Study on 80 symptomatic menorrhagia patients less than 18 years old treated at Institute for Protection of Mother and Newborn in the year 2000. Results: the rate of patients with irregular menstruation was highest (38.75%). 70% of patients lived in rural, so the rate of late hospital admission (>15 days) accounted for 73.75%. All patients suffered from anemia with 82.5% patients with moderate and severe anemia. Treatment with 2 tablets Rigevidon a day only one time in the evening until menorrhagia reduces, follows by 1 tablet a day for making artificial menstruation of 28 days, is effective in 96.25% patients. This finding showed that using Rigevidon for treating pubertal menorrhagia is simple, safe, and effective, no significant complication.
Menorrhagia ; Ethinyl Estradiol-Norgestrel Combination ; Therapeutics

There are a number of published reports aimed at clarifying the effect of hormonal contracept -ives upon the quantity and quality of breast milk during postpartum and lactation periods. As to the volume of milk produced by breast feeding mothers, many authors seem to have agreed on a decrease as an established pattern in the periods following regular administration of oral contraceptives containing estrogen in varying dosage. The quality of milk following administration of hormonal contraceptives, however, remsins a controversial issue. Korea's experience in oral contraceptive is rather a brief one, but use of Eugynon has been widespread and frequent since this hormonal contraceptive was introduced into the national program in 1967. The authors have reviewed the potential significance of data concerning regular use of an oral contraceptive as affecting lactation, and have sought to clarify the interrelationship between the administration of Eugynon and quantity and quality of breast milk from mothers contracepting. with Eugynon in different periods following confinement. A total of 85 women, who were at different periods following deliveries, have been divided into, two groups, one comprising 28 women regularly taking oral pills and the other (57 women) not resorting to hormonal contraceptives if they were contracepting at all. 1. Milk Volume. In view of the possible influence of suckling on the amount of milk produced, efforts were made in this study to standardize the technique by extracting breastmilk by applying manual pressures on one side of the maw-nae, While the nipple on the other side was being sucked by the mother's own baby. The effetct of an exogenic ovarian hormone on the quantity as well as quality of breastmilk is generally understood to be inapparent until the drug is administered to women whose milk secreting function has been normalized. ") In the present study, it was observed that the decrease in the ammount of milk obtained from mothers in the periods following the 4th cycle of oral contraceptives or thereafter has turned out to be statistically insignificant. This result conforms i.u the findings by Tubari and others. It is assumed that it takes at lest 2 to 3 cycles of use before mammary glands are functionally adjusted to the use of exogenic hormonal contraceptives. 2. Specific Gravity and Composition of Milk There was no noticeable change in the protein and chloride content following continuous administration of ore.l contraceptives, while meaningful changes were observed in fat (increase) and calcium (decrease up to the 5th cycle use) contents. Also, there was a rather significant decrease in the specific gravity in the period following administration of the first cycle of the oral contraceptive. The findings from the present study partially conforms the results published by Ramadan and others, who reported that little change was noticed in the contents of total solids. ash, chlorides and lactose in the breast milk of women who had taken 4 cycles of ovosiston, although in our study lactose was not measured. Ramaden, however, reported that fat content did increase in the same milk, as in our study. A definitive conclusion, however, could not be made unless measures are taken to rule out the physiological changes of the maternal body affecting the composition of milks.
Breast Feeding ; Calcium ; Chlorides ; Contraceptive Agents ; Contraceptives, Oral ; Estrogens ; Ethinyl Estradiol-Norgestrel Combination ; Female ; Health Resorts ; Humans ; Lactation* ; Lactose ; Mammary Glands, Human ; Milk ; Milk, Human ; Mothers ; Nipples ; Postpartum Period ; Specific Gravity

