DOCSLIB.ORG

Use of Postmenopausal Hormone Therapy and Risk of Alzheimer’S BMJ: First Published As 10.1136/Bmj.L665 on 6 March 2019

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Use of Postmenopausal Hormone Therapy and Risk of Alzheimer’S BMJ: First Published As 10.1136/Bmj.L665 on 6 March 2019 RESEARCH Use of postmenopausal hormone therapy and risk of Alzheimer’s BMJ: first published as 10.1136/bmj.l665 on 6 March 2019. Downloaded from disease in Finland: nationwide case-control study Hanna Savolainen-Peltonen,1,2 Päivi Rahkola-Soisalo,1 Fabian Hoti,3 Pia Vattulainen,3 Mika Gissler,4,5,6 Olavi Ylikorkala,1 Tomi S Mikkola1,2 1University of Helsinki and ABSTRACT ratio 1.09, 95% confidence interval 1.05 to 1.14) and Helsinki University Hospital, OBJECTIVES those of oestrogen-progestogen (1.17, 1.13 to 1.21). Obstetrics and Gynecology, To compare the use of hormone therapy between The risk increases in users of oestrogen-progestogen Haartmaninkatu 2, PO Box 140, FIN-00029 HUS, 00029 Finnish postmenopausal women with and without a therapy were not related to different progestogens Helsinki, Finland diagnosis for Alzheimer’s disease. (noreth isterone acetate, medroxyprogesterone 2 Folkhälsan Research Center, DESIGN acetate, or other progestogens); but in women Biomedicum, Helsinki, Finland younger than 60 at hormone therapy initiation, 3 Nationwide case-control study. EPID Research Oy, Espoo, these risk increases were associated with hormone Finland SETTING therapy exposure over 10 years. Furthermore, the 4National Institute for Health Finnish national population and drug register, age at initiation of systemic hormone therapy was and Welfare, Helsinki, Finland between 1999 and 2013. 5Karolinska Institute, not a decisive determinant for the increase in risk Department of Neurobiology, PARTICIPANTS of Alzheimer’s disease. The exclusive use of vaginal Care Sciences and Society, All postmenopausal women (n=84 739) in Finland estradiol did not affect the risk of the disease (0.99, Division of Family Medicine, who, between 1999 and 2013, received a diagnosis of 0.96 to 1.01). Huddinge, Sweden Alzheimer’s disease from a neurologist or geriatrician, 6 CONCLUSIONS University of Turku, Research and who were identified from a national drug register. Centre for Child Psychiatry, Long term use of systemic hormone therapy might Control women without a diagnosis (n=84 739), Turku, Finland be accompanied with an overall increased risk of matched by age and hospital district, were traced from Correspondence to: T S Mikkola Alzheimer’s disease, which is not related to the type [email protected] the Finnish national population register. (ORCID 0000-0003-2049-088X) of progestogen or the age at initiation of systemic INTERVENTIONS Additional material is published hormone therapy. By contrast, use of vaginal estradiol online only. To view please visit Data on hormone therapy use were obtained from the shows no such risk. Even though the absolute risk the journal online. Finnish national drug reimbursement register. increase for Alzheimer’s disease is small, our data http://www.bmj.com/ Cite this as: BMJ 2019;364:l665 MAIN OUTCOME MEASURES should be implemented into information for present http://dx.doi.org/10.1136/bmj.l665 Odds ratios and 95% confidence intervals for and future users of hormone therapy. Accepted: 1 February 2019 Alzheimer’s disease, calculated with conditional logistic regression analysis. Introduction RESULTS Alzheimer’s disease, the most common cause of In 83 688 (98.8%) women, a diagnosis for Alzheimer’s dementia, occurs more frequently in women than in disease was made at the age of 60 years or older, and men.1 This difference might be due to the longer life on 27 September 2021 by guest. Protected copyright. 47 239 (55.7%) women had been over 80 years of age expectancy of women, but sex specific differences in at diagnosis. Use of systemic hormone therapy was the incidence of Alzheimer’s disease might also exist.1-3 associated with a 9-17% increased risk of Alzheimer’s It is known that oestrogens exert neuroprotection in disease. The risk of the disease did not differ several animal studies.4-6 Also, oestrogen deficiency as significantly between users of estradiol only (odds a result of early menopause has been associated with an increased risk of Alzheimer’s disease.7 Therefore, WHAT IS ALREADY KNOWN ON THIS TOPIC prolonging the oestrogen supply with postmenopausal Data on the association between use of postmenopausal hormone therapy and hormone therapy could protect against Alzheimer’s risk of Alzheimer’s disease are conflicting disease. Several observational studies have indicated that hormone therapy might have a However, clinical data on the association between protective effect on the risk of Alzheimer’s disease, but this was not supported by hormone therapy and the disease have remained the placebo controlled Women’s Health Initiative Memory Study inconclusive. Despite several observational studies supporting the protective effect of hormone therapy These findings were later challenged by the timing hypothesis, which indicates on Alzheimer’s disease,8-13 a subsequent placebo that oestrogen could