International Journal of Fertility最新文献_第8页

Effects of hormone replacement therapy. 激素替代疗法的效果。

International Journal of Fertility Pub Date : 1992-01-01

P G Crosignani

{"title":"Effects of hormone replacement therapy.","authors":"P G Crosignani","doi":"","DOIUrl":"","url":null,"abstract":"According to the World Health Organization, the global life expectancy at birth was 55 years in 1974, will be 63 years in 2000, and will be close to 70 years in the year 2025. By the year 2025, approximately 20% of the world's population will be more than 60 years old, and the problems associated with hormonal changes become significant with more than one third of a woman's expected life concentrated in the postmenopausal years. Much evidence suggests that the use of postmenopausal estrogen substantially reduces the morbidity and mortality of coronary heart disease, and to date, low-dose estrogen therapy is the single most effective method for prevention of osteoporosis. However, only hysterectomized women can use estrogen alone because of the risk of endometrial cancer associated with unopposed estrogen therapy. Thus, women with an intact uterus must use estrogen in combination with progestogen to avoid this risk, but the different progestogens may variously modify the beneficial effects of estrogen on lipoproteins, and, ultimately, coronary heart disease. Although hormone replacement therapy during menopause soon will be one of the major areas of preventive medicine, the effects of estrogen in combination with different progestins on coronary heart disease, blood pressure, blood coagulation, bone density, and the central nervous system have not been investigated adequately. This paper reviews the current knowledge of known or suspected effects.","PeriodicalId":13990,"journal":{"name":"International Journal of Fertility","volume":"37 Suppl 2 ","pages":"98-103"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12527845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diabetes mellitus, hypertriglyceridemia, and heart disease risk in women. 糖尿病、高甘油三酯血症和女性心脏病风险

International Journal of Fertility Pub Date : 1992-01-01

E Barrett-Connor

引用次数: 0

Norgestimate: a preclinical profile. Norgestimate:临床前概况。

International Journal of Fertility Pub Date : 1992-01-01

F D Anderson

引用次数: 0

Comparative review of third-generation progestins. 第三代孕激素的比较综述。

International Journal of Fertility Pub Date : 1992-01-01

M E Kafrissen, S L Corson

引用次数: 0

Oral contraception: past, present, and future perspectives. 口服避孕药:过去，现在和未来的观点。

International Journal of Fertility Pub Date : 1992-01-01

D R Mishell

{"title":"Oral contraception: past, present, and future perspectives.","authors":"D R Mishell","doi":"","DOIUrl":"","url":null,"abstract":"Oral contraceptives (OCs) were initially approved for unrestricted use in 1960 in the United States and have been used and studied extensively for 30 years. The initial formulations contained a fixed dose of estrogen and progestogen ingested for 21 days, with a seven-day pill-free interval. Subsequent formulations contained a sequential estrogen dose, a progestogen alone given daily, and variable doses of both progestogen and estrogen. Although the estrogen and progestogen doses employed in currently marketed OCs are markedly lower than those used in the OCs of the 1960s and 1970s, the excellent contraceptive efficacy of these compounds has not been compromised. The estrogen component produces a dose-related increase in serum globulin concentrations, triglycerides, and high-density lipoprotein (HDL) cholesterol, along with a decrease in low-density lipoprotein (LDL) cholesterol, while the progestogen component causes peripheral insulin resistance, a decrease in HDL cholesterol, an increase in LDL cholesterol, and various androgenic effects. The effect of nicotine on thromboxane release acts synergistically with the elevated serum clotting factors to increase the incidence of both arterial and venous thrombotic events, particularly in women smokers over 35 years of age. However, there is no evidence of increased risk of myocardial infarction or stroke in healthy, nonsmoking women of any age who use OCs containing less than 50 micrograms estrogen. Likewise, the lower-dose estrogen/progestogen formulations do not have a clinically significant effect on glucose metabolism and have a neutral effect on lipoprotein metabolism. In addition, the many noncontraceptive health benefits associated with OCs are maintained with the lower-dose formulations. Thus, the low-dose formulations should improve the overall health of healthy, nonsmoking women as well as effectively prevent unwanted pregnancy.","PeriodicalId":13990,"journal":{"name":"International Journal of Fertility","volume":"37 Suppl 1 ","pages":"7-18"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12519663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Steroids and lipid metabolism: mechanism of action. 类固醇与脂质代谢:作用机制。

