Menstrual

Testosterone promotes muscle growth deepening of the voice the growth of body hair and other male secondary sex characteristics Testosterone is formed from cholesterol and IS the biosynthetic precursor of estradiol the principal female sex hormone or estrogen Estradiol is a key substance m the regulation of the menstrual cycle and the reproductive process It is the hormone most responsible for the development of female secondary sex characteristics... 

LynestrenoL Lynestrenol (73) has been used in oral contraceptives and to treat menstrual disorders. It is converted in vivo to its active metabohte norethindrone (102,103). It can be recrystallized from methanol, and is soluble in ethanol, ether, chloroform, and acetone, and insoluble in water (102). The crystal stmcture (104) and other spectral and analytical data have been reported for lynestrenol (62). 

Thus, our attention should shift from the concern of potential adverse effects to the health benefits imparted by hormonal contraceptives. The use of oral contraceptives for at least 12 months reduces the risk of developing endometrial cancer by 50%. Furthermore, the risk of epithelial ovarian cancer in users of oral contraceptives is reduced by 40% compared with that on nonusers. This kind of protection is already seen after as little as 3-6 months of use. Oral contraceptives also decrease the incidence of ovarian cysts and fibrocystic breast disease. They reduce menstrual blood loss and thus the incidence of iron-deficiency anemia. A decreased incidence of pelvic inflammatory disease and ectopic pregnancies has been reported as well as an ameliorating effect on the clinical course of endometriosis. 

This drug may cause spontaneous abortion. Women of childbearing age must use a reliable contraceptive If pregnancy is suspected, discontinue use of tiie drug and notify the primary health care provider. Report severe menstrual pain, bleeding, or spotting. 

Endocrine system—menstrual irregularities, hyperglycemia, and decreased growth in children and... 

Amenorrhea, other menstrual irregularities, development of cushingoid state, suppression of growth in children, secondary adrenocortical and pituitary unresponsive (particularly in times of stress), decreased carbohydrate tolerance, manifestation of latent diabetes mellitus, increased requirements for insulin or oral hypoglycemic agents (in diabetics)... 

In women receiving an androgen preparation for breast carcinoma, the most common adverse reactions are amenorrhea, other menstrual irregularities, and virilization (acquisition of male sexual characteristics by a woman). Virilization produces facial hair, a deepening of the voice, and enlargement of the clitoris. Male pattern baldness and acne may also be seen. 

Taking the contraceptive hormones provides health benefits not related to contraception, such as regulating the menstrual cycle and decreased blood loss, and incidence of iron deficiency anemia, and dysmenorrhea Health benefits related to the inhibition of ovulation include a decrease in ovarian cysts and ectopic pregnancies. hi addition, there is a decrease in fibrocyctic breast disease, acute pelvic inflammatory disease endometrial cancer, ovarian cancer, maintenance of bone density, and symptoms related to endometriosis in women taking contraceptive hormones. Newer combination contraceptives such as norgestimate and ethinyl estradiol... 

Improvement in menstrual cydes by balancing the hor-monesand reducing uterine spasms... 

These drugs can be used anytime during the menstrual cycle. 

Consider the menstrual cycle, ovulation, and the possibility of pregnancy before beginning treatment. 

Retrieval threads should be visible. If they are not visible, they may have retracted into the uterus or have been broken. After menstrual period, determine if the threads still protrude from the cervix. If threads are not found, the system is considered displaced and removed. 

Irregular menstrual bleeding, spotting, prolonged episodes of bleeding, and amenorrhea may occur. These symptoms diminish with continued use. 

Teach the patient to check after each menstrual period to make certain that the thread still protrudes from the cervix and caution her not to pull the thread. 

Menstrual flow usually decreases after the first 3—6 months of LRIS use therefore, an increase of menstrual flow may indicate expulsion of the device. 

The first injection is given during the first 5 days of a normal menstrual period and is administered no earlier than 4 weeks after delivery if not breastfeeding or 6 weeks if breastfeeding. Second and subsequent injections given monthly (28-30 days) after the previous injection, not to exceed 33 days. 

Gve patient a copy of the patient labeling before administration of the drug. The injection schedules are indicated according to the number of days and not bleeding episodes. If any patient misses 2 consecutive menstrual periods, the possibility of pregnancy should be considered. 

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