Matching articles for "estrogens"
Drugs for Menopausal Symptoms
The Medical Letter on Drugs and Therapeutics • March 4, 2024; (Issue 1697)
The primary symptoms of menopause are genitourinary
and vasomotor. The genitourinary syndrome
of menopause (GSM) includes symptoms such as
burning, irritation, dryness, dyspareunia, dysuria,
and recurrent...
The primary symptoms of menopause are genitourinary
and vasomotor. The genitourinary syndrome
of menopause (GSM) includes symptoms such as
burning, irritation, dryness, dyspareunia, dysuria,
and recurrent urinary tract infection. Vasomotor
symptoms (VMS; hot flashes, night sweats) often
disrupt sleep.
Opill — An OTC Oral Contraceptive
The Medical Letter on Drugs and Therapeutics • September 18, 2023; (Issue 1685)
The FDA has approved Opill (Perrigo), a progestin-only
oral contraceptive that contains norgestrel, for
sale over the counter (OTC). Opill is the first oral
contraceptive to be approved in the US for sale...
The FDA has approved Opill (Perrigo), a progestin-only
oral contraceptive that contains norgestrel, for
sale over the counter (OTC). Opill is the first oral
contraceptive to be approved in the US for sale without
a prescription. Approval of OTC Opill is intended
to increase access to effective contraception and
reduce the rate of unintended pregnancies.
Fezolinetant (Veozah) for Menopausal Vasomotor Symptoms
The Medical Letter on Drugs and Therapeutics • June 26, 2023; (Issue 1679)
Fezolinetant (Veozah – Astellas), a first-in-class
neurokinin 3 (NK3) receptor antagonist, has been
approved by the FDA for treatment of moderate to
severe vasomotor symptoms (VMS) due to menopause.
It is...
Fezolinetant (Veozah – Astellas), a first-in-class
neurokinin 3 (NK3) receptor antagonist, has been
approved by the FDA for treatment of moderate to
severe vasomotor symptoms (VMS) due to menopause.
It is the second nonhormonal treatment to be approved
in the US for this indication; a low-dose formulation of
the selective serotonin reuptake inhibitor (SSRI)
paroxetine mesylate (Brisdelle) was approved in 2013.
Choice of Contraceptives
The Medical Letter on Drugs and Therapeutics • May 15, 2023; (Issue 1676)
Intrauterine devices (IUDs) and the etonogestrel
implant are the most effective reversible contraceptive
methods available. Hormonal oral contraceptives,
patches, rings, and injectables are also effective...
Intrauterine devices (IUDs) and the etonogestrel
implant are the most effective reversible contraceptive
methods available. Hormonal oral contraceptives,
patches, rings, and injectables are also effective in
preventing pregnancy. When used alone, barrier and
behavioral methods generally have higher failure
rates than other methods (see Table 1). Selection of
a contraceptive method is usually based on patient-specific factors and personal preference
Drugs for Overactive Bladder
The Medical Letter on Drugs and Therapeutics • March 20, 2023; (Issue 1672)
In overactive bladder, involuntary bladder contractions
due to detrusor overactivity result in urinary
urgency, frequency, nocturia, and incontinence.
The prevalence of the disorder increases with...
In overactive bladder, involuntary bladder contractions
due to detrusor overactivity result in urinary
urgency, frequency, nocturia, and incontinence.
The prevalence of the disorder increases with age.
Nonpharmacologic treatment, including bladder
training, urge suppression, pelvic floor muscle
exercises, constipation management, modification of
fluid intake, and avoidance of dietary irritants such as
alcohol and caffeine, should be tried first.
Myfembree for Fibroid-Associated Heavy Menstrual Bleeding
The Medical Letter on Drugs and Therapeutics • August 9, 2021; (Issue 1630)
Myfembree (Myovant/Pfizer), an oral fixed-dose
combination of the gonadotropin-releasing hormone
(GnRH) receptor antagonist relugolix, the estrogen
estradiol, and the progestin norethindrone acetate,
has...
Myfembree (Myovant/Pfizer), an oral fixed-dose
combination of the gonadotropin-releasing hormone
(GnRH) receptor antagonist relugolix, the estrogen
estradiol, and the progestin norethindrone acetate,
has been approved by the FDA for management of
heavy menstrual bleeding associated with uterine
leiomyomas (fibroids) in premenopausal women. It is
the second product to be approved in the US for this
indication; Oriahnn, which contains the GnRH receptor
antagonist elagolix in combination with estradiol and
norethindrone acetate, was approved earlier. Relugolix
was approved for treatment of advanced prostate
cancer as Orgovyx in 2020.
