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Medication for bone loss in female patients with anorexia nervosa: a systematic review and management algorithm.

PURPOSE: Anorexia Nervosa can have a major impact on bone health through low bone mass and bone loss. Considering the lack of consensual guidelines for the prevention and treatment of bone loss in this condition, a systematic review was performed to provide practical treatment guidance for clinicians. METHODS: We systematically searched Medline, Cochrane, Psychinfo, and the Web of Science for anorexia nervosa AND (osteopenia OR osteoporosis OR bone density OR bone loss) AND (prevention OR treatment OR medication OR therapeutic) in clinical studies from March 1st, 2017, to October 31st, 2024,

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… In a single-arm prospective study including 11 women with AN that received weekly transdermal patch with 17-β-estradiol (0.045 mg/day) and levonorgestrel (0.015 mg/day), lumbar spine and lateral spine BMD increased significantly over 6 months ( p < 0.05), while hip and femoral neck BMD did not(32). … In case hormonal contraception is needed: oral contraceptive pill (continuous or cyclic) with a dose of 30 mcg ethinyl estradiol and levonorgestrel. 2) In adults or adolescents with secondary amenorrhea before physeal closure , discuss transdermal 17-β-estradiol with cyclic oral progesterone. …

Update on the management of endometriosis-associated pain in France.

The French National College of Obstetricians and Gynecologists (CNGOF) published guidelines for managing endometriosis-associated pain in 20 … he use of DNG has grown considerably, and the French guidelines should be modified accordingly. The levonorgestrel intrauterine system (LNG IUS) and other available progestins per os, including DNG, or the subcutaneous implant, can be offered as first-line therapy, gonadotropin-releasing hormone (GnRH) agonists with add-back therapy (ABT) as second-line therapy. …

Preventing recurrence of endometriosis by means of long-acting progestogen therapy (PRE-EMPT): report of an internal pilot, multi-arm, randomised controlled trial incorporating flexible entry design and adaption of design based on feasibility of recruitment.

BACKGROUND: Endometriosis is associated with the growth of endometrium in ectopic sites mainly within the pelvis. This results in inflammati … f endometriosis. A survey of gynaecologists indicated that there was no consensus about which LARC (Levonorgestrel Intrauterine System (LNG-IUS) or depot medroxyprogesterone acetate injection (DMPA)) or comparator (combined oral contraceptive pill (COCP) or no treatment) should be evaluated. Hence, we designed a 'flexible-entry' internal pilot to assess whether …

Therapeutic management of uterine fibroid tumors: updated French guidelines.

The medical management of symptomatic non-submucosal uterine fibroid tumors (leiomyomas or myomas) is based on the treatment of abnormal uterine bleeding by any of the following: progestogens, a levonorgestrel-releasing intrauterine device, tranexamic acid, nonsteroidal anti-inflammatory drugs, or GnRH analogs. Selective progesterone receptor modulators are currently being evaluated and have recently been approved for fibroid treatment. Neither combined estrogen-progestogen contraception nor hormone treatment of the menopause is contraindicated in women with fibroids. When pregnancy is desired…

The use of a large-scale surveillance system in Planned Parenthood Federation of America clinics to monitor cardiovascular events in users of combination oral contraceptives.

BACKGROUND: The publication of a series of papers based on three large, case-controlled studies raised questions about the safety of oral contraceptives (OCs) containing either desogestrel or gestodene as the progestational agent. In light of these studies, the Planned Parenthood Federation of America (PPFA) assessed the risk of thromboembolic events in patients who attended its clinics in the United States (U.S.). These PPFA patients were prescribed contraceptives containing one of the following progestins: desogestrel, levonorgestrel, norethindrone, or norgestimate. All of the contraceptives…

Progesterone Exposure in Pregnancy, Obstetric Stabilization, and Developmental Outcomes: A Focused Review of Direct and Indirect Pathways.

