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Progestin Androgenic Activity

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101. Combined hormonal contraception and the risk of VTE: a guideline

- indrone; norethindron; norethynodrel; norgestimat; norgestimate; norgestrel; AND ethinyl estradiol; ethinyl estra- diol; ethinylestradiol; mestranol; pro- gesterone; progestin; progestins; progestogen; progestogens; AND Received September 13, 2016; accepted September 13, 2016. Reprint requests: Practice Committee, American Society for Reproductive Medicine, 1209 Montgom- ery Hwy, Birmingham, Alabama 35216 (E-mail: ASRM@asrm.org). Fertility and Sterility® Vol.-, No.-,- 2016 0015-0282/$36.00 Copyright © (...) norethindrone and its derivatives, including levonorgestrel (4). Third-generation combined oral contraceptive pills con- tainingtheprogestinsdesogestrelandgestodenewereformu- lated to be less androgenic than the second-generation progestins (5). Norgestimate is technically a third- generation progestin; however, its bioactivity is mediated mainly through levonorgestrel, which distinguishes it from other third-generation progestins (6). Finally, fourth- generationcontraceptivepillsinclude,amongothers,thepro

2016 Society for Assisted Reproductive Technology

102. Aromatase Inhibitors in Gynecologic Practice

rate compared with clomiphene citrate. Lifestyle changes that result in weight loss should be strongly encouraged. Aromatase inhibitors are a promising therapeutic option that may be helpful for the management of endometriosis-associated pain in combination therapy with progestins. Conclusions and Recommendations The American College of Obstetricians and Gynecologists supports the following recommendations and conclusions: For women with breast cancer, bone mineral density screening is recommended (...) with letrozole compared with clomiphene citrate. Aromatase inhibitors are a promising therapeutic option that may help manage endometriosis-associated pain in combination therapy with progestins. This Committee Opinion revision provides updated information on the use of aromatase inhibitors in breast cancer, ovulation induction, and endometriosis, and long-term follow-up data from relevant studies. Aromatase is a microsomal cytochrome P450 hemoprotein-containing enzyme (P450arom, the product of the CYP19

2016 American College of Obstetricians and Gynecologists

103. Prevention of Cardiovascular Disease in Women

should form 50% of total grain intake. • Naturally occurring sugars are preferred. Avoid sweets and sucrose -sweetened beverages. • Reduce daily salt intake to approximately 1-1¼ teaspoon salt. • Replace saturated and trans-fats with monounsaturated and polyunsaturated fats. Nutrition Physical Activity • Exercise for at least 30 - 45 minutes, 5 times a week. Women who need to lose weight or sustain weight loss should exercise more. Weight maintenance /reduction • Ideal BMI for Asian women is 18.5 (...) hypertension appears to be related to the progesterogenic, not the estrogenic, potency of the preparation. 292 Hypertension due to COC is likely the most frequent cause of secondary hypertension in young women. 293 Women on COC should have their BP monitored periodically. In contrast, HRT as either oral or transdermal oestrogen alone or in combination with a progestin, has neutral effects or may lower the BP in normotensive and in hypertensive women. 290 Factors that predispose to pregnancy-induced

2016 Ministry of Health, Malaysia

104. Management of Osteoporosis

• Hyperparathyroidism 2. Drugs • Glucocorticoids • Heparin • Anticonvulsants (phenytoin) • Immunosuppressants • Thiazolidinediones • Oncology (e.g. Aromatase inhibitors, androgen deprivation therapy) 3. Chronic Diseases • Renal impairment • Liver cirrhosis • Malabsorption • Chronic inflammatory polyarthropathies (e.g. rheumatoid arthritis) 4. Others • Nutritional deficiency e.g. anorexia nervosa • Multiple myeloma and malignancy • Osteogenesis imperfecta • Post-gastrectomy / gastric bypass surgical procedures21 3.3 (...) per day. Elderly who are institutionalised, immobile, lack outdoor activities and have a poor diet will benefit from 800 IU vitamin D supplementation daily. 4631 Vitamin D supplements are available as ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). With daily dosing, vitamin D2 and D3 appear to be equally potent 47 (Level 1a), but with intermittent (weekly or monthly) dosing, vitamin D3 appears to be about 3 times more potent than vitamin D2 48 (Level IIa) Vitamin D supplementation