Oriahnn for Fibroid-Associated Heavy Menstrual Bleeding
The Medical Letter on Drugs and Therapeutics • April 5, 2021; (Issue 1621)
Oriahnn (Abbvie), a fixed-dose combination of the
gonadotropin-releasing hormone (GnRH) receptor
antagonist elagolix, the estrogen estradiol, and the
progestin norethindrone acetate copackaged with
elagolix...
Oriahnn (Abbvie), a fixed-dose combination of the
gonadotropin-releasing hormone (GnRH) receptor
antagonist elagolix, the estrogen estradiol, and the
progestin norethindrone acetate copackaged with
elagolix alone, has been approved by the FDA for oral
treatment of heavy menstrual bleeding associated
with uterine leiomyomas (fibroids) in premenopausal
women. It is the first product to be approved in the
US for this indication. Elagolix (Orilissa) has been
available since 2018 for treatment of moderate to
severe pain associated with endometriosis. The
GnRH receptor antagonist relugolix (Orgovyx), which is
approved for treatment of advanced prostate cancer,
is being reviewed by the FDA for use in combination
with estradiol and norethindrone acetate for the same
indication as Oriahnn.
Twirla - A New Contraceptive Patch
The Medical Letter on Drugs and Therapeutics • February 8, 2021; (Issue 1617)
The FDA has approved Twirla (Agile Therapeutics),
a transdermal contraceptive patch containing the
estrogen ethinyl estradiol and the progestin
levonorgestrel, for use in women with a BMI...
The FDA has approved Twirla (Agile Therapeutics),
a transdermal contraceptive patch containing the
estrogen ethinyl estradiol and the progestin
levonorgestrel, for use in women with a BMI <30 kg/m2.
It is the second contraceptive patch to become
available in the US; Xulane, a patch that delivers
ethinyl estradiol and the progestin norelgestromin,
has been available since 2014.
Drugs for Acne
The Medical Letter on Drugs and Therapeutics • November 30, 2020; (Issue 1612)
Acne is common among adolescents and young adults,
but its prevalence appears to have increased in people
of all ages due to prolonged wearing of masks during
the COVID-19 pandemic. Guidelines for treatment...
Acne is common among adolescents and young adults,
but its prevalence appears to have increased in people
of all ages due to prolonged wearing of masks during
the COVID-19 pandemic. Guidelines for treatment of
acne were last published in 2016.
Drugs for Menopausal Symptoms
The Medical Letter on Drugs and Therapeutics • August 10, 2020; (Issue 1604)
The primary symptoms of menopause are genitourinary
(genitourinary syndrome of menopause; GSM) and
vasomotor (VMS). Vulvovaginal atrophy can cause
vaginal burning, irritation and dryness, dyspareunia,...
The primary symptoms of menopause are genitourinary
(genitourinary syndrome of menopause; GSM) and
vasomotor (VMS). Vulvovaginal atrophy can cause
vaginal burning, irritation and dryness, dyspareunia, and
dysuria, and increase the risk of urinary tract infections.
Vasomotor symptoms ("hot flashes") cause daytime
discomfort and night sweats that may disrupt sleep.
Hormone therapy is the most effective treatment for both
genitourinary and vasomotor symptoms.
Drugs for Postmenopausal Osteoporosis
The Medical Letter on Drugs and Therapeutics • July 13, 2020; (Issue 1602)
US guidelines recommend pharmacologic therapy for
postmenopausal women with a bone density T-score
(standard deviation from normal mean values in
healthy young women) of -2.5 or below in the lumbar
spine,...
US guidelines recommend pharmacologic therapy for
postmenopausal women with a bone density T-score
(standard deviation from normal mean values in
healthy young women) of -2.5 or below in the lumbar
spine, femoral neck, total hip, or distal radius, a
T-score between -1.0 and -2.5 and a history of fragility
(low-trauma) fracture of the hip or spine, or a T-score
between -1.0 and -2.5 and a FRAX 10-year probability
of ≥3% for hip fracture or ≥20% for major osteoporotic
fracture (hip, clinical spine, humerus, distal radius).
Comparison Table: Some Drugs for Postmenopausal Osteoporosis (online only)
The Medical Letter on Drugs and Therapeutics • July 13, 2020; (Issue 1602)
...