BACKGROUND: Progesterone is an endogenous pregnancy hormone widely used in reproductive medicine and obstetrics. Its developmental relevance … o contraceptive progestins during unrecognized pregnancy, including progestin-only preparations and levonorgestrel-releasing intrauterine systems, should be considered separately from therapeutic obstetric progesterone use. Available evidence has not shown a consistent early adverse signal for natural progesterone when used for recognized indications, although l …

Self-Reported Experiences of Women Taking Hormonal Treatments for Their Endometriosis and Uterine Fibroids Symptoms: Results from a Real-World Study in the US (MyEndoUF).

PURPOSE: To characterize the experiences of individuals taking hormonal therapies to manage their symptoms of endometriosis (EM) or uterine … In both cohorts, the most frequently used hormonal treatments were combined contraceptive pills and levonorgestrel intrauterine devices, with most participants having received their current treatments for >2 years. Hormonal treatment switching or discontinuation during the study was low. Pain medication use, most frequently over-the-counter medications, was high …

Population characteristics of intrauterine device users in real-world clinical practice across Europe - insights from the EURAS-LCS12 study.

BACKGROUND: The European Active Surveillance Study of LCS12 (EURAS-LCS12) investigates effectiveness and safety of intrauterine devices (IUDs) in routine clinical practice. Here, we aim to characterise the general population of IUD users across Europe recorded in a real-world setting. METHODS: EURAS-LCS12 is a prospective, non-interventional cohort study in ten European countries, that started in 2014. All types of approved IUDs were enrolled: levonorgestrel (LNG)-IUS 8 (LNG release rate ~ 8 µg/day); LNG-IUS 12 (LNG release rate ~ 12 µg/day; LNG-IUS 20 (LNG release rate ~ 20 µg/day; ); copper…

The impact of progestogens on RAAS - a systematic review.

BACKGROUND: Progestogens, synthetic analogues of progesterone, are widely used in clinical practice for contraception, hormone replacement t … presented conflicting results on BP and a higher risk of hyperkalemia. Other progestogens, such as levonorgestrel (LNG) and medroxyprogesterone acetate (MPA), showed varied effects on RAAS parameters. Notably, changes in plasma renin activity (PRA), serum aldosterone, and angiotensin II levels were inconsistent across different progestogens and study designs. …

Safety of contraception among women using anticoagulant therapy: An updated systematic review.

OBJECTIVE: Women on anticoagulant therapy are at risk for bleeding and may be at risk for recurrent thrombosis, which may be further increas … bleeding was increased during use of copper intrauterine devices (IUDs) and decreased during use of levonorgestrel (LNG) IUDs. Two studies examined pharmacokinetic outcomes and found no decreases in anticoagulant levels with combined oral contraceptive exposure. CONCLUSIONS: Limited evidence suggests risk for recurrent VTE may not be increased with hormonal con …

Association of vaginal oestradiol and the rate of breast cancer in Denmark: registry based, case-control study, nested in a nationwide cohort.

OBJECTIVE: To estimate the rate of breast cancer associated with use of vaginal oestradiol tablets according to duration and intensity of th … ded. Exclusions were a history of cancer, mastectomy, use of systemic hormone treatment, use of the levonorgestrel releasing intrauterine system, or use of vaginal oestrogen treatments other than oestradiol tablets. To each woman who developed breast cancer during follow-up (18 997), five women in the control group (94 985) were incidence density matched by birt …

High HIV incidence among young women in South Africa: Data from a large prospective study.

INTRODUCTION: South Africa has the highest national burden of HIV globally. Understanding drivers of HIV acquisition in recently completed, … traceptive methods (intramuscular depot medroxyprogesterone acetate, copper intrauterine device, or levonorgestrel implant) for 12-18 months at nine sites in South Africa. HIV incidence based on prospectively observed HIV seroconversion events. Cox proportional hazards regression models were used to define baseline cofactors related to incident HIV infection. R …

Cost-Effectiveness of Early Detection and Prevention Strategies for Endometrial Cancer-A Systematic Review.

