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IUD levonorgestrel

Anne R Davis, Heva J Saadatmand, Alison Pack
OBJECTIVE: Effective contraception enables women with epilepsy (WWE) to plan their pregnancies and improve outcomes for themselves and their children. Although popular among all women, complex drug interactions limit the efficacy and safety of oral contraceptives (OCs) for WWE. We sought to explore the safety, acceptability, and pharmacokinetic impact of a progestin-containing intrauterine device (IUD) in WWE. METHODS: We enrolled 20 women with well-controlled epilepsy and a stable antiepileptic drug (AED) regimen and who were initiating a progestin-containing IUD (levonorgestrel 52 mg) in a prospective, observational study...
September 28, 2016: Epilepsia
Wing Kay Fok, Paul D Blumenthal
PURPOSE OF REVIEW: Emergency contraception provides a critical and time-sensitive opportunity for women to prevent undesired pregnancy after intercourse. Both access and available options for emergency contraception have changed over the last several years. RECENT FINDINGS: Emergency contraceptive pills can be less effective in obese women. The maximum achieved serum concentration of levonorgestrel (LNG) is lower in obese women than women of normal BMI, and doubling the dose of LNG (3 mg) increases its concentration maximum, approximating the level in normal BMI women receiving one dose of LNG...
September 24, 2016: Current Opinion in Obstetrics & Gynecology
Moazzam Ali, Ayse Akin, Luis Bahamondes, Vivian Brache, Ndema Habib, Sihem Landoulsi, David Hubacher
STUDY QUESTION: Is it possible to extend the use of the 3-year one-rod etonogestrel (ENG)-releasing subdermal contraceptive implant to 5 years? SUMMARY ANSWER: The extended use of the one-rod ENG-releasing subdermal contraceptive implant showed 100% efficacy in years 4 and 5. WHAT IS KNOWN ALREADY: The initial regulated trials on the ENG-releasing subdermal contraceptive implant conducted in the 1990 s were designed to measure cumulative 3-year efficacy...
September 26, 2016: Human Reproduction
Joseph A Dottino, Vic Hasselblad, Angeles Alvarez Secord, Evan R Myers, Junzo Chino, Laura J Havrilesky
OBJECTIVE: To estimate the cost-effectiveness of the levonorgestrel intrauterine device (IUD) as an endometrial cancer prevention strategy in obese women. METHODS: A modified Markov model was used to compare IUD placement at age 50 with usual care among women with a body mass index (BMI, kg/m) 40 or greater or BMI 30 or greater. The effects of obesity on incidence and survival were incorporated. The IUD was assumed to confer a 50% reduction in cancer incidence over 5 years...
October 2016: Obstetrics and Gynecology
Patricia A Lohr, Richard Lyus, Sarah Prager
Four intrauterine devices (IUDs) are available in the United States, three levonorgestrel-releasing intrauterine systems (two containing 52 mg and one containing 13.5 mg of levonorgestrel) and one copper-bearing device (Copper T 380 A). All IUDS have very low typical-use failure rates; nevertheless, the devices are used by a minority of women, with nulliparous women less likely to do so than parous women. The objective of this clinical review is to give evidence-based recommendations for the use of IUDs in nulliparous women...
August 31, 2016: Contraception
Kate H Rademacher, Marsden Solomon, Tracey Brett, John H Bratt, Claire Pascual, Jesse Njunguru, Markus J Steiner
BACKGROUND: The levonorgestrel intrauterine system (LNG IUS) is one of the most effective forms of contraception and offers important non-contraceptive health benefits. However, it is not widely available in developing countries, largely due to the high price of existing products. Medicines360 plans to introduce its new, more affordable LNG IUS in Kenya. The public-sector transfer price will vary by volume between US$12 to US$16 per unit; for an order of 100,000 units, the public-sector transfer price will be approximately US$15 per unit...
August 11, 2016: Global Health, Science and Practice
Bernard J Moncla, Catherine A Chappell, Brian M Debo, Leslie A Meyn
In this study, we characterized the glycome of cervical-vaginal fluid, collected with a Catamenial cup. We quantified: glycosidase levels; sialic acid and high mannose specific lectin binding; mucins, MUC1, MUC4, MUC5AC, MUC7; and albumin in the samples collected. These data were analyzed in the context of hormonal status (day of menstrual cycle, hormonal contraception use) and role, if any, of the type of the vaginal microflora present. When the Nugent score was used to stratify the subjects by microflora as normal, intermediate, or bacterial vaginosis, several important differences were observed...