2015 Ministry of Health, Malaysia

105. Medical eligibility criteria for contraceptive use

contraceptives among breastfeeding women 28 Recommendations for combined hormonal contraceptives among postpartum women 34 Recommendations for combined hormonal contraceptives among women with superficial venous disorders 38 Recommendations for combined hormonal contraceptives among women with dyslipidaemias 42 Recommendations for progestogen-only contraceptives and levonorgestrel-releasing intrauterine devices among breastfeeding women 47 Recommendations for safety of depot medroxyprogesterone acetate (...) , and women living with HIV using antiretroviral therapy 82 PART II. USING THE RECOMMENDATIONS Background 99 How to use this document 104 Using the categories in practice 105 Programmatic implications 106 Clients with special needs 106 Summary of changes within the MEC fifth edition 107 TABLES Combined hormonal contraceptives 111 Progestogen-only contraceptives 157 Emergency contraceptive pills 186 Intrauterine devices 189 Copper-bearing IUD for emergency contraception 211 Barrier methods 214 Fertility

2015 World Health Organisation Guidelines

106. Sex Differences in the Cardiovascular Consequences of Diabetes Mellitus Full Text available with Trip Pro

mortality/major cardiovascular events) Observational studies suggest that women with DM may require greater frequency/intensity of physical activity than men to reduce cardiovascular events Fitness: Look AHEAD showed greater improvements in cardiorespiratory fitness in men compared with women Diabetes Aerobic and Resistance Exercise trial and a meta-analysis showed similar improvements in fitness in response to exercise training Glycemic control/DM prevention: Women with T1DM may have greater (...) , it does by race. Almost 50% of NHBs compared with one third of NHWs and Hispanics have hypertension. Therefore, hypertension has the potential to magnify the severity of diabetic heart disease in NHB women. High-Density Lipoprotein Cholesterol Women have higher high-density lipoprotein cholesterol (HDL-C) than men, and nondiabetic NHBs have higher HDL-C levels than NHWs. In addition to being active in reverse cholesterol transport, HDL-C has antithrombotic, anti-inflammatory, and antioxidant activity

2015 American Heart Association

107. Practice Bulletin: Endometrial Cancer

2 diabetes mellitus and hypertension are associated with an increased risk of endometrial cancer that may be related to concurrent obe- sity (19, 20), although an independent association between diabetes and endometrial cancer has been reported (21). Systemic unopposed estrogen therapy increases the risk of endometrial cancer by up to 20-fold, with the increasing risk correlating with the duration of use (22–26). Concomitant progestin administration mitigates this risk. When progestins (...) are discussed in this section. Additional risk factors for type I endometrial cancer are listed in Table 1. Unopposed Estrogen Prolonged exposure to unopposed estrogen, whether endo- genous or exogenous, is associated with most cases of type I endometrial cancer. Unopposed endogenous estro- gen exposure occurs in chronic anovulation (eg, poly- cystic ovary syndrome), with estrogen-producing tumors, and with excessive peripheral conversion of androgens to estrone in adipose tissue. Obesity is associated

2015 Society of Gynecologic Oncology

108. Menopausal Symptoms: Comparative Effectiveness of Therapies

vasomotor symptoms and were accompanied by better quality-of-life scores. SSRIs/SNRIs relieve vasomotor symptoms less effectively than estrogens but were accompanied by the largest improvement in global measures of psychological well-being. Estrogens administered vaginally diminished pain during sex and testosterone increased sexual activity. Measures of urogenital atrophy were improved with ospemifene and vaginal or oral estrogens. Estrogens also improved sleep, but the effect appeared to be modest (...) . Over the long term, estrogen combined with progestogen has both beneficial effects (fewer osteoporotic fractures) and harmful effects (increased risk of breast cancer, gallbladder disease, venous thromboembolic events, and stroke). Estrogens given alone do not appear to increase breast cancer risk, although endometrial cancer risk is increased. There is limited evidence on the long-term effects of most nonhormone treatments. No studies were identified that examined the efficacy or safety

