Guest guest Posted May 9, 2005 Report Share Posted May 9, 2005 " I realize that there must be an individual sweet spot for both E and P for everyone, but how to balance those and any other hormones is the hard part. " Well said Karin Carole > > There have been a number of reports of hair loss for women on the Wiley > > Protocol. I personally lost massive amounts of hair in the third and 4th > > cycles during the progesterone dosing. This did not stop until I > > significantly lowered my dose. I had many other side effects, but this note > > is focused on hair loss. Below are studies discussing this issue and other > > effects too. > > > > Laurel > > > > > > > > Saudi Med J. 2000 Apr;21(4):348-51. Related > > <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Display & dopt=pu > > bmed_pubmed & from_uid=11533816> Articles, Links > > <javascript:PopUpMenu2_Set(Menu11533816);> > > > > Efficacy and acceptability of depo-medroxyprogesterone acetate injection. As > > a method of contraception in Saudi Arabia. > > > > Sobande AA, Al-Bar HM, Archibong EI, Sadek AA. > > > > Department of Obstetrics & Gynecology, College of Medicine & Medical Sciences, > > King Khalid University, PO Box 641, Abha, Kingdom of Saudi Arabia. > > > > OBJECTIVE: To determine the efficacy and acceptability of > > Depo-Medroxyprogesterone acetate (depo-provera) among the women using that > > method of contraception at King Faisal Military Hospital in the south-west > > region of Saudi Arabia. METHODS: A preliminary retrospective and > > questionnaire analysis of 165 Saudi women who had depo-provera as a method > > of contraception at the contraception clinic of King Faisal Military > > Hospital over a period of 2 months. RESULTS: The mean age of the women was > > 31.21 years and the mean parity 6.77. There was no pregnancy reported during > > the period of use of the contraceptive method which ranged from 3 months to > > 7.25 years. The side effects were mainly irregular spotting (69%), > > continuous bleeding per vaginam (7%), amenorrhoea (8%) and menorrhagia (1%). > > The rest reported normal menstrual pattern. Irregular spotting was common in > > women who had used the method for less than 2 years while amenorrhoea was > > the most common menstrual abnormality after 3 years of use. The other > > complaints included weight gain, loss of hair, abdominal pain and backache. > > The side effects were not acceptable to 4% of the women and they tried other > > methods of contraception. Thirteen percent of the women became pregnant > > after stopping the injections within intervals varying between 6 months to 2 > > years. Seventeen percent were using the method for the 2nd time. CONCLUSION: > > Depo-provera is a very effective form of contraception in our community. > > While a few of the patients (4%) in our series would try other methods if > > not happy with the side effects, the majority were prepared to cope with the > > side effects as long as the desired prevention of pregnancy was guaranteed. > > Further studies are needed to validate these findings. > > > > > > > > > > > > Vet Dermatol. 2003 Apr;14(2):91-7. Related > > <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Display & dopt=pu > > bmed_pubmed & from_uid=12662266> Articles, Links > > <javascript:PopUpMenu2_Set(Menu12662266);> > > > > Retrospective evaluation of sex hormones and steroid hormone intermediates > > in dogs with alopecia. > > > > LA, Hnilica KA, Rohrbach BW, Oliver JW. > > > > Department of Small Animal Clinical Sciences, University of Tennessee, > > Knoxville, TN 37996-4544, USA. lfrank@u... > > > > The purpose of this study was to determine if there are specific steroid > > hormone aberrations associated with suspect endocrine alopecias in dogs in > > whom hypothyroidism and hyperadrenocorticism have been excluded. Steroid > > hormone panels submitted to the UTCVM endocrinology laboratory over a > > 7.5-year period (783 samples) from dogs with alopecia were reviewed. During > > this period, 276 dogs met the criteria for inclusion and were comprised of > > 54 different breeds. Approximately 73% of dogs had at least one baseline or > > post-ACTH stimulation steroid hormone intermediate greater than the normal > > range. The most frequent hormone elevation noted was for progesterone (57.6% > > of samples). When compared with normal dogs, oestradiol was significantly > > greater in Keeshond dogs and progesterone was significantly greater in > > Pomeranian and Siberian Husky dogs. Not all individual dogs had hormone > > abnormalities. Chow Chow, Samoyed and Malamute dogs had the greatest > > percentage of normal steroid hormone intermediates of the dogs in this > > study. Baseline cortisol concentrations were significantly correlated with > > progesterone, 17-hydroxyprogesterone (17-OHP) and androstenedione. Results > > of this study suggest that the pathomechanism of the alopecia, at least for > > some breeds, may not relate to steroid hormone intermediates and emphasizes > > the need for breed specific normals. > > > > Lyon Pharm. 