Clinical Applications of Mifepristone (RU486) and Other Antiprogestins Assessing the Science and Recommending a Research Agenda (1993) / Chapter Skim
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Uses of Antiprogestins: The Reproductive Cycle (Part I)
Uses of Antiprogestins: The Reproductive Cycle (Part I)
Pages 19-25
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From page 19... ...
This regression is accompanied by declining levels of estrogen and progesterone, which in turn precipitate shedding of the endometrium; this shedding is experienced as a woman's monthly menstrual bleeding, or menses. If conception occurs, the corpus luteum continues to produce estrogen and progesterone under the influence of a hormone from the developing embryo (human chorionic gonadotropin)
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From page 20... ...
With regard to possible side effects, for example, currently used estrogen-progestin combination oral contraceptives are undergoing continuing epidemiologic study because of their possible role in increasing the risk of early-onset breast cancer (IOM, 1991~. Other possible side effects for which questions persist include alteration in lipid profiles and, for older women who smoke, cardiovascular effects as well as possible thromboembolic events.
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From page 21... ...
However, the few samples of endometrial tissue that have been obtained from women using mifepristone do not show proliferative effects, nor do they show a progestin-induced secretory effect. If changes in the endometrium caused by mifepristone are sufficient to prevent implantation, then a dose lower than the 2 mg daily required to suppress ovulation may be adequate.
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From page 22... ...
A more recently studied experimental post-coital therapy consists of three 200-mg tablets of danazol taken within 72 hours of unprotected intercourse and repeated 12 hours later. Danazol, a synthetic steroid used in the treatment of endometriosis, lowers the estrogen level and so produces a lower incidence of nausea, vomiting, and breast tenderness
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From page 23... ...
In a British randomized trial involving all three regimens, women assigned to mifepristone and danazol experienced much lower incidences of nausea and vomiting; none of 195 women assigned to mifepristone became pregnant, compared with 2.6 percent and 4.7 percent of those receiving combined oral contraceptives and danazol, respectively (Webb et al., 1992~. In a larger Scottish trial, 800 women were randomly assigned to use either mifepristone or the combined oral contraceptives regimen.
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From page 24... ...
These methods of delivery might include vaginal suppositories, intramuscular administration, cutaneous patches, or sustained-release capsules. Given that a more specific antiprogestin compound would be expected to induce menses without any additional treatment, research that results in the development of such a compound would be particularly useful for menses induction.
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From page 25... ...
Inhibition of ovulation by low dose mifepristone (RU 486)
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