be neuroprotective only if it is started soon after the onset controlled trial (the Women’s Health Initiative Memory of menopause Study (WHIMS)) failed to confirm this benefit, and WHAT THIS STUDY ADDS in fact implied an increased risk of overall dementia 14 15 Use of postmenopausal systemic hormone therapy is accompanied with an in hormone therapy users. The conflicting data increase in the risk of Alzheimer’s disease in postmenopausal women, whereas could in part result from differences in the study the use of vaginal estradiol shows no such risk design, study populations, or hormone therapy regimens. Unlike clinical practice, hormone therapy Particularly long term exposure to hormone therapy is associated with an in the WHIMS trial was initiated in women aged 65 increased risk of Alzheimer’s disease, but the increase in risk is not dependent or older.14 15 Thus, one explanation might also be the on the age at treatment initiation timing hypothesis, which suggests that oestrogen the bmj | BMJ 2019;364:l665 | doi: 10.1136/bmj.l665 1 RESEARCH could be neuroprotective only if started soon after the opened) or later (that is, fresh starters: 65 102 cases onset of menopause.16 This hypothesis originates from and 65 102 controls), because this group’s detailed BMJ: first published as 10.1136/bmj.l665 on 6 March 2019. Downloaded from cardiovascular studies17 where the age at the start of history of treatment use was documented in the hormone therapy appears to predict the cardiovascular register. The findings in this subanalysis were fully in effects of hormone therapy. Treatment initiated before line with those in the whole study population, so the age 60 is protective, but if started at a later age, it is data of this subanalysis are not shown. detrimental towards the vasculature. Such a window The regimens of systemic hormone therapy in for hormone therapy use has also been suggested for Finland contain exclusively estradiol, which is given cognitive effects.16 either orally (90%) or transdermally (10%). The By using Finnish comprehensive nationwide regimens identified by trade names were transformed registers, we were able to conduct a case-control into doses of estradiol (oral or transdermal). Various comparison to investigate whether hormone therapy progestogens were used in combination with estradiol had an effect on the risk of Alzheimer’s disease, and (that is, oestrogen-progestogen therapy), of which whether this risk was associated with age of treatment norethisterone acetate and medroxyprogesterone initiation or duration of treatment use. acetate were the most common.20 According to the Finnish guidelines, only women who have had Methods hysterectomies can use estradiol without progestogen, In Finland, patients with Alzheimer’s disease and these women were studied as an estradiol only are entitled to 40% reimbursement for treatment group. Oral estradiol doses in Finland are usually 1-2 from national health insurance, but this requires a mg/day, and transdermal (gel or patch) estradiol is statement from a neurologist or geriatrician. They must used with equivalent doses (25-100 μg/day). However, base the diagnosis on symptoms consistent of mild owing to the switching of the use of hormone therapy or moderate Alzheimer’s disease, decrease in social from one route to another and to the relatively similar capacity for at least three months, cognitive tests, route independent levels of circulating oestrogen, we magnetic resonance imaging or computed tomography did no subanalyses according to the treatment route. scanning of the brain, and exclusion of alternative Sequential users of oestrogen-progestogen therapy diagnoses. The physician also must confirm whether were defined as women who used estradiol with 10- the patient has other dementia related diseases, such 14 days of progestogen courses each month, or at as Lewy body dementia or mixed dementia. For mixed intervals of one to three months. Women who used both http://www.bmj.com/ dementia, patients are entitled to reimbursement only estradiol and progestogen every day were considered if the symptoms and findings are caused mainly by as continuous users of oestrogen-progestogen therapy. Alzheimer’s disease. In total, 84 739 women with a Tibolone users were considered as a separate group. diagnosis for Alzheimer’s disease were entered into this Users of vaginal estradiol only (Vagifem, NovoNordisk, register in 1999-2013. During the same period of time, Copenhagen, Denmark; 25 μg twice a week) were control women without a diagnosis were identified analysed separately. from the Finnish National population register (one Exposure to hormone therapy (ever use) was on 27 September 2021 by guest. Protected copyright. control per case; n=84 739). Control women were considered to have started from the date of the matched with cases by age (within 1 month) and by first purchase, or from age 52 if systemic hormone hospital district according to the woman’s municipality therapy was used at the register opening or from of residence. Hospital districts were further divided age 65 years if vaginal estradiol was used at register into five university hospital districts.