International Journal of Fertility Pub Date : 1992-01-01

A Basdevant

引用次数: 0

Women, lipoproteins, and cardiovascular disease risk. 女性、脂蛋白和心血管疾病风险

International Journal of Fertility Pub Date : 1992-01-01

J C LaRosa

{"title":"Women, lipoproteins, and cardiovascular disease risk.","authors":"J C LaRosa","doi":"","DOIUrl":"","url":null,"abstract":"Women, like men, are susceptible to coronary atherosclerosis. Like men, more women die of heart disease than all forms of cancer combined. Coronary atherosclerosis is the result of the interplay of a number of factors, the most important of which are abnormal levels of circulating lipoproteins. As more has become known about the mechanisms by which abnormal levels of circulating lipoproteins promote atherosclerosis, certain risk factors have emerged as concerns for women, including: (1) diabetes mellitus as a risk factor, perhaps through its more profound effects on circulating lipoproteins; (2) serum triglyceride levels, and (3) changes in high-density lipoprotein cholesterol. The widespread use of exogenous hormones in women as both oral contraceptives and postmenopausal hormone replacement may also play a role in developing atherosclerosis. In general, estrogen affects circulating lipoprotein levels favorably, whereas progestins have the opposite effect. The effects of estrogen/progestin combinations in either oral contraceptives or postmenopausal hormone replacement will depend on the relative dose and potency of each of these constituents. Epidemiologic studies indicate that the use of oral contraceptives has no profound effect on the long-term risk of heart disease, whereas unopposed estrogen (without progestin) in postmenopausal hormone replacement therapy may lower that risk considerably. Recent U.S. and European guidelines for the detection, evaluation, and treatment of hypercholesterolemia in adults make it imperative that obstetrician-gynecologists, in their dual role as primary-care physicians and prescribers of exogenous hormones, be aware of and informed about the relationship between circulating lipids and lipoproteins and coronary heart disease in women.","PeriodicalId":13990,"journal":{"name":"International Journal of Fertility","volume":"37 Suppl 2 ","pages":"63-71"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12528536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ovarian consequences of the transient interruption of combined oral contraceptives. 联合口服避孕药短暂中断对卵巢的影响。

International Journal of Fertility Pub Date : 1992-01-01

B Hedon, P Cristol, A Plauchut, A M Vallon, F Desachampts, M L Taillant, P Mares, A M Pizelle, F Laffargue, J L Viala

{"title":"Ovarian consequences of the transient interruption of combined oral contraceptives.","authors":"B Hedon, P Cristol, A Plauchut, A M Vallon, F Desachampts, M L Taillant, P Mares, A M Pizelle, F Laffargue, J L Viala","doi":"","DOIUrl":"","url":null,"abstract":"The combined oral contraceptive pill is an efficient means of contraception. It acts at different levels of the genital tract. Despite its efficiency, it is universally suggested that patients take the pill at regular daily intervals. Little attention has been given to the question of what happens if you miss the pill one day or more. A study was undertaken to evaluate the consequences of pill misses at different times of the cycle. Forty-seven young, healthy, normally menstruating patients voluntarily enrolled. All were given Cilest (ethinyl estradiol 35 micrograms and norgestimate 250 mg, Cilag France) for 21 days without any misses. Then, after a 7-day interval, they were prescribed one (group 1), two (group 2), three (group 3) or four days of pill misses, to occur respectively on day 1 (group a), 6 (group b), 12 (group c) or 18 (group d) of a new 21 day cycle; supplementary contraceptive means were recommended. Four patients had no miss prescribed and served as controls. Ovarian function was evaluated with daily estrogen measurements (E1 + E2 enzymatic dosage, BioMérieux, France) and ultrasound examinations. When required, because of significant increase in estrogen or because of follicular growth detected on ultrasound, LH and progesterone were measured. None of the patients experienced a normal ovulation. Four patients (1 control, 1 from group 2a, and 2 from group 3a) had a significant increase in estrogen levels and had a follicular image on ultrasounds. One of them (group 3a) had a follicular rupture, but none had a LH surge or increase in progesterone.(ABSTRACT TRUNCATED AT 250 WORDS)","PeriodicalId":13990,"journal":{"name":"International Journal of Fertility","volume":"37 Suppl 3 ","pages":"162-8"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12533515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The underrated benefits of oral contraception: consequences of pregnancy and induced abortion in teenagers. 口服避孕药被低估的好处:青少年怀孕和人工流产的后果。

