Verónica Reyes - Profile on Academia.edu (original) (raw)

Papers by Verónica Reyes

Research paper thumbnail of Levonorgestrel pharmacokinetics in plasma and milk of lactating women who take 1.5 mg for emergency contraception

Human Reproduction, 2007

BACKGROUND: Progestin-only methods are among the contraceptive options available for breastfeedin... more BACKGROUND: Progestin-only methods are among the contraceptive options available for breastfeeding women, however the doses of progestin used in emergency contraception (EC) have not been evaluated in nursing mothers. We therefore investigated the pharmacokinetics of 1.5 mg levonorgestrel (LNG) in lactating women. METHODS: Twelve healthy exclusively breastfeeding volunteers received 1.5 mg LNG. Women refrained from nursing for 72 h after dosing and fed their infants with milk frozen beforehand. Serial blood and milk samples were collected for 120 h and assayed for LNG and sex hormone binding globulin. RESULTS: LNG concentrations peaked in plasma and in milk 1-4 h and 2-4 h after dosing, respectively. Concentrations in milk (M) paralleled those in plasma (P) but were consistently lower (mean M:P ratio 0.28). Estimated infant exposure to LNG is 1.6 mg on the day of dosing (1 mg in the first 8 h), 0.3 mg on the second day and 0.2 mg on the third day. CONCLUSIONS: Nursing mothers may need EC. These results suggest that to limit infant exposure to the period of maximum LNG excretion in milk, mothers should discontinue nursing for at least 8 h, but not more than 24 h, after EC.

Research paper thumbnail of Pain from copper intrauterine device insertion: Randomized trial of prophylactic ibuprofen

American Journal of Obstetrics and Gynecology, 2006

Research paper thumbnail of Two-year performance of a Nestorone®-releasing contraceptive implant: a three-center study of 300 women

Two-year performance of a Nestorone®-releasing contraceptive implant: a three-center study of 300 women

Contraception, 2004

A 2-year trial of a single Nestorone (NES) rod implant was conducted at three Latin American cent... more A 2-year trial of a single Nestorone (NES) rod implant was conducted at three Latin American centers, each enrolling 100 women. We studied the safety, effectiveness and acceptability of this progestin-releasing contraceptive implant. Three pregnancies occurred, the last at 18 months of use. Because no pregnancies were expected in the first 18 months, the trial was halted. At that time, 224 women had completed at least 18 months of use, and 99 women had used the implant for more than 24 months. Few participants used adjunctive contraception between the time the study was halted and the time they had their implant removed. No additional pregnancies occurred before the removal of the last implant. The 2-year cumulative pregnancy rate was 1.7 per 100 with a Pearl index of 0.6 per 100 for the 2-year period. The 1-year and 2-year continuation rates were 80.5 and 66.7 per 100, respectively. Menstrual and medical disturbances were the principal reasons for discontinuation, followed by planned pregnancy. Headache and weight gain frequently led to discontinuation. The NES implant had little important effect on most clinical chemistry and lipid parameters. Over the study course, the mean change in hemoglobin was <1%. Slight modification of the design of this single 2-year implant, restoring features previously examined in clinical trials, is likely to improve its effectiveness. A single NES implant appears to provide acceptable contraception for women.

Research paper thumbnail of Effects of a novel estrogen-free, progesterone receptor modulator-contraceptive vaginal ring on inhibition of ovulation, bleeding patterns and endometrium in normal women

Contraception

Background-Progesterone receptor modulators (PRMs) delivered by contraceptive vaginal rings provi... more Background-Progesterone receptor modulators (PRMs) delivered by contraceptive vaginal rings provide an opportunity for development of an estrogen-free contraceptive that does not require daily oral intake of steroids. The objective of this proof-of-concept study was to determine whether continuous delivery of 600-800 mcg of ulipristal acetate (UPA) from a contraceptive vaginal ring could achieve 80% to 90% inhibition of ovulation.

