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Turan G, Yalcin Bahat P, Aslan Cetin B, Peker N. The effect of a levonorgestrel-releasing intrauterine device on female sexual function. J OBSTET GYNAECOL 2020; 41:269-274. [PMID: 32498582 DOI: 10.1080/01443615.2020.1755630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study aimed to evaluate the effect of a levonorgestrel-releasing intrauterine system (LNG-IUS) on the sexual function of women. Participants who had abnormal uterine bleeding (AUB) complaints with LNG-IUSs were included (study registration: Kanuni Sultan Suleyman Training and Research Hospital, 2018/10/34). The demographic data of all participants were recorded. The female sexual function index (FSFI) questionnaire was used to participants before the insertion of LNG-IUSs and 6 months after its insertion. FSFI scores were calculated at both timepoints and were compared. The total FSFI score after LNG-IUS insertion was significantly higher than the total FSFI score application (p < .001). The scores of the desire, arousal, lubrication, orgasm, satisfaction and pain categories significantly increased after LNG-IUS compared to those before LNG-IUS. As a result, the present study demonstrated that after LNG-IUS insertion, these women had higher FSFI scores.Impact StatementWhat is already known on this subject? There are many publications in the literature comparing the effects of LNG-IUSs, IUSs, OCs and other contraceptive methods on female sexuality. However, there are markedly few studies that compare sexual function before and after LNG-IUS insertion.What do the results of this study add? The total FSFI score after LNG-IUS insertion was significantly higher than the total FSFI score before the insertion (p < .001). The scores of the desire, arousal, lubrication, orgasm, satisfaction and pain categories significantly increased after LNG-IUS insertion compared to those before the application. The number of participants with FSFI scores ≥26.5 before LNG-IUS insertion was 17 (12.5%), and this number increased to 71 (52.5%) after the applicationWhat are the implications of these findings for clinical practice and/or further research? This study contributes to the literature because there are few researches that compare sexual function before and after LNG-IUS insertion. As a result of our study, sexual dysfunction decreased after LNG-IUS, and the scores increased in all sub-groups together with the total FSFI scores.
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Affiliation(s)
- Gokce Turan
- School of Medicine, Department of Obstetrics and Gynecology, Gazi University, Ankara, Turkey
| | - Pinar Yalcin Bahat
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Berna Aslan Cetin
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Nurullah Peker
- Department of Obstetrics and Gynecology, Dicle University Medical Faculty, Diyarbakır, Turkey
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Long J, Etxeberria AE, Kornelsen C, Nand AV, Ray S, Bunt CR, Seyfoddin A. Development of a Long-Term Drug Delivery System with Levonorgestrel-Loaded Chitosan Microspheres Embedded in Poly(vinyl alcohol) Hydrogel. ACS APPLIED BIO MATERIALS 2019; 2:2766-2779. [DOI: 10.1021/acsabm.9b00190] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jingjunjiao Long
- Drug Delivery Research Group, School of Science, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 1142, New Zealand
| | - Alaitz Etxabide Etxeberria
- Drug Delivery Research Group, School of Science, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 1142, New Zealand
- Department of Chemical and Environmental Engineering, Engineering College of Gipuzkoa, BIOMAT Research Group, University of the Basque Country (UPV/EHU), Donostia-San Sebastian 48080, Spain
| | - Caroline Kornelsen
- Department of Chemistry, University of Arkansas at Little Rock, Little Rock, Arkansas 72204, United States
| | - Ashveen V. Nand
- Health and Community, and Environmental and Animal Sciences Network, Unitec Institute of Technology, Auckland 1142, New Zealand
| | - Sudip Ray
- MBIE Biocide Toolbox and NZProduct Accelerator Programmes, School of Chemical Sciences, University of Auckland, Auckland 1142, New Zealand
