991 research outputs found
Hormonal contraception in women with migraine: is progestogen-only contraception a better choice?
Get PDFA significant number of women with migraine has to face the choice of reliable hormonal contraception during their fertile life. Combined hormonal contraceptives (CHCs) may be used in the majority of women with headache and migraine. However, they carry a small, but significant vascular risk, especially in migraine with aura (MA) and, eventually in migraine without aura (MO) with additional risk factors for stroke (smoking, hypertension, diabetes, hyperlipidemia and thrombophilia, age over 35 years). Guidelines recommend progestogen-only contraception as an alternative safer option because it does not seem to be associated with an increased risk of venous thromboembolism (VTE) and ischemic stroke.
Potentially, the maintenance of stable estrogen level by the administration of progestins in ovulation inhibiting dosages may have a positive influence of nociceptive threshold in women with migraine. Preliminary evidences based on headache diaries in migraineurs suggest that the progestin-only pill containing desogestrel 75 μg has a positive effect on the course of both MA and MO in the majority of women, reducing the number of days with migraine, the number of analgesics and the intensity of associated symptoms. Further prospective trials have to be performed to confirm that progestogen-only contraception may be a better option for the management of both migraine and birth control. Differences between MA and MO should also be taken into account in further studies
European society of contraception statement on contraception in obese women
No full textAbstract The obesity 'epidemic' continues to increase, mostly but not only in developed countries. As overweight and obese women are at an increased risk for venous thromboembolism (VTE) at baseline and at a much higher risk during pregnancy, it is essential to help these women to plan pregnancies carefully and to use contraceptives with a positive ratio of benefits versus risks. The Expert Group on hormonal and molecular contraception of the European Society of Contraception convened to review the existing evidence and propose recommendations to the prescribers in line with most recent studies and with the Medical Eligibility Criteria of the World Health Organisation
Schwangerschaftsverhütung „up to date“: Kontraindikationen ausschliessen, Benefit nutzen
Get PDFDie mittlerweile zahlreichen modernen hormonellen Methoden zur Verhütung einer Schwangerschaft zeichnen sich dadurch aus, dass sie neben einer hohen Sicherheit auch positive Nebeneffekte, z.B. auf Akne oder Dysmenorrhö bieten. Voraussetzungen für die Auswahl der individuell günstigsten Option sind eine gründliche Anamnese sowie der Ausschluss von Kontraindikationen. Dies macht die folgende Kasuistik deutlich, die wir in Zusammenarbeit mit Dr. Gabriele Merki, Oberärztin und Leiterin der Schwangerschaftsverhütungssprechstunde, Klinik für Reproduktions-Endokrinologie, Universitätsspital Zürich, erstellt haben
European society of contraception statement on contraception in obese women
No full textAbstract The obesity 'epidemic' continues to increase, mostly but not only in developed countries. As overweight and obese women are at an increased risk for venous thromboembolism (VTE) at baseline and at a much higher risk during pregnancy, it is essential to help these women to plan pregnancies carefully and to use contraceptives with a positive ratio of benefits versus risks. The Expert Group on hormonal and molecular contraception of the European Society of Contraception convened to review the existing evidence and propose recommendations to the prescribers in line with most recent studies and with the Medical Eligibility Criteria of the World Health Organisation
sj-doc-1-msj-10.1177_13524585241228103 – Supplemental material for Expert opinion on the use of contraception in people with multiple sclerosis
No full textSupplemental material, sj-doc-1-msj-10.1177_13524585241228103 for Expert opinion on the use of contraception in people with multiple sclerosis by Jan Hillert, Riley Bove, Lisa B Haddad, Kerstin Hellwig, Maria Houtchens, Melinda Magyari, Gabriele S Merki-Feld, Scott Montgomery, Rossella E Nappi, Egon Stenager, Heidi Thompson, Zeliha Tulek, Elisabetta Verdun Di Cantogno and Manuela Simoni in Multiple Sclerosis Journal</p
Clinical features of migraine with onset prior to or during start of combined hormonal contraception: a prospective cohort study.