Research paper thumbnail of Pain from copper intrauterine device insertion: randomized trial of prophylactic ibuprofen

Research paper thumbnail of Contraceptive efficacy of emergency contraception with levonorgestrel given before or after ovulation

Contraception, 2010

Recibido el 9 de noviembre de 2009, revisado el 10 de diciembre de 2009; aceptado el 16 de diciem... more Recibido el 9 de noviembre de 2009, revisado el 10 de diciembre de 2009; aceptado el 16 de diciembre de 2009 ___________________________________________________________ Resumen Antecedentes: Nos propusimos evaluar si la anticoncepción de emergencia con levonorgestrel (LNG-EC) administrado después de la ovulación es igualmente efectiva con el LNG-EC administrado antes de la ovulación. Diseño del estudio: Estudiamos un grupo de mujeres que asistían a una clínica de planificación familiar para CE. A partir de la entrevista, registramos su historial menstrual, el momento del coito y la ingesta de LNG-EC. El día de la ingesta de LNG-EC y durante el seguimiento por cinco días, se tomaron muestras de sangre para examinar las concentraciones de hormona luteinizante, estradiol y progesterona, y se efectuaron exámenes de ultrasonido vaginal para ver el tamaño del folículo principal y/o del cuerpo lúteo. Posteriormente, no se contactó a las mujeres has que se presentara su siguiente menstruación o el embarazo. Resultados: De 388 mujeres que se presentaron para el LNG-EC, 122 mujeres tuvieron coitos durante los días del ciclo fértil, de acuerdo a los 2 hallazgos del ultrasonido y endocrinos. Para el momento de la ingesta del LNG-EC, 87 mujeres estaban en los días del -5 al -1 y 35 mujeres estaban en el día 0 (día de la ovulación) o más allá. Con el uso de la probabilidad de embarazo clínico reportado por Wilcox et al. [N Engl J Med 333 (1995) 1517 -1521], los números de embarazos esperados entre las 87 y las 35 mujeres eran de 13 y 7, respectivamente, mientras se presentaron 0 y 6 embarazos, respectivamente. Conclusión: Concluimos que el LNG-EC impide el embarazo solamente cuando es ingerido antes de que se haya presentado la fertilización del óvulo. © 2010 Elsevier Inc. Todos los derechos reservados. Palabras clave: Anticoncepción de emergencia; Levonorgestrel, eficacia anticonceptiva. ___________________________________________________________ 0010-7824/$ -ver asunto principal

Research paper thumbnail of Preventing copper intrauterine device removals due to side effects among first-time users: randomized trial to study the effect of prophylactic ibuprofen

BACKGROUND: Increased menstrual bleeding and pain are the primary side effects that lead to early... more BACKGROUND: Increased menstrual bleeding and pain are the primary side effects that lead to early removal of the copper intrauterine device (IUD). Ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs) are proven treatments for such IUD-induced problems, but their effect on early IUD removal is unknown. METHODS: A total of 2019 first-time IUD users were recruited in Chile for this double-blind, randomized, placebo-controlled trial. Half of the participants were given ibuprofen and instructions to take 1200 mg daily during menses (for up to 5 days each cycle) for the first 6 months of IUD use. The other half were asked to take an identical appearing placebo in the same manner. The primary outcome was IUD removal within 12 months of insertion. RESULTS: A total of 1011 and 1008 women were randomly assigned to ibuprofen and placebo, respectively. During 12 months of observation, 190 had the device removed because of dysmenorrhoea and/or increased menstrual bleeding: 85 in the placebo group and 105 in the ibuprofen group. For ibuprofen users, the hazard ratio for removal for these IUD-induced side effects was 1.0 and 1.2 at 6 and 12 months, respectively (both not significant). CONCLUSION: Although increased menstrual bleeding and pain are common reasons for early IUD removal, prophylactic use of ibuprofen, at the dosage used here, does not reduce removal rates.