Postcoital contraception or emergency contraception(EC), commonly known as the "morning after pills", prevents pregnancy after unprotected intercourse. A comprehensive definition of EC is as follows : "specific contraceptive methods that can be used as emergency measures to prevent pregnancy after unproteted intercourse". Both drugs and certain devices can be used for emergency contraception. The best-studied regimen(Yuzpe) consists of an ordinary combination of oral contraceptives containing ethinyl estradiol and norgestrel. Conventional clinical guidelines recommend a first dose within 72 hours after unprotected intercourse and a second dose 12 hours thereafter. These drugs are most effective when taken as soon as possible after the intercourse. The Yuzpe regimen reduced the risk of unintended pregnancy by at least 75% in clinical trials. The most common side effects of the Yuzpe method are nausea and vomiting. Levonorgestrel is the synthetic progesterone. The major benefits of levonorgestrel are the decreased side effects and greater contraceptive efficacy than Yuzpe regimen. Mifepristone (RU486) is a synthetic steroid that prevents progesterone from binding to the progesterone receptors and glucocorticoid receptors. It has been used extensively in Europe as an abortifacient and also has been used as an effective EC. Its common side effect is a delay in the onset of menses, leading to anxiety for the user. The intrauterine contraceptive device(IUCD) is the only method of emergency contraception available to women presenting beyond 72 h and within 5 days from unprotected intercourse. EC is not protective against infections such as STD(sexually transmitted diseases). There are many situations where EC is indicated, including condom rupture or slip, unplanned unprotected intercourse, incidental misuse of regular contraceptive methods, and sexual assault. Emergency contraceptive pills can prevent ovulation, but an alternative major mechanism of action is to prevent uterine implantation of the embryo at the endometrial level. A 3-week follow-up visit should be scheduled to assess the result and to counsel for regular contraception. EC provides a second chance at preventing undesired pregnancies. but it should not be used as a routine birth control method, because it is actually less effective and needs a higher dose at preventing pregnancies than most types of oral contraceptives. Widespread and appropriate use of EC will provide a promising means to reduce the incidence of unplanned pregnancy and to contribute to the women's health.
Anxiety ; Condoms ; Contraception ; Contraception, Postcoital ; Contraceptives, Oral ; Embryonic Structures ; Emergencies ; Ethinyl Estradiol ; Europe ; Female ; Follow-Up Studies ; Humans ; Incidence ; Levonorgestrel ; Methods ; Mifepristone ; Nausea ; Norgestrel ; Ovulation ; Pregnancy ; Pregnancy, Unplanned ; Progesterone ; Receptors, Glucocorticoid ; Receptors, Progesterone ; Rupture ; Vomiting ; Women's Health

The purpose of this study is to investigate the enantioselectivity of norgestrel (NG) transdermal permeation and the potential influence of linalool and lipids on the enantioselectivity. In vitro skin permeation studies of NG across the excised rat skins were performed with Valia-Chien diffusion cells, and the permeation samples were analyzed by enantioselective HPLC. The possible enantioselective permeation of NG across intact rat back skin and lipids extracted rat back skin and the influence of linalool were evaluated. The skin permeation rate of dl-NG was two times higher than that of l-NG when donor solutions (EtOH/H2O 2 : 8, v/v) containing l-NG or dl-NG. It may be mainly attributed to the solubility discrepancy between enantiomer and racemate. The enantioselective permeation of dl-NG across intact rat skin was observed when the donor solutions containing dl-linalool. The permeation flux of l-NG was 22% higher than that of d-NG. But interestingly, the enantioselective permeation of dl-NG disappeared under the same experimental condition except that the lipid extracted rat skin was used. Attenuated total reflection-fourier transform infrared spectroscopy analysis of stratum corneum showed that the wave number for asymmetric CH2 stretching vibrations of lipids treated with dl-linalool was greater than that of the control. The results indicated that the enantioselective permeation of NG may be contributed by the interaction between dl-linalool and lipids. More than half of lipids were composed of ceramides. The stereospecific interaction maybe existed among chiral enhancer (linalool), lipids (ceramides) and/or chiral drugs (NG).
Administration, Cutaneous ; Animals ; Lipids ; pharmacology ; Monoterpenes ; pharmacology ; Norgestrel ; pharmacokinetics ; Rats ; Skin Absorption ; drug effects ; Spectroscopy, Fourier Transform Infrared ; Stereoisomerism

