Hormonal Contraception and Post-menopausal Hormonal Therapy

Hormonal Contraception and Post-menopausal Hormonal Therapy
Author: IARC Working Group on the Evaluation of Carcinogenic Risks to Humans
Publisher: World Health Organization
Total Pages: 692
Release: 1999
Genre: Medical
ISBN:

Evaluates evidence for an increased risk of cancer in women using combined oral contraceptives, progestogen-only hormonal contraceptives, post-menopausal estrogen therapy, and post-menopausal estrogen-progestogen therapy. Although the carcinogenicity of these preparations has been extensively investigated, the book stresses the many complex methodological issues that must be considered when interpreting findings and weighing results. Evidence of an association between use of these preparations and positive effects on health, including a reduced risk of some cancers, is also critically assessed. The first and most extensive monograph evaluates evidence of an association between the use of combined oral contraceptives and cancer at nine sites. Concerning breast cancer, the evaluation concludes that, even if the association is causal, the excess risk for breast cancer associated with patterns of use that are typical today is very small. Studies of predominantly high-dose preparations found an increased risk of hepatocellular carcinoma in the absence of hepatitis viruses. Citing these findings, the evaluation concludes that there is sufficient evidence in humans for the carcinogenicity of combined oral contraceptives. The evaluation also found sufficient evidence for the carcinogenicity of some, but not all, combined preparations in animals. Combined oral contraceptives were classified as carcinogenic to humans. The evaluation also cites conclusive evidence that these agents have a protective effect against cancers of the ovary and endometrium. Progestogen-only contraceptives are evaluated in the second monograph, which considers the association with cancer at six sites. The evaluation found no evidence of an increased risk for breast cancer. Although the evaluation found sufficient evidence in animals for the carcinogenicity of medroxyprogesterone acetate, evidence for the carcinogenicity of progestogen-only contraceptives in humans was judged inadequate. Progestogen-only contraceptives were classified as possibly carcinogenic to humans. The third monograph, on post-menopausal estrogen therapy, considers evidence of an association with cancer at eight sites. Findings from a large number of epidemiological studies indicate a small increase in the risk of breast cancer in women who have used these preparations for five years or more. Studies consistently show an association between use of post-menopausal estrogen therapy and an increased risk for endometrial cancer. Data on the association with other cancers were either inconclusive or suggested no effect on risk. The evaluation concludes that post-menopausal estrogen therapy is carcinogenic to humans. The final monograph evaluates the association between the use of post-menopausal estrogen-progestogen therapy and cancer at four sites. The evaluation of limited data on breast cancer found an increased relative risk observed with long-term use. Data were judged insufficient to assess the effects of past use and of different progestogen compounds, doses, and treatment schedules. For endometrial cancer, the evaluation found an increase in risk relative to non-users when the progestogen was added to the cycle for 10 days or fewer. Post-menopausal estrogen-progestogen therapy was classified as possibly carcinogenic to humans. Concerning post-menopausal therapy in general, the book notes that evidence of carcinogenic risks must be placed in perspective of potential benefits. The prevention of osteoporotic fractures is cited as the best-established benefit. Evidence also suggests that estrogen prevents heart disease and may prevent memory loss and dementia.

Contraception and Reproduction

Contraception and Reproduction
Author: Working Group on the Health Consequences of Contraceptive Use and Controlled Fertility
Publisher:
Total Pages: 0
Release: 1989
Genre:
ISBN:

Se estudian las consecuencias sanitarias de los diferentes patrones reproductivos en la salud de la mujer y de los niños. Tambien se evaluan el riesgo y los beneficios de los diferentes metodos anticonceptivos, aunque algunos de los datos en los que se basa son de paises desarrollados, el nucleo central del informe son los paises en desarrollo.

