Contraceptives, Oral: Compounds, usually hormonal, taken orally in order to block ovulation and prevent the occurrence of pregnancy. The hormones are generally estrogen or progesterone or both.Contraceptives, Oral, Combined: Fixed drug combinations administered orally for contraceptive purposes.Contraceptive Agents: Chemical substances that prevent or reduce the probability of CONCEPTION.Contraceptives, Oral, Hormonal: Oral contraceptives which owe their effectiveness to hormonal preparations.Contraceptive Agents, Female: Chemical substances or agents with contraceptive activity in females. Use for female contraceptive agents in general or for which there is no specific heading.Contraceptives, Oral, Synthetic: Oral contraceptives which owe their effectiveness to synthetic preparations.Contraceptive Devices: Devices that diminish the likelihood of or prevent conception. (From Dorland, 28th ed)Contraception: Prevention of CONCEPTION by blocking fertility temporarily, or permanently (STERILIZATION, REPRODUCTIVE). Common means of reversible contraception include NATURAL FAMILY PLANNING METHODS; CONTRACEPTIVE AGENTS; or CONTRACEPTIVE DEVICES.Contraceptive Devices, Female: Contraceptive devices used by females.Contraception Behavior: Behavior patterns of those practicing CONTRACEPTION.Contraceptive Agents, Male: Chemical substances or agents with contraceptive activity in males. Use for male contraceptive agents in general or for which there is no specific heading.Intrauterine Devices: Contraceptive devices placed high in the uterine fundus.Family Planning Services: Health care programs or services designed to assist individuals in the planning of family size. Various methods of CONTRACEPTION can be used to control the number and timing of childbirths.Ethinyl Estradiol: A semisynthetic alkylated ESTRADIOL with a 17-alpha-ethinyl substitution. It has high estrogenic potency when administered orally, and is often used as the estrogenic component in ORAL CONTRACEPTIVES.Desogestrel: A synthetic progestational hormone used often as the progestogenic component of combined oral contraceptive agents.Norgestrel: A synthetic progestational agent with actions similar to those of PROGESTERONE. This racemic or (+-)-form has about half the potency of the levo form (LEVONORGESTREL). Norgestrel is used as a contraceptive, ovulation inhibitor, and for the control of menstrual disorders and endometriosis.Levonorgestrel: A synthetic progestational hormone with actions similar to those of PROGESTERONE and about twice as potent as its racemic or (+-)-isomer (NORGESTREL). It is used for contraception, control of menstrual disorders, and treatment of endometriosis.Contraceptives, Postcoital: Contraceptive substances to be used after COITUS. These agents include high doses of estrogenic drugs; progesterone-receptor blockers; ANTIMETABOLITES; ALKALOIDS, and PROSTAGLANDINS.Mestranol: The 3-methyl ether of ETHINYL ESTRADIOL. It must be demethylated to be biologically active. It is used as the estrogen component of many combination ORAL CONTRACEPTIVES.Norethindrone: A synthetic progestational hormone with actions similar to those of PROGESTERONE but functioning as a more potent inhibitor of ovulation. It has weak estrogenic and androgenic properties. The hormone has been used in treating amenorrhea, functional uterine bleeding, endometriosis, and for contraception.Vaccines, Contraceptive: Vaccines or candidate vaccines used to prevent conception.Pregnancy, Unplanned: Unintended accidental pregnancy, including pregnancy resulting from failed contraceptive measures.Sterilization, Reproductive: Procedures to block or remove all or part of the genital tract for the purpose of rendering individuals sterile, incapable of reproduction. Surgical sterilization procedures are the most commonly used. There are also sterilization procedures involving chemical or physical means.Pregnancy, Unwanted: Pregnancy, usually accidental, that is not desired by the parent or parents.Medroxyprogesterone Acetate: A synthetic progestin that is derived from 17-hydroxyprogesterone. It is a long-acting contraceptive that is effective both orally or by intramuscular injection and has also been used to treat breast and endometrial neoplasms.Spermatocidal Agents: Chemical substances that are destructive to spermatozoa used as topically administered vaginal contraceptives.Contraception, Postcoital: Means of postcoital intervention to avoid pregnancy, such as the administration of POSTCOITAL CONTRACEPTIVES to prevent FERTILIZATION of an egg or implantation of a fertilized egg (OVUM IMPLANTATION).Intrauterine Devices, Copper: Intrauterine contraceptive devices that depend on the release of metallic copper.Menstruation: The periodic shedding of the ENDOMETRIUM and associated menstrual bleeding in the MENSTRUAL CYCLE of humans and primates. Menstruation is due to the decline in circulating PROGESTERONE, and occurs at the late LUTEAL PHASE when LUTEOLYSIS of the CORPUS LUTEUM takes place.Norethynodrel: A synthetic progestational hormone with actions and uses similar to those of PROGESTERONE. It has been used in the treatment of functional uterine bleeding and endometriosis. As a contraceptive, it has usually been administered in combination with MESTRANOL.Ethynodiol Diacetate: A synthetic progestational hormone used alone or in combination with estrogens as an oral contraceptive.