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  • Title: Long-acting steroids provide new options.
    Journal: Netw Res Triangle Park N C; 1988; 9(3):1-3, 7. PubMed ID: 12315656.
    Abstract:
    New injectable and implantable contraceptives that provide a slow, steady dose of hormone over long periods of time promise convenient, trouble-free contraception not related to intercourse. Like oral progestagen-only contraceptives, they prevent fertilization by impeding sperm penetration through the cervical mucus, and, also like oral progestagens, their major side effects are menstrual disorders. Injectable contraceptives have the advantage that they can be administered by trained health workers and the disadvantage that they cannot be removed. New 90-day injectables that do not release initial high levels of progestagens are being developed. Family Health International is conducting Phase III clinical trials of the NET 90-day injectable, which releases .66 mg progestagen a day. Other 90-day injectables include a levonorgestrel and a progesterone injectable being developed by Stolle, a norgestimate injectable being tested by Ortho Pharmaceutical, and steroid ester injectables being developed by the World Health Organization and the US National Institute of Child Health and Human Development. Combined estrogen-progesterone monthly injectables are used by millions of women in Mexico, Latin America, and China; and 2 monthly combined injectables, HRP112 and HRP102, are being tested by the World Health Organization. 2 injectables, Upjohn's Depo-Provera and Schering's Noristerat, have been available for over a decade. Both are extremely effective, with pregnancy rates of less than 2/100 woman-years of use. Depo-Provera has been approved for use in the UK and West Germany but not in the US, due to the development of breast and endometrial tumors in experimental animals. The longest acting steroid contraceptives are the implantables. Family Health International is conducting Phase III clinical trials of the biodegradable NET pellets, containing 85% norethindrone and 15% cholesterol, developed by Endocon, Inc. Capronor, a biodegradable capsule containing levonorgestrel, developed by the Research Triangle Institute, is currently being tested in animals. The Population Council's Norplant consists of 36 mg levonorgestrel in 6 silicon elastomer capsules, which are not biodegradable. Norplant is effective for 5 years, after which the capsules must be removed. Norplant is highly effective, with a pregnancy rate of less than 1/100 woman-years of use. Its advantages are the lack of estrogen-related side effects and a swift return to fertility. Disadvantages are a higher initial cost and the need for insertion and removal by trained personnel.
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