Research paper thumbnail of Corrientes psicológicas

Research paper thumbnail of Levonorgestrel pharmacokinetics in plasma and milk of lactating women who take 1.5 mg for emergency contraception

Human Reproduction, 2007

BACKGROUND: Progestin-only methods are among the contraceptive options available for breastfeedin... more BACKGROUND: Progestin-only methods are among the contraceptive options available for breastfeeding women, however the doses of progestin used in emergency contraception (EC) have not been evaluated in nursing mothers. We therefore investigated the pharmacokinetics of 1.5 mg levonorgestrel (LNG) in lactating women. METHODS: Twelve healthy exclusively breastfeeding volunteers received 1.5 mg LNG. Women refrained from nursing for 72 h after dosing and fed their infants with milk frozen beforehand. Serial blood and milk samples were collected for 120 h and assayed for LNG and sex hormone binding globulin. RESULTS: LNG concentrations peaked in plasma and in milk 1-4 h and 2-4 h after dosing, respectively. Concentrations in milk (M) paralleled those in plasma (P) but were consistently lower (mean M:P ratio 0.28). Estimated infant exposure to LNG is 1.6 mg on the day of dosing (1 mg in the first 8 h), 0.3 mg on the second day and 0.2 mg on the third day. CONCLUSIONS: Nursing mothers may need EC. These results suggest that to limit infant exposure to the period of maximum LNG excretion in milk, mothers should discontinue nursing for at least 8 h, but not more than 24 h, after EC.

Research paper thumbnail of Pain from copper intrauterine device insertion: Randomized trial of prophylactic ibuprofen

American Journal of Obstetrics and Gynecology, 2006

Research paper thumbnail of Two-year performance of a Nestorone®-releasing contraceptive implant: a three-center study of 300 women

Two-year performance of a Nestorone®-releasing contraceptive implant: a three-center study of 300 women

Contraception, 2004

A 2-year trial of a single Nestorone (NES) rod implant was conducted at three Latin American cent... more A 2-year trial of a single Nestorone (NES) rod implant was conducted at three Latin American centers, each enrolling 100 women. We studied the safety, effectiveness and acceptability of this progestin-releasing contraceptive implant. Three pregnancies occurred, the last at 18 months of use. Because no pregnancies were expected in the first 18 months, the trial was halted. At that time, 224 women had completed at least 18 months of use, and 99 women had used the implant for more than 24 months. Few participants used adjunctive contraception between the time the study was halted and the time they had their implant removed. No additional pregnancies occurred before the removal of the last implant. The 2-year cumulative pregnancy rate was 1.7 per 100 with a Pearl index of 0.6 per 100 for the 2-year period. The 1-year and 2-year continuation rates were 80.5 and 66.7 per 100, respectively. Menstrual and medical disturbances were the principal reasons for discontinuation, followed by planned pregnancy. Headache and weight gain frequently led to discontinuation. The NES implant had little important effect on most clinical chemistry and lipid parameters. Over the study course, the mean change in hemoglobin was <1%. Slight modification of the design of this single 2-year implant, restoring features previously examined in clinical trials, is likely to improve its effectiveness. A single NES implant appears to provide acceptable contraception for women.

Research paper thumbnail of Effects of a novel estrogen-free, progesterone receptor modulator-contraceptive vaginal ring on inhibition of ovulation, bleeding patterns and endometrium in normal women

Contraception

Background-Progesterone receptor modulators (PRMs) delivered by contraceptive vaginal rings provi... more Background-Progesterone receptor modulators (PRMs) delivered by contraceptive vaginal rings provide an opportunity for development of an estrogen-free contraceptive that does not require daily oral intake of steroids. The objective of this proof-of-concept study was to determine whether continuous delivery of 600-800 mcg of ulipristal acetate (UPA) from a contraceptive vaginal ring could achieve 80% to 90% inhibition of ovulation.

