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  • Title: Systemics.
    Journal: Netw Res Triangle Park N C; 1985; 6(3):1-3. PubMed ID: 12280131.
    Abstract:
    This discussion of systemics covers oral contraceptives (OCs), injectables, depot medroxyprogesterone acetate (DMPA), known as Depo-Provera; and Norplant implants and injectable microspheres of norethisterone (NET). To minimize the side effects of OCs, pharmaceutical companies have worked to get OCs with the lowest possible dose of hormones that is still effective. Family Health International (FHI) has conducted several studies around the world comparing low-dose and standard-dose pills. A new FHI study will determine the acceptability of switching from standard-dose to low-dose pills. FHI also is undertaking a study of OCs with and without iron supplements among women with low hemoglobin counts to see if 7 days of iron each month causes a rise in the hemoglobin and if side effects are higher for the group taking iron supplements. The estrogen component of combined OCs has been associated with suppression of lactation. This is of serious concern, particularly for breastfeeding women with no alternative method of feeding their infants. While increasing the risk of some diseases (such as myocardial infarction and stroke), OCs provide protection from others. Over 100,000 Latin American women use injectable steroidal contraceptives. The World Health Organization (WHO) and FHI are collaborating on a study to compare 2 injectables. The study will evaluate effectiveness, side effects, and user satisfaction for each formulation. A new FHI study in Costa Rica addresses the question of whether longterm users of OCs or Depo-Provera run an increases risk of breast cancer or cervical cancer. The short-term safety and efficacy of Norplant implants has been established, and it has been approved for marketing in Finland. The primary objectives of FHI's clinical trials are to introduce the NORPLANT implant system into countries with no previous experience with this method and to determine overall acceptability of the method in different patient populations. By 1985 or early 1986, FHI will initiate studies in several Latin American countries. Every woman receiving the NORPLANT system will be followed up every 6 months for 5 years, the life of the system. Animals studies of the NET microspheres are concluding. There are plans to test it in a small number of women.
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