1984 Nov;35(6):385-93. Related > > <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Display & dopt=pu > > bmed_pubmed & from_uid=12280590> Articles, Links > > <javascript:PopUpMenu2_Set(Menu12280590);> > > > > 57% of the dogs with alopecia were progesterone dominant - L > > > > [Oral contraception: failures and risks] > > > > [Article in French] > > > > Foussard-blanpin O, Paillot-renaud P, Bruneau-bigot A. > > > > PIP: This work describes oral contraceptives (OCs) in current use and > > examines their risks. OC pills are composed of synthetic estrogens, usually > > either ethinyl estradiol or mestranol, and progestins. Either estrogens or > > progestins can be used alone, but combinations permit smaller doses to be > > used. Combined pills are available in monophasic, biphasic, or triphasic > > formulations. Different modalities of administration are also available for > > progestin-only pills. The " morning after " pill containing high doses of > > steroids to be taken within 72 hours of unprotected intercourse can contain > > either estrogen or progestin alone or combined. The mechanisms of action of > > OCs vary according to the type of pill. Classic combined OCs inhibit > > ovulation, render the cervical mucus inhospitable to sperm, and cause > > endometrial atrophy which hinders nidation. Low-dose pills have various > > effects but in general depend on changes in the cervical mucus for their > > contraceptive effect. Pregnancy may result from forgetting pills or using > > them incorrectly, or in the case of low-dose pills may occur even if they > > are used correctly. Some drugs can lower the concentrations of the OC > > hormones at the level of the receptors by hindering their intestinal > > absorption or by increasing the metabolic power of the liver. Considerable > > individual variability limits the incidence of pill failure due to drug > > interactions, but OC use should be avoided if rifampicine or certain other > > drugs are used. Among undesirable effects of OCs on endocrine glands and > > reproductive function are the adaptation syndrome characterized by symptoms > > similar to those of early pregnancy and reversible in most but not all > > women; galactorrhea resulting from diminished levels of " prolactin > > inhibiting factor " ; and virilizing effects such as alopecia, hirsutism, and > > acne usually occurring during use of high-dose formulations. Pills should be > > carefully adapted to the hormonal profile of the user to avoid these side > > effects. OCs very rarely entail longterm infertility. OCs in current use do > > not appear to be teratogenic but it is advisable to wait 2 months after > > termination of use before becoming pregnant. Lactation is a contraindication > > to OC use. Combined OCs frequently cause problems in glucose tolerance of > > variable significance. Low-dose progestins do not seem to affect lipid > > metabolism, but low and normal dose combined pills may provoke increases in > > the levels of cholesterol and triglycerides. OCs are implicated in vascular > > accidents of various kinds, but low-dose pills are better tolerated. > > Cardiovascular risks are increased by age, smoking, use of alcohol, and > > excess fat in the diet. Hepatobiliary complications may occur during pill > > use. The carcinogenic role of OCx remains controversial, although growth of > > preexisting breast cancers is accelerated with pill use. The multifactorial > > etiologies of cardiovascular ailments, atherosclerosis, and cancerous tumors > > make the role of OCs difficult to assess. OCs can interact with various > > drugs, heightening the undesirable effects of each. Research on hormonal > > methods of contraception is currently directed toward achieving a better > > tolerance and administration of both male and female methods. > > > > PMID: 12280590 [PubMed - indexed for MEDLINE] > > > > Work Woman. 1994 Jul;:68-70, 72, 84. Related > > <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Display & dopt=pu > > bmed_pubmed & from_uid=12291485> Articles, Links > > <javascript:PopUpMenu2_Set(Menu12291485);> > > > > Birth control over 30. > > > > Asnes M. > > > > PIP: Among 30-40 year old women, 40% of pregnancies are unplanned, which is > > indicative of the unreliability of the birth control methods they are using. > > The 1992 Ortho Birth Control Study interviewed almost 7000 women, of whom 8% > > listed withdrawal and 4% listed the rhythm method. These two methods have > > failure rates of 24% and 19%, respectively. Birth control methods often > > disappoint the users and increasingly they turn to sterilization. 48% of > > married women aged 15-44 had themselves been sterilized or had a sterilized > > partner in the Ortho survey. Although reversal of tubal ligation succeeds in > > 43-88% of cases, conception cannot be guaranteed. For women over the age of > > 30 who are healthy and do not smoke, low-estrogen or no-estrogen oral > > contraceptive pills are considered safe. Taking the pill also helps prevent > > ovarian and endometrial cancer. The failure rate is 6%. Barrier methods also > > offer protection from sexually transmitted diseases including HIV. Condoms > > are favored by 33% of unmarried women and 19% of married women. Sexually > > active 40-44 year old unmarried women run a 14-19% risk of contracting a > > sexually transmitted disease (STD) in a 12-month period. Diaphragms offer > > some protection against STDs, but their failure rate is 18%. IUDs are > > regaining popularity, but only 1% of women use them (ParaGard T380A or > > Progestasert). Pelvic