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Abortion, Induced: Intentional removal of a fetus from the uterus by any of a number of techniques. (POPLINE, 1978)Contraception, Immunologic: Contraceptive methods based on immunological processes and techniques, such as the use of CONTRACEPTIVE VACCINES.Norpregnenes: Pregnenes with one double bond or more than three double bonds which have undergone ring contractions or are lacking carbon-18 or carbon-19..Ethinyl Estradiol-Norgestrel Combination: ETHINYL ESTRADIOL and NORGESTREL given in fixed proportions. It has proved to be an effective contraceptive (CONTRACEPTIVES, ORAL, COMBINED).Progestins: Compounds that interact with PROGESTERONE RECEPTORS in target tissues to bring about the effects similar to those of PROGESTERONE. Primary actions of progestins, including natural and synthetic steroids, are on the UTERUS and the MAMMARY GLAND in preparation for and in maintenance of PREGNANCY.Contraceptives, Oral, Sequential: Drugs administered orally and sequentially for contraceptive purposes.Contraceptives, Postcoital, Hormonal: Postcoital contraceptives which owe their effectiveness to hormonal preparations.Sterilization, Tubal: Procedures that render the female sterile by interrupting the flow in the FALLOPIAN TUBE. These procedures generally are surgical, and may also use chemicals or physical means.Androstenes: Unsaturated derivatives of the steroid androstane containing at least one double bond at any site in any of the rings.Menstrual Cycle: The period from onset of one menstrual bleeding (MENSTRUATION) to the next in an ovulating woman or female primate. The menstrual cycle is regulated by endocrine interactions of the HYPOTHALAMUS; the PITUITARY GLAND; the ovaries; and the genital tract. The menstrual cycle is divided by OVULATION into two phases. Based on the endocrine status of the OVARY, there is a FOLLICULAR PHASE and a LUTEAL PHASE. Based on the response in the ENDOMETRIUM, the menstrual cycle is divided into a proliferative and a secretory phase.Progesterone Congeners: Steroidal compounds related to PROGESTERONE, the major mammalian progestational hormone. Progesterone congeners include important progesterone precursors in the biosynthetic pathways, metabolites, derivatives, and synthetic steroids with progestational activities.Parity: The number of offspring a female has borne. It is contrasted with GRAVIDITY, which refers to the number of pregnancies, regardless of outcome.Intrauterine Devices, Medicated: Intrauterine devices that release contraceptive agents.Health Knowledge, Attitudes, Practice: Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL).Contraceptive Devices, Male: Contraceptive devices used by males.Pregnancy in Adolescence: Pregnancy in human adolescent females under the age of 19.Menstruation Disturbances: Variations of menstruation which may be indicative of disease.Megestrol: 17-Hydroxy-6-methylpregna-3,6-diene-3,20-dione. A progestational hormone used most commonly as the acetate ester. As the acetate, it is more potent than progesterone both as a progestagen and as an ovulation inhibitor. It has also been used in the palliative treatment of breast cancer.Contraceptives, Postcoital, Synthetic: Postcoital contraceptives which owe their effectiveness to synthetic preparations.Drug Implants: Small containers or pellets of a solid drug implanted in the body to achieve sustained release of the drug.Sex Education: Education which increases the knowledge of the functional, structural, and behavioral aspects of human reproduction.Spermatogenesis-Blocking Agents: Chemical substances which inhibit the process of spermatozoa formation at either the first stage, in which spermatogonia develop into spermatocytes and then into spermatids, or the second stage, in which spermatids transform into spermatozoa.Ovulation Inhibition: Blocking the process leading to OVULATION. Various factors are known to inhibit ovulation, such as neuroendocrine, psychological, and pharmacological agents.Medroxyprogesterone: (6 alpha)-17-Hydroxy-6-methylpregn-4-ene-3,20-dione. A synthetic progestational hormone used in veterinary practice as an estrus regulator.Fertility: The capacity to conceive or to induce conception. It may refer to either the male or female.Condoms: A sheath that is worn over the penis during sexual behavior in order to prevent pregnancy or spread of sexually transmitted disease.Sexual Behavior: Sexual activities of humans.Norpregnadienes: Pregnadienes which have undergone ring contractions or are lacking carbon-18 or carbon-19.Transdermal Patch: A medicated adhesive patch placed on the skin to deliver a specific dose of medication into the bloodstream.Ethisterone: 17 alpha-Hydroxypregn-4-en-20-yn-3-one. A synthetic steroid hormone with progestational effects.Uterine Hemorrhage: Bleeding from blood vessels in the UTERUS, sometimes manifested as vaginal bleeding.Estradiol Congeners: Steroidal compounds related to ESTRADIOL, the major mammalian female sex hormone. Estradiol congeners include important estradiol precursors in the biosynthetic pathways, metabolites, derivatives, and synthetic steroids with estrogenic activities.Metrorrhagia: Abnormal uterine bleeding that is not related to MENSTRUATION, usually in females without regular MENSTRUAL CYCLE. The irregular and unpredictable bleeding usually comes from a dysfunctional ENDOMETRIUM.