Get PDFMany studies have described the features of menstrually related migraines but there is a lack of knowledge regarding the features of migraine in combined hormonal contraceptive users (CHC). Hormone-withdrawal migraines in the pill-free period could differ from those in the natural cycle. Gynaecologic comorbidities, like dysmenorrhea and endometriosis, but also depression or a family history might modify the course of migraine. A better understanding of migraine features linked to special hormonal situations could improve treatment. For this prospective cohort study, we conducted telephone interviews with women using a CHC and reporting withdrawal migraine to collect information on migraine frequency, intensity, triggers, symptoms, pain medication, gynaecologic history and comorbidities (n = 48). A subset of women agreed to also document their migraines in prospective diaries. The mean number of migraine days per cycle was 4.2 (± 2.7). Around 50% of these migraines occurred during the hormone-free interval. Migraine frequency was significantly higher in women who suffered from migraine before CHC start (5.0 ± 3.1) (n = 22) in comparison to those with migraine onset after CHC start (3.5 ± 2.1) (n = 26). Menstrually related attacks were described as more painful (57.5%), especially in women with migraine onset before CHC use (72%) (p < 0.02). Comorbidities were rare, except dysmenorrhea. The majority of migraine attacks in CHC users occur during the hormone-free interval. Similar as in the natural cycle, hormone-withdrawal migraines in CHC users are very intense and the response to acute medication is less good, especially in those women, who developed migraine before CHC use
Family planning and contraception in people with multiple sclerosis: Perspectives for obstetricians, gynaecologists, and other health care professionals involved in reproductive planning
No full textPurpose: Multiple sclerosis (MS) is often diagnosed in people of reproductive age. However, family planning counselling is not always integrated within MS care. Decisions on family planning can be further complicated by potential side effects associated with several disease-modifying therapies. While neurologists may lack training in contraceptive use and family planning counselling, obstetricians and gynaecologists (OB-GYNs) and other health care professionals involved in reproductive life planning (RHCPs) may lack detailed knowledge and experience around the use of contemporary MS treatments. Material and methods: Through a modified Delphi consensus programme, a multidisciplinary steering committee of 13 international experts developed practical clinical recommendations on contraceptive use and family planning for people with MS (PwMS). This article offers insights to help OB-GYNs and RHCPs implement these recommendations, focusing on contraceptive decision-making and MS medications. Results: The perspectives discussed emphasise providing education on MS to OB-GYNs and other RHCPs, enabling informed counselling for PwMS and their partners regarding contraception and family planning. Close collaboration among the multidisciplinary team, including neurologists, is crucial in providing reproductive care for PwMS. Conclusions: The detailed perspectives provided aim to enable OB-GYNs and other RHCPs to provide informed counselling for PwMS and their partners regarding contraception and family planning
Rome. The Centre(s) Elsewhere
No full textRome: The Centre(s) Elsewhere is the result of a Berlage Institute postgraduate studio led by Pier Vittorio Aureli and Martino Tattara, in collaboration with Gabriele Mastrigli. The book proposes both the definition of a new urban strategy for the city of Rome and a critical framework through which to understand the city’s history. Going beyond the grandeur of the past and the uncertainty of the present, Rome: The Centre(s) Elsewhere offers a project for the city’s possible future by reclaiming the greatest and yet currently neglected asset of its urban structure: the consular roads system. The book is a critical and concise pamphlet about urban design and the project of the city. It represents an attempt to gather into one approach the issues of large-scale design, political thinking, and urban history. The publication is based on a research at the Berlage Institute Rotterdam entitled Rome: The Centre(s) Elsewhere, which took place during the 2008–2009 academic year. The research was presented first at The Berlage Institute in Rotterdam then in an international conference and an exhibition entitled Rome: The Centre(s) Elsewhere, held at the Casa dell’Architettura from 9 June to 7 July 2010 and organized as part of the Festa dell’Architettura of Rome 2010. Together with being co-curator of the research exhibition, Gabriele Mastrigli is author of the exhibition design
Polyzystisches Ovarsyndrom
Get PDFDas PCOS ist eine der häufigsten Ursachen für weibliche Infertilität, und bei mehr als 50 Prozent der betroffenen Frauen besteht ein erhöhtes Risiko für Diabetes und kardiovaskuläre Erkrankungen. Es ist jedoch umstritten, ob und wann die Diagnose PCOS in der Adoleszenz sinnvoll ist und gestellt werden darf, da viele Kriterien für das Vorliegen
eines PCOS zum normalen Verlauf der Pubertät gehören
Migraine and Use of Progestin-Only Contraception
Get PDFProgestin-only contraception (POC) is not associated with an increased risk for cardiovascular events. In contrast to combined hormonal contraceptives, POC does not increase frequency of migraine attacks and does not initiate migraine. The continuous use of this contraceptive might contribute to the good tolerability in migraineurs. Only for the progestin-only pill with desogestrel 75 μg has it been demonstrated in several studies that it exerts significant reduction in migraine days and migraine intensity. This observation was made for migraine with and without aura. The LNG_IUS 20 is not well tolerated by many migraineurs, potentially as a result of highly fluctuating estrogen levels caused from ovarian cysts
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