Contraceptive Steroids

Contraceptive Steroids
Author: A. T. Gregoire
Publisher: Springer Science & Business Media
Total Pages: 387
Release: 2013-03-13
Genre: Medical
ISBN: 1461322413

One of the United States Food and Drug Administration's most difficult tasks is the assessment of risk-benefit ratios for a broad spectrum of therapeutic and prophylactic drugs. Furthermore, it is now widely recog nized that no drug, chemical or even natural substance is completely devoid of risk. Nowhere has this issue been the subject of more controversy than with steroidal contraceptive drugs. Regulated as a special class of products because of their prophylactic use in healthy individuals for prevention of pregnancy rather than for treatment of disease, steroid contraceptives drugs undergo more extensive animal safety tests than any other pharmaceutical agent. This view also contemplates the availability of alternative contraceptive measures posing fewer risks, but the use of less effective methods must take into consideration the hazards associated with pregnancy itself. In April 1983, the Food and Drug Administration and the National Insti tutes of Health in cooperation with the World Health Organization, the Population Council, and the Agency for International Development sponsored a three-day workshop to evaluate current guidelines for preclinical safety studies of contraceptive drugs in light of our extensive knowledge of the side effects of marketed products. The meeting included presenta tions by experts in the fields of comparative metabolism, pharmacokinetics, pharmacology, carcinogenicity, toxicology, coagulation, lipid metabolism, epidemiology and pathology at a meeting of the Fertility and Maternal Health Drugs Advisory Committee of the National Center for Drugs and Biologics, Food and Drug Administration.

Contraceptive Research and Development

Contraceptive Research and Development
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 534
Release: 1996-11-04
Genre: Medical
ISBN: 0309175658

The "contraceptive revolution" of the 1960s and 1970s introduced totally new contraceptive options and launched an era of research and product development. Yet by the late 1980s, conditions had changed and improvements in contraceptive products, while very important in relation to improved oral contraceptives, IUDs, implants, and injectables, had become primarily incremental. Is it time for a second contraceptive revolution and how might it happen? Contraceptive Research and Development explores the frontiers of science where the contraceptives of the future are likely to be found and lays out criteria for deciding where to make the next R&D investments. The book comprehensively examines today's contraceptive needs, identifies "niches" in those needs that seem most readily translatable into market terms, and scrutinizes issues that shape the market: method side effects and contraceptive failure, the challenge of HIV/AIDS and other sexually transmitted diseases, and the implications of the "women's agenda." Contraceptive Research and Development analyzes the response of the pharmaceutical industry to current dynamics in regulation, liability, public opinion, and the economics of the health sector and offers an integrated set of recommendations for public- and private-sector action to meet a whole new generation of demand.

Medical Eligibility Criteria for Contraceptive Use

Medical Eligibility Criteria for Contraceptive Use
Author:
Publisher: World Health Organization
Total Pages: 130
Release: 2010
Genre: Business & Economics
ISBN: 9241563885

Medical Eligibility Criteria for Contraceptive Use reviews the medical eligibility criteria for use of contraception, offering guidance on the safety and use of different methods for women and men with specific characteristics or known medical conditions. The recommendations are based on systematic reviews of available clinical and epidemiological research. It is a companion guideline to Selected Practice Recommendations for Contraceptive Use. Together, these documents are intended to be used by policy-makers, program managers, and the scientific community to support national programs in the preparation of service delivery guidelines. The fourth edition of this useful resource supersedes previous editions, and has been fully updated and expanded. It includes over 86 new recommendations and 165 updates to recommendations in the previous edition. Guidance for populations with special needs is now provided, and a new annex details evidence on drug interactions from concomitant use of antiretroviral therapies and hormonal contraceptives. To assist users familiar with the third edition, new and updated recommendations are highlighted. Everyone involved in providing family planning services and contraception should have the fourth edition of Medical Eligibility Criteria for Contraceptive Use at hand.

Steroid Contraceptives and Women’s Response

Steroid Contraceptives and Women’s Response
Author: Rachel Snow
Publisher: Springer Science & Business Media
Total Pages: 260
Release: 2012-12-06
Genre: Medical
ISBN: 1461524458

Pharmacokinetic variability of contraceptive steroids is a relatively under-explored area of contraceptive research, and hardly a common point of discussion among those who plan and deliver family planning services. Nevertheless, numerous independent studies over the last 15 years have indicated that women in different regions of the world vary in their pharmacokinetic response to contraceptive steroids. The causes of such variability are not known, but it has important consequences for contraceptive effectiveness. It may also offer insight to the basis of contraceptive side-effects. The impetus for this volume was to collect documentation of pharmacokinetic variability of contraceptive steroids, and to explore both the possible causes and implications of these data. Factors known to affect steroid pharmacokinetics, such as concurrent use of specific medications, are reviewed by Back and Orme. Other factors known to affect endogenous steroid dynamics are presented in chapters by Bradlow, Longcope, Goldin and Snow, because of their possible role in contraceptive steroid pharmacokinetics.