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Estrogens: Compounds that interact with ESTROGEN RECEPTORS in target tissues to bring about the effects similar to those of ESTRADIOL. Estrogens stimulate the female reproductive organs, and the development of secondary female SEX CHARACTERISTICS. Estrogenic chemicals include natural, synthetic, steroidal, or non-steroidal compounds.Nonoxynol: Nonionic surfactant mixtures varying in the number of repeating ethoxy (oxy-1,2-ethanediyl) groups. They are used as detergents, emulsifiers, wetting agents, defoaming agents, etc. Nonoxynol-9, the compound with 9 repeating ethoxy groups, is a spermatocide, formulated primarily as a component of vaginal foams and creams.Coitus: The sexual union of a male and a female, a term used for human only.Abortion Applicants: Individuals requesting induced abortions.XanthurenatesAbortion, Legal: Termination of pregnancy under conditions allowed under local laws. (POPLINE Thesaurus, 1991)Apraxias: A group of cognitive disorders characterized by the inability to perform previously learned skills that cannot be attributed to deficits of motor or sensory function. The two major subtypes of this condition are ideomotor (see APRAXIA, IDEOMOTOR) and ideational apraxia, which refers to loss of the ability to mentally formulate the processes involved with performing an action. For example, dressing apraxia may result from an inability to mentally formulate the act of placing clothes on the body. Apraxias are generally associated with lesions of the dominant PARIETAL LOBE and supramarginal gyrus. (From Adams et al., Principles of Neurology, 6th ed, pp56-7)Age Factors: Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.Marriage: The social institution involving legal and/or religious sanction whereby individuals are joined together.Case-Control Studies: Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group.Women's Health: The concept covering the physical and mental conditions of women.Reproductive History: An important aggregate factor in epidemiological studies of women's health. The concept usually includes the number and timing of pregnancies and their outcomes, the incidence of breast feeding, and may include age of menarche and menopause, regularity of menstruation, fertility, gynecological or obstetric problems, or contraceptive usage.Questionnaires: Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.Sexually Transmitted Diseases: Diseases due to or propagated by sexual contact.Coitus Interruptus: A contraceptive method whereby coitus is purposely interrupted in order to prevent EJACULATION of SEMEN into the VAGINA.Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.Amenorrhea: Absence of menstruation.Birth Rate: The number of births in a given population per year or other unit of time.Men: Human males as cultural, psychological, sociological, political, and economic entities.Postpartum Period: In females, the period that is shortly after giving birth (PARTURITION).Chlormadinone Acetate: An orally active synthetic progestational hormone used often in combinations as an oral contraceptive.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Counseling: The giving of advice and assistance to individuals with educational or personal problems.Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure.Family Planning Policy: A course or method of action selected, usually by a government, to guide and determine present and future decisions on population control by limiting the number of children or controlling fertility, notably through family planning and contraception within the nuclear family.United StatesNorprogesterones: Progesterones which have undergone ring contraction or which are lacking carbon 18 or 19.Vasectomy: Surgical removal of the ductus deferens, or a portion of it. It is done in association with prostatectomy, or to induce infertility. (Dorland, 28th ed)Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.Delayed-Action Preparations: Dosage forms of a drug that act over a period of time by controlled-release processes or technology.Natural Family Planning Methods: A class of natural contraceptive methods in which SEXUAL ABSTINENCE is practiced a few days before and after the estimated day of ovulation, during the fertile phase. Methods for determining the fertile period or OVULATION DETECTION are based on various physiological indicators, such as circulating hormones, changes in cervical mucus (CERVIX MUCUS), and the basal body temperature.Thromboembolism: Obstruction of a blood vessel (embolism) by a blood clot (THROMBUS) in the blood stream.Reproductive Medicine: A medical-surgical specialty concerned with the morphology, physiology, biochemistry, and pathology of reproduction in man and other animals, and on the biological, medical, and veterinary problems of fertility and lactation. It includes ovulation induction, diagnosis of infertility and recurrent pregnancy loss, and assisted reproductive technologies such as embryo transfer, in vitro fertilization, and intrafallopian transfer of zygotes. (From Infertility and Reproductive Medicine Clinics of North America, Foreword 1990; Journal of Reproduction and Fertility, Notice to Contributors, Jan 1979)Single Person: The unmarried man or woman.Sexual Partners: Married or single individuals who share sexual relations.Dysmenorrhea: Painful menstruation.Religion and SexAppointments and Schedules: The different methods of scheduling patient visits, appointment systems, individual or group appointments, waiting times, waiting lists for hospitals, walk-in clinics, etc.Women's Health Services: Organized services to provide health care to women. It excludes maternal care services for which MATERNAL HEALTH SERVICES is available.Barium: An element of the alkaline earth group of metals. It has an atomic symbol Ba, atomic number 56, and atomic weight 138. All of its acid-soluble salts are poisonous.Menopause: The last menstrual period. Permanent cessation of menses (MENSTRUATION) is usually defined after 6 to 12 months of AMENORRHEA in a woman over 45 years of age. In the United States, menopause generally occurs in women between 48 and 55 years of age.Menarche: The first MENSTRUAL CYCLE marked by the initiation of MENSTRUATION.Choice Behavior: The act of making a selection among two or more alternatives, usually after a period of deliberation.Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.Venous Thrombosis: The formation or presence of a blood clot (THROMBUS) within a vein.Acne Vulgaris: A chronic disorder of the pilosebaceous apparatus associated with an increase in sebum secretion. It is characterized by open comedones (blackheads), closed comedones (whiteheads), and pustular nodules. The cause is unknown, but heredity and age are predisposing factors.Health Services Accessibility: The degree to which individuals are inhibited or facilitated in their ability to gain entry to and to receive care and services from the health care system. Factors influencing this ability include geographic, architectural, transportational, and financial considerations, among others.Uganda: A republic in eastern Africa, south of SUDAN and west of KENYA. Its capital is Kampala.Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug.Odds Ratio: The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases.Menorrhagia: Excessive uterine bleeding during MENSTRUATION.Pyridoxine: The 4-methanol form of VITAMIN B 6 which is converted to PYRIDOXAL PHOSPHATE which is a coenzyme for synthesis of amino acids, neurotransmitters (serotonin, norepinephrine), sphingolipids, aminolevulinic acid. Although pyridoxine and Vitamin B 6 are still frequently used as synonyms, especially by medical researchers, this practice is erroneous and sometimes misleading (EE Snell; Ann NY Acad Sci, vol 585 pg 1, 1990).Ethiopia: An independent state in eastern Africa. Ethiopia is located in the Horn of Africa and is bordered on the north and northeast by Eritrea, on the east by Djibouti and Somalia, on the south by Kenya, and on the west and southwest by Sudan. Its capital is Addis Ababa.Risk: The probability that an event will occur. It encompasses a variety of measures of the probability of a generally unfavorable outcome.Premenopause: The period before MENOPAUSE. In premenopausal women, the climacteric transition from full sexual maturity to cessation of ovarian cycle takes place between the age of late thirty and early fifty.Menstrual Hygiene Products: Personal care items used during MENSTRUATION.Marital Status: A demographic parameter indicating a person's status with respect to marriage, divorce, widowhood, singleness, etc.Indians, Central American: Individual members of Central American ethnic groups with ancient historic ancestral origins in Asia. Mexican Indians are not included.Endometrium: The mucous membrane lining of the uterine cavity that is hormonally responsive during the MENSTRUAL CYCLE and PREGNANCY. The endometrium undergoes cyclic changes that characterize MENSTRUATION. After successful FERTILIZATION, it serves to sustain the developing embryo.Adolescent Behavior: Any observable response or action of an adolescent.Thrombophlebitis: Inflammation of a vein associated with a blood clot (THROMBUS).Ambulatory Care Facilities: Those facilities which administer health services to individuals who do not require hospitalization or institutionalization.Spermatozoa: Mature male germ cells derived from SPERMATIDS. As spermatids move toward the lumen of the SEMINIFEROUS TUBULES, they undergo extensive structural changes including the loss of cytoplasm, condensation of CHROMATIN into the SPERM HEAD, formation of the ACROSOME cap, the SPERM MIDPIECE and the SPERM TAIL that provides motility.Vagina: The genital canal in the female, extending from the UTERUS to the VULVA. (Stedman, 25th ed)MissouriAntispermatogenic Agents: Agents, either mechanical or chemical, which destroy spermatozoa in the male genitalia and block spermatogenesis.Women: Human females as cultural, psychological, sociological, political, and economic entities.Administration, Cutaneous: The application of suitable drug dosage forms to the skin for either local or systemic effects.Nonprescription Drugs: Medicines that can be sold legally without a DRUG PRESCRIPTION.Uterine Cervical Neoplasms: Tumors or cancer of the UTERINE CERVIX.Intrauterine Device Expulsion: Spontaneous loss of INTRAUTERINE DEVICES from the UTERUS.Hormone Replacement Therapy: Therapeutic use of hormones to alleviate the effects of hormone deficiency.Cyproterone Acetate: An agent with anti-androgen and progestational properties. It shows competitive binding with dihydrotestosterone at androgen receptor sites.Gonadal Steroid Hormones: Steroid hormones produced by the GONADS. They stimulate reproductive organs, germ cell maturation, and the secondary sex characteristics in the males and the females. The major sex steroid hormones include ESTRADIOL; PROGESTERONE; and TESTOSTERONE.Patient Acceptance of Health Care: The seeking