By Sylvia Rosevear
This can be an simply obtainable consultant providing suggestion on all gynaecological stipulations and remedy. It serves as a better half textual content to instruction manual of Obstetric administration, additionally edited through Sylvia Rosevear. This finished textual content presents details on stipulations and therapy modalities. It displays the present proof base in addition to professional wisdom, and comprises contributions from a couple of experts in the box.
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Additional resources for Handbook of Gynaecology Management
877. World Health Organisation, Geneva. 4 Collaborative Group on Hormonal Factors in Breast Cancer (1996) Breast cancer and hormonal contraceptives: collaborative reanalysis of individual data on 53 297 women with breast cancer and 100 239 women without breast cancer from 54 epidemiological studies. The Lancet, 347, 1713–1727. J. (1995) Net effect of oral contraceptive use on the risk of cancer in women in the United States. Obstetrics and Gynecology, 85, 793–801. J. & Rosner, B. (1992) A quantitative assessment of oral contraceptive use and risk of ovarian cancer.
Progestogen Effects include increase in depression, irritability, tension and fatigue. Because progestogens are structurally related to testosterone they can produce predominantly adverse androgenic effects: weight gain (anabolic effect), acne, nervousness. Women who have acne should have a pill formulation with a low progestogen/oestrogen ratio. Amenorrhoea may occur due to the decrease in synthesis of oestrogen receptors in the endometrium induced by progestogens. It is not essential, medically, to have a withdrawal bleed, but some women prefer a withdrawal bleed as an indicator of the absence of pregnancy.
2 Continued Third generation triphasics Tri-Minulet/Triadene 6 tablets containing 50 mg gestodene + 30 mg ethinyloestradiol, 5 tablets containing 70 mg gestodene + 40 mg ethinyloestradiol, and 10 tablets containing 100 mg gestodene + 30 mg ethinyloestradiol Among the newest pills, none exhibits real progestogenic side effects, but all vary in their oestrogen dominance and control of bleeding. In descending order of oestrogen dominance they are: Cilest/Marvelon Minulet/Femodene Mercilon Best cycle control is given by Minulet/Femodene; Cilest is next in order and then Marvelon and Mercilon.
Handbook of Gynaecology Management by Sylvia Rosevear