International Journal of Fertility Pub Date : 1992-01-01

R Dreyfus

{"title":"The underrated benefits of oral contraception: consequences of pregnancy and induced abortion in teenagers.","authors":"R Dreyfus","doi":"","DOIUrl":"","url":null,"abstract":"If complications occur within a pregnancy planned and brought to term, they often can be dealt with and accepted. They are even more traumatic when they occur in an unwanted pregnancy that could have been prevented through contraception. Teenagers, because of their physical and psychological immaturity and also because of their social environment, seem to suffer with undue frequency from the complications of induced abortion. Its result, for the teenager, is a handicapped future in comparison to other women. Hence, access to contraception is important for all women, and especially for teenagers, in order to avoid such prejudicial situations. It is important, then, to prescribe oral contraception for its efficacy and its short- and long-term innocuousness. Because of her immaturity, the pregnant teenager is at risk: of spontaneous abortion, pre-eclampsia, anemia, hemorrhage, and prematurity. She is also at risk because of the social difficulties she will be facing. This is particularly true in families from developing countries. From birth, the child is also at risk: of low birth weight for the term, mortality in the first year of life, and all risks linked to abandonment, or education by a third party. In a proportion of 13 to 30% in western countries and in a proportion of 3% in East Asia or in Northwest Africa (Maghreb), induced abortions are a reflection of the following: early sexual activity without contraception even if fertility is still low in very young teenagers, absence of social protection or social independence, refusal of forced marriage, and presence or absence of liberal legislation.(ABSTRACT TRUNCATED AT 250 WORDS)","PeriodicalId":13990,"journal":{"name":"International Journal of Fertility","volume":"37 Suppl 4 ","pages":"204-10"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12535834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Long-term profile of a new progestin. 一种新型黄体酮的长期概况。

International Journal of Fertility Pub Date : 1992-01-01

J Lippman

{"title":"Long-term profile of a new progestin.","authors":"J Lippman","doi":"","DOIUrl":"","url":null,"abstract":"Major complications attributable to oral contraceptives (OCs) may occur in the circulatory system. The inherent risk factors, such as race and family history, are unchangeable. Others may be altered by patient counseling and subsequent adjustment of certain behaviors. Hypercoagulability is estrogen dose related. Older, high-dose-estrogen OC users were at 40% increased risk of mortality from thromboembolic phenomena. Reduction in estrogen content has unmasked the androgenic effects of some synthetic progestogens. These effects may include progression of atherogenesis, effected through changes in cholesterol and lipoproteins; reduction in sex hormone binding globulin (SHBG), which enhances the androgenic effect; and changes in carbohydrate metabolism. This review of clinical findings is based on four studies; three had prospective cohort designs, and one was a prospective randomized comparison of a norgestimate-containing OC with a norgestrel-containing one. Numbers of subjects ranged from 20 to 59,701; the largest evaluated 343,348 cycles of treatment. Study intervals were from 4 to 24 months. The findings reported here are from the individual studies. 1. The normal value for cholesterol is less than 200 mg/dL. Of 2,197 women who met this cut-off point, 95% remained below it after 6 months of treatment. Of 756 who initially exceeded this value, 25% were below after 6 months and 75% remained above it. All studies to date have demonstrated that norgestimate produces consistent and significant elevations in high-density lipoprotein levels and variable change in low-density lipoproteins. A similar effect was noted on serum triglyceride values.(ABSTRACT TRUNCATED AT 250 WORDS)","PeriodicalId":13990,"journal":{"name":"International Journal of Fertility","volume":"37 Suppl 4 ","pages":"218-22"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12535742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0