View the Comparison Table: Some Drugs for Postmenopausal Osteoporosis
Drospirenone (Slynd) - A New Progestin-Only Oral Contraceptive
The Medical Letter on Drugs and Therapeutics • February 10, 2020; (Issue 1591)
The FDA has approved a progestin-only oral
contraceptive ("minipill") containing drospirenone
(Slynd – Exeltis). All other progestin-only oral
contraceptives available in the US contain
norethindrone...
The FDA has approved a progestin-only oral
contraceptive ("minipill") containing drospirenone
(Slynd – Exeltis). All other progestin-only oral
contraceptives available in the US contain
norethindrone (Camila, and others). Progestin-only oral
contraceptives are similar in efficacy to combination
oral contraceptives. They are used predominantly by
breastfeeding women and by those in whom estrogen
is poorly tolerated or contraindicated. Combination
oral contraceptives containing drospirenone and
ethinyl estradiol have been available for years.
Annovera - A New Contraceptive Vaginal Ring
The Medical Letter on Drugs and Therapeutics • December 16, 2019; (Issue 1587)
Annovera (TherapeuticsMD), a contraceptive vaginal
ring that releases segesterone acetate, a synthetic
progestin, and ethinyl estradiol, was approved by the
FDA in 2018 and is now available. It is the first...
Annovera (TherapeuticsMD), a contraceptive vaginal
ring that releases segesterone acetate, a synthetic
progestin, and ethinyl estradiol, was approved by the
FDA in 2018 and is now available. It is the first product
to contain segesterone and the second vaginal ring
to become available in the US; NuvaRing, which
delivers etonogestrel and ethinyl estradiol, was the
first. Unlike NuvaRing, which requires use of a new
ring each month, the Annovera ring can be used for
an entire year, but it must be removed for one week
each month.
Addendum: Estradiol/Progesterone (Bijuva) for Menopausal Vasomotor Symptoms
The Medical Letter on Drugs and Therapeutics • July 29, 2019; (Issue 1577)
In our article on Bijuva, the oral fixed-dose combination of estradiol and progesterone (Med Lett Drugs Ther 2019; 61:99), Table 1 should have included single-ingredient oral formulations of estradiol and...
In our article on Bijuva, the oral fixed-dose combination of estradiol and progesterone (Med Lett Drugs Ther 2019; 61:99), Table 1 should have included single-ingredient oral formulations of estradiol and progesterone (see below). They will be added to the table as it appears online, along with medroxyprogesterone (Provera, and generics), another single-ingredient progestin available for use in women with an intact uterus who take systemic estrogen for menopausal symptoms. Taking generic estradiol and progesterone separately may be less convenient than taking Bijuva, but they cost less and allow for more dosing flexibility.
Estradiol/Progesterone (Bijuva) for Menopausal Vasomotor Symptoms
The Medical Letter on Drugs and Therapeutics • July 1, 2019; (Issue 1575)
The FDA has approved Bijuva (TherapeuticsMD), a
fixed-dose combination of estradiol and progesterone,
for oral treatment of moderate to severe vasomotor
symptoms (hot flashes) due to menopause in women
with...
The FDA has approved Bijuva (TherapeuticsMD), a
fixed-dose combination of estradiol and progesterone,
for oral treatment of moderate to severe vasomotor
symptoms (hot flashes) due to menopause in women
with an intact uterus. The manufacturer is marketing
Bijuva as "the first and only FDA-approved combination
of bio-identical estradiol and bio-identical progesterone
in a single daily oral capsule".
Choice of Contraceptives
The Medical Letter on Drugs and Therapeutics • October 8, 2018; (Issue 1557)
Intrauterine devices (IUDs) and the etonogestrel
implant are the most effective reversible contraceptive
methods available. Hormonal oral contraceptives,
patches, rings, and injectables are also highly...
Intrauterine devices (IUDs) and the etonogestrel
implant are the most effective reversible contraceptive
methods available. Hormonal oral contraceptives,
patches, rings, and injectables are also highly effective
in preventing pregnancy. When used alone, barrier and
fertility-based methods generally have higher failure
rates than other methods.
Imvexxy - Another Estradiol Vaginal Insert for Dyspareunia
The Medical Letter on Drugs and Therapeutics • September 10, 2018; (Issue 1555)
The FDA has approved an estradiol softgel vaginal
insert (Imvexxy – TherapeuticsMD) for treatment of
postmenopausal women with moderate to severe
dyspareunia due to vulvovaginal atrophy (VVA).
