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Long-Acting Reversible Contraception

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2961. An effective hormonal male contraceptive using testosterone undecanoate with oral or injectable norethisterone preparations. (PubMed)

An effective hormonal male contraceptive using testosterone undecanoate with oral or injectable norethisterone preparations. Suppression of spermatogenesis to azoospermia is the goal of hormonal male contraception based on T combined with gestagens. The combination of the long-acting T, ester testosterone undecanoate (TU), with norethisterone (NET) enanthate (E) showed high efficacy. In the present study, we tested the validity of this approach by varying the NET dose and mode of application (...) (NETA) from wk 0 to 24 (group III). In all groups marked suppression of gonadotropins resulted in a significant decrease of spermatogenesis and azoospermia in 13/14, 11/12, and 12/14 men in groups I to III, respectively. The remaining men all had less than 1 million sperm/ml. Reversible side effects included increase in body weight, erythrocytes, hemoglobin, and hematocrit and decrease in high-density lipoprotein cholesterol and alkaline phosphatase in all groups and increase in liver enzymes

2002 The Journal of clinical endocrinology and metabolism Controlled trial quality: uncertain

2962. What are the risks of the long term use of depot contraception in a forty year old woman in particular the risk of osteoporosis?

NICE commissioned the National Collaborating Centre for Women’s and Children’s Health to undertake a review of long-acting reversible contraception [1]. Starting on page 80 of the document is a section on progestogen-only injectable contraceptives. This discusses a number of potential side effects and other cautions. This is too large to reproduce here, but we recommend you read the article via the URL below. They review the evidence on BMD and DMPA concluding: “There is conflicting evidence (...) . Long-acting reversible contraception. 2005 ( ) 2) FFPRHC. Contraception for women aged over 40 years. 2005 ( ) Answered 12 October 2006 Follow us: © 2019 Trip Database Ltd. company number 04316414. Trip is proud to be made in the UK.

2006 TRIP Answers

2963. Long-acting reversible contraception

Long-acting reversible contraception Long-acting reversible contraception Long-acting reversible contraception National Institute for Clinical Excellence Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation National Institute for Clinical Excellence. Long-acting reversible contraception. London: National Institute for Clinical Excellence (NICE) 2005: 47 Authors (...) ' objectives The aim of this guideline is to offer the best-practice advice for all women of reproductive age who may wish to regulate their fertility by using long-acting reversible contraceptive (LARC) methods. Authors' conclusions The following recommendations have been identified as priorities for implementation. Contraceptive provision 1. Women requiring contraception should be given information about and offered a choice of all methods, including long-acting reversible contraception (LARC) methods. 2

2005 Health Technology Assessment (HTA) Database.

2964. Economic analysis of long term reversible contraceptives: focus on Implanon

Economic analysis of long term reversible contraceptives: focus on Implanon Economic analysis of long term reversible contraceptives: focus on Implanon Economic analysis of long term reversible contraceptives: focus on Implanon Phillips C J Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment (...) on the reliability of the study and the conclusions drawn. Health technology Contraception using the long-term reversible contraceptive, Implanon. Type of intervention Primary prevention. Economic study type Cost-effectiveness analysis. Study population A hypothetical cohort of women using long-term reversible contraceptives. Setting Community and hospital. The economic study was conducted in the UK, using data from studies conducted both in the UK, and in other European countries. Dates to which data relate

2000 NHS Economic Evaluation Database.

2965. Study To Evaluate Long Term Maintenance With TRIZIVIR After Boosted Protease Inhibitor (PI) Or Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI) In HIV-1 Infected Adults

Study To Evaluate Long Term Maintenance With TRIZIVIR After Boosted Protease Inhibitor (PI) Or Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI) In HIV-1 Infected Adults Study To Evaluate Long Term Maintenance With TRIZIVIR After Boosted Protease Inhibitor (PI) Or Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI) In HIV-1 Infected Adults - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information (...) . Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Study To Evaluate Long Term Maintenance With TRIZIVIR After Boosted Protease Inhibitor (PI) Or Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI) In HIV-1 Infected Adults The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does