2016: PloS One
Erin N Berry-Bibee, Naomi K Tepper, Tara C Jatlaoui, Maura K Whiteman, Denise J Jamieson, Kathryn M Curtis
OBJECTIVES: To investigate levonorgestrel (LNG)-releasing and copper-bearing (Cu) intrauterine device (IUD) safety among breastfeeding women and, for Cu-IUD use, breastfeeding performance and infant health. STUDY DESIGN: Systematic review METHODS: We searched PubMed, Embase, Cochrane Library and for articles through January 2016. We included studies of Cu-IUD or LNG-IUD users comparing IUD-specific (perforation, expulsion) and other contraceptive-related (infection, removal/cessation due to bleeding/pain, and other adverse events) outcomes for breastfeeding versus non-breastfeeding women...
July 12, 2016: Contraception
Caron R Kim, Otoniel Martinez-Maza, Larry Magpantay, Clara Magyar, Jeffrey Gornbein, Radhika Rible, Peggy Sullivan
OBJECTIVES: To describe the endometrial milieu of stable transplant patients and healthy women before and after levonorgestrel intrauterine system (LNG-IUS) insertion. STUDY DESIGN: Women between 18-45 years of age desiring LNG-IUS insertion were enrolled with a 2:1 ratio of healthy to stable solid organ transplant patients. The first visit entailed a blood draw, uterine lavage and endometrial biopsy followed by LNG-IUS insertion. Follow-up visit involved a repeat serum draw, uterine lavage and endometrial biopsy...
June 30, 2016: Contraception
Lauren B Zapata, Tara C Jatlaoui, Polly A Marchbanks, Kathryn M Curtis
BACKGROUND: Potential barriers to intrauterine device (IUD) use include provider concern about difficult insertion, particularly for nulliparous women. OBJECTIVE: This study aims to evaluate the evidence on the effectiveness of medications to ease IUD insertion on provider outcomes (i.e., ease of insertion, need for adjunctive insertion measures, insertion success). SEARCH STRATEGY: We searched the PubMed database for peer-reviewed articles published in any language from database inception through February 2016...
June 29, 2016: Contraception
H Pamela Pagano, Lauren B Zapata, Erin N Berry-Bibee, Kavita Nanda, Kathryn M Curtis
BACKGROUND: Women with depressive or bipolar disorders are at an increased risk for unintended pregnancy. OBJECTIVE: To examine the safety of hormonal contraception among women with depressive and bipolar disorders. METHODS: We searched for articles published through January 2016 on the safety of using any hormonal contraceptive method among women with depressive or bipolar disorders, including those who had been diagnosed clinically or scored above threshold levels on a validated screening instrument...
June 27, 2016: Contraception
Jessica N Sanders, Laura Howell, Hanna M Saltzman, E Bimla Schwarz, Ivana S Thompson, David K Turok
BACKGROUND: Previous emergency contraception studies have excluded women who report >1 episode of unprotected or underprotected intercourse. Thus, clinical recommendations are based on exposure to a single episode of underprotected intercourse. OBJECTIVE: We sought to assess the prevalence and timing of underprotected intercourse episodes among women requesting emergency contraception and to examine the probability of pregnancy following an emergency contraception regimen including placement of either a copper intrauterine device or a levonorgestrel intrauterine device with simultaneous administration of an oral levonorgestrel pill in women reporting multiple underprotected intercourse episodes, including episodes beyond the Food and Drug Administration-approved emergency contraception time frame (6-14 days)...
June 24, 2016: American Journal of Obstetrics and Gynecology
Tayfun Gungor, Nilufer Cetinkaya, Hakan Yalcin, Sema Zergeroglu, Salim Erkaya
OBJECTIVE: The aim of this study was to investigate the clinical and laboratory features of patients with the incidental diagnosis of endometrial adenocarcinoma (EC) during infertility work-up, with special attention given to treatment approaches, recurrence rate, and fertility outcome. MATERIAL AND METHODS: The medical records of 577 patients who were diagnosed with EC and treated between 2007 and 2013 were included in the study. Out of 577 EC patients, 5.1% (n = 30) were ≤ 40 years of age...