Science and Babies

Science and Babies
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 183
Release: 1990-02-01
Genre: Medical
ISBN: 0309041368

By all indicators, the reproductive health of Americans has been deteriorating since 1980. Our nation is troubled by rates of teen pregnancies and newborn deaths that are worse than almost all others in the Western world. Science and Babies is a straightforward presentation of the major reproductive issues we face that suggests answers for the public. The book discusses how the clash of opinions on sex and family planning prevents us from making a national commitment to reproductive health; why people in the United States have fewer contraceptive choices than those in many other countries; what we need to do to improve social and medical services for teens and people living in poverty; how couples should "shop" for a fertility service and make consumer-wise decisions; and what we can expect in the futureâ€"featuring interesting accounts of potential scientific advances.

The Immunoassay Handbook

The Immunoassay Handbook
Author: David Wild
Publisher: Newnes
Total Pages: 1037
Release: 2013-01-21
Genre: Science
ISBN: 0080970389

The fourth edition of The Immunoassay Handbook provides an excellent, thoroughly updated guide to the science, technology and applications of ELISA and other immunoassays, including a wealth of practical advice. It encompasses a wide range of methods and gives an insight into the latest developments and applications in clinical and veterinary practice and in pharmaceutical and life science research. Highly illustrated and clearly written, this award-winning reference work provides an excellent guide to this fast-growing field. Revised and extensively updated, with over 30% new material and 77 chapters, it reveals the underlying common principles and simplifies an abundance of innovation. The Immunoassay Handbook reviews a wide range of topics, now including lateral flow, microsphere multiplex assays, immunohistochemistry, practical ELISA development, assay interferences, pharmaceutical applications, qualitative immunoassays, antibody detection and lab-on-a-chip. This handbook is a must-read for all who use immunoassay as a tool, including clinicians, clinical and veterinary chemists, biochemists, food technologists, environmental scientists, and students and researchers in medicine, immunology and proteomics. It is an essential reference for the immunoassay industry. Provides an excellent revised guide to this commercially highly successful technology in diagnostics and research, from consumer home pregnancy kits to AIDS testing.www.immunoassayhandbook.com is a great resource that we put a lot of effort into. The content is designed to encourage purchases of single chapters or the entire book. David Wild is a healthcare industry veteran, with experience in biotechnology, pharmaceuticals, medical devices and immunodiagnostics, which remains his passion. He worked for Amersham, Eastman-Kodak, Johnson & Johnson, and Bristol-Myers Squibb, and consulted for diagnostics and biotechnology companies. He led research and development programs, design and construction of chemical and biotechnology plants, and integration of acquired companies. Director-level positions included Research and Development, Design Engineering, Operations and Strategy, for billion dollar businesses. He retired from full-time work in 2012 to focus on his role as Editor of The Immunoassay Handbook, and advises on product development, manufacturing and marketing. - Provides a unique mix of theory, practical advice and applications, with numerous examples - Offers explanations of technologies under development and practical insider tips that are sometimes omitted from scientific papers - Includes a comprehensive troubleshooting guide, useful for solving problems and improving assay performancee - Provides valuable chapter updates, now available on www.immunoassayhandbook.com

Selected Practice Recommendations for Contraceptive Use

Selected Practice Recommendations for Contraceptive Use
Author: World Health Organization. Reproductive Health and Research
Publisher: World Health Organization
Total Pages: 144
Release: 2005
Genre: Medical
ISBN: 9241562846

This document is one of two evidence-based cornerstones of the World Health Organization's (WHO) new initiative to develop and implement evidence-based guidelines for family planning. The first cornerstone, the Medical eligibility criteria for contraceptive use (third edition) published in 2004, provides guidance for who can use contraceptive methods safely. This document, the Selected practice recommendations for contraceptive use (second edition), provides guidance for how to use contraceptive methods safely and effectively once they are deemed to be medically appropriate. The recommendations contained in this document are the product of a process that culminated in an expert Working Group meeting held at the World Health Organization, Geneva, 13-16 April 2004.