Browsing by Subject "Drug implants"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Long-Acting Reversible Contraception
    (Massachusetts Medical Society, 2017) Curtis, Kathryn M.; Peipert, Jeffrey F.; Obstetrics and Gynecology, School of Medicine
    A 17-year-old high school student who has never been pregnant presents for advice regarding contraception. She has an unremarkable medical history and is planning to become sexually active with her boyfriend in the near future. Her primary concern is an unintended pregnancy, and she inquires about methods of contraception that are highly effective. How would you counsel her about options for contraception?
  • Thumbnail Image
    Item
    Random Luteinizing Hormone Often Remains Pubertal in Children Treated with the Histrelin Implant for Central Precocious Puberty
    (Elsevier, 2013) Lewis, Katherine A.; Eugster, Erica A.; Pediatrics, School of Medicine
    Objective: To investigate the use of random ultrasensitive (US) luteinizing hormone (LH) levels to monitor children being treated with a histrelin implant for central precocious puberty (CPP). Study design: This was a prospective, uncontrolled, observational study at a pediatric endocrinology tertiary center. Thirty-three children (26 girls; mean age 7.2 ± 2.5 years) treated with a histrelin implant for CPP were enrolled. A random US LH measurement was obtained at 6 months, and a gonadotropin-releasing hormone analog stimulation test was performed at 12 months. Clinic visits occurred at baseline and at 6-month intervals. Results: In 59% of the patients (17 of 29), the 6-month random US LH exceeded the prepubertal range of ≤0.3 IU/L. In contrast, gonadotropin-releasing hormone analog stimulation tests revealed complete hypothalamic-pituitary-gonadal axis suppression (peak LH <4 IU/L) in all 31 patients who underwent testing. US LH levels were highly correlated with peak stimulated LH levels. The mean peak stimulated LH level was higher in patients with a pubertal random LH than in those with a prepubertal random LH (1.2 ± 0.5 IU/L vs 0.5 ± 0.1 IU/L; P < .01). No patient had clinical evidence of pubertal progression. Conclusion: The random US LH level does not revert to a prepubertal range in more than one-half of patients with a histrelin implant and documented hypothalamic-pituitary-gonadal axis suppression. Long-term studies are needed to elucidate the optimal strategy for monitoring treatment in children with CPP.
  • Thumbnail Image
    Item
    Resumption of Puberty in Girls and Boys Following Removal of the Histrelin Implant
    (Elsevier, 2014) Fisher, Marisa M.; Lemay, Deborah; Eugster, Erica A.; Pediatrics, School of Medicine
    Objectives: To determine time to menarche in girls and testicular volume increase in boys after removal of a histrelin implant, which causes profound hypothalamic-pituitary-gonadal axis suppression. Study design: Medical records of patients treated with a histrelin implant were reviewed. Seventy-one patients (56 girls) treated with the histrelin implant were identified, of these patients, 37 explanted girls (68% naïve) and 6 explanted boys (83% naïve) were included in the analysis. Time to menarche after explantation in girls and time to testicular volume increase after explantation in boys were determined. Additional variables investigated included indication for and duration of treatment, history of menarche (girls), previous therapy, and age at beginning and end of histrelin treatment. Results: Of the girls, 30 were treated for central precocious puberty (CPP), 26 had menarche at an average of 12.75 months after explantation. Of the 30, 7 were treated for other indications, of whom 6 had reached menarche. In girls with CPP, older age at explantation correlated with sooner menarche (P = .04). All boys achieved spontaneous testicular enlargement within 1 year of explantation. Conclusions: This study documented resumption of puberty after histrelin explantation in treatment naïve and non-naïve boys and girls with and without CPP. Menarche in girls with CPP occurs within a similar timeframe to that observed after other treatment approaches.