lorenzo Sabbioni, Felice Petraglia, Stefano Luisi
Levonorgestrel intrauterine systems (LNG-IUS) represent a modern therapy for an array of preexisting gynecological conditions, though they were first marketed in Finland in 1990. However, there are countries in which their use is extremely limited by social and cultural factors. This manuscript describes the possible reasons for this misuse, taking in consideration the clinical noncontraceptive benefits of intrauterine levonorgestrel in routinary practice. Medical diseases in which LNG-IUS represent a treatment include abnormal uterine bleeding, iron-deficiency anemia, endometrial hyperplasia, uterine fibroids, adenomyosis, endometriosis, and coagulopathies...
June 6, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28562472/gonadotropin-releasing-hormone-agonist-combined-with-a-levonorgestrel-releasing-intrauterine-system-or-letrozole-for-fertility-preserving-treatment-of-endometrial-carcinoma-and-complex-atypical-hyperplasia-in-young-women
#8
Huimei Zhou, Dongyan Cao, Jiaxin Yang, Keng Shen, Jinghe Lang
OBJECTIVES: The aim of this study was to evaluate the efficacy and safety with gonadotropin-releasing hormone agonist (GnRHa) combined with a levonorgestrel-releasing intrauterine system or an aromatase inhibitor (letrozole) in young women with well-differentiated early endometrial carcinoma (EC) and complex atypical hyperplasia (CAH). METHODS: We performed a retrospective analysis including the clinical characteristics of 29 patients younger than 45 years with early well-differentiated endometrioid adenocarcinoma of the uterus (EC) or CAH who were treated at the Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, from January 2012 to April 2016...
May 29, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28545268/-efficacy-and-impact-on-quality-of-life-of-different-drug-treatments-after-partial-resection-of-rectovaginal-endometriosis
#9
T Li, X X Xu, Y Dai, J J Zhang, J H Lang, J H Leng
Objective: To evaluate different postoperative medications as maintenance treatment for rectovaginal endometriosis (RVE) patients after conservative surgery. Methods: RVE patients who underwent transvaginal partial excision from January 2007 to September 2016 with regular outpatient follow-up were retrospectively screened. Those followed by a levonorgestrel-releasing intrauterine system (LNG-IUS) insertion or oral contraceptive drospirenone/ethinylestradiol (DRSP/EE) 3 mg/30 μg administration were enrolled...
May 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/28537655/comparative-effectiveness-and-impact-on-health-related-quality-of-life-of-hysterectomy-vs-levonorgestrel-intra-uterine-system-for-abnormal-uterine-bleeding
#10
G Cozza, A Pinto, V Giovanale, P Bianchi, A Guarino, R Marziani, A Frega, D Caserta
OBJECTIVE: To compare hysterectomy and levonorgestrel intra-uterine system (LNG-IUS) for the treatment of abnormal uterine bleeding (AUB) and iron deficiency anemia. PATIENTS AND METHODS: Retrospective study evaluating quality of life, sexual function, satisfaction and blood hemoglobin concentration improvement in 60 pre-menopausal women treated with hysterectomy or LNG-IUS. All analysis was performed with statistical software SPSS 21.0 (SPSS Inc., Chicago, IL, USA)...
May 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28536231/pregnant-with-a-perforated-levonorgestrel-intrauterine-system-and-visible-threads-at-the-cervical-os
#11
David L Howard, Lauren M Beasley
We present a case in which a patient presented with a pregnancy of unknown location and normally rising human chorionic gonadotropin (hCG) levels but with a levonorgestrel intrauterine device (LNG-IUD) present. The LNG-IUD had been placed 4.5 years ago. Although unintended, this pregnancy was desired. Strings were clearly visible and initial 2D ultrasound suggested intrauterine location of the LNG-IUD. The LNG-IUD could not be removed however. The patient was managed expectantly with close follow-up, serial beta-hCGs and serial ultrasounds until definitive diagnosis of the location of the pregnancy...
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28525380/comparison-among-fertility-sparing-therapies-for-well-differentiate-early-stage-endometrial-carcinoma-and-complex-atypical-hyperplasia
#12
REVIEW
Qing Zhang, Gonghua Qi, Margaux J Kanis, Ruifen Dong, Baoxia Cui, Xingsheng Yang, Beihua Kong
OBJECTIVE: To compare fertility-sparing therapies including oral progestogens, hysteroscopic resection (HR), and the levonorgestrel- releasing intrauterine system (LNG-IUS) in achieving disease regression, recurrence and live birth rate in well differentiate early-stage endometrial carcinoma (eEC) and complex atypical hyperplasia(CAH). STUDY DESIGN: This was a meta-analysis of previous studies focus on the fertility-sparing therapy for well differentiate early-stage endometrial carcinoma (eEC) and complex atypical hyperplasia (CAH)...
May 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/28485895/with-smart-strategies-immediate-postpartum-larc-is-possible
#13
Ara Aiken
No abstract text is available yet for this article.
