服用左炔诺孕酮滴丸和妈富隆1年对血压、血糖和血脂的影响

目的：观察第二、三代口服避孕药(COC)对育龄妇女体重指数、血压、血糖和血脂的影响。方法：将自愿服用COC避孕1年的妇女105例随机分为两组，其中54例给予第二代COC(EE／LNG组)，51例给予第三代COC(EE／DG组)。并对研究前后所有病例的体重指数(BMI)、血压、血糖和血脂代谢指标进行比较分析。结果：EE／LNG组：BMI、收缩压、舒张压、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)和载脂蛋白B(ApoB)水平均升高，高密度脂蛋白(HDL)水平下降，血糖、载脂蛋白AI(ApoAI)水平无明显改变。EE／DG组收缩压、TG、HDL水平升高，BMI、舒张压、血糖、TC、LDL、ApoAI和ApoB均未发生显著变化。以上所有测量指标均未超出正常范围。结论：使用1年第二、三代COC对妇女BMI、血压和血脂代谢都有微弱的影响，对空腹血糖无明显影响。第三代COC对妇女BMI、收缩压、舒张压、TG、TC、LDL、HDL水平和ApoB的不利影响小于第二代，更加安全可靠。     

米非司酮和去氧孕烯炔雌醇治疗围绝经期功能失调性子宫出血分析

目的:比较和分析2种治疗围绝经期功能失调性子宫出血药物的临床效果。方法:采用回顾性分析方法对2003年7月—2006年7月我院80例围绝经期功血病人分别进行米非司酮和去氧孕烯炔雌醇治疗比较。结果:米非司酮组治疗有效率98%,去氧孕烯炔雌醇组治疗有效率100%,2组差异无显著意义(P>0.05);2组治疗后血清雌二醇(E_2)、孕酮(P)均下降,治疗前后差异具有非常显著意义(P<0.01),卵泡刺激素(FSH)、黄体生成素(LH)下降但无显著意义(P>0.05),催乳素(PRL)、睾酮(T)相对稳定;米非司酮组治疗后39例子宫内膜变薄,有1例出现子宫内膜异常增生;氧孕烯炔雌醇组治疗后子宫内膜均变薄,差异有显著意义(P<0.05)。2组不良反应均轻微。结论:米非司酮和去氧孕烯炔雌醇治疗围绝经期功能失调性子宫出血的临床效果相当,长期应用米非司酮应注意其安全性。     

Gastrointestinal metabolism of contraceptive steroids

A number of oral contraceptive steroids undergo first-pass metabolism in the gastrointestinal mucosa. Ethinyl estradiol (mean systemic bioavailability 40% to 50%) is extensively metabolized, principally to a sulfate conjugate. In vivo studies that use portal vein catheterization and the administration of radiolabeled ethinyl estradiol have shown that the fraction of steroid metabolized in the gut wall is 0.44. In vitro studies with jejunal biopsy samples or larger pieces of jejunum or terminal ileum mounted in Ussing chambers have indicated that more than 30% of added ethinyl estradiol is sulfated. The progestogen desogestrel is a prodrug that is converted to the active metabolite 3-ketodesogestrel. Substantial first-pass metabolism of desogestrel occurs in the gut mucosa, with evidence from Ussing chamber studies for the formation of the active metabolite. Another progestogen, norgestimate, is also metabolized by the gut wall in vitro of which the principal metabolite is the deacetylated product, norgestrel oxime. It seems very likely that this will also occur in vivo. Drug interactions occurring in the gut wall have been reported with ascorbic acid (vitamin C) and paracetamol.     

Post-marketing Surveillance for Combined Oral Contraceptive Containing Desogestrel(Marvelon~) in Chinese Rural Areas

Objective To assess the side effects and the continuation rate of combined oral contraceptive(COC) containing desogestrel(Marvelon) during 12 months. Methods This was a post-marketing surveillance study on Marvelon COC among 870 healthy rural women in 5 different counties of Jiangsu Province during 12 months. Results About 24.02% of the women who used Marvelon COC experienced side effects during 12 months. Gastrointestinal disorder,bleeding/spotting and chloasma were ranked the first three in the side ef...     

Effect of desogestrel 75 µg on headache frequency and intensity in women with migraine: a prospective controlled trial

Objective: In contrast with combined hormonal contraception, progestin-only contraception is not associated with an increase in venous thromboembolism or stroke. Women with migraine are at increased risk of ischaemic stroke. Several studies have reported a reduction in migraine frequency and intensity with desogestrel 75 µg, a progestin-only pill. At present the quality of data is limited by retrospective study designs, lack of control groups and small sample sizes. We present the first prospective nonrandomised controlled trial.

Methods: A total of 150 women with migraine visiting our clinic for contraceptive counselling were screened. The intervention group comprised women who opted for contraception with desogestrel (n?=?98); the control group comprised women who continued their usual contraceptive (n?=?36). Participants completed daily diaries for 90 days before the intervention and 180 days after the intervention.

Results: In the intervention group, we found improvements in migraine frequency (p?<?.001), migraine intensity (p?<?.001) and the number of triptans used (p?<?.001). These improvements were already significant after 90 days of desogestrel use (p?<?.001). Disability scores also decreased significantly. No improvement was seen in the nonintervention group.

