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  • Title: [Progress in the contraceptive use of the LH-RH agonist buserelin: intermittent medication with gestagen-induced withdrawal bleeding].
    Author: Hardt W, Schmidt-Gollwitzer K, Nevinny-Stickel J, Schmidt-Gollwitzer M.
    Journal: Geburtshilfe Frauenheilkd; 1982 Dec; 42(12):874-7. PubMed ID: 6819180.
    Abstract:
    This is a report on the intermittent administration of the potent luteinizing hormone-releasing hormone (LH-RH) agonist buserelin (400 mcg for 22 days with a 6 day rest) in combination with a short course of the progestational agent (10 mg norethisterone acetate from days 20-22 of buserelin medication) on the gonadotropin and sexual steroid secretion in 21 fertile women during 101 treatment cycles. In 87 of 101 treatment cycles, inhibition of ovulation was secularly documented by frequent blood tests. In 13 months, a short-term increase in the progesterone level in the serum was observed; in 8 cases it was up to 3 ng/ml and in 5 cases it was up to 6 ng/ml. Only in 1 treatment cycle was there found on the 7th day at the beginning of treatment an ovulatory cycle with normal corpus luteum function. In 95 of 101 treatment cycles, secure inhibition of ovulation was obtained and in 5 of the 6 remaining treatment cycles, was a sufficient contraceptive effect obtained. In 97 of 101 rest periods between treatment, withdrawal bleeding occurred. In 25 treatment cycles, intermenstrual bleeding occurred. 17 of 21 women had regular menstrual cycles and 4 had frequent intermenstrual bleeding or failed to have withdrawal bleeding. In accordance with the recorded menstrual cycles, 17 women had cyclic stimulation of estradiol secretion. The endometrial biopsies during the last days of treatment prior to the administration of the progestational agent showed a moderate proliferative endometrium and at the onset of bleeding, secretory transformation of the endometrium and at the end of the bleeding early proliferative phase endometrium. 2 women had marked suppression of ovarian function in spite of the intermittent medication with intermittent suppression of endometrial growth or resting endometrium. In comparison to the continual medication of 400 mcg buserelin, intermittent treatment with a short-term progestational agent is recommended more strongly for LH-RH contraception since the intermittent administration allows for more regular menstrual cycles. Significant side effects were not observed. The acceptance of this method was high. (author's modified)
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