Imvexxy is...
The FDA has approved an estradiol softgel vaginal
insert (Imvexxy – TherapeuticsMD) for treatment of
postmenopausal women with moderate to severe
dyspareunia due to vulvovaginal atrophy (VVA).
Imvexxy is the second estradiol vaginal insert to be
approved in the US; Vagifem, an intravaginal tablet
formulation, was the first. Vagifem and Imvexxy are
both available in inserts containing 10 mcg of estradiol;
Imvexxy is also available in a 4-mcg strength.
Drugs for Postmenopausal Osteoporosis
The Medical Letter on Drugs and Therapeutics • December 18, 2017; (Issue 1536)
Diagnosis of osteoporosis is based on the results
of bone mineral density (BMD) testing or by the
occurrence of a fragility fracture. Bone densitometry
results are generally reported in terms of...
Diagnosis of osteoporosis is based on the results
of bone mineral density (BMD) testing or by the
occurrence of a fragility fracture. Bone densitometry
results are generally reported in terms of standard
deviations (SD) from the mean value for young adults
(T-score). The World Health Organization (WHO)
defines osteoporosis in women as a T-score of -2.5
or below in the spine, femoral neck, or total hip. A
computerized model (FRAX) is available that estimates
the 10-year probability of a hip fracture or other major
osteoporotic fracture based on clinical risk factors and
BMD at the femoral neck.
Prasterone (Intrarosa) for Dyspareunia
The Medical Letter on Drugs and Therapeutics • September 11, 2017; (Issue 1529)
The FDA has approved the steroid prasterone
(Intrarosa – Endoceutics) for intravaginal treatment
of postmenopausal women with moderate-to-severe
dyspareunia due to vulvovaginal atrophy (VVA). Also
called...
The FDA has approved the steroid prasterone
(Intrarosa – Endoceutics) for intravaginal treatment
of postmenopausal women with moderate-to-severe
dyspareunia due to vulvovaginal atrophy (VVA). Also
called dehydroepiandrosterone (DHEA), prasterone
is produced in the adrenal glands, gonads, and brain
and converted intracellularly into active metabolites
of estrogens and androgens. DHEA has been available
over the counter for years as an oral dietary supplement
claimed to benefit sexual, cardiovascular, and
neuropsychiatric dysfunction.
Comparison Table: Drugs for Postmenopausal Osteoporosis (online only)
The Medical Letter on Drugs and Therapeutics • June 19, 2017; (Issue 1523)
...
View the Comparison Table: Drugs for Postmenopausal Osteoporosis
Drugs for Menopausal Symptoms
The Medical Letter on Drugs and Therapeutics • November 7, 2016; (Issue 1507)
The primary symptoms of menopause are
genitourinary and vasomotor. A thin, dry vaginal lining
and thin urethral mucosa can cause vaginal and vulvar
burning and irritation, pain during intercourse, and...
The primary symptoms of menopause are
genitourinary and vasomotor. A thin, dry vaginal lining
and thin urethral mucosa can cause vaginal and vulvar
burning and irritation, pain during intercourse, and an
increased risk of urinary tract infections. Vasomotor
symptoms ("hot flashes") cause daytime discomfort
and night sweats that may disrupt sleep.
Drugs for Acne
The Medical Letter on Drugs and Therapeutics • February 1, 2016; (Issue 1487)
The pathogenesis of acne is multifactorial: follicular
hyperkeratinization, bacteria, sebum production,
androgens, and inflammation all play a role. The gram-positive
microaerophilic bacteria...
The pathogenesis of acne is multifactorial: follicular
hyperkeratinization, bacteria, sebum production,
androgens, and inflammation all play a role. The gram-positive
microaerophilic bacteria Propionibacterium
acnes promotes development of acne lesions by
secreting chemotactic factors that attract leukocytes
to the follicle, causing inflammation.
Drugs for Hypothyroidism
The Medical Letter on Drugs and Therapeutics • October 26, 2015; (Issue 1480)
Primary hypothyroidism is usually the result of
Hashimoto's thyroiditis, thyroidectomy, or radioactive
iodine therapy. Treatment of hypothyroidism with
replacement doses of thyroid hormone is...
