Steroid contraceptives and women's response regional variability in side-effects and pharmacokinetics ; [proceedings based on a Symposium on Steroid Contraceptives and Women's Response: Regional Variability in Side-Effects and Steroid Pharmacokinetics, he

Pharmacokinetic variability of contraceptive steroids is a relatively under-explored area of contraceptive research, and hardly a common point of discussion among those who plan and deliver family planning services. Nevertheless, numerous independent studies over the last 15 years have indicated that women in different regions of the world vary in their pharmacokinetic response to contraceptive steroids. The causes of such variability are not known, but it has important consequences for contraceptive effectiveness. It may also offer insight to the basis of contraceptive side-effects. The impetus for this volume was to collect documentation of pharmacokinetic variability of contraceptive steroids, and to explore both the possible causes and implications of these data. Factors known to affect steroid pharmacokinetics, such as concurrent use of specific medications, are reviewed by Back and Orme. Other factors known to affect endogenous steroid dynamics are presented in chapters by Bradlow, Longcope, Goldin and Snow, because of their possible role in contraceptive steroid pharmacokinetics. Front Matter....Pages i-ix Why Pharmacokinetics? An Introduction And Overview....Pages 1-7 Selection of a Contraceptive: What Guides A Woman?....Pages 9-14 Contraceptives and Women’s Complaints &— Preliminary Results From the Post-Marketing Surveillance of Norplant R ....Pages 15-26 Regional and Individual Variation in Bleeding Patterns Associated with Steroid Contraception....Pages 27-53 Variability in Menstrual Bleeding Patterns: Comparing Treated and Untreated Menstrual Cycles....Pages 55-59 Contraceptive Use and Discontinuation: The Social Meaning of Side-Effects....Pages 61-68 Population and Delivery Systems: Variability in Pharmacokevettcs of Long-Acting Injectable Contraceptives....Pages 69-83 Pharmacology of The Ethynyl Estrogens in Various Countries....Pages 85-89 Pharmacodynamics of Norplant R Implants....Pages 91-102 Pharmacokinetic Drug Interactions with Oral Contraceptives....Pages 103-123 A Critical Evaluation of the Pharmacokinetics of Contraceptive Steroids....Pages 125-132 A Short Review on the Sources of Variability in Pharmacokinetic Parameters of Sex Steroids: Comment on the Paper by K. Fotherby....Pages 133-141 Diet and Estrogen Metabolism....Pages 143-151 Diet, Circulating Estrogen Levels and Estrogen Excretion....Pages 153-169 Variations in Estrogen Metabolism....Pages 171-177 Body Fat, Fat Topography and Endogenous Steroid Dynamics....Pages 179-186 Steroid Contraceptives and Women’s Response: Program Considerations from the Quality of Care Perspective....Pages 187-197 Bringing a Client and Life-Cycle Perspective to Scientific Evidence....Pages 199-205 Commentary on Presentation of Dr. Pramilla Senanayake....Pages 207-211 A Clinician’s Perspective....Pages 213-217 Regional Population Differences and Population Pharmacokinetics of Steroidal Contraceptives....Pages 219-237 Variability in Steroid Pharmacokinetics: Needs for Future Research....Pages 239-245 Experimental Design for Future Research....Pages 247-250 Looking Forward: New Research Priorities....Pages 251-256 Back Matter....Pages 257-266 Edited By Rachel Snow And Peter Hall. Proceedings Based On A Symposium On Steroid Contraceptives And Women's Response: Regional Variability In Side-effects And Steroid Pharmacokinetics, Held October 21-25, 1990, In Exeter, New Hampshire--t.p. Verso. Includes Bibliographical References And Index. Proceedings of a symposium held in Exeter, New Hampshire, October 21-25, 1990