Blog dedicated to the continuous education in Gynecology and Endocrinology

 

SEXUAL FUNCTION IN FIRST-TIME CONTRACEPTIVE RING AND CONTRACEPTIVE PATCH USERS.

1) Fertil Steril. 2008 Oct 29.

Gracia CR, Sammel MD, Charlesworth S, Lin H, Barnhart KT, Creinin MD.

OBJECTIVE: To assess sexual function of first-time users of the contraceptive ring and contraceptive patch. DESIGN: Open-label randomized trial.

SETTING: Multicenter study.

PATIENT(S): A total of 500 healthy, premenopausal, nonpregnant women who had recently used combined oral contraceptives.

INTERVENTION(S): Contraceptive ring vs. contraceptive patch.

MAIN OUTCOME MEASURE(S): Subjects completed the Female Sexual Function Index (FSFI) before randomization to the study product and after 3 months. Unadjusted and adjusted changes in total and domain FSFI scores from baseline to exit were compared between treatment groups using linear regression (intention-to-treat approach).

RESULT(S): Final adjusted mean total FSFI scores increased by 0.32 points in the patch group and decreased by 0.74 points in the ring group. Subjects in the ring group had worsening scores in the areas of arousal (score change -0.169 ring vs 0.010 patch), lubrication (score change -0.202 ring vs. 0.031 patch), and pain (score change -0.162 ring vs. 0.182 patch).

CONCLUSION(S): Among recent combined oral contraceptive users, slight decrements in sexual function scores were noted with contraceptive ring use overall and in several domains of sexual functioning, whereas slight increases were noted with patch use. However, for both products, these changes are not likely to be clinically significant.

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TREATMENT OF ACNE USING A 3-MILLIGRAM DROSPIRENONE/20-MICROGRAM ETHINYL ESTRADIOL ORAL CONTRACEPTIVE ADMINISTERED IN A 24/4 REGIMEN: A RANDOMIZED CONTROLLED TRIAL.

Maloney JM, Dietze P Jr, Watson D, Niknian M, Lee-Rugh S, Sampson-Landers C, Korner P.

Obstet Gynecol. 2008 Oct;112(4):773-81.

OBJECTIVE: To assess the efficacy of the combined oral contraceptive containing 3-mg drospirenone/20-microgram ethinyl estradiol (3-mg drospirenone/20-microgram ethinyl estradiol) administered as 24 consecutive days of active treatment after a 4-day hormone-free interval (24/4 regimen) compared with placebo for the treatment of moderate acne vulgaris. more

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HEALTH RISKS AND BENEFITS 3 YEARS AFTER STOPPING RANDOMIZED TREATMENT WITH ESTROGEN AND PROGESTIN.

JAMA. 2008 Mar 5;299(9):1036-45
Heiss G, Wallace R, Anderson GL, Aragaki A, Beresford SA, Brzyski R, Chlebowski RT, Gass M, LaCroix A, Manson JE, Prentice RL, Rossouw J, Stefanick ML; WHI Investigators.

CONTEXT: The Women’s Health Initiative (WHI) trial of estrogen plus progestin vs placebo was stopped early, after a mean 5.6 years of follow-up, because the overall health risks of hormone therapy exceeded its benefits. OBJECTIVE: To report health outcomes at 3 years (mean 2.4 years of follow-up) after the intervention was stopped. DESIGN, SETTING, AND PARTICIPANTS: The intervention phase was a double-blind, placebo-controlled, randomized trial of conjugated equine estrogens (CEE) 0.625 mg daily plus medroxyprogesterone acetate (MPA) 2.5 mg daily, in 16,608 women aged 50 through 79 years, recruited by 40 centers from 1993 to 1998. The postintervention phase commenced July 8, 2002, and included 15 730 women. more

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USE OF HORMONE-RELEASING SYSTEM “NUVARING®” IN WOMEN WITH TYPE 1 DIABETES MELLITUS IN LATE REPRODUCTIVE PERIOD

Olga R. Grigoryan, Elena E. Grodnitskaya, Elena N. Andreeva, Tatyana V. Chebotnikova, Galina A. Melnichenko

Aim: to evaluate the effect of the vaginally inserted hormone-releasing system “NuvaRing®” on carbohydrate and lipid metabolism, as well as on the haemostasis system in women with type 1 diabetes mellitus in late reproductive period during 6 months.
Methods: The open randomized study included a total of 25 women with type 1 DM, using “NuvaRing®”. Average daily insulin requirements; the levels of glycosylated haemoglobin, total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol; the state of coagulation haemostatis and fibrinolytic activity were determined at baseline, after 3 and 6 months of contraception. more

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MULTICENTER COMPARISON OF THE CONTRACEPTIVE RING AND PATCH: A RANDOMIZED CONTROLLED TRIAL.

Obstet Gynecol. 2008 Feb;111(2):267-277
Creinin MD, Meyn LA, Borgatta L, Barnhart K, Jensen J, Burke AE, Westhoff C, Gilliam M, Dutton C, Ballagh SA.

OBJECTIVE: To understand if the contraceptive ring or patch was more acceptable, as measured primarily by continuation, to women using an oral contraceptive and interested in a nondaily, combined hormonal contraceptive. METHODS: Five hundred women were randomly assigned to use the contraceptive ring (n=249) or contraceptive patch (n=251) for four consecutive menstrual cycles, starting with their next menses. Participants returned for a single follow-up visit during the fourth cycle for an evaluation, which included a questionnaire to assess acceptability and adverse effects. RESULTS: Rates of completion of three cycles were 94.6% (95% confidence interval [CI] 91.0-97.1%) and 88.2% (95% CI 83.4-92.0%) for ring and patch users, respectively (P=.03). Of these women, 71.0% (95% CI 64.8-76.6%) and 26.5% (95% CI 21.0-32.6%), respectively, planned to continue their method after the study (P<.001). Women switching to the patch were significantly more likely than women switching to the ring to experience longer periods (38% compared with 9%), increased dysmenorrhea (29% compared with 16%), frequent nausea (8% compared with 1%), frequent mood swings (14% compared with 8%), and frequent skin rash (12% compared with 2%) and were less likely to experience frequent vaginal discharge (8% compared with 17%). Ring users preferred the ring to the oral contraceptive (P<.001), and patch users preferred the oral contraceptive to the patch (P<.001). Nugent scores increased only in patch users (P=.01), although most of these women were asymptomatic. CONCLUSION: Women satisfied with combined oral contraceptives and interested in a nondaily method are more likely to continue using the contraceptive ring than the contraceptive patch.

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