Endometrial cancer is the most common female genital tract cancer in developed countries. We systematically reviewed the current health-econ … urgery, surgery was more effective and less costly than screening. In obese women, prevention using Levonorgestrel as of age 30 for five years had an ICER of 72,000 EUR/LYG; the ICER for using oral contraceptives for five years as of age 50 was 450,000 EUR/LYG. Genetic testing for mutations in women at increased risk for carrying a mutation followed by risk-redu …

Is it possible to investigate menopausal age? A comparative cross-sectional study of five cohorts between 1968 and 2017 from the Population Study of Women in Gothenburg, Sweden.

OBJECTIVE: The aim of this study was to examine if the previously found trend of increasing menopausal age is continuing, taking into consid … almost 22% in 2016/2017. From 2004/2005 the use of hormonal intrauterine contraceptive method (the Levonorgestrel-releasing intrauterine system [LNG-IUS]) increased from about 11% to 14% in 2016/2017. The same pattern was found in 50-year-old women using LNG-IUS, increasing from 6% to 15.5% between 2004/2005 and 2016/2017. The total hormonal use, including LNG- …

Treatment Modalities in Adolescents Who Present with Heavy Menstrual Bleeding.

STUDY OBJECTIVE: On this study we sought to determine the relationship of bleeding disorders to iron deficiency anemia. Additionally, this s … tly higher in subjects without a bleeding disorder. In a comparison of hormone therapy success, the levonorgestrel intrauterine device (89%, 8 out of 9 subjects) had the highest rate of menstrual suppression followed by norethindrone acetate 5-10 mg/d (83%, 5 out of 6 subjects), and the transdermal patch (80%, 4 out of 5 subjects). All subjects using tranexamic …

Assessing prevalence of missed laboratory-confirmed sexually transmitted infections among women in Kingston, Jamaica: results from a secondary analysis of the Sino-Implant clinical trial.

OBJECTIVES: To assess potentially missed sexually transmitted infections (STIs), we compared clinically diagnosed STIs to laboratory-confirmed diagnoses of gonorrhoea (GC), chlamydia (CT) and trichomonas (Tvag). DESIGN: Secondary analysis of a randomised controlled trial. SETTING: We used data and specimens previously collected for the Sino-Implant Study in Kingston, Jamaica. PARTICIPANTS: The Sino-Implant Study randomised 414 women to receive a levonorgestrel implant at either baseline or 3 months post-enrolment to evaluate unprotected sex after implant initiation. This analysis used 254 a…

Pharmacokinetic Interactions Between Mirabegron and Metformin, Warfarin, Digoxin or Combined Oral Contraceptives.

BACKGROUND AND OBJECTIVES: Mirabeg ron is a selective β3-adrenoceptor agonist approved for the treatment of overactive bladder (OAB). Four p … (100 mg once daily). Thirty female subjects received low-dose COC containing ethinylestradiol (EE)/levonorgestrel (LNG) (30/150 µg once daily) in combination with mirabegron (100 mg once daily) or placebo. Pharmacokinetic parameters were determined by non-compartmental methods. Absence of a Pharmacokinetic interaction was concluded if the 90 % confidence interv …

A Novel Microbicide/Contraceptive Intravaginal Ring Protects Macaque Genital Mucosa against SHIV-RT Infection Ex Vivo.

Women need multipurpose prevention products (MPTs) that protect against sexually transmitted infections (STIs) and provide contraception. The Population Council has developed a prototype intravaginal ring (IVR) releasing the non-nucleoside reverse transcriptase inhibitor (NNRTI) MIV-150 (M), zinc acetate (ZA), carrageenan (CG) and levonorgestrel (LNG) (MZCL IVR) to protect against HIV, HSV-2, HPV and unintended pregnancy. Our objective was to evaluate the anti-SHIV-RT activity of MZCL IVR in genital mucosa. First, macaque vaginal tissues were challenged with SHIV-RT in the presence of (i) MIV-…