Contraception In Patients Research Articles

Comparing patient telephone callback rates for different hormonal birth control delivery systems

Introduction: This study was conducted to determine the number of callbacks in the first 3 months after the initiation of vaginal rings, transdermal patches or oral contraceptives in patients. If a patient called back, the reason for the call was noted.

Risk of taking oral contraceptives in patients with a history of migraine with neurological signs.

Medical Journal of AustraliaVolume 176, Issue 5 p. 237-238 EBM in Action Risk of taking oral contraceptives in patients with a history of migraine with neurological signs Vivienne F Bernath, Vivienne F Bernath Research Officer Centre for Clinical Effectiveness, Southern Health/Monash Institute of Health Services Research, Clayton, VIC.Search for more papers by this authorOrnella Clavisi, Ornella Clavisi Research Officer Centre for Clinical Effectiveness, Southern Health/Monash Institute of Health Services Research, Clayton, VIC.Search for more papers by this authorJeremy N Anderson, Jeremy N Anderson Associate Professor and Director Centre for Clinical Effectiveness, Southern Health/Monash Institute of Health Services Research, Clayton, VIC.Search for more papers by this author Vivienne F Bernath, Vivienne F Bernath Research Officer Centre for Clinical Effectiveness, Southern Health/Monash Institute of Health Services Research, Clayton, VIC.Search for more papers by this authorOrnella Clavisi, Ornella Clavisi Research Officer Centre for Clinical Effectiveness, Southern Health/Monash Institute of Health Services Research, Clayton, VIC.Search for more papers by this authorJeremy N Anderson, Jeremy N Anderson Associate Professor and Director Centre for Clinical Effectiveness, Southern Health/Monash Institute of Health Services Research, Clayton, VIC.Search for more papers by this author First published: 04 March 2002 https://doi.org/10.5694/j.1326-5377.2002.tb04382.xCitations: 1 Correspondence: cce@med.monash.edu.au Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume176, Issue5March 2002Pages 237-238 RelatedInformation

Contraception in the patient with liver disease

Selection of a method of contraception in patients with liver disease can be complicated. Tubal ligation should be considered in the setting of chronic liver disease for those patients who have completed families. Multiple reversible methods of contraception are currently available but may affect hepatic disease. Estrogen-containing contraceptive methods are contraindicated in patients with acute liver disease. Progestin contraceptives appear to be safe and multiple delivery systems are available. With rare exception, barrier methods and the intrauterine device may be offered as alternative methods.

Oral contraceptives in patients with protein C or protein S deficiency: Risk assessment and impact on screening procedures

Oral contraceptives in patients with protein C or protein S deficiency: Risk assessment and impact on screening procedures

Contraception for patients with psychiatric or medical disorders

Contraception for patients with psychiatric or medical disorders

Contraception for patients with psychiatric or medical disorders

The increased risk that pregnancy carries for women with medical disorders must be weighed against the risks of reversible contraception. In the absence of prospective randomized trials of various contraceptive methods and their effect on a given disease process, the clinician must use information regarding the risk of pregnancy in a woman with medical problems, the well-documented failure rates of various methods, and the probability that the patient will use the method (or any other method) effectively. The possible effects of contraceptive methods on cardiovascular, endocrinologic, neurologic, and other medical disorders are discussed as are appropriate contraceptive options and considerations for these women.

Fibromuscular dysplasia of the carotid arteries complicating pregnancy

Fibromuscular dysplasia is an arteriopathy of unknown etiology that affects the intermediate-size branches of the aorta. Partial occlusion of these arteries may result in neurologic symptoms when carotid arteries are affected, and impaired liver or kidney function when their blood supply is compromised. Pregnancy and delivery in women who are diagnosed as having fibromuscular dysplasia may be associated with disease-related complications such as ischemic attacks. We report the course of a pregnancy and delivery in a patient with carotid artery fibromuscular dysplasia and suggest steps for general obstetric management and contraception in patients suffering from fibromuscular dysplasia.

Contraception and the Adolescent Diabetic

We believe our data suggests that pregnancy among adolescent diabetics is more frequent than would be expected from the general population at a time when diabetic control is at its worse. Thus patients and their offspring are exposed to extreme morbidity. Current recommendations regarding contraception in patients with diabetes are not appropriate for the adolescent population and therefore tend to support this phenomenon rather than relieve it. Because of the peculiar physiological and developmental characteristics of this population, more medical research is necessary regarding various hormonal preparations available to determine the safest acceptable contraceptive for the adolescent diabetic. To be truly effective, these new alternatives must be presented to the patient in the context of a counseling program that (1) recognizes that this population does have an unusually high frequency of pregnancy for reasons unknown, and that (2) stresses the need for the patient to take control of the diabetes prior to becoming pregnant.

Einsatz von Gn-RH-Analoga bei markumarisierten Patientinnen zur Antikonzeption und Prophylaxe von lebensbedrohlichen Ovulationsblutungen

Five severe cases of intra-abdominal gynaecological haemorrhage (four haemorrhages from corpora lutea haemorrhagica and one haemorrhage of the endometritis genitalis externa) are described in relation to prolonged marcumar therapy. The problem of contraception in patients under marcumar therapy is highlighted and the possibility is discussed of prevention of ovulation and cardio-vascularly neutral treatment, to achieve contraception as well as avoidance of haemorrhage at ovulation with the Gn-RH analogue Buserelin.