2015 Effective Health Care Program (AHRQ)

109. Long-term Consequences Polycystic Ovary Syndrome

/Progestin Interventions (PEPI) Trial. JAMA 1996;275:370–5.13 of 15 RCOG Green-top Guideline No. 33 © Royal College of Obstetricians and Gynaecologists 59. Gambrell RD Jr. Prevention of endometrial cancer with progestogens. Maturitas 1986;8:159–68. 60. Hickey M, Higham JM, Fraser I. Progestogens with or without oestrogen for irregular uterine bleeding associated with anovulation. Cochrane Database Syst Rev 2012;(9):CD001895. 61. McCormick BA, Wilburn RD, Thomas MA, Williams DB, Maxwell R, Aubuchon M (...) activity, cigarette smoking, family history of type II diabetes, dyslipidaemia, hypertension, impaired glucose tolerance, type II diabetes) at the time of initial diagnosis. In clinical practice, hypertension should be treated; however, lipid-lowering treatment is not recommended routinely and should only be prescribed by a specialist. P D D C P B B P B© Royal College of Obstetricians and Gynaecologists 3of 15 RCOG Green-top Guideline No. 33 What is the risk of having reduced health-related quality

2014 Royal College of Obstetricians and Gynaecologists

110. The use of newer progestins for contraception. (Abstract)

The use of newer progestins for contraception. The synthetic progestins used for contraception so far are structurally related either to testosterone (estranes and gonanes) or to progesterone (pregnanes and 19-norpregnanes). Several new progestins have been designed to minimize side-effects related to androgenic, estrogenic or glucocorticoid receptor (GR) interactions. Dienogest (DNG) and drospirenone (DRSP) exhibit a partial antiandrogenic action, and DRSP has predominant anti (...) with estradiol (E2). Nestorone is not active orally but proved to be the most active antiovulatory progestin when used parenterally. It has been developed in various formulations such as implants, vaginal rings or transdermal gel or spray. Risks and benefits of the new progestins depend upon the type of molecular structure, the type of estrogen associated in a combination and the route of administration.Copyright © 2010 Elsevier Inc. All rights reserved.

2010 Contraception

111. Bone health in estrogen-free contraception. (Abstract)

estrogen-free contraceptives. All progestins exert activity through binding to specific progesterone receptors; hereby, three different groups of progestins exist: pregnanes, gonanes, and estranges. Progestins also comprise specific glucocorticoid, androgen, or mineralocorticoid receptor interactions. Anabolic action of a progestogen may be affected via androgenic, anti-androgenic, or synadrogenic activity. The C 19 nortestosterone class of progestogens is known to bind with more affinity to androgen (...) Bone health in estrogen-free contraception. Estrogens and progestogens influence the bone. The major physiological effect of estrogen is the inhibition of bone resorption whereas progestogens exert activity through binding to specific progesterone receptors. New estrogen-free contraceptive and its possible implication on bone turnover are discussed in this review. Insufficient bone acquisition during development and/or accelerated bone loss after attainment of peak bone mass (PBM) are 2

2019 Osteoporosis International

112. Homeostasis of the sebaceous gland and mechanisms of acne pathogenesis. (Abstract)

, progestogens and oestrogens; retinoids; receptor tyrosine kinases such as ErbB family receptors, fibroblast growth factor receptor 2 and insulin/insulin-like growth factor 1 receptors; peroxisome proliferator-activated receptor γ; aryl hydrocarbon receptor; and the Wnt signalling pathway. Where possible, the cellular and molecular mechanisms by which these regulatory factors control SG biology are indicated, along with considerations as to how they might contribute to acne pathogenesis.Future research (...) that generate the SG and infundibulum: the 'comedo switch'. Understanding the biological processes that govern SG homeostasis promises to highlight potential aetiological mechanisms underlying acne and other SG-associated skin disorders.In this review, we discuss the clinical data, genetic mouse models and in vitro research that have highlighted major hormones, paracrine factors, transcription factors and signalling pathways that control SG homeostasis. These include, but are not limited to androgens