Load more

Recommended publications
  • Compositions Comprising Drospirenone Molecularly
    (19) & (11) EP 1 748 756 B1 (12) EUROPEAN PATENT SPECIFICATION (45) Date of publication and mention (51) Int Cl.: of the grant of the patent: A61K 9/00 (2006.01) A61K 9/107 (2006.01) 29.04.2009 Bulletin 2009/18 A61K 9/48 (2006.01) A61K 9/16 (2006.01) A61K 9/20 (2006.01) A61K 9/14 (2006.01) (2006.01) (2006.01) (21) Application number: 05708751.2 A61K 9/70 A61K 31/565 (22) Date of filing: 10.03.2005 (86) International application number: PCT/IB2005/000665 (87) International publication number: WO 2005/087194 (22.09.2005 Gazette 2005/38) (54) COMPOSITIONS COMPRISING DROSPIRENONE MOLECULARLY DISPERSED ZUSAMMENSETZUNGEN AUS DROSPIRENON IN MOLEKULARER DISPERSION DES COMPOSITIONS CONTENANT DROSPIRENONE A DISPERSION MOLECULAIRE (84) Designated Contracting States: (72) Inventors: AT BE BG CH CY CZ DE DK EE ES FI FR GB GR • FUNKE, Adrian HU IE IS IT LI LT LU MC NL PL PT RO SE SI SK TR D-14055 Berlin (DE) Designated Extension States: • WAGNER, Torsten AL BA HR MK YU 13127 Berlin (DE) (30) Priority: 10.03.2004 EP 04075713 (74) Representative: Wagner, Kim 10.03.2004 US 551355 P Plougmann & Vingtoft a/s Sundkrogsgade 9 (43) Date of publication of application: P.O. Box 831 07.02.2007 Bulletin 2007/06 2100 Copenhagen Ø (DK) (60) Divisional application: (56) References cited: 08011577.7 / 1 980 242 EP-A- 1 260 225 EP-A- 1 380 301 WO-A-01/52857 WO-A-20/04022065 (73) Proprietor: Bayer Schering Pharma WO-A-20/04041289 US-A- 5 569 652 Aktiengesellschaft US-A- 5 656 622 US-A- 5 789 442 13353 Berlin (DE) Note: Within nine months of the publication of the mention of the grant of the European patent in the European Patent Bulletin, any person may give notice to the European Patent Office of opposition to that patent, in accordance with the Implementing Regulations.
    [Show full text]
  • Drospirenone-Containing Birth Control Pills (Yaz, Yasmin, Ocella, Gianvi and Their Generics)
    Drospirenone-Containing Birth Control Pills (Yaz, Yasmin, Ocella, Gianvi and their generics) Drospirenone is a progestin component of some birth control pills that does some blocking of testosterone (the "male hormone" that women have, too, and the hormone that can be a part of making acne worse). This is why drospirenone-containing birth control pills are especially good at helping acne (and why they can theoretically help hirsutism and female-pattern scalp hair loss as well). Drospirenone is also a mild diuretic and is why these birth control pills do not cause the water weight gain that some birth control pills can. Any birth control pill can theoretically help acne just by evening out hormonal fluctuations, but for many birth control pills, the effects on acne is very minimal. Which birth control pills are most likely to help acne? Some birth control pills are more like testosterone and some are less like testosterone. The ones that are less like testosterone can theoretically help acne more. The drospirenone-containing birth control pills go one step further by blocking testosterone, and may show the most benefit on clearing acne. Drospirenone is a progestin that is derived from 17-alpha-spironolactone and is chemically related to the diuretic spironolactone. Spironolactone is a diuretic (used for high blood pressure) that is sometimes used off-label for the treatment of acne, hirsutism or female-pattern hair loss. Often people say that a drospirenone-containing birth control pill may be equivalent to 25mg of spironolactone. Risks : Any estrogen-containing birth control pill increases the risk of a high blood pressure, stroke, or other life-threatening blood clot, and one study showed possibly a slightly higher risk with a drospirenone-containing birth control pill.