inflammatory disease is the reason: a 1992 study > > showed that 0.97% of women developed it within 20 days of use. Norplant is a > > long-term implant containing levonorgestrel with a failure rate of 0.5%. A > > 1993 study followed 1253 implant users over 12 months and found a very low > > rate of pregnancy, but 75% experienced some side effects during the first > > year. About half of the women using Norplant removed it after 2.5 years > > because of irregular bleeding. Depo-Provera is an injectable administered > > every 3 months, but after removal it can take up to a year for ovulation to > > return. Side effects may include hair loss and weight gain; and links to > > breast cancer have also been suggested. > > <http://www.ncbi.nlm.nih.gov/coreweb/images/tabs/pixel.gif> > > <http://www.ncbi.nlm.nih.gov/coreweb/images/tabs/pixel.gif> > > > > 1: J Adolesc Health. 1998 Aug;23(2):81-8. Related > > <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Display & dopt=pu > > bmed_pubmed & from_uid=9714170> Articles, Links > > <javascript:PopUpMenu2_Set(Menu9714170);> > > > > Long-term depot medroxyprogesterone acetate (Depo-Provera) use in inner-city > > adolescents. > > > > Polaneczky M, Liblanc M. > > > > Department of Obstetrics and Gynecology, New York Hospital--Cornell Medical > > Center, New York 10021, USA. > > > > PURPOSE: To determine Depo-Provera continuation rates and reasons for its > > discontinuation among adolescents. STUDY DESIGN: Medical record reviews and > > telephone interviews with 159 adolescents who initiated Depo-Provera use > > between 1 December 1992 and 31 December 1995 at two clinics in New York > > City. Depo-Provera continuation was measured using lifetable analysis. > > RESULTS: The mean age was 17.7 +/- 1.5 years, with a median of 1 pregnancy > > (range 0-11). Mean follow-up was 23.4 +/- 10.7 months. Depo-Provera > > continuation rates were 71% at 3 months, 48% at 6 months, and 27% at 12 > > months, and were not affected by age, race, pregnancy or contraceptive > > history, clinic, or foster care status. Forty-three subjects (37% of > > discontinuers) restarted Depo-Provera during the study period, with a mean > > time to restart of 8.4 months after the last Depo-Provera injection. Side > > effects were the main reported reason for Depo-Provera discontinuation, > > primarily menstrual irregularities (26%) and weight gain (18%). Seventy > > percent of those discontinuing Depo-Provera owing to irregular bleeding did > > so after only one injection. For 23%, the single reason for discontinuation > > was appointment noncompliance. Restart rates were lowest among those who > > reported irregular bleeding (15%), weight gain (9%), and hair loss (10%), > > and highest among those discontinuing owing to missed appointments (87%) (p > > < 0.05). Pregnancies occurred in 19% of Depo-Provera discontinuers. > > CONCLUSION: Although Depo-Provera continuation rates among adolescents are > > low, over a third of discontinuers may restart the method. Aggressive > > management of side effects and assistance with appointment follow-up may > > improve long-term use. High pregnancy rates warrant close follow-up after > > Depo-Provera discontinuation. > > > > PIP: Depo-Provera continuation rates and reasons for discontinuation among > > low-income US adolescents were investigated through a review of the records > > of the 159 teens who initiated use of this method at two inner-city clinics > > in New York City, New York (US), during 1992-95. At both study sites, > > Depo-Provera was available as a family planning option without parental > > consent. Mean age of acceptors was 17.7 years, with a median of one prior > > pregnancy. Almost all were unmarried, Black or Hispanic, and Medicaid > > recipients. At follow-up (mean duration, 23.4 months), only 21 teens (13%) > > were still using Depo-Provera; 115 (72%) had discontinued use and the > > remaining 23 had been lost to follow-up. The median duration of Depo-Provera > > use was 6.9 months. Continuation rates were 71% at 3 months, 48% at 6 > > months, 27% at 12 months, and 15% at 18 months. Side effects, especially > > menstrual irregularities (25%) and weight gain (19%), were the main reason > > for Depo-Provera discontinuation. 70% of those discontinuing the method for > > irregular bleeding did so after only one injection. Another 23% discontinued > > because of problems keeping appointments. Methods adopted after Depo-Provera > > discontinuation included oral contraceptives (31%) and condoms (21%); > > pregnancies occurred in 19% of discontinuers. 43 teens (37% of > > discontinuers) restarted Depo-Provera during the study period, after a mean > > interval of 8.4 months following the last injection. Restart rates were > > highest among those discontinuing due to missed appointments (87%) and > > lowest among those reporting irregular bleeding (15%), weight gain (9%), or > > hair loss (10%). Recommended, to improve Depo-Provera compliance among > > adolescents, are strategies to motivate attendance at follow-up appointments > > and manage method-related side effects. > > > > Also see: > > > > http://www.pharmahg.co.uk/female/bcp/theories.htm Quote Link to comment Share on other sites More sharing options...
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