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OB/GYN News - Bone loss related to Depo-Provera reverses after discontinuing therapy

admin — Sun, 04 Jan 2009 10:46:05 +0000

Bone loss associated with depot medroxyprogesterone acetate was reversible in a prospective population-based cohort study.
In 183 nonpregnant, reproductive-age users of the injectable contraceptive, which is sold as Depo-Provera, bone density at the spine changed at an annualized mean rate of -0.87%, compared with 0.40% in 274 nonusers. Bone density at the hip changed by -1.12% in users, compared with -0.05% in nonusers, reported. Delia Scholes, Ph.D., and her colleagues at the University of Washington, Seattle.

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But in 110 of the Depo-Provera users who discontinued the agent, sizable increases in bone density were noted. The estimated annualized mean change at the spine was 1.41% in those who stopped using Depo-Provera, compared with 1.03 in those who continued using it. At the hip, the estimated change was 0.40% in those who stopped use, compared with -0.05% in those who continued. At 30 months follow-up, bone density in those who stopped using Depo-Provera was similar to that of the control patients who had not used it (Epidemiology 13[5]:581-87, 2002).
COPYRIGHT 2002 International Medical News Group
COPYRIGHT 2008 Gale, Cengage Learning

Resources for Feminist Research - "Depo-Provera: Does this Contraceptive Choice Support the Health and Well-Being of Adolescents and Young Women?

admin — Sun, 28 Dec 2008 20:16:02 +0000

Wershler, Laura. “Depo-Provera: Does this Contraceptive Choice Support the Health and Well-Being of Adolescents and Young Women?” Canadian Woman Studies/ les cahiers de la femme. Special Issue: Women’s Health and Well-Being, vol. 24, no. 1 (Fall 2004), pp. 105-107.

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Exploring how menstrual health is an important sign of the well-being of adolescents and young women is one analysis put forth in this article. The author discusses how Depo-Provera suppresses menstruation and the health implications of this for women. Should a birth control method like this disrupt the normal functioning of the menstrual cycle? What are the political and social ramifications of promoting a drug like Depo-Provera? This article grapples with the answers to these particular questions.
COPYRIGHT 2006 O.I.S.E.
COPYRIGHT 2008 Gale, Cengage Learning

Internal Medicine News - Chronic Depo-Provera linked to heart disease risk in small study

admin — Fri, 26 Dec 2008 02:31:02 +0000

Chronic use of depot medroxyprogesterone acetate may have an adverse effect on cardiovascular health, a small, nonrandomized study suggests.
The widely used, long-acting contraceptive sold as Depo-Provera and given as a 150-mg injection every 12 weeks inhibits ovarian follicle proliferation. This causes anovulation and decreased circulating estrogen, which could lead to reduced arterial function and increased risk of cardiovascular disease, Morten B. Sorenson, Ph.D., of Royal Brompton Hospital, London, and his colleagues reported (Circulation; available at: http: / /circ.ahajournals.org/ rapidaccess.shtml; published online Sept. 3, 2002).

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While the investigators concluded that the “prevailing recommendation to use [Depo-Provera] in women with cardiovascular disease” should be further evaluated, Pharmacia, the drug’s maker, is emphasizing its “well-proven” safety profile.
“There is no increased risk of cardiovascular disease noted in large-scale clinical or epidemiological trials with Depo-Provera,” Dr. Joel Krasnow, medical director of women’s healthcare for Pharmacia, Peapack, NJ., said in a statement issued by the company.
The drug has been used safely by millions of women for more than 30 years, but healthcare professionals should always carefully consider the use of any medication, including Depo-Provera, before prescribing, particularly for women with preexisting cardiac risk factors, Dr. Krasnow said.
The study included 13 amenorrheic Depo-Provera users and 10 controls with regular menstrual cycles. Cardiovascular magnetic resonance was used to measure changes in the brachial artery area.
Hyperemia-induced flow-mediated dilatation, which is an endothelium-dependent indicator of vascular reactivity, was significantly reduced in the Depo-Provera group (to 1%), compared with controls (to 8%) during menstruation. There were no differences in levels of glyceryl trinitrate, an endothelium-independent indicator of vascular reactivity.
S-estradiol levels, however, were found to be significantly lower in the Depo-Provera patients–who had been using the drug and been amenorrheic for at least 1 year–than in controls during menstruation (58 vs. 96 pmol/L). The estradiol levels were significantly correlated to flow-mediated dilatation.
COPYRIGHT 2002 International Medical News Group
COPYRIGHT 2008 Gale, Cengage Learning

Reproductive Health Matters - Improving contraceptive delivery to women with HIV: Kenya

admin — Tue, 23 Dec 2008 17:21:03 +0000

319 pregnant women with HIV participating in a perinatal HIV transmission study were referred to local clinics for contraceptive counselling and management and followed prospectively. Median time to sexual activity post-partum was two months. 72% (231) initiated hormonal contraceptive use at about three months post-partum (range 1-11 months) and used it for at least two months during follow-up. This included 44% Depo Provera, 31% oral contraception and 25% who switched methods during follow-up. Partner notification, infant mortality and condom use were similar between contraceptive users and non-users. (1)

