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The absence of a menstrual period in a woman of reproductive age.

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The lactational amenorrhoea method (LAM) is a contraceptive method where the mother is informed and supported how to use breastfeeding for contraception. Breastfeeding while not giving supplementary feeds delays the return of fertility and menstrual periods, which is a normal (physiological) protection against pregnancy. In this review we have studied the effectiveness of LAM as a contraceptive method in fully breastfeeding women in comparison to breastfeeding women without any support. We found no clear differences in effectiveness (pregnancy) between women using LAM and being supported in doing so, and fully breastfeeding amenorrheic women not using any method. Apart from this we recommend breastfeeding itself from a public health point of view.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: October 12, 2015

Researchers reviewed the evidence about the effectiveness and safety of metformin and other drugs that improve the body's sensitivity to insulin, for inducing ovulation in women with polycystic ovary syndrome (PCOS). Of interest were live birth rate, adverse effects and additional reproductive and metabolic outcomes.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2018

To evaluate the incidence of chemotherapy-induced amenorrhea (CIA) and its therapeutic impact in premenopausal breast cancer patients. A systematic search was performed to identify clinical studies that compared the incidence of CIA with different chemotherapy regimens and oncological outcomes with and without CIA. The fixed-effects and random-effects models were used to assess the pooled estimates. Heterogeneity and sensitivity analyses were performed to explore heterogeneity among studies and to assess the effects of study quality. A total of 15,916 premenopausal breast cancer patients from 46 studies were included. The cyclophosphamide-based regimens, taxane-based regimens, and anthracycline/epirubicin-based regimens all increased the incidence of CIA with pooled odds ratios of 2.25 (95 % CI 1.26-4.03, P = 0.006), 1.26 (95 % CI 1.11-1.43, P = 0.0003) and 1.39 (95 % CI 1.15-1.70, P = 0.0008), respectively. The three-drug combination regimens of cyclophosphamide,anthracycline/epirubicin, and taxanes (CAT/CET) caused the highest rate of CIA compared with the other three drug combinations (OR 1.41, 95 % CI 1.16-1.73, P = 0.0008). Tamoxifen therapy was also correlated with a higher incidence of CIA, with an OR of 1.48. Patients with CIA were found to exhibit better disease-free survival (DFS) and overall survival (OS) compared with patients without CIA. With respect to molecular subtype, this DFS advantage remained significant in hormone-sensitive patients (HR 0.61, 95 % CI 0.52-0.72, P < 0.00001). The current meta-analysis has demonstrated that anthracycline/epirubicin, taxanes, cyclophosphamide, and tamoxifen all contributed to elevated rates of CIA, and CIA was not merely a side effect of chemotherapy but was a better prognostic marker, particularly for ER-positive premenopausal early-stage breast cancer patients. However, this topic merits further randomized control studies to detect the associations between CIA and patient prognosis after adjusting for age, ER status, and other influential factors.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

This guideline has been developed to advise on the identification, treatment and management of the eating disorders anorexia nervosa, bulimia nervosa and related conditions. The guideline recommendations have been developed by a multidisciplinary group of health care professionals, patients and their representatives, and guideline methodologists after careful consideration of the best available evidence. It is intended that the guideline will be useful to clinicians and service commissioners in providing and planning high quality care for those with eating disorders while also emphasising the importance of the experience of care for patients and carers.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2004

Contraception can be divided into two broad categories: hormonal and nonhormonal. There are two categories of hormonal contraception: combined oestrogen and progestogen and progestogen-only. Long-acting reversible contraception (LARC) is defined in this guideline as methods that require administering less than once per cycle or month.

NICE Clinical Guidelines - National Collaborating Centre for Women’s and Children’s Health (UK).

Version: October 2005

Antipsychotic medications are approved by the U.S. Food and Drug Administration (FDA) for treatment of schizophrenia, bipolar disorder, and for some drugs, depression. We performed a systematic review on the efficacy and safety of atypical antipsychotic drugs for use in conditions lacking FDA approval.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: September 2011

This review evaluated the effect of oral contraceptives on bone mineral density. The authors concluded that there is good evidence of a positive effect in perimenopausal women and fair evidence of a positive effect in hypothalamic oligo/amenorrhoeic premenopausal women. Poor reporting of review methods and reliance on a few small randomised controlled trials mean that these results should be interpreted with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

This guideline offers best practice advice on assisting people of reproductive age who have problems conceiving.

NICE Clinical Guidelines - National Collaborating Centre for Women’s and Children’s Health (UK).