Primary hypothyroidism is usually the result of
Hashimoto's thyroiditis, thyroidectomy, or radioactive
iodine therapy. Treatment of hypothyroidism with
replacement doses of thyroid hormone is usually
lifelong. Levothyroxine is the drug of choice.
Choice of Contraceptives
The Medical Letter on Drugs and Therapeutics • September 14, 2015; (Issue 1477)
Implants, intrauterine devices (IUDs), and sterilization
are the most effective contraceptive methods available.
Pills, patches, rings, and injectables, when used
correctly, are also highly effective in...
Implants, intrauterine devices (IUDs), and sterilization
are the most effective contraceptive methods available.
Pills, patches, rings, and injectables, when used
correctly, are also highly effective in preventing pregnancy.
Barrier and fertility-based methods have the
highest rates of failure.
Drugs for Postmenopausal Osteoporosis
The Medical Letter on Drugs and Therapeutics • September 29, 2014; (Issue 1452)
US guidelines for the treatment of osteoporosis have
been published. The diagnosis of osteoporosis has
traditionally been established by the occurrence of
fragility fractures or by bone densitometry, which...
US guidelines for the treatment of osteoporosis have
been published. The diagnosis of osteoporosis has
traditionally been established by the occurrence of
fragility fractures or by bone densitometry, which is
generally reported in terms of standard deviations (SD)
from mean values in young adults (T-score). The World
Health Organization (WHO) has defined normal bone
mineral density (BMD) for women as a value within one
SD of the young adult mean. Values 2.5 SD or more
below the mean (T-score -2.5 or below) at the spine,
femoral neck, or total hip are defined as osteoporosis.
The WHO has developed a computerized model (FRAX)
that predicts the 10-year probability of a hip fracture or
other major osteoporotic fracture based on clinical risk
factors and BMD at the femoral neck.
Conjugated Estrogens/Bazedoxifene (Duavee) for Menopausal Symptoms and Prevention of Osteoporosis
The Medical Letter on Drugs and Therapeutics • April 28, 2014; (Issue 1441)
The FDA has approved Duavee (Pfizer), a fixed-dose
combination of conjugated estrogens and the
new selective estrogen receptor modulator (SERM)
bazedoxifene, for treatment of moderate to severe
vasomotor...
The FDA has approved Duavee (Pfizer), a fixed-dose
combination of conjugated estrogens and the
new selective estrogen receptor modulator (SERM)
bazedoxifene, for treatment of moderate to severe
vasomotor symptoms and for prevention of osteoporosis
in postmenopausal women with an intact uterus.
Bazedoxifene is an estrogen agonist/antagonist with
estrogen-like effects on bone and antiestrogen effects
on the uterus. It is the second SERM to be approved
for prevention of osteoporosis; raloxifene (Evista, and
generics) has been available as a single agent for this
indication since 1997.
Quartette: An Ascending-Dose, Extended-Cycle Oral Contraceptive
The Medical Letter on Drugs and Therapeutics • July 8, 2013; (Issue 1420)
The FDA has approved Quartette (Teva), an extended-cycle
combination oral contraceptive containing increasing
doses of the estrogen ethinyl estradiol (EE)
combined with the progestin levonorgestrel (LNG)....
The FDA has approved Quartette (Teva), an extended-cycle
combination oral contraceptive containing increasing
doses of the estrogen ethinyl estradiol (EE)
combined with the progestin levonorgestrel (LNG). The
rationale is that a gradual increase in the EE dose may
reduce unscheduled bleeding or spotting, a common
adverse effect of extended-cycle oral contraceptives.
Addendum: Transdermal Estrogen
The Medical Letter on Drugs and Therapeutics • July 9, 2012; (Issue 1394)
A reader commented that our recent article on treatment of menopausal symptoms (Med Lett Drugs Ther 2012; 54:41) should have mentioned the potential advantages of transdermal estrogen. Transdermal estrogens are...
A reader commented that our recent article on treatment of menopausal symptoms (Med Lett Drugs Ther 2012; 54:41) should have mentioned the potential advantages of transdermal estrogen. Transdermal estrogens are probably as effective as oral estrogens in treating vasomotor menopausal symptoms, but transdermal administration may have less effect on serum triglycerides, C-reactive protein, thyroxine-binding globulin, cortisol-binding globulin and sex hormone-binding globulin. Observational data suggest that the risk of venous thromboembolism may be lower with transdermal administration compared to standard-dose oral estrogens, but comparative randomized controlled trials are lacking.