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(1.) Balkus J, Bosire R, John-Stewart G, et al. High uptake of postpartum hormonal contraception among HIV-1 seropositive women in Kenya [abstract]. Sexually Transmitted Diseases 2007;34(1):25-29.
COPYRIGHT 2007 Reproductive Health Matters
COPYRIGHT 2008 Gale, Cengage Learning

Food Trade Review - Griffith Laboratories launches BBQ food flavours.(Products)

admin — Thu, 18 Dec 2008 13:16:02 +0000

In Anne Walch’s article, “Hormones and Menopause Revisited” Jun/July 04, the paragraph beginning “Premarin, also known as conjugated equilin estrogen (CEE) …” should have read: “Premarin, also known as conjugated equilin estrogen (CEE), is derived from pregnant mare’s urine. The estrogens in Premarin are perfect for a menopausal mare, but foreign to a human female. The same goes for Provera, aka, medroxy-progesterone acetate (MPA). This is a progestin, a progesterone-like substance that is also not native in the human female. It is these synthetic progesterones that appear to be the biggest culprit in increasing breast cancer risk.”

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The Philadelphia Inquirer Business Summary Column.

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Hormone replacement therapy not for everyone.(Health & Fitness)

We sincerely apologize to Anne Watch for this mistake.
COPYRIGHT 2004 Natural Arts
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Reproductive Health Matters - Hormonal contraception and risk of HIV acquisition: Uganda and Zimbabwe.(ROUND UP: HIV/AIDS)(Clinical report)

admin — Tue, 16 Dec 2008 01:16:02 +0000

This study among 6,109 HIV-negative women recruited from family planning clinics who were using either Depo Provera or combined oral contraception in Uganda and Zimbabwe tested the women quarterly for HIV over 15-24 months. 213 women became HIV positive during the study. Neither hormonal contraceptive method was …

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Business Wire - Statement from Attorney James Morris of Brent Coon & Associates Regarding Jury’s Verdict in the Case of Simon Vs. Wyeth Et Al

admin — Fri, 12 Dec 2008 01:41:02 +0000

PHILADELPHIA — “Once again, we have proven that postmenopausal hormone therapy causes breast cancer,” said attorney James A. Morris of the firm Brent Coon & Associates, commenting on the latest verdict in the nationwide hormone replacement therapy litigation. A Philadelphia jury found Pfizer Inc. (NYSE: PFE) liable for failing to properly warn New Jersey plaintiff Merle Simon’s physicians of the breast cancer risk posed by Provera, the progestin half of hormone replacement therapy. Pfizer was ordered to pay $1.5 million in damages. This trial was the first case to examine Provera’s “beagle dog warning,” determined by the jury to be inadequate.

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Merle and Stephen Simon of West Orange, New Jersey brought this case against both Wyeth (NYSE: WYE) and Pfizer for their insufficient labels on their hormone therapy products Premarin, Prempro (Wyeth) and Provera (Pfizer). Both plaintiffs sat in the courtroom every day for the four weeks of trial.
Mrs. Simon took hormone replacement therapy from 1992-2002 and discontinued use of the drugs when she was diagnosed with breast cancer in 2002. While Wyeth escaped liability after two previous losses in Philadelphia finding Premarin and Prempro defective, the finding against Pfizer affirmed Wyeth CEO Robert Essner’s statement that the progestin side of the combination therapy may be the “bad actor”.
Attorneys James A. Morris, Jr. and Brian Ketterer of Brent Coon & Associates represented the Simons in this trial against Wyeth and Pfizer. Mr. Morris stated, “This verdict proves what we’ve suspected all along - that Essner is right, and the MPA is causing breast cancer. While we are disappointed that Wyeth was not, once again, held responsible, we respect the jury’s verdict and the excellent job they did considering the evidence over a four week trial. We believe this is an incredibly important verdict for women’s health. We remain committed to trying these cases and representing victims of these dangerous drugs.”
This is the third case to go to trial in Philadelphia. In the first two cases, Pfizer was not a defendant, and Wyeth was found liable in both cases.
COPYRIGHT 2007 Business Wire
COPYRIGHT 2008 Gale, Cengage Learning

OB/GYN News - Variety of contraceptives okay for disabled women - Not Limited to Depo-Provera

admin — Sun, 07 Dec 2008 12:41:03 +0000

NEW YORK — Although contraceptive injection is widely used in mentally and physically disabled women, many of these patients are candidates for a much wider variety of contraceptive methods, according to Dr. Maida Taylor.
“There is a ton of Depo-Provera [medroxyprogesterone acetate] used in women with disabilities, because it requires one injection every 12 weeks and is highly effective in preventing pregnancy. However, it has a host of side effects such as headache and bloating, weight gain, and irritability and is not for everyone. Clinicians should remember that the disabled are not a monolithic group and are capable of using a variety of contraceptives,” Dr. Taylor said at a gynecology symposium sponsored by Symposia Medicus.