| | - Craig R. Bunt
- Department of Agricultural Sciences, Faculty of Agriculture and Life Sciences, Lincoln University, Canterbury 7647, New Zealand
| | - Ali Seyfoddin
- Drug Delivery Research Group, School of Science, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 1142, New Zealand
- School of Interprofessional Health Studies, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 1010, New Zealand
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Lazzeri L, Luisi S, Petraglia F. Progestins for the Treatment of Endometriosis: An Update. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/228402651000200401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Endometriosis is a gynecological condition that affects approximately 10% of women of reproductive age, including 25–40% of infertile women. Dysmenorrhea, dyspareunia and chronic pelvic pain are the most common symptoms. Currently available medical therapies for endometriosis do not cure the disease, but are directed at symptom relief, typically utilizing the hormone responsiveness of endometriotic tissue to induce lesion atrophy. Unfortunately, pain relapse after treatment suspension is a common event. Treatment with pharmacological therapies for endometriosis should be conceived in terms of years, thus agents that must be withdrawn after a few months due to poor tolerability or severe metabolic side effects do not greatly benefit women with symptomatic endometriosis. The characteristics of progestins render this class an ideal pharmacological choice for administration over extended periods. The present paper will review the rationale for using progestins and their mechanism of action in endometriosis. Thereafter, the results obtained by various progestins in the treatment of endometriosis will be evaluated (danazol, gestrinone, norethisterone acetate, desogestrel, cyproterone acetate, megestrol acetate, medroxyprogesterone acetate, and levonorgestrel). A progestin called dienogest, recently introduced for the treatment of endometriosis, will be given special focus, describing its mechanism of action and clinical results.
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Affiliation(s)
- Lucia Lazzeri
- Obstetrics and Gynecology, Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena - Italy
| | - Stefano Luisi
- Obstetrics and Gynecology, Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena - Italy
| | - Felice Petraglia
- Obstetrics and Gynecology, Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena - Italy
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Cim N, Soysal S, Sayan S, Yildizhan B, Karaman E, Cetin O, Tolunay HE, Yildizhan R. Two Years Follow-Up of Patients with Abnormal Uterine Bleeding after Insertion of the Levonorgestrel-Releasing Intrauterine System. Gynecol Obstet Invest 2017; 83:569-575. [PMID: 29223999 DOI: 10.1159/000480012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 08/03/2017] [Indexed: 11/19/2022]
Abstract
AIM To evaluate the efficacy and safety of levonorgestrel-releasing intrauterine system (LNG-IUS) in the long-term treatment of heavy menstrual blood loss in women unrelated to intrauterine pathology. METHODS One hundred and six parous women aged 33-48 years with recurrent heavy menstrual bleeding (HMB) participated in this study. The women were followed up for 24 months and were assessed for intensity of bleeding both for pre- and post-insertion periods. An LNG-IUS was inserted in each patient within 7 days of the start of menstrual flow. The women were followed up at 1, 3, 6, 12, 18, and 24 months following the insertion of the intrauterine device. RESULTS One hundred and two women completed the follow-up period and had a significant reduction in the amount of menstrual blood loss. The LNG-IUS was well tolerated by all women. Pre-treatment of the use of the LNG-IUS, endometrial biopsy patterns for irregular proliferative endometrium and for atypical simple hyperplasia were 34/106 (32.08%) and 61/106 (57.55%) respectively and after treatment no abnormal pathologic findings were determined (p < 0.001). CONCLUSION Our findings indicate that the LNG-IUS is effective for significantly reducing the amount of menstrual blood loss in women with HMB.