and acceptance by patients of health service.Health Surveys: A systematic collection of factual data pertaining to health and disease in a human population within a given geographic area.Ovulation: The discharge of an OVUM from a rupturing follicle in the OVARY.Interviews as Topic: Conversations with an individual or individuals held in order to obtain information about their background and other personal biographical data, their attitudes and opinions, etc. It includes school admission or job interviews.NicaraguaReproductive Behavior: Human behavior or decision related to REPRODUCTION.Vaginal Creams, Foams, and Jellies: Medicated dosage forms for topical application in the vagina. A cream is a semisolid emulsion containing suspended or dissolved medication; a foam is a dispersion of a gas in a medicated liquid resulting in a light, frothy mass; a jelly is a colloidal semisolid mass of a water soluble medicated material, usually translucent.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Estrogen Replacement Therapy: The use of hormonal agents with estrogen-like activity in postmenopausal or other estrogen-deficient women to alleviate effects of hormone deficiency, such as vasomotor symptoms, DYSPAREUNIA, and progressive development of OSTEOPOROSIS. This may also include the use of progestational agents in combination therapy.Contraception, Barrier: Methods of contraception in which physical, chemical, or biological means are used to prevent the SPERM from reaching the fertilizable OVUM.Danazol: A synthetic steroid with antigonadotropic and anti-estrogenic activities that acts as an anterior pituitary suppressant by inhibiting the pituitary output of gonadotropins. It possesses some androgenic properties. Danazol has been used in the treatment of endometriosis and some benign breast disorders.Smoking: Inhaling and exhaling the smoke of burning TOBACCO.Nandrolone: C18 steroid with androgenic and anabolic properties. It is generally prepared from alkyl ethers of ESTRADIOL to resemble TESTOSTERONE but less one carbon at the 19 position.Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data.Great BritainCervix Uteri: The neck portion of the UTERUS between the lower isthmus and the VAGINA forming the cervical canal.Family Characteristics: Size and composition of the family.Breast Neoplasms: Tumors or cancer of the human BREAST.Abnormalities, Drug-Induced: Congenital abnormalities caused by medicinal substances or drugs of abuse given to or taken by the mother, or to which she is inadvertently exposed during the manufacture of such substances. The concept excludes abnormalities resulting from exposure to non-medicinal chemicals in the environment.Population Control: Includes mechanisms or programs which control the numbers of individuals in a population of humans or animals.Progesterone: The major progestational steroid that is secreted primarily by the CORPUS LUTEUM and the PLACENTA. Progesterone acts on the UTERUS, the MAMMARY GLANDS and the BRAIN. It is required in EMBRYO IMPLANTATION; PREGNANCY maintenance, and the development of mammary tissue for MILK production. Progesterone, converted from PREGNENOLONE, also serves as an intermediate in the biosynthesis of GONADAL STEROID HORMONES and adrenal CORTICOSTEROIDS.Uterine Perforation: A hole or break through the wall of the UTERUS, usually made by the placement of an instrument or INTRAUTERINE DEVICES.Spermatogenesis: The process of germ cell development in the male from the primordial germ cells, through SPERMATOGONIA; SPERMATOCYTES; SPERMATIDS; to the mature haploid SPERMATOZOA.Mifepristone: A progestational and glucocorticoid hormone antagonist. Its inhibition of progesterone induces bleeding during the luteal phase and in early pregnancy by releasing endogenous prostaglandins from the endometrium or decidua. As a glucocorticoid receptor antagonist, the drug has been used to treat hypercortisolism in patients with nonpituitary CUSHING SYNDROME.Gynecology: A medical-surgical specialty concerned with the physiology and disorders primarily of the female genital tract, as well as female endocrinology and reproductive physiology.Pregnanediol: An inactive metabolite of PROGESTERONE by reduction at C5, C3, and C20 position. Pregnanediol has two hydroxyl groups, at 3-alpha and 20-alpha. It is detectable in URINE after OVULATION and is found in great quantities in the pregnancy urine.Megaloblasts: Red blood cell precursors, corresponding to ERYTHROBLASTS, that are larger than normal, usually resulting from a FOLIC ACID DEFICIENCY or VITAMIN B 12 DEFICIENCY.GuatemalaPregnancy Rate: The ratio of the number of conceptions (CONCEPTION) including LIVE BIRTH; STILLBIRTH; and fetal losses, to the mean number of females of reproductive age in a population during a set time period.Nigeria: A republic in western Africa, south of NIGER between BENIN and CAMEROON. Its capital is Abuja.Ovarian Neoplasms: Tumors or cancer of the OVARY. These neoplasms can be benign or malignant. They are classified according to the tissue of origin, such as the surface EPITHELIUM, the stromal endocrine cells, and the totipotent GERM CELLS.Urban Population: The inhabitants of a city or town, including metropolitan areas and suburban areas.Follicular Phase: The period of the MENSTRUAL CYCLE representing follicular growth, increase in ovarian estrogen (ESTROGENS) production, and epithelial proliferation of the ENDOMETRIUM. Follicular phase begins with