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  • Title: Menstrual regulation with prostaglandin analogues.
    Author: Hagenfeldt K, Bygdeman M.
    Journal: Reproduccion; 1981; 5(3):195-201. PubMed ID: 7026317.
    Abstract:
    The development of generally applicable, simple non-surgical methods for menstrual regulation has been desired for a long time. Such an approach to fertility control depends on the availability of a suitable therapeutic agent that should be effective, reliable, simple to administer and free from disturbing side effects. The classical prostaglandins have shown the capability but are unsuitable mainly due to high incidence of side effects. Most of these drawbacks seem to be overcome when prostaglandin analogues are used; however, vaginal administration caused appreciable pain in 10-30% of women, and so severely limits self-administration of these analogues. The field of fertility control has long needed a simple, nonsurgical method for early pregnancy termination. Such a technique should ideally be effective, reliable, free from disturbing side effects, and able to be self-administered. The prostaglandins (PGs) have shown the capability but are unsuitable due mainly to an unacceptably high rate of side effects. Recent development of PG analogs holds promise since some of these seem more specific to uterine rather than gastrointestinal musculature when administered either vaginally or by intrauterine route. 15-methyl PGE2 and 15-methyl PGF2alpha methyl ester, 16-phenoxy-tetranor PGE2 sulphonylamide and 16,16-dimethyl-trans-delta 2-PGE1 methyl ester seem to be the most suitable for intrauterine administration. Clinical experience with intrauterine PG analogs is cited from the literature. The main disadvantage was that this method of administration requires medical skill and carries a risk of infection. A noninvasive method, e.g., a vaginal suppository to be administered by paramedical personnel or by the woman herself, would be preferable. Clinical experience with vaginal administration so far has been discouraging due to dependence on systemic absorption. 2 comparative studies have shown PGs to be as effective as vacuum aspiration in termination of early pregnancy. Both treatments were positively evaluated. There is high acceptability of the idea of self-administered PG analogs for pregnancy termination if the other problems, mainly the appreciable pain suffered by 10-30% of the women, can be resolved.
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