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Affiliation(s)
- Numan Cim
- Department of Obstetrics and Gynecology, Yuzuncu Yil University Medical Faculty, Van,
| | - Sunullah Soysal
- Department of Obstetrics and Gynecology, Marmara University Medical Faculty, Istanbul, Turkey
| | - Sena Sayan
- Department of Obstetrics and Gynecology, Marmara University Medical Faculty, Istanbul, Turkey
| | - Begum Yildizhan
- Department of Obstetrics and Gynecology, Marmara University Medical Faculty, Istanbul, Turkey
| | - Erbil Karaman
- Department of Obstetrics and Gynecology, Yuzuncu Yil University Medical Faculty, Van, Turkey
| | - Orkun Cetin
- Department of Obstetrics and Gynecology, Yuzuncu Yil University Medical Faculty, Van, Turkey
| | - Harun Egemen Tolunay
- Department of Obstetrics and Gynecology, Yuzuncu Yil University Medical Faculty, Van, Turkey
| | - Recep Yildizhan
- Department of Obstetrics and Gynecology, Yuzuncu Yil University Medical Faculty, Van, Turkey
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Viganò P, Somigliana E, Vercellini P. Levonorgestrel-Releasing Intrauterine System for the Treatment of Endometriosis: Biological and Clinical Evidence. WOMENS HEALTH 2016; 3:207-14. [DOI: 10.2217/17455057.3.2.207] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Endometriosis-associated symptomatology can be safely and effectively treated with intrauterine-released progestin, which is associated with fewer adverse effects than other therapeutic options and may be used on a long-term basis. We have herein reviewed the current literature in relation to the biological and clinical rationale for the use of an intrauterine system releasing 20 μg/day of levonorgestrel for the treatment of pelvic pain symptoms associated with endometriosis. Levonorgestrel induces endometrial glandular atrophy and decidual transformation of the stroma, reduces endometrial cell proliferation and increases apoptotic activity. After the first year of use, a 70–90% reduction in menstrual blood loss is observed. The levonorgestrel-releasing intrauterine system has proven effective in relieving pelvic pain symptoms caused by peritoneal and rectovaginal endometriosis and in reducing the risk of recurrence of dysmenorrhea after conservative surgery. Thus, the intrauterine delivery of a potent progestin may constitute an innovative, effective, safe and convenient alternative for local delivery of a potent progestin in the long-term therapy of symptomatic endometriosis.
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Affiliation(s)
- Paola Viganò
- University of Milan, Department of Obstetrics, Gynecology and Neonatology, Fondazione Ospedale Policlinico-Mangiagalli-Regina Elena, Center for Research in Obstetrics and Gynecology, Milano, Via Commenda 12, 20122 Milan, Italy, Tel.: +39 025 799 2331; Fax: +39 025 032 0252
| | - Edgardo Somigliana
- University of Milan, Department of Obstetrics, Gynecology and Neonatology, Fondazione Ospedale Policlinico-Mangiagalli-Regina Elena, Center for Research in Obstetrics and Gynecology, Milano, Via Commenda 12, 20122 Milan, Italy, Tel.: +39 025 799 2331; Fax: +39 025 032 0252
| | - Paolo Vercellini
- University of Milan, Department of Obstetrics, Gynecology and Neonatology, Fondazione Ospedale Policlinico-Mangiagalli-Regina Elena, Center for Research in Obstetrics and Gynecology, Milano, Via Commenda 12, 20122 Milan, Italy, Tel.: +39 025 799 2331; Fax: +39 025 032 0252
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Berlanda N, Somigliana E, Viganò P, Vercellini P. Safety of medical treatments for endometriosis. Expert Opin Drug Saf 2015; 15:21-30. [DOI: 10.1517/14740338.2016.1121991] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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van Hylckama Vlieg A, Middeldorp S. Hormone therapies and venous thromboembolism: where are we now? J Thromb Haemost 2011; 9:257-66. [PMID: 21114755 DOI: 10.1111/j.1538-7836.2010.04148.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- A van Hylckama Vlieg
- Leiden University Medical Center, Department of Clinical Epidemiology, Leiden, The Netherlands.