2019 British Journal of Dermatology

113. Endometrial Cancer Prevention (PDQ®): Health Professional Version

with estrogenic, progestogenic, and androgenic properties, has been associated with an increased incidence rate ratio of endometrial cancer of 3.56 (95% CI, 3.08–4.69) for current users compared with never users. Tibolone is approved for use to manage menopausal symptoms or to prevent osteoporosis in many countries. However, it is not approved for use in Canada or the United States. Other combined therapy with estrogen and progestin may also increase the risk of breast cancer, so the risks and benefits must (...) therapy (HT) with estrogen: Unopposed estrogen Based on solid evidence, unopposed estrogen is associated with an increased risk of endometrial cancer. This excess risk can be eliminated by adding continuous progestin to estrogen therapy, but this combination is associated with an increased risk of breast cancer.[ - ] (Refer to the PDQ summary on for more information.) Magnitude of Effect : The associated risk of endometrial cancer in women who use unopposed estrogen for 5 or more years is at least

2017 PDQ - NCI's Comprehensive Cancer Database

114. Hot Flashes and Night Sweats (PDQ®): Health Professional Version

. [ ] Etiology Causes of menopausal hot flashes include the occurrence of natural menopause, surgical menopause, or chemical menopause; in the cancer patient, chemical menopause may be caused by cytotoxic chemotherapy, radiation therapy, or androgen treatment. Causes of so-called male menopause include orchiectomy, gonadotropin-releasing hormone use, or estrogen use. Drug-associated causes of hot flashes and night sweats in men and women include the use of tamoxifen, aromatase inhibitors, opioids, tricyclic (...) of such a risk.[ ] In May 2002, the Women’s Health Initiative, a large, randomized, placebo-controlled trial of the risks and benefits of estrogen plus progestin in healthy postmenopausal women, was stopped prematurely at a mean follow-up of 5.2 years (±1.3) because of the detection of a 1.26-fold increased breast cancer risk (95% confidence interval [CI], 1.00–1.59) in women receiving hormone replacement therapy. Tumors among women in the hormone replacement therapy group were slightly larger and more

2017 PDQ - NCI's Comprehensive Cancer Database

115. Guideline on the management of women with endometriosis

endometriosis 24 2. Treatment of endometriosis-associated pain 27 2.1 Empirical treatment of pain 27 2.2 Hormonal therapies for treatment of endometriosis-associated pain 28 2.2.1 Hormonal contraceptives 29 2.2.2 Progestagens and anti-progestagens 31 2.2.3 GnRH agonists 34 2.2.4 Aromatase inhibitors 36 2.3 Analgesics for treatment of endometriosis-associated pain 37 2.4 Surgery for treatment of endometriosis-associated pain 39 2.4.1 Surgery for treatment of endometriosis-associated pain 39 2.4.2 Ablation

2013 European Society of Human Reproduction and Embryology

116. Prostate cancer

options and adverse effects with a named nurse specialist. Men with low-risk localised prostate cancer for whom radical treatment is suitable are offered a choice between active surveillance, radical prostatectomy or radical radiotherapy. Men with intermediate- or high-risk localised prostate cancer who are offered non-surgical radical treatment are offered radical radiotherapy and androgen deprivation therapy in combination. Men with adverse effects of prostate cancer treatment are referred (...) include: Watchful waiting, radical prostatectomy, or radical radiotherapy (external-beam radiotherapy [EBR], or brachytherapy). Intermediate risk — radical prostatectomy, or radical radiotherapy with 6 months of androgen deprivation therapy (before, during or after radiotherapy) can be offered (rather than radical radiotherapy or androgen therapy alone). Other treatments that can be considered include watchful waiting, active surveillance, or high-dose rate brachytherapy in combination with EBR. High

