The cyclofemina is a combined hormonal drug type parenteral use. It is a comfortable and safe alternative for the treatment of menstrual dysfunction, contraception and hormone replacement therapy. Administration by the intramuscular route is an advantage over oral hormonal preparations.
The drug is a combination of two active ingredients -medroxyprogesterone and estradiol-, which ensures its effectiveness. Both hormones are presented in an aqueous suspension for monthly injection. The joint action of two hormones gives several mechanisms of action, constituting an advantage over simple preparations.
The development of cyclofemin is due to the Concept Foundation, a Thai organization supported by the World Health Organization. It was initially marketed in Indonesia and Mexico in 1993, and later distributed in other countries. In 1997 Concept Foundation obtained the rights to the drug, under the name Cyclofem®.
Around 16 million women in the world use injectable contraception, due to the convenience of its monthly or quarterly administration. In Latin America and China, the use of injectable contraceptives is increasingly regular.
The need for effective birth control mechanisms makes cyclofemin a drug of choice for this purpose. Beyond contraception, the drug is also useful in pathologies related to menstrual function.
What is it for?
Medroxyprogesterone acetate, a component of cyclofemin
The usefulness of cyclofemin is determined by its composition and the effects it produces. The association of two hormonal compounds produces an additive effect that exceeds the effect of preparations with a single hormone.
Composition
Cyclofemin is made up of two hormones:
- Medroxyprogesterone Acetate, 25 mg.
- Estradiol cypionate, 5 mg (combination on which its effect is based).
Medroxyprogesterone is the most abundant progestin in women. Its biological function is related to the control of the menstrual cycle.
Estradiol is an estrogenic hormone with a wide range of effects on the female body, including sexual and reproductive function, protection of the skin and the cardiovascular system.
Effect
Both hormones are capable of inhibiting the effect of follicle-stimulating (FSH), luteinizing (LH) hormones and, to a lesser extent, chorionic gonadotropin. Consequently, there are three changes in female reproductive physiology:
- Inhibits the release of eggs from the ovarian follicle.
- Prevents the proliferation of the endometrium.
- Increases the viscosity of cervical mucus.
Applications
The main use of cyclofemin is as a contraceptive, because it does not favor the female reproductive mechanism. The inhibition of ovulation, the barrier posed by the viscosity of the cervical mucus and the lack of endometrial proliferation are determining factors of the contraceptive effect.
Proper use prevents pregnancies in sexually active women, without causing effects on fertility after suspension.
The action on female hormones also involves other effects, useful for the treatment of menstrual dysfunction:
- Helps regulate menstrual cycles in women with abnormal cycles.
- Treatment of secondary amenorrhea.
- Avoid endometrial hyperplasia.
- Corrects abnormal uterine bleeding; that is, abundant or outside the period.
- It is used as hormone replacement treatment in women with total hysterectomy or menopause.
Effectiveness
The composition of cyclofemina, made up of 2 hormones, increases the effectiveness of the drug; the effectiveness of cyclofemin is estimated to be nearly 100%. However, the pregnancy rate of 0.1 to 0.2% can be seen before the first 6 months of continuous use.
Some medications can decrease the effectiveness of the hormonal compound, such as aminoglutetamide, which lowers the serum concentration of medroxyprogesterone. Other drugs that interact with cyclofemin by increasing its liver metabolism are:
- Ampicillin.
- Rifampicin.
- Chloramphenicol.
- Tetracyclines.
- Drugs such as barbiturates.
- Benzodiazepines.
Side effects
Like most medicines, estradiol and medroxyprogesterone can cause unwanted effects. Although cyclofemin is well tolerated and the rate of side effects is low, it must be taken into account that these can occur.
The most severe and rapid complication that occurs from the administration of a drug is hypersensitivity, both to the active principle and to its vehicle.
In the case of cyclofemin, it can cause urticaria, facial, eyelid or limb edema, respiratory distress or cough. These symptoms should be treated as soon as they appear.
Other side effects, no less important, are:
- Alterations in body weight, such as obesity.
- Hyporexia.
- Increase in blood glucose or lipids.
- Amenorrhea.
- Increased menstrual bleeding or short menstrual cycles.
- Tachycardias.
- Increased blood pressure.
- Headache.
- dizziness
- Varicose veins in lower limbs.
- Increased risk of thrombophlebitis and pulmonary thromboembolism.
- Body weakness.
- Depression.
- insomnia
It should be noted that other side effects occur related to the age and predisposition of each person. The increased risk for cardiovascular and cerebrovascular diseases is typical of the use of hormonal contraceptives after the age of 40.
Some types of cancer - such as cervical or breast cancer - have specific hormonal receptors, so the use of cyclofemin could promote or worsen them.
Contraindications
Some clinical situations or conditions in women mean avoiding the administration of cyclofemin. Contraindications to the use of hormonal compounds arise because the risk of administration outweighs the benefit.
The medical history and the appropriate physical examination are the tools to determine the indication of the hormonal compound. The use of cyclofemina is contraindicated in the following situations:
- Hypersensitivity to the active principle or to the vehicle, due to the risk of presenting anaphylaxis.
- Pregnancy and lactation. During pregnancy it is not necessary to use hormones that could affect its normal development. In general, simple hormonal preparations are used in lactation.
- Cancer of the hormone-dependent reproductive system.
- Breast cancer.
- Genital bleeding whose cause has not been specified.
- Endometrial hyperplasia of unknown origin.
- Galactorrhea not related to pregnancy or lactation.
- Cardiovascular diseases, such as high blood pressure or heart disease.
- Dyslipidemias, due to the increase in cardiovascular risk.
- Long-standing diabetes mellitus.
- Liver disease or failure.
- Gallstones or choledocholithiasis.
- History of vascular, arterial or venous disease.
- Moderate to severe depression.
- Bronchial asthma.
References
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