the onset of MENSTRUATION and ends with OVULATION.Intrauterine Device Migration: The shifting in position or location of an INTRAUTERINE DEVICE from its original placement.Administration, Intravaginal: The insertion of drugs into the vagina to treat local infections, neoplasms, or to induce labor. The dosage forms may include medicated pessaries, irrigation fluids, and suppositories.Student Health Services: Health services for college and university students usually provided by the educational institution.Sexual Abstinence: Refraining from SEXUAL INTERCOURSE.Educational Status: Educational attainment or level of education of individuals.Rwanda: A republic in eastern Africa, south of UGANDA, east of DEMOCRATIC REPUBLIC OF THE CONGO, west of TANZANIA. Its capital is Kigali. It was formerly part of the Belgian trust territory of Ruanda-Urund.Estradiol: The 17-beta-isomer of estradiol, an aromatized C18 steroid with hydroxyl group at 3-beta- and 17-beta-position. Estradiol-17-beta is the most potent form of mammalian estrogenic steroids.Attitude: An enduring, learned predisposition to behave in a consistent way toward a given class of objects, or a persistent mental and/or neural state of readiness to react to a certain class of objects, not as they are but as they are conceived to be.Vaginal Smears: Collection of pooled secretions of the posterior vaginal fornix for cytologic examination.Factor V: Heat- and storage-labile plasma glycoprotein which accelerates the conversion of prothrombin to thrombin in blood coagulation. Factor V accomplishes this by forming a complex with factor Xa, phospholipid, and calcium (prothrombinase complex). Deficiency of factor V leads to Owren's disease.Multivariate Analysis: A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.Paternalism: Interference with the FREEDOM or PERSONAL AUTONOMY of another person, with justifications referring to the promotion of the person's good or the prevention of harm to the person. (from Cambridge Dictionary of Philosophy, 1995); more generally, not allowing a person to make decisions on his or her own behalf.Premenstrual Syndrome: A combination of distressing physical, psychologic, or behavioral changes that occur during the luteal phase of the menstrual cycle. Symptoms of PMS are diverse (such as pain, water-retention, anxiety, cravings, and depression) and they diminish markedly 2 or 3 days after the initiation of menses.Developing Countries: Countries in the process of change with economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures.Luteal Phase: The period in the MENSTRUAL CYCLE that follows OVULATION, characterized by the development of CORPUS LUTEUM, increase in PROGESTERONE production by the OVARY and secretion by the glandular epithelium of the ENDOMETRIUM. The luteal phase begins with ovulation and ends with the onset of MENSTRUATION.Zambia: A republic in southern Africa, south of DEMOCRATIC REPUBLIC OF THE CONGO and TANZANIA, and north of ZIMBABWE. Its capital is Lusaka. It was formerly called Northern Rhodesia.Libido: The psychic drive or energy associated with sexual instinct in the broad sense (pleasure and love-object seeking). It may also connote the psychic energy associated with instincts in general that motivate behavior.Madagascar: One of the Indian Ocean Islands off the southeast coast of Africa. Its capital is Antananarivo. It was formerly called the Malagasy Republic. Discovered by the Portuguese in 1500, its history has been tied predominantly to the French, becoming a French protectorate in 1882, a French colony in 1896, and a territory within the French union in 1946. The Malagasy Republic was established in the French Community in 1958 but it achieved independence in 1960. Its name was changed to Madagascar in 1975. (From Webster's New Geographical Dictionary, 1988, p714)Sex: The totality of characteristics of reproductive structure, functions, PHENOTYPE, and GENOTYPE, differentiating the MALE from the FEMALE organism.Birth Intervals: The lengths of intervals between births to women in the population.Confidence Intervals: A range of values for a variable of interest, e.g., a rate, constructed so that this range has a specified probability of including the true value of the variable.Venous Thromboembolism: Obstruction of a vein or VEINS (embolism) by a blood clot (THROMBUS) in the blood stream.Abortion, Criminal: Illegal termination of pregnancy.Pelvic Inflammatory Disease: A spectrum of inflammation involving the female upper genital tract and the supporting tissues. It is usually caused by an ascending infection of organisms from the endocervix. Infection may be confined to the uterus (ENDOMETRITIS), the FALLOPIAN TUBES; (SALPINGITIS); the ovaries (OOPHORITIS), the supporting ligaments (PARAMETRITIS), or may involve several of the above uterine appendages. Such inflammation can lead to functional impairment and infertility.Injections, Intramuscular: Forceful administration into a muscle of liquid medication, nutrient, or other fluid through a hollow needle piercing the muscle and any tissue covering it.Gossypol: A dimeric sesquiterpene found in cottonseed (GOSSYPIUM). The (-) isomer is active as a male contraceptive (CONTRACEPTIVE AGENTS, MALE) whereas toxic symptoms are associated with the (+) isomer.Risk Assessment: The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)Patient Compliance: Voluntary cooperation of the patient in following a prescribed regimen.