    [Show full text]
  • Index Vol. 12-15
    353 INDEX VOL. 12-15 Die Stichworte des Sachregisters sind in der jeweiligen Sprache der einzelnen Beitrage aufgefiihrt. Les termes repris dans la Table des matieres sont donnes selon la langue dans laquelle l'ouvrage est ecrit. The references of the Subject Index are given in the language of the respective contribution. 14 AAG (Alpha-acid glycoprotein) 120 14 Adenosine 108 12 Abortion 151 12 Adenosine-phosphate 311 13 Abscisin 12, 46, 66 13 Adenosine-5'-phosphosulfate 148 14 Absorbierbarkeit 317 13 Adenosine triphosphate 358 14 Absorption 309, 350 15 S-Adenosylmethionine 261 13 Absorption of drugs 139 13 Adipaenin (Spasmolytin) 318 14 - 15 12 Adrenal atrophy 96 14 Absorptionsgeschwindigkeit 300, 306 14 - 163, 164 14 Absorptionsquote 324 13 Adrenal gland 362 14 ACAI (Anticorticocatabolic activity in­ 12 Adrenalin(e) 319 dex) 145 14 - 209, 210 12 Acalo 197 15 - 161 13 Aceclidine (3-Acetoxyquinuclidine) 307, 13 {i-Adrenergic blockers 119 308, 310, 311, 330, 332 13 Adrenergic-blocking activity 56 13 Acedapsone 193,195,197 14 O(-Adrenergic blocking drugs 36, 37, 43 13 Aceperone (Acetabutone) 121 14 {i-Adrenergic blocking drugs 38 12 Acepromazin (Plegizil) 200 14 Adrenergic drugs 90 15 Acetanilid 156 12 Adrenocorticosteroids 14, 30 15 Acetazolamide 219 12 Adrenocorticotropic hormone (ACTH) 13 Acetoacetyl-coenzyme A 258 16,30,155 12 Acetohexamide 16 14 - 149,153,163,165,167,171 15 1-Acetoxy-8-aminooctahydroindolizin 15 Adrenocorticotropin (ACTH) 216 (Slaframin) 168 14 Adrenosterone 153 13 4-Acetoxy-1-azabicyclo(3, 2, 2)-nonane 12 Adreson 252
    [Show full text]
  • Download PDF File
    Ginekologia Polska 2019, vol. 90, no. 9, 520–526 Copyright © 2019 Via Medica ORIGINAL PAPER / GYNECologY ISSN 0017–0011 DOI: 10.5603/GP.2019.0091 Anti-androgenic therapy in young patients and its impact on intensity of hirsutism, acne, menstrual pain intensity and sexuality — a preliminary study Anna Fuchs, Aleksandra Matonog, Paulina Sieradzka, Joanna Pilarska, Aleksandra Hauzer, Iwona Czech, Agnieszka Drosdzol-Cop Department of Pregnancy Pathology, Department of Woman’s Health, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland ABSTRACT Objectives: Using anti-androgenic contraception is one of the methods of birth control. It also has a significant, non-con- traceptive impact on women’s body. These drugs can be used in various endocrinological disorders, because of their ability to reduce the level of male hormones. The aim of our study is to establish a correlation between taking different types of anti-androgenic drugs and intensity of hirsutism, acne, menstrual pain intensity and sexuality . Material and methods: 570 women in childbearing age that had been using oral contraception for at least three months took part in our research. We examined women and asked them about quality of life, health, direct causes and effects of that treatment, intensity of acne and menstrual pain before and after. Our research group has been divided according to the type of gestagen contained in the contraceptive pill: dienogest, cyproterone, chlormadynone and drospirenone. Ad- ditionally, the control group consisted of women taking oral contraceptives without antiandrogenic component. Results: The mean age of the studied group was 23 years ± 3.23. 225 of 570 women complained of hirsutism.