Version: February 2013

We reviewed the evidence on effectiveness and safety of a new class of medications called selective progesterone receptor modulators (SPRMs) for treating premenopausal women with uterine fibroids.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: April 26, 2017

Birth control methods that can be injected may contain two hormones, a progestin and an estrogen. These combined injectable contraceptives (CICs) are effective in preventing pregnancy and can be stopped when a woman wants to get pregnant. This review looked at CICs for how well they prevented pregnancy and for the bleeding patterns and other side effects that may occur. We also studied whether women stopped using them early and whether women liked them.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: October 8, 2008

MS is a chronic disease of the nervous system affecting young and middle‐aged adults. MS is supposed to be related to the immune system. CFX is an immunosuppressive drug used for various autoimmune diseases. As its use for MS is controversial, the Authors of this review aimed to assess CFX efficacy for patients with progressive MS. Among the pertinent literature, only five studies met the inclusion criteria of minimum methodological quality , with a total of 90 MS patients treated with CFX.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: January 24, 2007

This review included 31 patients taking cyclophosphamide and 39 patients taking placebo. Patients taking cyclophosphamide had improved tender and swollen joint scores. Patients receiving placebo were six times more likely to discontinue treatment because of lack of treatment effect than patients receiving cyclophosphamide. Withdrawals from adverse reactions were higher in the cyclophosphamide group. Side effects from cyclophosphamide included hemorrhagic cystitis, nausea, vomiting, leucopenia, thrombocytopenia, alopecia, amenorrhea and herpes zoster infections.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: October 23, 2000

There are several different surgical techniques for early termination of pregnancy (abortion in the first three months). These are dilatation and curettage (D&C to scrape out the contents of the uterus), vacuum aspiration (sucking out the contents of the uterus with a manual or power‐operated device). Hysterotomy (surgery through the uterus, like caesarean section) is not commonly used. The cervix (opening of the uterus) can be prepared beforehand with hormones to minimise the risk of damage. The review found that both, D&C and vacuum aspiration, are safe and effective methods for first trimester termination of pregnancy and complications are rare. The review does not reveal women's or surgeons' preference of one method over the other.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: October 23, 2001

Researchers in the Cochrane Collaboration reviewed evidence on the effectiveness and safety of progesterone receptor modulators for women with endometriosis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 25, 2017

This is an update of the Cochrane review "Mitoxantrone for multiple sclerosis" (published on Cochrane Database of Systematic Reviews 2013, Issue 5).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: May 31, 2013

Injectable hormonal contraceptives remain in extensive use in many developing countries. There are two progestogen‐only injectable contraceptives that have been available in many countries since the 1980's. These are depot medroxyprogesterone acetate (DMPA) and norethisterone oenanthate (NET‐EN). They are both highly effective contraceptives that receive wide acceptance amongst women in their fertile years, and form a sizeable proportion of the health expenditure on contraception. They differ in frequency of administration and cost, and a systematic comparison aids to ensure their rational use. This review seeks to compare DPMA given at a dose of 150 mg IM every 3 months and NET‐EN given at a dose of 200mg IM every 2 months, and determine whether there are differences in contraceptive effectiveness, reversibility and patterns of discontinuation, and their minor and major clinical effects.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 19, 2006

The aim of the project was to estimate the clinical effectiveness and cost-effectiveness of microwave endometrial ablation (MEA) and thermal balloon endometrial ablation (TBEA) for heavy menstrual bleeding (HMB) compared with the existing (first-generation) endometrial ablation (EA) techniques of transcervical resection (TCRE) and rollerball (RB) ablation, and hysterectomy.

NIHR Health Technology Assessment programme: Executive Summaries - NIHR Journals Library.

Version: 2004

Endometriosis is a painful condition where tissue from the lining of the womb (uterus) is found outside the uterus as well. It can cause pain in the abdomen, generally and during periods (menstruation) or sex. Endometriosis can also lead to infertility. Treatments include surgery or drugs to try and shrink the tissue. Progestagens and anti‐progestagens are some of the hormonal drugs used for treatment. This systematic review of trials found limited evidence for the effectiveness of these drugs in the reduction of pain from endometriosis. This was due to the limited number of randomised controlled trials comparing each drug.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: March 14, 2012

Options to help avoid surgery can be important for many women who are having problems with heavy menstrual bleeding. One of the drug options is Danazol. Danazol suppresses the hormones that increase the endometrium (the lining of the uterus that is shed during menstruation). However, Danazol can also produce male characteristics and some menopause‐like symptoms, as well as weight gain and acne. The review found that although Danazol is effective at reducing menstrual blood loss there are not enough trials to show whether this treatment is acceptable to women with heavy menstrual bleeding.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 18, 2007

Side effects of birth control pills may keep women from using them as planned. Attempts to decrease side effects led to the two‐phase pill. Pills with phases provide different amounts of hormones over three weeks. Whether two‐phase pills lead to fewer pregnancies than one‐phase pills is unknown. Nor is it known if the pills give better cycle control or have fewer side effects. This review looked at whether two‐phase pills worked as well as one‐phase pills. It also studied whether women had fewer side effects with these pills.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 19, 2006

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