The effects of different formulations of oral contraceptive agents on lipid and carbohydrate metabolism. (1/5)

BACKGROUND: Oral contraceptives can induce changes in lipid and carbohydrate metabolism similar to those associated with an increased risk of coronary heart disease, including increased serum triglyceride, low-density lipoprotein (LDL) cholesterol, and insulin levels and decreased high-density lipoprotein (HDL) cholesterol levels. In this study, we examined whether modification of the type or dose of progestin in oral-contraceptive preparations diminishes these changes. METHODS: We measured plasma lipoprotein levels and performed oral glucose-tolerance tests in a cross section of 1060 women who took one of nine types of oral contraceptives for at least three months and 418 women who took none. Seven of the contraceptive formulations contained various doses and types of progestin: levonorgestrel in low (150 micrograms), high (250 micrograms), and triphasic (50 to 125 micrograms) doses; norethindrone in low (500 micrograms), high (1000 micrograms), and triphasic (500 to 1000 micrograms) doses; and a new progestin, desogestrel, in one dose (150 micrograms). All seven contained 30 to 40 micrograms of ethinyl estradiol. Two additional formulations contained progestin alone. RESULTS: As compared with controls, women taking combination drugs did not have increased serum total cholesterol levels but did have increases of 13 to 75 percent in fasting triglyceride levels. Levels of LDL cholesterol were reduced by 14 percent in women taking the combination containing desogestrel and by 12 percent in those taking low-dose norethindrone. Levels of HDL cholesterol were lowered by 5 percent and 16 percent by the combinations containing low-dose and high-dose levonorgestrel, respectively; these decreases were due to reductions of 29 percent and 43 percent, respectively, in the levels of HDL subclass 2. The combination pill containing high-dose norethindrone did not affect HDL cholesterol levels, whereas that containing low-dose norethindrone increased HDL cholesterol levels by 10 percent. The desogestrel combination increased HDL cholesterol levels by 12 percent. Levels of apolipoproteins A-I, A-II, and B were generally increased by combination drugs. Depending on the dose and type of progestin, combination drugs were associated with plasma glucose levels on the glucose-tolerance test that were 43 to 61 percent higher than in controls, insulin responses 12 to 40 percent higher, and C-peptide responses 18 to 45 percent higher. Progestin-only formulations had only minor metabolic effects. CONCLUSIONS: The appropriate dose and type of progestin may reduce the adverse effects of oral contraceptives on many metabolic markers of risk for coronary heart disease. Progestin-only formulations or combinations containing desogestrel or low-dose norethindrone were associated wtih the most favorable profiles.  (+info)

Types of combined oral contraceptives used by US women. (2/5)


The epidemiology of endometrial cancer in young women. (3/5)

A case-control study was conducted in Los Angeles County, California, of 127 endometrial cancer cases aged 45 years or less at diagnosis, to investigate the role of fertility, obesity and exogenous oestrogens in the development of the disease in young women. Use of sequential oral contraceptive (SOCs) or oestrogen replacement therapy (ERT) for greater than or equal to 2 years was strongly associated with increased risk of endometrial cancer. After excluding these cases, since the SOC or ERT use was probably the cause of their disease, we were left with 110 case-control pairs for further study. Among these remaining case-control pairs increasing parity was strongly associated with decreased risk (relative risk of 0.12 for women of parity 3 compared to nulliparous women, P less than 0.001). Current weight was associated with increased risk (relative risk of 17.7 for women weighing greater than or equal to 190 lbs compared to women weighing less than 130 lbs, P less than 0.001). Combination oral contraceptive (COC) use was associated with a decreased risk, which decreased with duration of COC use (relative risk of approximately 0.28 at 5 years of use, P less than 0.001), but the estimate of the protective effect was reduced and became statistically non-significant when allowance was made for weight and parity. The protective effect of COC use was only clearly evident in women who had less than 3 live-births and weighed less than 170 lbs. These results provide further support for the "unopposed" oestrogen hypothesis of the aetiology of endometrial cancer.  (+info)

The effect of kind of carbohydrate in the diet and use of oral contraceptives on metabolism of young women. II. Serum lipid levels. (4/5)

The response of lipids in the blood between two groups of six young women was compared. Group 1 took oral contraceptives and group 2 had never taken oral contraceptives. Two experimental diets supplied about 13% of the calories from protein, 36% from fat, and 51% from carbohydrate. Of the carbohydrate, 84% was either sucrose or wheat starch. Each diet was fed for 4 weeks in a cross-over design. In the portion of the research presented here, subjects were fed a high sucrose meal before each dietary period and after weeks 1 and 3 of each dietary period. Blood lipids were measured before and 30, 60, 120, and 180 min after each meal. Cholesterol and lipoproteins were not affected by the sucrose meal, but free fatty acid levels decreased significantly in both groups. The serum levels of triglycerides, beta-lipoproteins, and cholesterol were significantly higher in users than in nonusers of oral contraceptives. Free fatty acid levels were affected by an interaction between diet and time, and the decrease in response was greater after the sucrose than after the wheat starch diet. Triglycerides, cholesterol, and total lipids were not significantly different after the two carbohydrate diets.  (+info)

In vitro and in vivo metabolism of desogestrel in several species. (5/5)