Research paper thumbnail of Pain from copper intrauterine device insertion: randomized trial of prophylactic ibuprofen

Research paper thumbnail of Contraceptive efficacy of emergency contraception with levonorgestrel given before or after ovulation

Contraception, 2010

Recibido el 9 de noviembre de 2009, revisado el 10 de diciembre de 2009; aceptado el 16 de diciem... more Recibido el 9 de noviembre de 2009, revisado el 10 de diciembre de 2009; aceptado el 16 de diciembre de 2009 ___________________________________________________________ Resumen Antecedentes: Nos propusimos evaluar si la anticoncepción de emergencia con levonorgestrel (LNG-EC) administrado después de la ovulación es igualmente efectiva con el LNG-EC administrado antes de la ovulación. Diseño del estudio: Estudiamos un grupo de mujeres que asistían a una clínica de planificación familiar para CE. A partir de la entrevista, registramos su historial menstrual, el momento del coito y la ingesta de LNG-EC. El día de la ingesta de LNG-EC y durante el seguimiento por cinco días, se tomaron muestras de sangre para examinar las concentraciones de hormona luteinizante, estradiol y progesterona, y se efectuaron exámenes de ultrasonido vaginal para ver el tamaño del folículo principal y/o del cuerpo lúteo. Posteriormente, no se contactó a las mujeres has que se presentara su siguiente menstruación o el embarazo. Resultados: De 388 mujeres que se presentaron para el LNG-EC, 122 mujeres tuvieron coitos durante los días del ciclo fértil, de acuerdo a los 2 hallazgos del ultrasonido y endocrinos. Para el momento de la ingesta del LNG-EC, 87 mujeres estaban en los días del -5 al -1 y 35 mujeres estaban en el día 0 (día de la ovulación) o más allá. Con el uso de la probabilidad de embarazo clínico reportado por Wilcox et al. [N Engl J Med 333 (1995) 1517 -1521], los números de embarazos esperados entre las 87 y las 35 mujeres eran de 13 y 7, respectivamente, mientras se presentaron 0 y 6 embarazos, respectivamente. Conclusión: Concluimos que el LNG-EC impide el embarazo solamente cuando es ingerido antes de que se haya presentado la fertilización del óvulo. © 2010 Elsevier Inc. Todos los derechos reservados. Palabras clave: Anticoncepción de emergencia; Levonorgestrel, eficacia anticonceptiva. ___________________________________________________________ 0010-7824/$ -ver asunto principal

Research paper thumbnail of Preventing copper intrauterine device removals due to side effects among first-time users: randomized trial to study the effect of prophylactic ibuprofen

BACKGROUND: Increased menstrual bleeding and pain are the primary side effects that lead to early... more BACKGROUND: Increased menstrual bleeding and pain are the primary side effects that lead to early removal of the copper intrauterine device (IUD). Ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs) are proven treatments for such IUD-induced problems, but their effect on early IUD removal is unknown. METHODS: A total of 2019 first-time IUD users were recruited in Chile for this double-blind, randomized, placebo-controlled trial. Half of the participants were given ibuprofen and instructions to take 1200 mg daily during menses (for up to 5 days each cycle) for the first 6 months of IUD use. The other half were asked to take an identical appearing placebo in the same manner. The primary outcome was IUD removal within 12 months of insertion. RESULTS: A total of 1011 and 1008 women were randomly assigned to ibuprofen and placebo, respectively. During 12 months of observation, 190 had the device removed because of dysmenorrhoea and/or increased menstrual bleeding: 85 in the placebo group and 105 in the ibuprofen group. For ibuprofen users, the hazard ratio for removal for these IUD-induced side effects was 1.0 and 1.2 at 6 and 12 months, respectively (both not significant). CONCLUSION: Although increased menstrual bleeding and pain are common reasons for early IUD removal, prophylactic use of ibuprofen, at the dosage used here, does not reduce removal rates.

Research paper thumbnail of Corrientes psicológicas