Download complete U.S. English article
Download complete U.S. English article
Drugs for Menopausal Symptoms
The Medical Letter on Drugs and Therapeutics • May 28, 2012; (Issue 1391)
The primary symptoms of menopause are vasomotor
and genitourinary. Vasomotor symptoms ("hot flashes")
cause daytime discomfort and chronic insomnia. A thin,
dry vaginal lining and thin urethral mucosa can...
The primary symptoms of menopause are vasomotor
and genitourinary. Vasomotor symptoms ("hot flashes")
cause daytime discomfort and chronic insomnia. A thin,
dry vaginal lining and thin urethral mucosa can cause
vaginal and vulvar irritation, pain during intercourse, and
an increased risk for urinary tract infection.
Drugs for Postmenopausal Osteoporosis
The Medical Letter on Drugs and Therapeutics • November 1, 2011; (Issue 111)
Osteoporosis is characterized by low bone mass with
microarchitectural disruption and skeletal fragility that
results in an increased risk of fracture. The diagnosis
has traditionally been established by...
Osteoporosis is characterized by low bone mass with
microarchitectural disruption and skeletal fragility that
results in an increased risk of fracture. The diagnosis
has traditionally been established by bone densitometry,
which is generally reported in terms of standard
deviations (SD) from mean values in young adults (T-score). The World Health Organization (WHO) has
defined normal bone mineral density (BMD) for
women as a value within one SD of the young adult
mean. Values 2.5 SD or more below the mean (T score
-2.5) are defined as osteoporosis. The WHO has developed
a computerized model (FRAX) that predicts the
10-year probability of a hip fracture or any other
major osteoporotic fracture based on clinical risk factors
and BMD at the femoral neck.
Drugs for Female Sexual Dysfunction
The Medical Letter on Drugs and Therapeutics • December 13, 2010; (Issue 1353)
Sexual complaints related to desire, arousal, orgasm
and painful intercourse are common in women. Since
the last Medical Letter article on this subject, some
new information has become...
Sexual complaints related to desire, arousal, orgasm
and painful intercourse are common in women. Since
the last Medical Letter article on this subject, some
new information has become available.
Bioidentical Hormones
The Medical Letter on Drugs and Therapeutics • May 31, 2010; (Issue 1339)
In recent years, many women have become concerned about the safety of pharmaceutical replacement
hormones for treatment of menopausal symptoms. “Bioidentical” hormone preparations, which are not approved...
In recent years, many women have become concerned about the safety of pharmaceutical replacement
hormones for treatment of menopausal symptoms. “Bioidentical” hormone preparations, which are not approved by the FDA, are heavily promoted in popular books and on TV as alternatives; these are
derivatives of soy or plant extracts, chemically modified to be structurally identical to endogenous hormones.
Most FDA-approved single-entity hormones are also derivatives of soy or plant extracts and are
structurally identical to hormones produced by the ovary.
Drugs for Thyroid Disorders
The Medical Letter on Drugs and Therapeutics • August 1, 2009; (Issue 84)
Primary hypothyroidism is usually the result of Hashimoto's thyroiditis, thyroidectomy for hyperthyroidism, goiter or cancer, or radioactive iodine therapy for...
Primary hypothyroidism is usually the result of Hashimoto's thyroiditis, thyroidectomy for hyperthyroidism, goiter or cancer, or radioactive iodine therapy for hyperthyroidism.
Conjugated Estrogens (Premarin) Vaginal Cream
The Medical Letter on Drugs and Therapeutics • February 23, 2009; (Issue 1306)
An old conjugated estrogens vaginal cream (Premarin Vaginal Cream - Wyeth) has been newly approved by the FDA specifically for treatment of moderate to severe dyspareunia due to vulvar and vaginal atrophy...
An old conjugated estrogens vaginal cream (Premarin Vaginal Cream - Wyeth) has been newly approved by the FDA specifically for treatment of moderate to severe dyspareunia due to vulvar and vaginal atrophy associated with menopause. Synthetic conjugated estrogens A vaginal cream (Barr) has also been approved for this indication, but has not yet been marketed.
Drugs for Postmenopausal Osteoporosis
The Medical Letter on Drugs and Therapeutics • October 1, 2008; (Issue 74)
Osteoporosis is characterized by low bone mass with microarchitectural disruption and skeletal fragility that results in an increased risk of fracture. The diagnosis has traditionally been established by bone...