    [Show full text]
  • Classification and Pharmacology of Progestins
    Maturitas 46S1 (2003) S7–S16 Classification and pharmacology of progestins Adolf E. Schindler a,∗, Carlo Campagnoli b, René Druckmann c, Johannes Huber d, Jorge R. Pasqualini e, Karl W. Schweppe f, Jos H. H. Thijssen g a Institut für Medizinische Forschung und Fortbildung, Universitätsklinikum, Hufelandstr. 55, Essen 45147, Germany b Ospedale Ginecologico St. Anna, Corso Spezia 60, 10126 Torino, Italy c Ameno-Menopause-Center, 12, Rue de France, 06000 Nice, France d Abt. für Gynäkologische Endokrinologie, AKH Wien, Währingergürtel 18-20, 1090 Wien, Austria e Institute de Puériculture26, Boulevard Brune, 75014 Paris, France f Abt. für Gynäkologie und Geburtshilfe, Ammerland Klinik, Langestr.38, 26622 Westerstede, Germany g Department of Endocrinology, Universitair Medisch Centrum Utrecht, P.O. Box 85090, 3508 AB Utrecht, The Netherlands Abstract Besides the natural progestin, progesterone, there are different classes of progestins, such as retroprogesterone (i.e. dydroges- terone), progesterone derivatives (i.e. medrogestone) 17␣-hydroxyprogesterone derivatives (i.e. chlormadinone acetate, cypro- terone acetate, medroxyprogesterone acetate, megestrol acetate), 19-norprogesterone derivatives (i.e. nomegestrol, promege- stone, trimegestone, nesterone), 19-nortestosterone derivatives norethisterone (NET), lynestrenol, levonorgestrel, desogestrel, gestodene, norgestimate, dienogest) and spironolactone derivatives (i.e. drospirenone). Some of the synthetic progestins are prodrugs, which need to be metabolized to become active compounds. Besides
    [Show full text]
  • Comparing the Effects of Combined Oral Contraceptives Containing Progestins with Low Androgenic and Antiandrogenic Activities on the Hypothalamic-Pituitary-Gonadal Axis In
    JMIR RESEARCH PROTOCOLS Amiri et al Review Comparing the Effects of Combined Oral Contraceptives Containing Progestins With Low Androgenic and Antiandrogenic Activities on the Hypothalamic-Pituitary-Gonadal Axis in Patients With Polycystic Ovary Syndrome: Systematic Review and Meta-Analysis Mina Amiri1,2, PhD, Postdoc; Fahimeh Ramezani Tehrani2, MD; Fatemeh Nahidi3, PhD; Ali Kabir4, MD, MPH, PhD; Fereidoun Azizi5, MD 1Students Research Committee, School of Nursing and Midwifery, Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic Of Iran 2Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic Of Iran 3School of Nursing and Midwifery, Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic Of Iran 4Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Islamic Republic Of Iran 5Endocrine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic Of Iran Corresponding Author: Fahimeh Ramezani Tehrani, MD Reproductive Endocrinology Research Center Research Institute for Endocrine Sciences Shahid Beheshti University of Medical Sciences 24 Parvaneh Yaman Street, Velenjak, PO Box 19395-4763 Tehran, 1985717413 Islamic Republic Of Iran Phone: 98 21 22432500 Email: [email protected] Abstract Background: Different products of combined oral contraceptives (COCs) can improve clinical and biochemical findings in patients with polycystic ovary syndrome (PCOS) through suppression of the hypothalamic-pituitary-gonadal (HPG) axis. Objective: This systematic review and meta-analysis aimed to compare the effects of COCs containing progestins with low androgenic and antiandrogenic activities on the HPG axis in patients with PCOS.