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van Hylckama Vlieg A, Helmerhorst FM, Rosendaal FR. The risk of deep venous thrombosis associated with injectable depot-medroxyprogesterone acetate contraceptives or a levonorgestrel intrauterine device. Arterioscler Thromb Vasc Biol 2010; 30:2297-300. [PMID: 20798377 DOI: 10.1161/atvbaha.110.211482] [Citation(s) in RCA: 122] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To assess the risk of venous thrombosis associated with nonoral contraceptives (ie, injectable depot-medroxyprogesterone acetate contraceptives, hormone [levonorgestrel]-releasing intrauterine devices, a contraceptive patch, or a contraceptive implant). METHODS AND RESULTS Analyses were performed in the Multiple Environmental and Genetic Assessment study, a large case-control study on risk factors for venous thrombosis. For the current analyses, we selected premenopausal women, aged 18 to 50 years, who were not pregnant nor within 4 weeks postpartum and were not using oral contraceptives; 446 patients and 1146 controls were included. Injectable depot-medroxyprogesterone acetate contraceptives were associated with a 3.6-fold (95% CI, 1.8- to 7.1-fold) increased risk of venous thrombosis compared with nonusers of hormonal contraceptives. The use of a levonorgestrel intrauterine device was not associated with an increased risk (odds ratio, 0.3; 95% CI, 0.1 to 1.1). Unfortunately, the few women using a contraceptive patch or an implant prevented a reliable estimate of the risk of thrombosis. CONCLUSIONS The risk of venous thrombosis was increased for injectable depot-medroxyprogesterone acetate contraceptive users, while we were able to reliably exclude an increased risk associated with levonorgestrel intrauterine device use. Therefore, the latter seems to be the safest option regarding the risk of venous thrombosis.
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Affiliation(s)
- Astrid van Hylckama Vlieg
- Department of Clinical Epidemiology, Leiden University Medical Center, C7-P, PO Box 9600, NL-2300 RC Leiden, the Netherlands
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Freeman S, Shulman LP. Considerations for the use of progestin-only contraceptives. ACTA ACUST UNITED AC 2010; 22:81-91. [DOI: 10.1111/j.1745-7599.2009.00473.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Vercellini P, Somigliana E, Viganò P, Abbiati A, Barbara G, Crosignani PG. Endometriosis: current therapies and new pharmacological developments. Drugs 2009; 69:649-75. [PMID: 19405548 DOI: 10.2165/00003495-200969060-00002] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Endometriosis is a chronic inflammatory condition that is responsive to management with steroids. The establishment of a steady hormonal environment and inhibition of ovulation can temporarily suppress ectopic implants and reduce inflammation as well as associated pain symptoms. In terms of pharmacological management, the currently available agents are not curative, and treatment often needs to be continued for years or until pregnancy is desired. Similar efficacy has been observed from the various therapies that have been investigated for endometriosis. Accordingly, combined oral contraceptives and progestins, based on their favourable safety profile, tolerability and cost, should be considered as first-line options, as an alternative to surgery and for post-operative adjuvant use. In situations where progestins and oral contraceptives prove ineffective, are poorly tolerated or are contraindicated, gonadotrophin-releasing hormone analogues, danazol or gestrinone may be used. Future therapeutic options for managing endometriosis must compare favourably against existing agents before they can be considered for inclusion into current practice. Finally, as reproductive prognosis is not ameliorated by medical treatment, it is not indicated for women seeking conception.
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Affiliation(s)
- Paolo Vercellini
- Clinica Ostetrica e Ginecologica I, University of Milan, Milan, Italy.
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Affiliation(s)
- Nupur Gupta
- Division of Adolescent Medicine, Massachusetts General Hospital for Children, Boston, MA, USA
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Vercellini P, Somigliana E, Viganò P, Abbiati A, Daguati R, Crosignani PG. Endometriosis: current and future medical therapies. Best Pract Res Clin Obstet Gynaecol 2008; 22:275-306. [DOI: 10.1016/j.bpobgyn.2007.10.001] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cunnane MS, Dickson G, Cook RL. Women's experiences with emergency contraception in an internal medicine practice. J Womens Health (Larchmt) 2007; 15:1080-9. [PMID: 17125427 DOI: 10.1089/jwh.2006.15.1080] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Emergency contraceptive pills (ECPs) are effective for preventing unintended pregnancy. Whether patients in primary care settings receive physician counseling regarding ECPs has not been evaluated. METHODS We conducted a cross-sectional telephone survey of reproductive-age women who sought care at a university-based general internal medicine clinic regarding receipt of physician counseling about ECPs, knowledge and experiences with ECPs, and attitudes toward using ECPs. RESULTS One hundred forty-nine women aged 18-45 completed the survey. Eighty percent of respondents (n = 119) were at risk for unintended pregnancy. Although all women in the sample had seen an internist in the previous 12 months, only 10% had received physician counseling about ECPs. There was little difference in the proportion of women who received counseling about ECPs comparing those who received care from an obstetrician/gynecologist and an internist with women who received care from an internist alone (13% vs. 8%, p = 0.529). Receipt of ECP counseling was not associated with the consistency of current contraceptive use. No women who were married or over the age of 40 were counseled about ECPs. The majority of participants (92%) had heard of ECPs, although most (54%) had learned about them through the media. Fifty-four percent of women would be likely to use ECPs to prevent unintended pregnancy. CONCLUSIONS Only a fraction of women seeing internists for their primary care are receiving counseling about ECPs, irrespective of receiving care from an obstetrician/gynecologist. As primary care physicians, internists should determine risk for unintended pregnancy, assess patients' knowledge and attitudes toward ECPs, and provide counseling about this effective therapy.