June 2016: Taiwanese Journal of Obstetrics & Gynecology
Patrick Rowe, Tim Farley, Alexandre Peregoudov, Gilda Piaggio, Simone Boccard, Sihem Landoulsi, Olav Meirik
No abstract text is available yet for this article.
June 13, 2016: Contraception
Tara C Jatlaoui, Katharine B Simmons, Kathryn M Curtis
OBJECTIVE: To assess risk of pelvic inflammatory disease (PID) among women with current asymptomatic undiagnosed cervical infection or who are at high risk of sexually transmitted infections (STIs), comparing those who have a copper-bearing (Cu-) or levonorgestrel (LNG-) intrauterine device (IUD) placed with women who do not. STUDY DESIGN: We searched PubMed and Cochrane Library for articles from January 1984 through January 2016 addressing our objective. We assessed study quality using the United States Preventive Services Task Force evidence grading system...
June 1, 2016: Contraception
Tara C Jatlaoui, Kathryn M Curtis
OBJECTIVE: This study aims to determine whether emergency contraceptive pills (ECPs) are less safe and effective for women with obesity compared with those without obesity. STUDY DESIGN: We searched PubMed for articles through November 2015 regarding the safety and effectiveness of ECPs [ulipristal acetate (UPA), levonorgestrel (LNG) and combined estrogen and progestin] among obese users. We assessed study quality using the United States Preventive Services Task Force evidence grading system...
May 24, 2016: Contraception
Jessica Mayra Ferreira, Ilza Monteiro, Sara Castro, Marina Villarroel, Carolina Silveira, Luis Bahamondes
Introduction Women require effective contraception until they reach menopause. The long acting reversible contraceptives (LARC) and the depot-medroxyprogesterone acetate (DMPA, Depo-Provera®, Pfizer, Puurs, Belgium) are great options and can replace possible sterilizations. Purpose To assess the relationship between the use of LARCs and DMPA and terminations ascribed to menopause and sterilizations in a Brazilian clinic. Methods We reviewed the records of women between 12 and 50 years of age attending the clinic that chose to use a LARC method or DMPA...
May 2016: Revista Brasileira de Ginecologia e Obstetrícia
Ki Hwan Lee, Jang Kew Kim, Min A Lee, Young Bok Ko, Jung Bo Yang, Byung Hun Kang, Heon Jong Yoo
OBJECTIVE: This study is to evaluate the relationship between the uterine volume and the failure of levonorgestrel-releasing intrauterine device (LNG-IUD) in patients with adenomyosis. METHODS: A total of 171 women with adenomysis were treated with LNG-IUD from November 2009 to December 2011. The amount of menorrhagia, degree of dysmenorrhea, and the uterine volume were compared before and after insertion of LNG-IUD, and the treatment failure of LNG-IUD was observed...
September 2016: Archives of Gynecology and Obstetrics
Naomi K Tepper, Maura K Whiteman, Polly A Marchbanks, Andra H James, Kathryn M Curtis
BACKGROUND: Women with medical conditions associated with increased risk for thrombosis generally should not use estrogen-containing contraceptives, however less is known about progestin-only contraceptives (POCs) and thrombosis risk. OBJECTIVES: To identify evidence regarding the risk of venous thromboembolism (VTE) or arterial thromboembolism (stroke or acute myocardial infarction [AMI]) among women using POCs. METHODS: We searched the PubMed database for all articles published from database inception through January 2016 for studies examining thrombosis among women using POCs...
May 3, 2016: Contraception
Gabriella Macchia, Francesco Deodato, Savino Cilla, Francesco Legge, Vito Carone, Vito Chiantera, Vincenzo Valentini, Alessio Giuseppe Morganti, Gabriella Ferrandina
The present study investigated the combination of levonorgestrel-releasing intrauterine device (LNG-IUD) insertion and palliative radiotherapy (RT) as a potential approach for treating frail, elderly endometrial cancer (EC) patients considered unfit for curative oncological treatments. The inclusion criteria were an age of ≥65 years, pathological confirmation of a uterine neoplasm, a Charlson comorbidity index (CCI) value of ≥4 and the presence of vaginal bleeding. Patients underwent intrauterine insertion of an LNG-IUD, and thereafter, received a total dose of 30 Gy at 3 Gy per fraction, over 10 days...
May 2016: Oncology Letters
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