The metabolism of desogestrel (13-ethyl-11-methylene-18, 19-dinor-17alpha-pregn-4-en-20-yn-17-ol), an orally active progestogen, was studied in vivo after administration of single oral doses to rats and dogs and in vitro using rat, rabbit, dog, and human liver microsomes. Metabolites were isolated and identified by NMR and MS analysis. After oral administration of [3H]desogestrel to rats and dogs, desogestrel was extensively metabolized in both species. Radioactivity was predominantly eliminated in the feces. In rats, desogestrel was metabolized mainly at the C3-, C5-, C11-, and C15-positions. Both in vivo and in vitro, the majority of metabolites were 3alpha-hydroxy,4,5alpha-dihydro derivatives. Other main metabolic routes for desogestrel in rats were 15alpha-hydroxylation and epoxidation of the C11-methylene moiety. In addition to phase I metabolites, glucuronic acid and sulfate conjugates of desogestrel were observed in vivo. In dogs, desogestrel was mainly metabolized at the C3- and C17-positions. In contrast to the rat metabolites, metabolites isolated from dog urine or feces were mainly 3beta-hydroxy,4,5alpha-dihydro derivatives. In most of the metabolites present in dog urine and feces, the five-membered D-ring was expanded to a six-membered D-ring, i.e. D-homoannulation to a 17A-keto-D-homo ring. D-Homo metabolites, which were major metabolites in plasma, urine, and feces of dogs, were not observed in vitro. In dog liver microsomes, the 3-keto metabolite of desogestrel was the major metabolite. Similarly to dog liver microsomes, rabbit and human liver microsomes mainly converted desogestrel to its 3-keto metabolite. Predominant positions for further hydroxylation of the 3-keto metabolite of desogestrel were the C6-position (6beta-hydroxy) and the ethyl substituent at the C13-position, for both species.  (+info)

  • This invention relates to a new method for preparing solid pharmaceutical compositions for oral administration of low-dose medications whose active ingredients have steroidal or steroid-like structures. (
  • Few guidelines exist for the use of estrogen, particularly low-dose oral contraceptives, during the perimenopausal years. (
  • In addition to adequate calcium supplementation and weight-bearing exercise, the use of low-dose oral contraceptives appears to be associated with a significant increase in bone density. (
  • Changes in circulating lipoproteins, which may be related to the risk for atherosclerotic vascular disease, were studied in a control group and in two groups of 24 or 26 women using different preparations of low-dose oral contraceptives for 3 months. (
  • Sixteen healthy women were treated with a low-dose OC (Loestrin 1/20) and a placebo for two consecutive 28-day cycles in a single-blind sequential trial. (
  • Treatment with St. John's Wort was associated with a significant 13-15% reduction in the dose exposure from the contraceptive. (
  • Given the current availability of the high sensitivity CRP test, it is possible to assess the effects of current low dose oral contraceptives on this biomarker for cardiovascular disease risk. (
  • Historically, the dose of a progestogen that produced secretory changes in the estrogen-primed endometrium was the one used in the first clinical contraceptive studies of that agent. (
  • At that point, the estrogen dose was increased until the product became clinically acceptable, that is, in terms of contraceptive efficacy and regulation of bleeding. (
  • It later became apparent that these levels of estrogen were unnecessarily high when it was learned that the progestogen dose alone provided a fully contraceptive effect. (
  • Only evidence from randomized controlled trials (RCTs) in which DMPA was given at a dose of 150mg every 3 months and NET-EN at a dose of 200mg every 2 months were included. (
  • In a study with 14 C-tolterodine solution in healthy volunteers who received a 5 mg oral dose, at least 77% of the radiolabeled dose was absorbed. (
  • It contains estradiol valerate and dienogest in 26 active tablets with sequential dose changes, followed by just two inactive tablets. (
  • Individual plasma dapivirine concentrations did not exceed 553 pg/mL and were well below plasma concentrations at the maximum tolerated dose for oral treatment (mean Cmax 2286 ng/mL). (
  • Estrogen doses, however, rather than undergoing proportional decreases, were retained at sufficiently high levels to ensure contraceptive efficacy of the product. (
  • A phase III, open-label, prospective, two-armed, multicenter, randomized, group sequential study to evaluate the efficacy and safety of subsequent treatment with the Zevalin (ibritumomab tiuxetan) stu. (
  • 1. A pharmaceutically acceptable nasal composition, in dosage unit form, for nasal administration to a female mammal for the purpose of mammalian contraception, said composition consisting essentially of, per nasal unit, a systemically effective contraceptive amount of a combination of progesterone and a pharmaceutically acceptable, estrogenically active form of 17β-estradiol, together with a nontoxic pharmaceutically acceptable nasal carrier therefor, said composition comprising a nasal ointment or a nasal gel. (
  • In the shorter (1-year) single site study, 27% of DMPA users and 40% of NET-EN users were lost to follow up. (
  • Both DMPA and NET-EN are extensively used in developing countries, but may be priced very differently. (
  • Based on data from the Management Sciences for Health International Drug price Indicator Guide 2005, the acquisition cost per couple-year of protection in Namibia was $6.0056 for DMPA and $6.2094 for NET-EN (4). (
  • Both DMPA and NET-EN appear on the core list of the WHO Model Essential Medicines List (14th edition)(5). (
  • The DMPA injection must be repeated every 3 months for continuing contraceptive benefit. (
  • Dimethisterone, also known as 6α,21-dimethylethisterone or as 6α,21-dimethyl-17α-ethynyltestosterone, as well as 17α-ethynyl-6α,21-dimethylandrost-4-en-17β-ol-3-one or as 6α,21-dimethyl-17β-hydroxy-17α-pregn-4-en-20-yn-3-one, is a synthetic androstane steroid and a derivative of testosterone. (
  • Gynecology A preparation of synthetic hormones intended to make a ♀ inconceivable by inhibiting ovulation OC formats Sequential method, combined method. (
  • Significant differences were found between the one pregnant group and the two reference groups as well as between the one pregnant group and two of the three groups using oral contraceptives. (
  • Association with stroke and with myocardial infarction seems to have been established and where other risk factors for either exist, such as smoking, hyperlipidaemia or hypertension, it would seem wise for other contraceptive measures to be used. (
  • After oral administration, tolterodine is metabolized in the liver, resulting in the formation of the 5-hydroxymethyl derivative, a major pharmacologically active metabolite. (
  • Tolterodine is extensively metabolized by the liver following oral dosing. (
  • Both of these new contraceptives are highly effective (≤0.3% pregnancies with typical use in the first year [ 5 ]) and require relatively little active involvement from the patient. (