    [Show full text]
  • Pp375-430-Annex 1.Qxd
    ANNEX 1 CHEMICAL AND PHYSICAL DATA ON COMPOUNDS USED IN COMBINED ESTROGEN–PROGESTOGEN CONTRACEPTIVES AND HORMONAL MENOPAUSAL THERAPY Annex 1 describes the chemical and physical data, technical products, trends in produc- tion by region and uses of estrogens and progestogens in combined estrogen–progestogen contraceptives and hormonal menopausal therapy. Estrogens and progestogens are listed separately in alphabetical order. Trade names for these compounds alone and in combination are given in Annexes 2–4. Sales are listed according to the regions designated by WHO. These are: Africa: Algeria, Angola, Benin, Botswana, Burkina Faso, Burundi, Cameroon, Cape Verde, Central African Republic, Chad, Comoros, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Eritrea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mauritius, Mozambique, Namibia, Niger, Nigeria, Rwanda, Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, South Africa, Swaziland, Togo, Uganda, United Republic of Tanzania, Zambia and Zimbabwe America (North): Canada, Central America (Antigua and Barbuda, Bahamas, Barbados, Belize, Costa Rica, Cuba, Dominica, El Salvador, Grenada, Guatemala, Haiti, Honduras, Jamaica, Mexico, Nicaragua, Panama, Puerto Rico, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Suriname, Trinidad and Tobago), United States of America America (South): Argentina, Bolivia, Brazil, Chile, Colombia, Dominican Republic, Ecuador, Guyana, Paraguay,
    [Show full text]
  • Progestogens and Venous Thromboembolism Among Postmenopausal Women Using Hormone Therapy. Marianne Canonico, Geneviève Plu-Bureau, Pierre-Yves Scarabin
    Progestogens and venous thromboembolism among postmenopausal women using hormone therapy. Marianne Canonico, Geneviève Plu-Bureau, Pierre-Yves Scarabin To cite this version: Marianne Canonico, Geneviève Plu-Bureau, Pierre-Yves Scarabin. Progestogens and venous throm- boembolism among postmenopausal women using hormone therapy.. Maturitas, Elsevier, 2011, 70 (4), pp.354-60. 10.1016/j.maturitas.2011.10.002. inserm-01148705 HAL Id: inserm-01148705 https://www.hal.inserm.fr/inserm-01148705 Submitted on 5 May 2015 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. Progestogens and VTE Finale version Progestogens and venous thromboembolism among postmenopausal women using hormone therapy Marianne Canonico1,2, Geneviève Plu-Bureau1,3 and Pierre-Yves Scarabin1,2 1 Centre for Research in Epidemiology and Population Health, U1018, Hormones and Cardiovascular Disease 2 University Paris-Sud, UMR-S 1018, Villejuif, France 3 University Paris Descartes and Hôtel-Dieu Hospital, Paris, France Adresse: 16 av. Paul Vaillant Couturier 94807 Villejuif Cedex Tel: +33 1 45 59 51 66 Fax: +33 1 45 59 51 70 Corresponding author: Marianne Canonico ([email protected]) 1/21 Progestogens and VTE Finale version Abstract Hormone therapy (HT) is the most effective treatment for correcting menopausal symptoms after menopause.
    [Show full text]
  • Drugs Contraindicated in Pregnancy
    DRUGS CONTRAINDICATED IN PREGNANCY (Part 1 of 2) This chart represents information on select drugs that are contraindicated (Pregnancy category X) for women who are pregnant. This is not an inclusive list of products that carry that pregnancy category. Those drugs that are contraindicated at a certain phase of the pregnancy are listed next to the product name. For more information on specific drug monographs, see product entries or consult the manufacturer. ALLERGIC DISORDERS Tazorac (tazarotene) METABOLIC DISORDERS Tilia Fe (norethindrone acetate/ethinyl Vistaril (hydroxyzine) Early pregnancy estradiol) Zavesca (miglustat) CARDIOVASCULAR SYSTEM Tri-Legest Fe (norethindrone acetate/ MUSCULOSKELETAL DISORDERS ethinyl estradiol) Advicor (niacin ext-rel/lovastatin) Tri-previfem (norgestimate/ethinyl Advil (ibuprofen) 3rd trimester Aggrenox (dipyridamole/aspirin) 3rd estradiol) Aleve (naproxen sodium) 3rd trimester trimester Tri-sprintec (norgestimate/ethinyl estradiol) Ansaid (flurbiprofen) Late pregnancy Altoprev (lovastatin) Yaz (drospirenone/ethinyl estradiol) Arava (leflunomide) Bayer (aspirin) 3rd trimester Arthrotec (diclofenac sodium/ Caduet (amlodipine/atorvastatin) ENDOCRINE SYSTEM misoprostol) Coumadin (warfarin sodium) 3rd trimester Androderm (testosterone) Bayer (aspirin) Crestor (rosuvastatin) Androgel (testosterone) BC Arthritis Strength (aspirin/ Ecotrin (aspirin) 3rd trimester 3rd trimester Android (methyltestosterone) caffeine/salicylamide) Lescol (fluvastatin) 3rd Axiron (testosterone) Carisoprodol/aspirin/codeine Lescol
    [Show full text]
  • Rominder P.S. Suri, Phd, PE Robert F. Chimchirian & Sandhya Meduri Department of Civil & Environmental Engineering Villa