We report a case of dislodged Levornogestrel-intrauterine system (LNG-IUS, Mirena®) without evidence of uterine perforation. A 37-year-old Para 4+1presented with 3 months history of lower abdominal pain. Examination and imaging showed that the device was not present in the uterine cavity. She underwent laparoscopic retrieval of Mirena®. There was no evidence of uterine perforation intra-operatively. This case illustrated the rare possibility of dislodged Mirena®intra-abdominally without evidence of uterine perforation. The management for missing IUS was reviewed.
Levonorgestrel

No abstract available.
Endometrial Neoplasms ; Female ; Humans ; Hyperplasia ; Levonorgestrel

OBJECTIVE: Levonorgestrel releasing intrauterine system (LNG-IUS) has been shown to treat patients with non-atypical & atypical endometrial hyperplasia (EH) successfully in many western studies. Our purpose was to examine the effectiveness of LNG-IUS in the treatment of Korean women with EH. METHODS: We conducted a prospective observational study of 12 women diagnosed with EH and treated with LNG-IUS insertion between February 2007 and August 2009 at the Department of Gynecology of Gangnam CHA Hospital, CHA University School of Medicine. Baseline endometrial biopsies were done before insertion of LNG-IUS, and outpatient follow-up endometrial biopsies were undertaken at 3-month intervals after insertion of LNG-IUS. We investigated the regression rate and the time to regression. RESULTS: Four patients had simple hyperplasia without atypia, 7 patients complex hyperplasia without atypia, and just 1 patient complex atypical hyperplasia. Complete regression of EH was achieved in all cases (100%, 12/12), with the significant proportion (66%, 8/12) achieving it within 3 months. The mean duration to regression was 4.5 months. All cases had regression within 9 months. In the case of complex atypical hyperplasia, the regression was attained at the 9th month after insertion of LNG-IUS. The mean follow-up duration was 12 months (range, 3 to 27 months). As long as LNG-IUS was maintained, the EH did not recur. CONCLUSION: LNG-IUS appears to be as highly effective in treating Korean women with EH.
Biopsy ; Endometrial Hyperplasia ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Hyperplasia ; Levonorgestrel ; Outpatients ; Prospective Studies

OBJECTIVES: We evaluated changes in mammographic density (MMGD) after hormone therapy (HT) using levonorgestrel (LNG) in Korean postmenopausal women. METHODS: In this retrospective study, 58 healthy postmenopausal women with no history of prior HT were included. Twenty-three women were given a cyclic regimen of estradiol valerate (E) 2 mg/day + LNG 0.075 mg/day and 25 untreated women served as a negative control and 10 women treated with continuous combined regimen of conjugated equine estrogen (CEE) 0.625 mg/day + medroxyprogesterone acetate (MPA) 2.5 mg/day as a positive control. Mammography was obtained at baseline and 1 year later, and MMGD was assessed. In addition, the change in the proportion of the dense area after HT was assessed using the J-image program. Data were analyzed with analysis of variance and chi-square or Fisher's exact test. RESULTS: There were no significant differences in baseline characteristics among three groups. After 1 year of HT, increase of BI-RADS grade in CEE + MPA group (7/9, 77.8%) was higher than in E + LNG group (2/16, 12.5%; P = 0.001). But there was no difference between untreated group (1/19, 5.3%) and E + LNG group (2/16, 12.5%; P = 0.446). In subgroup analysis of women with BI-RADS grade 3 at baseline, no significant difference. Changes in the proportion of dense areas assessed by the J-image program showed similar results. Regression analysis revealed that there was no correlation between baseline dense area and changes after HT in E + LNG group. CONCLUSION: HT using LNG did not influence MMGD in Korean postmenopausal women. Further study on breast cancer risk may be needed.
Breast Neoplasms ; Estradiol ; Estrogens ; Female ; Humans ; Levonorgestrel ; Mammary Glands, Human ; Mammography ; Medroxyprogesterone Acetate ; Retrospective Studies