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Affiliation(s)
- Megan S Cunnane
- Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
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Vercellini P, Viganò P, Somigliana E. The role of the levonorgestrel-releasing intrauterine device in the management of symptomatic endometriosis. Curr Opin Obstet Gynecol 2006; 17:359-65. [PMID: 15976541 DOI: 10.1097/01.gco.0000175353.03061.7f] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The aim of this article is to evaluate the biological rationale for the use of an intrauterine device releasing 20 mug/day of levonorgestrel in women with endometriosis, and to assess its efficacy in relieving pelvic pain symptoms. RECENT FINDINGS Levonorgestrel induces endometrial glandular atrophy and extensive decidual transformation of the stroma, downregulates endometrial cell proliferation, increases apoptotic activity, and has antiinflammatory and immunomodulatory effects. Up to 85% of patients wearing the device have anovulatory cycles during the first 3 months of use, but the proportion falls to below 35% by 12 months. After the first year of use, a 70-90% reduction in monthly blood loss is observed; few women report intermenstrual bleeding and about 20-30% amenorrhea. This is advantageous in patients experiencing dysmenorrhea. Although it is maintained that the hormonal activity of the levonorgestrel intrauterine device is local, a systemic effect secondary to uterine absorption of levonorgestrel is probable. The levonorgestrel intrauterine device has proven effective in relieving pelvic pain symptoms caused by peritoneal and rectovaginal endometriosis and in reducing the risk of recurrence of dysmenorrhea after conservative surgery. SUMMARY Intrauterine administration of levonorgestrel with direct distribution to pelvic tissues would imply a local concentration greater than plasma levels. This could result in a superior effectiveness with limited adverse effects and increased patient compliance during long-term treatment. Further trials are needed, however, to verify whether the good results observed are maintained during an entire 5-year period, to confirm the efficacy on dyspareunia and dyschezia, and to compare the effects of the levonorgestrel intrauterine device with those of other treatment options.
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Affiliation(s)
- Paolo Vercellini
- Obstetrics and Gynecology Clinic, Luigi Mangiagalli Institute, University of Milan, Milan, Italy.
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Ma G, Song C, Sun H, Yang J, Leng X. A biodegradable levonorgestrel-releasing implant made of PCL/F68 compound as tested in rats and dogs. Contraception 2006; 74:141-7. [PMID: 16860052 DOI: 10.1016/j.contraception.2006.02.013] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2005] [Revised: 02/16/2006] [Accepted: 02/24/2006] [Indexed: 11/23/2022]
Abstract
PURPOSE Our objective was to report preclinical studies on a biodegradable long-acting contraceptive implant. METHODS A poly (epsilon-caprolactone) (PCL)/pluronic F68 (F68) compound was used to construct an implant, which was filled with dry levonorgestrel (LNG) powder (PCL/F68/LNG). LNG release rate, contraceptive efficacy and polymer degradation were evaluated in rats and followed for 2 years. A 2-year toxicity study was conducted in dogs. RESULTS The in vitro and in vivo release of LNG from the implant followed zero-order release kinetics. Serum LNG level in rats was very stable during the 2-year period. Studies on polymer degradation indicated that the molecular weight of PCL dropped from 66,000 to 15,000 Da, but the implant was still in good shape by the end of 2 years. CONCLUSION Toxicological study demonstrated that the PCL/F68 polymer had no adverse effect in all aspects. The contraceptive efficacy in rats showed dose response. The implant was physically and chemically stable for up to 3 years in airproof aluminum foil packing at room temperature.