Osteoporosis is characterized by low bone mass with microarchitectural disruption and skeletal fragility that results in an increased risk of fracture. The diagnosis has traditionally been established by bone densitometry, which is generally reported in terms of standard deviations (SD) from mean values in young adults (T score). The World Health Organization (WHO) has defined normal bone mineral density (BMD) for women as a value within one SD of the young adult mean. Values 2.5 SD (T score -2.5) or more below the mean are defined as osteoporosis. The WHO has developed a computerized model (FRAX) that predicts the 10-year probability of hip fracture based on clinical risk factors and BMD at the femoral neck.
Choice of Contraceptives
The Medical Letter on Drugs and Therapeutics • December 1, 2007; (Issue 64)
Transdermal, transvaginal and intrauterine hormone delivery systems have made highly effective contraceptive products more convenient to use. New oral contraceptive options include regimens with fewer or...
Transdermal, transvaginal and intrauterine hormone delivery systems have made highly effective contraceptive products more convenient to use. New oral contraceptive options include regimens with fewer or shorter hormone-free intervals.
Low-Dose Transdermal Estrogens
The Medical Letter on Drugs and Therapeutics • August 27, 2007; (Issue 1268)
Three low-dose transdermal estrogens were recently approved by the FDA for treatment of menopausal vasomotor symptoms. Elestrin and Divigel are transdermal estradiol gels and Evamist is an estradiol spray....
Three low-dose transdermal estrogens were recently approved by the FDA for treatment of menopausal vasomotor symptoms. Elestrin and Divigel are transdermal estradiol gels and Evamist is an estradiol spray. Elestrin has been marketed in Europe since 1976.
Drugs for Prevention and Treatment of Postmenopausal Osteoporosis
The Medical Letter on Drugs and Therapeutics • October 1, 2005; (Issue 38)
Many drugs are now marketed for treatment of postmenopausal osteoporosis, but questions remain about their...
Many drugs are now marketed for treatment of postmenopausal osteoporosis, but questions remain about their use.
Atypical Antipsychotics in the Elderly
The Medical Letter on Drugs and Therapeutics • August 1, 2005; (Issue 1214)
The FDA has reported that 5106 elderly patients with dementia treated with atypical (second generation) antipsychotics in 17 randomized controlled trials had a higher mortality rate (4.5% vs. 2.6%) than those...
The FDA has reported that 5106 elderly patients with dementia treated with atypical (second generation) antipsychotics in 17 randomized controlled trials had a higher mortality rate (4.5% vs. 2.6%) than those receiving placebo. Most of the deaths were due to cardiovascular and infectious causes (such as pneumonia). The drugs used in the trials were aripiprazole (Abilify), olanzapine (Zyprexa), quetiapine (Seroquel), and risperidone (Risperdal). As the increase in mortality was considered a class effect, the FDA advisory also included ziprasidone (Geodon), clozapine (Clozaril) and the olanzapine/fluoxetine combination (Symbyax). The manufacturers of all of these drugs will be required to add a "black box" warning to their labeling.
Drugs for Acne, Rosacea and Psoriasis
The Medical Letter on Drugs and Therapeutics • July 1, 2005; (Issue 35)
The pathogenesis of acne is multifactorial: follicular hyperkeratinization, Propionibacterium acnes bacteria, sebum production, androgens and inflammation have all been implicated. P. acnes, a gram-positive...
The pathogenesis of acne is multifactorial: follicular hyperkeratinization, Propionibacterium acnes bacteria, sebum production, androgens and inflammation have all been implicated. P. acnes, a gram-positive microaerophilic bacterium, plays an important role in the development of acne lesions by secreting chemotactic factors that attract leukocytes to the follicle, causing inflammation.
Treatment of Menopausal Vasomotor Symptoms
The Medical Letter on Drugs and Therapeutics • December 6, 2004; (Issue 1197)
Estrogen is the most effective treatment for menopausal vasomotor symptoms (hot flashes), but the Women's Health Initiative study found that women who took estrogen plus a progestin for more than 5 years were...
Estrogen is the most effective treatment for menopausal vasomotor symptoms (hot flashes), but the Women's Health Initiative study found that women who took estrogen plus a progestin for more than 5 years were at increased risk for myocardial infarction, stroke, pulmonary emboli, deep vein thrombosis, breast cancer, and possibly dementia. Are there effective alternatives?