May 9, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28346240/combined-oral-medroxyprogesterone-levonorgestrel-intrauterine-system-treatment-for-women-with-grade-2-stage-ia-endometrial-cancer
#14
Ji Young Hwang, Da Hee Kim, Hyo Sook Bae, Mi-La Kim, Yong Wook Jung, Bo Seong Yun, Seok Ju Seong, Eunah Shin, Mi Kyoung Kim
OBJECTIVE: The aim of this study was to evaluate the oncologic and pregnancy outcomes of combined oral medroxyprogesterone acetate (MPA)/levonorgestrel-intrauterine system (LNG-IUS) treatment in young women with grade 2-differentiated stage IA endometrial adenocarcinoma who wish to preserve fertility. METHODS: We retrospectively reviewed the medical records of patients with grade 2 stage IA endometrial adenocarcinoma who had received fertility-sparing treatment at CHA Gangnam Medical Center between 2011 and 2015...
May 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28330857/estimated-disability-adjusted-life-years-averted-by-free-of-charge-provision-of-the-levonorgestrel-releasing-intrauterine-system-over-a-9-year-period-in-brazil
#15
Jessica M Ferreira, Ilza Monteiro, Arlete Fernandes, Maria V Bahamondes, Ana Pitoli, Luis Bahamondes
BACKGROUND: The objective was to analyse the contribution of the provision at no cost to users of the 20 µg/day levonorgestrel-releasing intrauterine system (LNG-IUS) towards disability-adjusted life years (DALY) averted over a 9-year period. METHODS: We analysed data from 15 030 new users of the LNG-IUS who had the device inserted at 26 Brazilian teaching hospitals between January 2007 and December 2015. The devices came from the International Contraceptive Access Foundation (ICA), a not-for-profit foundation that donates the devices to developing countries for use by low-income women who desire long-term contraception and who freely choose to use this device...
March 22, 2017: Journal of Family Planning and Reproductive Health Care
https://www.readbyqxmd.com/read/28299789/menstrual-management-in-developmentally-delayed-adolescent-females
#16
Irene Chuah, Alexandra McRae, Kim Matthews, Ann M Maguire, Katharine Steinbeck
BACKGROUND: Requests for assistance in menstrual management and menstrual suppression are a common, emotive and sometimes controversial aspect of adolescent disability care. AIMS: To review the uptake and outcomes of menstrual suppression among adolescent patients with developmental delay. METHODS: A retrospective review of the medical records of adolescent females with intellectual disability referred for menstrual management to the Paediatric and Adolescent Gynaecology Clinic, Children's Hospital at Westmead, Sydney, for the three-year period between January 1, 2010 and January 1, 2013...
March 15, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28283026/preventing-recurrence-of-endometriosis-by-means-of-long-acting-progestogen-therapy-pre-empt-report-of-an-internal-pilot-multi-arm-randomised-controlled-trial-incorporating-flexible-entry-design-and-adaption-of-design-based-on-feasibility-of-recruitment
#17
Lee J Middleton, Jane P Daniels, Annalise Weckesser, Siladitya Bhattacharya
BACKGROUND: Endometriosis is associated with the growth of endometrium in ectopic sites mainly within the pelvis. This results in inflammation and scarring, causing pain and impaired quality of life. Endometriotic lesions can be excised or ablated surgically, but the risk of recurrence is high. A Heath Technology Assessment commissioning call in 2011 sought applications for trials aimed at evaluating long-term effectiveness of postoperative, long-acting, reversible contraceptives (LARCs) in preventing recurrence of endometriosis...
March 11, 2017: Trials
https://www.readbyqxmd.com/read/28262240/heavy-menstrual-bleeding-an-update-on-management
#18
REVIEW
Joanna Davies, Rezan A Kadir
Heavy menstrual bleeding (HMB) is defined as excessive menstrual blood loss (MBL) >80 mL per cycle, that interferes with a woman's physical, emotional, social wellbeing and quality of life. Aetiology is due to underlying uterine pathologies, coagulopathy, ovulation dysfunction, or iatrogenic. Up to 20% of women with HMB will have an underlying inherited bleeding disorder (IBD). Assessment of HMB should entail a menstrual and gynaecological history and a bleeding score to distinguish those women who require additional haematological investigations...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28256913/family-planning-and-zika-virus-need-for-renewed-and-cohesive-efforts-to-ensure-availability-of-intrauterine-contraception-in-latin-america-and-the-caribbean
#19
Moazzam Ali, Kelsey Miller, Rodolfo Federico Gómez Ponce de Leon
OBJECTIVES: The advantages of intrauterine contraception (IUC) are well established (highly effective, low discontinuation rate, easy to use, low cost, and suitable for immediate postpartum use), but low levels of use in many countries and declining use in others are causes for concern. Due to the ongoing Zika virus outbreak, public health officials are calling for the continued practice of safe sex and the delay of pregnancy. Our study was conducted to assess the current situation of IUC availability and provision in Latin America and to determine the role of national policies in meeting the contraceptive needs of the populations in these countries...
April 2017: European Journal of Contraception & Reproductive Health Care
https://www.readbyqxmd.com/read/28238590/the-current-status-of-hormonal-therapies-for-heavy-menstrual-bleeding
#20
REVIEW
Oskari Heikinheimo, Ian Fraser
Hormonal treatment of abnormal uterine bleeding (AUB), especially bleeding related to endometrial causes (AUB-E), ovulatory dysfunction (AUB-O) and coagulopathy (AUB-C), and to some extent, uterine leiomyomas and adenomyosis, has become the first-line evidence-based management strategy during recent years. Hormonal treatment of heavy menstrual bleeding (HMB) is also endorsed as the first line of treatment in several international guidelines. In the present article, we review the efficacy of the commonly used and widely available hormonal treatments of AUB-O, AUB-E and AUB-C...
April 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
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