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Affiliation(s)
- Guilei Ma
- The Tianjin Key Laboratory of Biomaterials, Institute of Biomedical Engineering, Peking Union Medical College and Chinese Academy of Medical Sciences, Nankai District, Tianjin 300192, China
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Bragg TWH, Jose RM, Bland JW, Matthews RN, Srivastava S. Implantable contraceptive devices: primum non nocere. ACTA ACUST UNITED AC 2006; 32:190-2. [PMID: 16857081 DOI: 10.1783/147118906777888503] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Thomas W H Bragg
- Department of Plastic and Reconstructive Surgery, George Eliot Hospital, Nuneaton, UK.
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Schatz F, Krikun G, Baergen RN, Critchley HOD, Kuczynski E, Lockwood CJ. Intercellular adhesion molecule-1 expression in human endometrium: implications for long term progestin only contraception. Reprod Biol Endocrinol 2006; 4:2. [PMID: 16445864 PMCID: PMC1403781 DOI: 10.1186/1477-7827-4-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2005] [Accepted: 01/30/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Neutrophils infiltrate the endometrium pre-menstrually and after long-term progestin only-contraceptive (LTPOC) treatment. Trafficking of neutrophils involves endothelial cell-expressed intercellular adhesion molecule (ICAM-1). Previous studies observed that ICAM-1 was immunolocalized to the endothelium of endometrial specimens across the menstrual cycle, but disagreed as to whether extra-endothelial cell types express ICAM-1 and whether ICAM-1 expression varies across the menstrual cycle. METHODS Endometrial biopsies were obtained from women across the menstrual cycle and from those on LTPOC treatment (either Mirena or Norplant). The biopsies were formalin-fixed and paraffin-embedded with subsequent immunohistochemical staining for ICAM-1. RESULTS The current study found prominent ICAM-1 staining in the endometrial endothelium that was of equivalent intensity in different blood vessel types irrespective of the steroidal or inflammatory endometrial milieu across the menstrual cycle and during LTPOC therapy. Unlike the endothelial cells, the glands were negative and the stromal cells were weakly positive for ICAM immunostaining. CONCLUSION The results of the current study suggest that altered expression of ICAM-1 by endothelial cells does not account for the influx of neutrophils into the premenstrual and LTPOC-derived endometrium. Such neutrophil infiltration may depend on altered expression of neutrophil chemoattractants.
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Affiliation(s)
- Frederick Schatz
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven CT, USA
| | - Graciela Krikun
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven CT, USA
| | - Rebecca N Baergen
- Department of Pathology, Weil-Cornell Medical Center, New York NY, USA
| | | | - Edward Kuczynski
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven CT, USA
| | - Charles J Lockwood
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven CT, USA
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Simon M, Shulman LP. Non-oral reversible contraceptive methods. WOMEN'S HEALTH (LONDON, ENGLAND) 2006; 2:167-177. [PMID: 19803936 DOI: 10.2217/17455057.2.1.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
There are many contraceptives in the world market today. Knowledge of the vast spectrum of contraceptive methods is essential to the everyday practice of healthcare personnel. Such knowledge translates to improved care and access for women so they can obtain and utilize the appropriate contraception for their individual needs. This is a review of non-oral and nonsurgical contraceptive methods.
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Affiliation(s)
- Melissa Simon
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 333 East Superior Street,Room 484,Chicago, IL 60062, USA.
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Khakpour M, Jamshidi A, Entezami A, Mirzadeh H. HPTLC procedure for determination of levonorgestrel in the drug-release media of an in-situ-forming delivery system. JPC-J PLANAR CHROMAT 2005. [DOI: 10.1556/jpc.18.2005.4.15] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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