Cyclic administration of an LHRH analogue and of progesterone in risk patients to oral contraceptives

Fifty-five cycles of 9 patients with normogonadotropic ovarian function having risks against oral contraceptives (OCs) and intrauterine devices (IUDs) were treated for contraception with buserelin in a dosage of 300 to 450 /ug per day i.n. from day 5 to day 26 of the cycles. Additionally, progesterone (P) in a dosage of 75 mg per day was given by intravaginal suppositories from day 20 to day 26 of the cycle followed by a 7-day drug-free interval. Serum levels of LH, FSH and estradiol-17β (E 2) showed a wide variability. However, most E 2 levels were in the early or middle follicular phase range. Mean serum P levels monitored during P replacement were found to be in the secretory phase range. Pattern of menstrual cycles was regular in all patients except one whose menstrual bleedings were already disturbed prior to treatment. This mode of contraception was well accepted, no side effects were observed, no pregnancy occurred. In conclusion, contraception by low-dose intranasal application of buserelin combined with transvaginal P replacement seems to be a useful approach for contraception in patients at risk for both OCs and IUDs.

Interaction of anticonvulsants and oral contraceptives in epileptic adolescents

Oral contraceptives are in widespread use, and are commonly prescribed for contraception in patients taking other medications. An example of this is the concomitant use of oral contraceptives and anticonvulsants in epileptic patients. This combination creates a potential for drug interactions which may alter the efficiay of both medications. An apparent interaction between oral contraceptives and anticonvulsants was observed in this study of epileptic adolescent females. This interaction was evidenced by menstrual irregularities which occurred in 65% (7 of 11) of adolescents on both medications concomitantly. The frequency of irregularity was significantly higher in these adolescents when compared to adolescents on either medication alone. Irregularities appeared to be alleviated by increasing the strength of the oral contraceptive, and although a concern, the increased dosage did not affect seizure control.

Sickle cell diseases and hormonal contraception.

The available data on the use of oral contraceptive agents in patients with sickle cell diseases is reviewed. The attitude which considers sickle cell anemia to be a contra-indication to OC's cannot be supported on the basis of available evidence. On the contrary, there are a number of reports where favorable effects of steroids on 'sickling' have been described. It is concluded that modern low-dose combined OC's are the method of choice for contraception in all patients carrying the HbS gene.

Oral contraception in patients with hyperprolactinaemia.

10 women aged 23-36 years were studied to determine whether the medical cost control of hyperprolactinemia could be maintained after introducing oral contraceptive (OC) treatment. 5 of the patients had radiological evidence of pituitary tumors. All had taken bromocriptine for 11-58 months before starting estrogen treatment. Doses (5-25 mg daily) were adjusted individually until prolactin concentrations were no longer raised. Minilyn was started on the 5th day of menstruation. When taking bromocriptine alone the serum prolactin concentration was below the limits of assay sensitivity in 1 patient but normal in 7 others. There was no overall change in prolactin concentrations during Minilyn. 3 patients complained of nausea or breast enlargements. Estrogen related side effects were noted in 3 patients but there were no overall changes in serum prolactin concentrations. Medical control of hyperprolactinemia was well maintained. In conclusion estrogen-containing OCs may be used in patients with hyperprolactinemia and pituitary tumors provided that serum prolactin concentrations are 1st restored to normal with bromocriptine.

Contraceptives in sickle cell disease.

Choosing the proper method of contraception for patients with sickle cell disease is an empiric exercise. In this manuscript, the commonly used contraceptive methods are examined for their risk-benefit ratio. However, because of its extensive use and effectiveness, steroid contraception is examined in greatest depth. Physiologic and pathologic changes induced by oral steroid contraceptives are evaluated, and their potential effects on patients with sickle cell disease are considered. Physiologic alterations evaluated are carbohydrate metabolism, blood lipid levels, hepatic function, thyroid function, and pigment changes. Pathologic changes reviewed are hypertension, thromboembolic phenomena, myocardial infarction, amenorrhea, and emotional changes. The choice of sterilization procedures is also considered for these patients.

Marked hyperlipidemia and pancreatitis associated with oral contraceptive therapy.

Marked hyperlipidemia, recurrent episodes of abdominal pain and ultimately pancreatitis developed in two women receiving oral contraceptive agents. Chylomicrons were absent from initial and subsequent samples drawn during admission with acute pancreatitis. Since contraceptive therapy was stopped, they have remained symptom free, although mild elevations of endogenous triglycerides persist when they are on ad lib diets. In four other cases reported in the literature massive hyperlipidemia developed during oral contraceptive therapy. Two of these patients also had pancreatitis; laparotomies were performed on three of the total of four patients with pancreatitis for presumptive gallbladder disease. These experiences suggest caution in the use of oral contraceptives in patients with Type 4 hyperlipidemia, and should alert physicians to the possibility of pancreatitis secondary to hyperlipidemia in patients receiving these agents. (N Engl J Med 289:552–555, 1973)

The "pill" in otolaryngology.

Symptoms related to use of oral contraceptives in patients seen by an otolaryngologist are discussed. Pressure in the ears due to obstructed eustacian tubes are often seen in pregnancy and in the luteal phase of the menstrual cycle. Whether ear pressure is the consequence of vascular congestion or of the cyclic response of the nasal mucosa to female hormones is unknown but patients can often find relief by switching from sequential to combined pills. Vertigo unsteadiness and imbalance are often noted a few days before menstruation during pill cycles. Their relationship with thrombosis is unknown. In menopause estrogen relieves vertigo. Distortion of sound is probably caused by patulous or obstructed eustacian tubes and requires discontinuing the pill. Nasal congestion can often be relieved by sequential pills because nasal mucous glands respond like the genital tract to estrogen in hypogonadal women. Premenstrual headache related to traction or alteration of cranial blood vessels can be treated with 2 mg Halotestin (fluoxymesterone) sublingually. Migraine headaches often respond to progestin because these hormones raise the threshhold of the reticular system and have an anitconvulsive effect. The possibility that the pill like pregnancy precipitates otosclerosis has not been proven.