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It has effects similar to those of the hormone progesterone. [11] As a contraceptive, it works primarily by preventing ovulation and closing off the cervix to prevent the passage of sperm. [11] The endometrial transformation dose of levonorgestrel is 150 to 250 μg/day or 2.5 to 6 mg per cycle. [8] [53] [54] [55]
Side effects can include nausea, headache, blood clots, breast pain, depression, and liver problems. [3] Use is not recommended during pregnancy, the initial three weeks after childbirth, and in those at high risk of blood clots. [3] However, it may be started immediately after a miscarriage or abortion. [5]
The Yuzpe regimen is a method of emergency contraception that uses a combination of ethinyl estradiol and levonorgestrel, specifically 1 mg of norgestrel (or 0.50mg of levonorgestrel) and 100 mcg of ethinyl estradiol ASAP and again in 12 hrs.
A higher dosage of estradiol gel containing 1.5 mg estradiol per daily application has been found to produce mean estradiol levels of 40 to 100 pg/mL and estrone levels of 90 pg/mL, while 3 mg per day has been found to result in respective mean estradiol and estrone levels of 60 to 140 pg/mL and 45 to 155 pg/mL. [15]
The use of COCP is dependent on desirable effects and risk of adverse events with progestin component and dose of estrogen and progestin component. Estrogen component: Estradiol, Ethinylestradiol, or Estetrol; First-generation progestin: Norethindrone acetate, Ethynodiol diacetate, Lynestrenol, Norethynodrel
Side effects of estradiol valerate include breast tenderness, breast enlargement, nausea, headache, and fluid retention. [15] [13] [14] Estradiol valerate is an estrogen and hence is an agonist of the estrogen receptor, the biological target of estrogens like estradiol. [5] [4] [16] It is an estrogen ester and a prodrug of estradiol in the body.
As unopposed estrogen therapy (using estrogen alone without progesterone) increases the risk of endometrial hyperplasia and endometrial cancer in women with intact uteruses, estradiol is usually combined with a progestogen like progesterone or medroxyprogesterone acetate to prevent the effects of estradiol on the endometrium.
Estradiol/levonorgestrel (E2/LNG), sold under brand name Climara Pro, is a combination of estradiol (E2) and levonorgestrel (LNG) which is used in menopausal hormone therapy. [ 1 ] [ 2 ] [ 3 ] It is a 22-cm 2 transdermal patch containing 4.4 mg estradiol and 1.39 mg levonorgestrel and delivers 45 μg/day estradiol and 15 μg/day levonorgestrel.
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