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Dr. Taylor, of the University of California, San Francisco, reviewed several disabilities and diseases and commented on what contraceptives were suitable for affected women:
* Visual impairment and blindness. “If the underlying cause is thrombotic, estrogen-containing methods may be contraindicated,” she said, “but there is no evidence that hormonal contraception accelerates microvascular disease in diabetics. Since pregnancy has a high probability of accelerating retinal disease, effective contraception is essential for susceptible insulin-requiring diabetics.”
* Stroke, cerebrovascular accident, and head injury. “Barriers and IUDs are okay. If the underlying disorder is thrombotic, then no estrogen-containing contraceptives should be used. Even if the underlying cause was trauma, be cautious with OCs. While the risk of a future [cerebrovascular accident] attributable to OCs is small, any further damage would be devastating in such cases. Contraceptive implant and progestin injectable might be considered with consultation,” Dr. Taylor said.
* Cerebral palsy, polio, and muscular dystrophy. “Use oral contraceptives and other estrogen-containing methods as dictated by how active the individual is. Immobility increases risks of venous thrombotic events. If there is impaired bladder function in the patient, a diaphragm may increase the risk of urinary retention and UTI,” she said.
* Mental retardation. “Barrier methods are not suitable for the severely retarded. However, if supervised, oral contraceptives are very useful in this group. Of course, contraceptive injection and implant are widely used with these women. With any and all contraception in this population, consent issues with parents, conservators, or courts may be raised. And there is a need to work with patients so they can comprehend, as much as possible, pregnancy, sexuality, and childbearing.”
* Upper-extremity amputation. “Barrier methods are good if there is a partner willing to assist,” she said.
* Lower-extremity paresis, paralysis, or amputation. “If confined to a chair or bed, the patient should be treated the same as [are] women suffering from paralytic disorders; namely, do not use the estrogen-containing contraceptive methods,” Dr. Taylor said. She also presented a couple of case studies to illustrate the complexities that some patients may present to gynecologists:
* Case 1. A pair of sisters, aged 33 and 35, both have progressive demyelinating inherited disorder. Both were normal until age 19, when they became increasingly impaired intellectually and developed unstable gaits, though both can still walk. Their mother placed them in a skilled nursing facility (SNF) and wants them to have contraception in case of rape. “The staff in the SNF had placed both women on oral contraceptives. Considering that both sisters were becoming increasingly debilitated and immobilized, we advised switching to Depo-Provera,” she said.
* Case 2. An 18-year-old had congenital heart disease and, as a result of a cardiac arrest, is partially deaf and completely blind. At age 1, she had a heart transplant and has since been on cyclosporine for immunosuppression. She is fully ambulatory, and is using condoms. “Great care needs to be taken in monitoring cyclosporine levels, since estrogen competes with cyclosporine for metabolism by CYP3A4 isoenzymes, thus posing a risk of increased levels of the immunosuppressant, Dr. Taylor said.
COPYRIGHT 2003 International Medical News Group
COPYRIGHT 2008 Gale, Cengage Learning

Canadian Corporate News - New Recommendations from National ob/gyn Society Address Depo-Provera’R', Bone Loss.

admin — Tue, 02 Dec 2008 11:06:02 +0000

OTTAWA, ONTARIO, May 11, 2006 (CCNMatthews via COMTEX) — The Society of Obstetricians and Gynaecologists of Canada (SOGC) today released new guidelines for Canadian healthcare professionals to provide clear recommendations on the use of the injectable contraceptive Depo-Provera(R) (Depot Medroxyprogesterone Acetate (DMPA)). The guidelines arrive following industry and government warnings linking the drug to the loss of bone-mineral density (BMD).

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Use of the hormonal contraceptive has plummeted since November 2004, when the United States Food and Drug Administration and …

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Europe - THE RISE OF TRONCHETTI PROVERA.(Pirelli’s Marco Tronchetti Provera)(Brief Article)

admin — Thu, 27 Nov 2008 16:41:03 +0000

Marco Tronchetti Provera is fast becoming Italy’s most famous businessman. The fifty-three-year-old chairman of Italian tires and cables group Pirelli was catapulted into the major league this July when he took charge at Olivetti, the holding company that controls Telecom Italia. With help from the Benetton family and a couple of Italian banks, Pirelli bought a controlling stake in Olivetti for just $6.2 billion.

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That deal, still to be approved, earned the Pirelli chief kudos and put him at the very pinnacle of Italian industry–on a level with the powerful Agnelli family. It also …

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