2007 Clinical Trials

2966. Acceptability of the long-term contraceptive levonorgestrel-releasing intrauterine system (Mirena): a 3-year follow-up study. (PubMed)

contraceptive method, without negative influences on the sexual relationship between users and their partners, and is suitable for women requiring long-term reversible contraceptive protection. (...) Acceptability of the long-term contraceptive levonorgestrel-releasing intrauterine system (Mirena): a 3-year follow-up study. This study investigated the long-term acceptability of a levonorgestrel-releasing intrauterine system (LNG-IUS) in 165 women after 6 and 36 months of use. Changes in menstrual bleeding pattern were experienced by 161 (98%) women, with a cessation or transient absence of menstruation occurring in 75 (47%) and 14 (9%) women, respectively. Amenorrhea was considered by most

2003 Contraception

2967. Long-term non-hormonal male contraception in mice using N-butyldeoxynojirimycin. (PubMed)

Long-term non-hormonal male contraception in mice using N-butyldeoxynojirimycin. The imino sugar N-butyldeoxynojirimycin (NB-DNJ) causes reversible infertility in male mice. This compound may have promise as a male contraceptive, because it is already in clinical use, for a non-reproductive condition. As contraceptives need to be taken for extended periods of time, it was essential to evaluate NB-DNJ for its reproductive effects over a long period of administration.We have assessed the imino (...) sugar for its long-term effects on the fertility of male C57BL/6 mice, reversibility and potential cumulative toxicity by monitoring various reproductive and systemic parameters over 12 months.Long-term low-dose (15 mg/kg/day) administration of NB-DNJ was sufficient to maintain infertility in male mice. In contrast to short-term drug treatment, imino sugar exposure for more than 3 months resulted in reduced sperm counts. Male mice that had been administered imino sugar for 6, 10 or 12 months

Full Text available with Trip Pro

2006 Human Reproduction

2968. Effects of thrombin, hypoxia, and steroids on interleukin-8 expression in decidualized human endometrial stromal cells: implications for long-term progestin-only contraceptive-induced bleeding. (PubMed)

Effects of thrombin, hypoxia, and steroids on interleukin-8 expression in decidualized human endometrial stromal cells: implications for long-term progestin-only contraceptive-induced bleeding. Abnormal uterine bleeding is the major reason for discontinuing long-term progesterone-only contraceptives (LTPOCs). Prior studies demonstrated that endometria exposed to the LTPOC, Norplant, display aberrant angiogenesis, leukocyte infiltration, and hypoxia-associated impaired blood flow. Paradoxically (...) in parallel for up to 48 h in a standard incubator (normoxia) or a sealed chamber at 0-1% O(2) (hypoxia). Under normoxia, immunoreactive IL-8 levels in the conditioned medium were reduced to one-third of control levels during decidualization with E(2)+MPA (P < 0.05; n = 5). In E(2)+MPA-treated cultures, thrombin (0.1 U/ml to 2.5 U/m) elicited a dose-dependent reversal of this inhibition, elevating IL-8 up to 60-fold (P < 0.05; n = 5) for more than 24 h and steady-state IL-8 mRNA levels by 3-fold for 3 h

Full Text available with Trip Pro

2004 Journal of Clinical Endocrinology and Metabolism

2969. Women's knowledge of taking oral contraceptive pills correctly and of emergency contraception: effect of providing information leaflets in general practice. (PubMed)

Women's knowledge of taking oral contraceptive pills correctly and of emergency contraception: effect of providing information leaflets in general practice. About one third of all pregnancies are unplanned and 20% of all pregnancies end in abortion. More than 170,000 legal abortions are performed in the United Kingdom annually. Nearly all general practitioners provide contraceptive advice; the most commonly used form of reversible contraception is the oral contraceptive pill.The aim (...) practitioner for oral contraception over six months from 1 October 1992. The questionnaire asked for: sociodemographic information; knowledge of how late women can be taking an oral contraceptive pill and still be protected against unplanned pregnancy; for how many days after being late with a pill they need to use other precautions; sources and methods of emergency contraception; and for how long the methods are effective after the primary contraceptive failure. After completing the questionnaire women

Full Text available with Trip Pro

1995 The British Journal of General Practice

2970. Reversible, non-barrier male contraception: status and prospects. (PubMed)

in recent years. Long-term studies involving a greater number of subjects may result in a safe, reversible and effective means. Asia is likely to be the first market for male, hormonal contraceptive methods. The clinical evaluation of non-endocrine approaches may ultimately lead to an alternative to hormone-based male contraception. (...) Reversible, non-barrier male contraception: status and prospects. Male, non-barrier, contraceptive options are limited to vasectomy and inadequate methods such as withdrawal and periodic abstinence. Herein we give an overview of current research on male contraception by pharmacological means.Literature search of PubMed documented publications and abstracts from meetings.Cross-cultural surveys show men's willingness to carry contraceptive responsibility. Clinical trials substantiate