OBJECTIVES: We evaluated changes in mammographic density (MMGD) after hormone therapy (HT) using levonorgestrel (LNG) in Korean postmenopausal women. METHODS: In this retrospective study, 58 healthy postmenopausal women with no history of prior HT were included. Twenty-three women were given a cyclic regimen of estradiol valerate (E) 2 mg/day + LNG 0.075 mg/day and 25 untreated women served as a negative control and 10 women treated with continuous combined regimen of conjugated equine estrogen (CEE) 0.625 mg/day + medroxyprogesterone acetate (MPA) 2.5 mg/day as a positive control. Mammography was obtained at baseline and 1 year later, and MMGD was assessed. In addition, the change in the proportion of the dense area after HT was assessed using the J-image program. Data were analyzed with analysis of variance and chi-square or Fisher's exact test. RESULTS: There were no significant differences in baseline characteristics among three groups. After 1 year of HT, increase of BI-RADS grade in CEE + MPA group (7/9, 77.8%) was higher than in E + LNG group (2/16, 12.5%; P = 0.001). But there was no difference between untreated group (1/19, 5.3%) and E + LNG group (2/16, 12.5%; P = 0.446). In subgroup analysis of women with BI-RADS grade 3 at baseline, no significant difference. Changes in the proportion of dense areas assessed by the J-image program showed similar results. Regression analysis revealed that there was no correlation between baseline dense area and changes after HT in E + LNG group. CONCLUSION: HT using LNG did not influence MMGD in Korean postmenopausal women. Further study on breast cancer risk may be needed.
Breast Neoplasms ; Estradiol ; Estrogens ; Female ; Humans ; Levonorgestrel ; Mammary Glands, Human ; Mammography ; Medroxyprogesterone Acetate ; Retrospective Studies

OBJECTIVETo observe the clinical efficacy of Bushen Huoxue Sanyu Decoction (BHSD) in treatment of adenomyosis (AM) patients.

METHODSSeventy AM patients of Shen deficiency blood stasis syndrome (SDBSS) were randomly assigned to two groups, the CM treatment group (50 cases) and the Mirena group (20 cases). Patients in the CM treatment group were treated with BHSD, one dose per day. Levonorgestrel intrauterine system (Mirena) was placed in the uterine cavity of those in the Mirena group. The therapeutic course for all was 3 months. Changes of dysmenorrhea, menstrual quantity, SDBSS, CM syndrome, uterine volume, and serum CA125 levels were observed before and after treatment.

RESULTSCompared with before treatment in the same group, scores for dysmenorrhea integral, scores for menstrual quantity, scores for SDBSS, and scores for CM syndrome all decreased in the two groups after treatment (P < 0.01). Compared with before treatment in the same group, the uterine volume was reduced after treatment in the two groups (P < 0.05) and serum carbohydrate antigen CA125 levels decreased between the two groups (P < 0.05, P < 0.01). Compared with the Mirena group, scores for dysmenorrhea integral increased and scores for SDBSS decreased in the CM treatment group (P < 0.01, P < 0.05). There was no statistical difference in the uterine volume or serum carbohydrate antigen CA125 levels (P > 0.05).

CONCLUSIONSBHSD could effectively alleviate main symptoms of AM patients of QSBSS such as dysmenorrhea, profuse menstrual blood volume, and increased uterine volume, and lower scores for QSBSS and the total score for CM syndrome.

Adenomyosis ; drug therapy ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Dysmenorrhea ; Female ; Humans ; Levonorgestrel ; therapeutic use