2017 NICE Clinical Knowledge Summaries

117. Menopause

Menopause Menopause - NICE CKS Share Menopause: Summary Menopause is a biological stage in a woman's life when menstruation ceases permanently due to the loss of ovarian follicular activity. It occurs with the final menstrual period and is usually diagnosed clinically after 12 months of amenorrhoea. In the UK, the mean age of the natural menopause is 51 years, although this can vary between different ethnic groups. Perimenopause is the period before the menopause when the endocrinological (...) investigations. The follicle stimulating hormone (FSH) blood test to diagnose menopause should only be considered in women aged: Over 45 years with atypical symptoms. Between 40–45 years with menopausal symptoms, including a change in their menstrual cycle. Younger than 40 years if premature menopause is suspected. The FSH test should not be used to diagnose menopause in women using combined oestrogen and progestogen contraception or high-dose progestogen, as the diagnostic accuracy may be confounded

2017 NICE Clinical Knowledge Summaries

118. Esmya - ulipristal

www.ema.europa.eu © European Medicines Agency, 2011. Reproduction is authorised provided the source is acknowledged. Product information Name of the medicinal product: Esmya Applicant: PregLem France SAS. 32, route de l’Eglise F-74140 Massongy France Active substance: ulipristal acetate International Non-proprietary Name: ulipristal Pharmaco-therapeutic group (ATC Code): Uterine myoma Therapeutic indication(s): Ulipristal acetate is indicated for pre-operative treatment of moderate to severe symptoms of uterine (...) or restrictions regarding supply and use 103 Conditions and requirements of the Marketing Authorisation 104 Esmya CHMP assessment report Rev06.11 Page 3/106 List of abbreviations AAS Atomic Absorption Spectrometry ACTH Adrenocorticotropic hormone ADME Absorption, Distribution, Metabolism and Elimination ADR Adverse drug reaction AE Adverse event AESI Adverse Event of Special Interest ALAT Alanine aminotransferase ALP Alkaline phosphatase AP Applicant's Part (or Open Part) of a DMF API Active Pharmaceutical

2012 European Medicines Agency - EPARs

119. A Study of SHR3680 in Treating Patients With Hormone Sensitive Prostate Cancer

to day 1; Previous use or are using a second-generation androgen receptor antagonist (enzalutamide, ARN-509, ODM-201), abiraterone, ketoconazole for prostate cancer, or other agents that will inhibit the production of androgens; Have participated in an interventional clinical trial or been treated with the following drugs in the past 4 weeks prior to day 1: 5-alpha reductase inhibitors, estrogen, progestin, and herbal products known to decrease PSA levels ; Evidence of brain metastasis or primary (...) Resource links provided by the National Library of Medicine related topics: related topics: available for: resources: Arms and Interventions Go to Arm Intervention/treatment Experimental: SHR3680 Participants will receive SHR3680 orally Drug: SHR3680 Tablet. Specifications of 80 mg; orally, once a day Active Comparator: bicalutamide Participants will receive bicalutamide orally Drug: Bicalutamide Tablet. Specifications of 50 mg; orally, once a day Outcome Measures Go to Primary Outcome Measures : rPFS

2018 Clinical Trials

120. Study of Daily Application of Nestorone® (NES) and Testosterone (T) Combination Gel for Male Contraception

will be eligible for enrollment in the trial: Good health as confirmed by medical history, physical examination, and clinical laboratory tests of blood and urine at the time of screening; 18 to 50 years of age, at the enrollment visit; BMI < 33 kg/m2; No history of androgen use in the six months prior to the first screening visit; Agreement to use an effective method of contraception with his female partner (refer to Appendix 11 for acceptable forms of contraception) during the suppression and recovery phases (...) and then only use the experimental method during the efficacy phase of the study; In the opinion of the investigator, the male subject is willing and able to comply with the protocol; The subject is legally competent, has been informed of the nature, the scope and the relevance of the study, voluntarily agrees to participation and the study's provisions and has duly signed the informed consent form (ICF); Sexually active with a female partner (as specified below) with whom he has been in a stable, mutually

2018 Clinical Trials

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