Conclusion: These data demonstrate for the first time in a prospective controlled setting that daily use of the progestin desogestrel is associated with a decrease in migraine frequency, migraine intensity and pain medication use in women with migraine, with and without aura, who had previously been experiencing at least three days of migraine per month.

Trial registration: The study is registered in the University of Zürich database (www.research-projects.uzh.ch/unizh.htm).     

No effect of Implanon® on inflammatory cardiovascular parameters

Objective.?Recently, we found decreased levels of C-reactive protein (CRP) during use of the low-dosed contraceptive implant Implanon®. To further elucidate, whether this finding might be a sign for a lower inflammatory reaction and is associated with changes in levels of other cytokines, we investigated the effect of this implant on interleukin-6 (IL-6) and adiponectin. Plasma lipids and sex hormone levels have been shown to interact with the investigated parameters in vivo and in vitro. Therefore these parameters were measured as well.

Design.?Prospective case–control study.

Setting.?Family-planning centre, University hospital.

Subjects.?Thirty-six non-smoking women with regular cycles.

Interventions.?Blood samples for the measurements were taken in the early follicular phase of the cycle in both groups. A second sample was taken 12 weeks after Implanon insertion or in the controls during the early follicular phase of cycle 4.

Results.?Implanon did not cause significant changes in IL-6, adiponectin or lipoprotein (Lp)(a). At baseline, there was a significant positive correlation between IL-6 and CRP and a negative correlation between adiponectin and CRP.

Conclusion.?We did not observe a negative impact of Implanon on risk markers for atherosclerotic disease such as IL-6, adiponectin, and Lp(a). These data are reassuring for clinicians who prescribe progestagen-only preparations as first choice contraceptives in females with cardiovascular risk factors.     

Ovarian activity suppression by two different low-dose triphasic oral contraceptives

In an open, randomized study in an outpatient clinic of a large teaching hospital, thirty-one female volunteers with regular cycles and established ovulation by ultrasonography were given one of two triphasic oral contraceptives containing ethinylestradiol combined with levonorgestrel or desogestrel during six cycles of treatment. The main outcome measures were transvaginal ultrasonography and serum E₂ and P measurements in pill cycles 1, 3 and 6.

No ovarian activity was found in 10 subjects. Among the remaining 21 women who showed ovarian activity, most follicle-like structures developed in the pill-free week and decreased in size or disappeared in the first pill week. One women taking triphasic desogestrel had evidence of a luteinized unruptured follicle and one women taking triphasic levonorgestrel had a possible ovulation. The latter women also showed symptoms of lower abdominal pain. A statistically significant difference in ovarian activity between the two oral contraceptives could not be established. The two triphasic oral contraceptives suppressed ovarian activity to the same degree. A trend was seen towards increasing ovarian activity with duration of use in both treatment groups.     

Ovarian activity and vaginal bleeding patterns with a desogestrel-only preparation at three different doses

A randomized, double-blind, group-comparative study was performedover a 6 month period to compare ovarian suppression and vaginalbleeding during the use of three oral contraceptives containingdoses of 30, 50 or 75 µg desogestrel. A total of 44 femalevolunteers with regular cycles and established ovulation byultrasonography were recruited from an out-patient clinic hia university hospital and asked to participate in the study.Ultrasonography and serum oestradiol and progesterone measurementswere performed during two assessment periods. The 75 µgdose showed complete suppression of ovulation and a more acceptablebleeding pattern than the lower doses. The 75 jig dose of desogestrelis the most promising dose for the development of a new progestogen-onlyoral contraceptive agent.     

八珍益母草胶囊联合欣妈富隆治疗药物流产后阴道出血临床观察

目的 探讨八珍益母草胶囊+欣妈富隆治疗药物流产后阴道出血效果.方法 选择2018年6月—2020年7月收治的64例药物流产后阴道出血患者为研究对象,以随机数字表法分为对照组(32例)和研究组(32例).2组均行清宫术治疗,对照组采用欣妈富隆治疗,研究组在对照组的基础上采用八珍益母草胶囊治疗,2组均治疗3周.观察2组治疗...     

去氧孕烯炔雌醇片治疗无排卵型功能性子宫出血62例

目的：观察去氧孕烯炔雌醇片治疗无排卵性功能失调型子宫出血患者的疗效及对血清激素的影响。方法随机将妇科收治的124例子宫内膜单纯型增生患者分为观察组与对照组,各62例,分别给予去氧孕烯炔雌醇片与甲羟孕酮片进行治疗。统计两组患者的临床疗效,观察月经周期、天数、血红蛋白以及子宫内膜厚度的变化,检测血清激素水平,记录不良反应的发生情况。结果治疗后,观察组总有效率为98.39%,明显高于对照组的91.94%（ P〈0.05）。观察组患者的月经周期、天数、血红蛋白水平以及子宫内膜厚度等方面的改善均明显优于对照组（ P〈0.05）。两组不良反应发生率无统计学差异（ P＞0.05）。结论去氧孕烯炔雌醇片在治疗无排卵型子宫功能性出血方面效果理想,能显著降低血清激素水平,不良反应少,安全性高,值得临床推广。