2005 European Urology

2971. Phase II randomized comparative clinical trial of Norplant (six capsules) with Norplant-2 (two covered rods) subdermal implants for long-term contraception: report of a 24-month study. National Programme of Research in Human Reproduction. (PubMed)

at the end of 12 months and over 65 per 100 users at the end of 24 months. Discontinuations due to expulsion of the device, bleeding problems or personal reasons were few and similar for both devices. The results suggest that silastic-covered rods, Norplant(R)-2, which are comparatively easier to insert and remove and have similar clinical effect, could replace capsules, Norplant(R), as a long-term reversible subdermal contraceptive. (...) Phase II randomized comparative clinical trial of Norplant (six capsules) with Norplant-2 (two covered rods) subdermal implants for long-term contraception: report of a 24-month study. National Programme of Research in Human Reproduction. In a randomized clinical study, contraceptive efficacy and bleeding patterns were studied in a group of healthy, regularly menstruating, non-lactating women (n = 84) using two 4.4 cm covered silastic rods containing levonorgestrel, Norplant(R)-2, and compared

1986 Contraception Controlled trial quality: uncertain

2972. Long-term contraception with the levonorgestrel 20 mcg/day (LNg 20) and the copper T 380Ag intrauterine devices: a five-year randomized study. (PubMed)

attributed to amenorrhea with the LNg device primarily account for differences in continuation. These two intrauterine devices are the most effective long-term, reversible IUDs yet reported in the literature. No other contraceptive methods have exhibited such low long-term pregnancy rates in randomized comparative trials. (...) Long-term contraception with the levonorgestrel 20 mcg/day (LNg 20) and the copper T 380Ag intrauterine devices: a five-year randomized study. An intrauterine device, releasing approximately 20 micrograms/day of levonorgestrel (LNg 20), used by 1124 women, was studied in a randomized trial of five years duration in comparison with the Copper T, model TCu 380Agm in 1121 women. At five years, the gross cumulative pregnancy rate of 1.1 +/- 0.5 per 100 among users of the LNg 20 devices

1990 Contraception Controlled trial quality: uncertain

2973. Subdermal implantable contraceptives versus other forms of reversible contraceptives or other implants as effective methods of preventing pregnancy. (PubMed)

Subdermal implantable contraceptives versus other forms of reversible contraceptives or other implants as effective methods of preventing pregnancy. Implantable methods of contraception offer long-acting reversible contraception. Their uptake rate in comparison to other contraceptive methods, particularly in developed countries, has historically been low.To assess the contraceptive effectiveness, tolerability and acceptability of subdermal implants in comparison to other reversible (...) contraceptive methods.Literature were identified through database searches, reference lists and individuals/organisations working in the contraceptive field.All randomised and controlled trials comparing subdermal implants with other forms of reversible contraceptives and reporting on pre-determined outcomes in women of reproductive years. Primary outcomes were pregnancy and continuation.Quality assessment of studies and data extraction were completed independently by two reviewers. A quality checklist

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2007 Cochrane database of systematic reviews (Online)

2974. Merits of DMPA relative to other reversible contraceptive methods. (PubMed)

effective, daily oral contraceptives are potentially less reliable than longer acting hormonal delivery systems, such as weekly patches, monthly injections or monthly rings. Intrauterine devices and progestin-only implants provide the lowest overall risk of failure but require provider assistance to be reversed. DMPA, administered by injection every 13 weeks, offers a comparable level of contraceptive activity but can be reversed simply by discontinuing injections. (...) Merits of DMPA relative to other reversible contraceptive methods. Of all the highly effective methods of reversible contraception, depo-medroxyprogesterone acetate (DMPA) offers the longest contraceptive activity after a single dose of any method that does not need an invasive procedure to be reversed. This is an important clinical characteristic in the context of a general correlation between duration of action and efficacy. While coitally dependent methods of birth control are the least