    Emerging Contaminants and Water Supply – Speaker Abstracts Emerging Contaminants and Water Supply – Speaker Abstracts PRESENCE OF ESTROGEN HORMONES AND ANTIBIOTICS IN detection limits for all 12 estrogen compounds ranged from 0.1 ng L-1 to THE ENVIRONMENT 10 ng L-1 using a sample size of 1 L. Eight antibiotics and venlaflaxine Rominder P.S. Suri, PhD, PE were detected in the effluent with concentrations that ranged from 50 to Robert F. Chimchirian & Sandhya Meduri 2,930 ng L-1. Department of Civil & Environmental Engineering Twenty-one streams in Chester County, southeast Pennsylvania, were Villanova University, Villanova PA 19085 also sampled for aqueous concentrations of the above hormones and 610-519-7631 [email protected] antibiotics. Chester County represents a very diverse land use. In addition to concentrated urban developments, there are many In recent years, the detection of trace amount of pharmaceutically active agricultural farms (dairy, cattle, hog, poultry, and mushroom). The compounds (PACs) in the surface water has gained widespread watershed is comprised of about 280,000 acres that eventually drain into attention. The presence of the PACs in the natural water systems causes the Chesapeake Bay via the Susquehanna River. The results showed that ecological problems and possible adverse effects to humans. Two classes there was at least one estrogen detected in every stream sampled and six of PACs, estrogen hormones and antibiotics make their way into the estrogens were detected at three different locations. The most abundant surface waters through effluents from wastewater treatment plants and PAC was estrone, which was detected in all but one stream, with areas where animal manure and biosolids are land applied, amongst concentrations as high as 2.4 ng L-1.
    [Show full text]
  • Guidance on Bioequivalence Studies for Reproductive Health Medicines
    Medicines Guidance Document 23 October 2019 Guidance on Bioequivalence Studies for Reproductive Health Medicines CONTENTS 1. Introduction........................................................................................................................................................... 2 2. Which products require a bioequivalence study? ................................................................................................ 3 3. Design and conduct of bioequivalence studies .................................................................................................... 4 3.1 Basic principles in the demonstration of bioequivalence ............................................................................... 4 3.2 Good clinical practice ..................................................................................................................................... 4 3.3 Contract research organizations .................................................................................................................... 5 3.4 Study design .................................................................................................................................................. 5 3.5 Comparator product ....................................................................................................................................... 6 3.6 Generic product .............................................................................................................................................. 6 3.7 Study subjects
    [Show full text]
  • The Influence of Hormone Therapy with Drospirenone-Estradiol on Endometrioid Type Endometrial Cancer Patients
    J Gynecol Oncol. 2018 Sep;29(5):e72 https://doi.org/10.3802/jgo.2018.29.e72 pISSN 2005-0380·eISSN 2005-0399 Original Article The influence of hormone therapy with drospirenone-estradiol on endometrioid type endometrial cancer patients Soyi Lim ,1,* Yun Hwan Kim ,2,* Kwang-Beom Lee ,1 Jong-Min Lee 3 1Department of Obstetrics and Gynecology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea 2Department of Obstetrics and Gynecology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea 3Department of Obstetrics and Gynecology, Kyung-Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea Received: Oct 30, 2017 ABSTRACT Revised: Apr 17, 2018 Accepted: Apr 22, 2018 Objective: To determine whether drospirenone/estradiol (DRSP/E2) has an adverse effect on Correspondence to clinical outcomes in surgically staged International Federation of Gynecology and Obstetrics Kwang-Beom Lee (FIGO) stage I/II endometrial cancer (EC) patients. Department of Obstetrics and Gynecology, Methods: In a retrospective case-controlled study, 58 women with EC who had received Gachon University Gil Medical Center, DRSP/E2 postoperatively were compared with 116 women who had not. And, oncologic safety Gachon University College of Medicine, 21 Namdong-daero 774-beon-gil, Namdong-gu, of postoperative hormone therapy with DRSP/E2 in EC survivors were compared between the Incheon 21565, Korea. 2 groups after propensity score matching using a logistic regression model. E-mail: [email protected] Results: The median ages were 47.7 years and 53.6 years for the study and the control groups, respectively (p<0.001).
    [Show full text]