Menostar - A Low-Dose Estrogen Patch for Osteoporosis
The Medical Letter on Drugs and Therapeutics • August 30, 2004; (Issue 1190)
The FDA has approved a new low-dose estrogen patch (Menostar - Berlex) for prevention of osteoporosis in postmenopausal women. Unlike other estrogen patches, it is not approved for treatment of hot flashes or...
The FDA has approved a new low-dose estrogen patch (Menostar - Berlex) for prevention of osteoporosis in postmenopausal women. Unlike other estrogen patches, it is not approved for treatment of hot flashes or other menopausal symptoms. Promotional material from the manufacturer suggests that this low dose of estrogen could prevent osteoporosis without some of the adverse effects of higher doses.
Choice of Contraceptives
The Medical Letter on Drugs and Therapeutics • August 1, 2004; (Issue 24)
In recent years, several new contraceptive options have become available in the United States. Novel hormone delivery systems such as transdermal, transvaginal and intrauterine devices have improved the...
In recent years, several new contraceptive options have become available in the United States. Novel hormone delivery systems such as transdermal, transvaginal and intrauterine devices have improved the convenience of highly effective contraceptive products. Like oral contraceptives and most barrier contraceptives, these devices do not protect against sexually transmitted diseases.
Drug Interactions with Grapefruit Juice
The Medical Letter on Drugs and Therapeutics • January 5, 2004; (Issue 1173)
The ability of grapefruit juice to increase serum concentrations of drugs was first discovered during a study of the effect of ethanol on felodipine (Plendil) pharmacokinetics. Double-strength grapefruit juice...
The ability of grapefruit juice to increase serum concentrations of drugs was first discovered during a study of the effect of ethanol on felodipine (Plendil) pharmacokinetics. Double-strength grapefruit juice used to disguise the taste of ethanol resulted in higher than expected serum concentrations of felodipine (DG Bailey et al, Clin Invest Med 1989; 12:357).
Drugs for Prevention and Treatment of Postmenopausal Osteoporosis
The Medical Letter on Drugs and Therapeutics • November 1, 2002; (Issue 3)
Many drugs are now marketed for treatment of post-menopausal osteoporosis (PD Delmas, Lancet 2002; 359:2018). Prevention of this disorder has been complicated by the news that hormone replacement therapy (HRT),...
Many drugs are now marketed for treatment of post-menopausal osteoporosis (PD Delmas, Lancet 2002; 359:2018). Prevention of this disorder has been complicated by the news that hormone replacement therapy (HRT), which many women have been taking to prevent osteoporosis, increases the incidence of coronary heart disease and that of breast cancer, stroke and pulmonary embolism as well (Medical Letter 2002; 44:78).
Hormone Replacement Therapy
The Medical Letter on Drugs and Therapeutics • September 2, 2002; (Issue 1138)
The results of a large randomized controlled trial of estrogen plus a progestin to prevent heart disease in postmenopausal women were recently reported (Writing Group for the Women's Health Initiative...
The results of a large randomized controlled trial of estrogen plus a progestin to prevent heart disease in postmenopausal women were recently reported (Writing Group for the Women's Health Initiative Investigators, JAMA 2002; 288:321).
Drugs That May Cause Psychiatric Symptoms
The Medical Letter on Drugs and Therapeutics • July 8, 2002; (Issue 1134)
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment may also be due to the underlying illness, previously...
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment may also be due to the underlying illness, previously unrecognized psychopathology, or psychosocial factors. The withdrawal of some drugs can cause symptoms such as anxiety, psychosis, delirium, agitation or depression.
Drugs For Prevention and Treament of Postmenopausal Osteoporosis
The Medical Letter on Drugs and Therapeutics • October 16, 2000; (Issue 1090)
Many drugs are now marketed for prevention and treatment of postmenopausal osteoporosis. All regimens should include an adequate intake of calcium and vitamin...
Many drugs are now marketed for prevention and treatment of postmenopausal osteoporosis. All regimens should include an adequate intake of calcium and vitamin D.
A New Conjugated Estrogen
The Medical Letter on Drugs and Therapeutics • July 30, 1999; (Issue 1058)
A new synthetic conjugated estrogen product (Cenestin - Duramed) was recently approved by the US Food and Drug Administration for treatment of vasomotor symptoms due to estrogen...
A new synthetic conjugated estrogen product (Cenestin - Duramed) was recently approved by the US Food and Drug Administration for treatment of vasomotor symptoms due to estrogen deficiency.