2002 Journal of Reproductive Medicine

2975. Long-acting contraceptives in adolescents. (PubMed)

Long-acting contraceptives in adolescents. To help clinicians guide adolescent patients to sound choices regarding long-acting contraceptives. The safety, side effects and non-contraceptive benefits of injectable, implantable and intrauterine contraception are detailed.The use of depot medroxyprogesterone acetate contraceptive injections has been associated with declines in teenage pregnancies in the United States. Although the US Food and Drug Administration has placed a black box warning (...) used in adolescents, intrauterine devices offer selected adolescents convenient, highly effective, safe birth control. Use of the progestin-releasing intrauterine device (Mirena) is also associated with important non-contraceptive benefits.The efficacy and convenience associated with long-acting contraceptives make them indispensable for adolescent patients. This review will help clinicians guide teenage patients towards sound contraceptive choices and the successful long-term use of injectable

2007 Current Opinion in Obstetrics and Gynecology

2976. A clinical trial of 7 alpha-methyl-19-nortestosterone implants for possible use as a long-acting contraceptive for men. (PubMed)

A clinical trial of 7 alpha-methyl-19-nortestosterone implants for possible use as a long-acting contraceptive for men. Several preparations of testosterone and its esters are being investigated alone or in combination with other gonadotropin-suppressing agents as possible antifertility agents for men. We studied the effectiveness of 7 alpha-methyl-19-nortestosterone (MENT) as an antispermatogenic agent in men. MENT has been shown to be more potent than testosterone and to be resistant to 5 (...) in the 2-implant group became oligozoospermic, 2 of whom reached azoospermia. Eight subjects in the 4-implant group reached azoospermia, with 1 exhibiting oligozoospermia, whereas 2 were nonresponders. Side effects generally seen with androgen administration, such as increases in erythrocyte count, hematocrit, and hemoglobin and a decrease in SHBG, were also seen in this study and were reversible. Changes in lipid parameters were moderate and transient. Liver enzymes showed small changes. This study

2003 The Journal of clinical endocrinology and metabolism Controlled trial quality: uncertain

2977. Long-term reversible contraception. Twelve years of experience with the TCu380A and TCu220C. (PubMed)

Long-term reversible contraception. Twelve years of experience with the TCu380A and TCu220C. Few data on the long-term efficacy of intrauterine devices (IUD) are available, and this article reports on the final 12-year experience with the TCu220C and TCu380A devices from two randomized, multicenter trials conducted in 24 centers. A total of 3,277 and 1,396 women, respectively, were recruited for use of each device between 1981 and 1986 and followed at 3, 6, and 12 months after insertion (...) and effective for at least 12 years of use and the low pregnancy rate with the TCu380A is comparable with that reported in the United States among women who had undergone tubal sterilization. The very high efficacy of the TCu380A makes it the IUD of choice, and it can be considered as a potentially reversible, non-surgical alternative to sterilization for women requiring very long-term pregnancy protection.

1997 Contraception Controlled trial quality: uncertain

2978. Suppression of spermatogenesis by etonogestrel implants with depot testosterone: potential for long-acting male contraception. (PubMed)

, hematocrit, or high-density lipoprotein cholesterol concentrations during treatment. These data demonstrate that etonogestrel implants with depot testosterone provide effective suppression of spermatogenesis with reduced metabolic effects and are, therefore, a promising approach to the development of long-acting yet reversible male contraception. (...) Suppression of spermatogenesis by etonogestrel implants with depot testosterone: potential for long-acting male contraception. The coadministration of a progestogen with testosterone increases the degree of suppression of spermatogenesis and is one approach to the development of hormonal male contraception. Depot formulations may allow a reduction in dosage, minimizing adverse effects. We have investigated the effects of a sc implant containing the progestogen etonogestrel (Implanon) with depot

2002 The Journal of clinical endocrinology and metabolism Controlled trial quality: uncertain

2979. Attitudes towards long-acting reversible methods of contraception in general practice in the UK. (PubMed)

Attitudes towards long-acting reversible methods of contraception in general practice in the UK. Recently published national guidance in England recommended that increased use of long-acting reversible methods of contraception could reduce unintended pregnancy rates. Usage rates of long-acting reversible methods of contraception in the UK are currently low. Since these methods require medical intervention, attitudes of professionals are important determinants of prevalence of use.A (...) questionnaire survey was conducted of 321 health professionals working in general practice which sought practitioner views on safety, efficacy and acceptability of contraceptive methods, and on the feasibility and desirability of prescribing long-acting methods.A high proportion of practitioners (80.2%) endorsed the role of LARC in preventing teenage pregnancy, but fewer than half (47.1%) saw them as returning to favor. The combined oral contraceptive pill is still the mainstay of prescriptions. Lack

2007 Contraception

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