Category Archives: HCG Diet

The diet requires that you eat only 500 calories a day, supposedly as part of an effort to help reset your metabolism and change your abnormal eating patterns, as the FDA explainsin its warning against the diet. (1) The HCGdiet also requires you to take a daily dose of the hormone human chorionic gonadotropin (HCG). Available in injections, pellets, sprays, oral drops, and pills, HCGis the hormone produced by the placenta during pregnancy.

In 1954, British physician A.T.W. Simeons theorized that HCGallows mothers-to-be to access fat reserves to feed their fetuses. He published a book,Pounds and Inches: A New Approach to Obesity,in which he suggested that HCGcould help people access their fat reserves and achieve weight loss.

The idea might have been that, if a woman had morning sickness or some other condition that prevented her from taking in ample nutrition at a certain point in her pregnancy, her baby would still have a reserve of energy to draw on, and the hormone HCGcould help facilitate access to that supply, Weinandy says. But, she notes, this really oversimplifies the numerous systems at work in pregnancy: A number of hormones are active, and the way they interact can sometimes even promote fat gain for the mother.

In fact, Weinandy says, this kind of speculation about HCGs role in weight loss can be really dangerous, and its sending a bad message to people because we dont know for certain how HCGworks. Another worry? Many chronic diseases, including breast cancer and prostate cancer, have been linked to an imbalance of hormones, so we cant predict what effects manipulating our hormones might have, Weinandy cautions.

See the article here:
The HCG Diet: What Is It and Does It Work? - Everyday Health

Q. I've been trying to lose weight for a long time and nothing seems to work. What do you know about the HCG diet?

A. The HCG diet is a weight-loss plan that combines daily injections of human chorionic gonadotropin (HCG) with severe calorie restriction only 500 calories per day. HCG is a hormone that's released in large quantities during pregnancy and can be extracted from the urine of pregnant women. It was first promoted as a weight-loss aid in the 1950s by British physician Dr. Albert T. Simeons, who claimed that the HCG regimen caused the body to preferentially burn stored fat, especially fat from the stomach, hips, and thighs. He also said that HCG dieters would lose more fat than muscle and would not be as hungry or irritable as you might expect. In 1954, Simeons reported that he had treated 500 patients and found that those who followed the HCG weight-loss plan for 40 days lost 20 to 30 pounds without feeling weak or excessively hungry.

As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.

No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Follow this link:
By the way, doctor: What do you know about the HCG diet?

First of all let me say this, that is TOTALLY an option(of course it is, thats what weve been doing so far right?) and its free to do that. Never feel like you are doomed without this program.

But one trouble I personally ran into is that even though I was eating low carb after the diet ended, I was still overeating.I thought If it was low carb thats all that mattered. And I have a pretty strong fear of being hungry or not being allowed to eat

There are right now 2 typical approaches to phase 3.1. Continue to eat Phase 2 but just more of everything.2. Find low carb recipes on Pinterest. Make and eat these.

Both of these CAN work. But they are often not ideal for most, and this is why:

DOUBLING UP ON PHASE 2 FOODS.

Positives:Two 100 gram portions of chicken breast have a total of 46 grams of protein. So with this as the example, doubling this would put you at 92 grams of protein for the day- which is a good amount, so that can totally work.

Problems:you are already quite sick of the foods, and because the variety is so limited, you are likely missing out on a lot of good nutrients from other foods. Additionally, adding more P2 fruits can cause the carb intake for a day on p3 to be too high. Doing this also wouldnt include any healthy fats, something that most of us should be adding back in during phase 3. Main point really though is the vast majority of us would have a pretty hard time sticking to just these foods for 3 more weeks after already being stuck with them for 3-6 prior.

FIND LOW CARB OR PALEO RECIPES ON PINTEREST.

Positives:Its free!

Problems: Low carb recipes can often be very calorie dense recipes. This can be a problem if you arent gradually raising your calories when you first come off the 500 calorie diet. Also, most low carb recipes are created by people with the one purpose of them simply being low carb, but there is no thought given to the getting the proper amount of protein, fat, and carbs to give you a balance day of eating. Its very easy to under eat protein. You would have to do quite a bit of legwork to create a plan where you could gradually increase your calories each week.

Excerpt from:
hCG Diet Phase 3: The P3toLife Program - EXACTLY what to cook & eat!

BUY 1 MONTH HCG INJECTIONS KIT INCLUDING ALL THE REQUIRED SUPPLIES

HCG is a protein-based hormone produced by the placenta during pregnancy.It is present at high levels during the early pregnancy. This hormone is in fact used in the hormone pregnancy tests. HCG hormone was first used as a weight loss remedy. It was noted by several physicians that women who are overweight lost weight when they got pregnant. Moreover, dozens of medical studies have shown that HCG hormone, when combined with a low-calorie diet and exercise increases can boost metabolism and helps lose a large amount of fats without feeling hungry. Human chorionic gonadotropin hormone is FDA approved for the treatments fertility issues but not as a weight loss tool. Only FDA drugs are allowed to use as an alternative drug. HCG is an Off-label Usage that common among medical professions. HCG is used in a very low dose for weight loss alongside a super-low-cal diet. The diet limits you to at 500 calories a day for 8 weeks while taking the hormone. You can get the hormone either by shot or by taking it as drops, pellets or sprays. The recommended daily injection for weight loss is somewhere between 125 iu to 175 iu. A good starting point is 150 iu but if you dont have much weight to lose, try starting at 125 iu and go from there. Human chorionic gonadotropin hormone is used in a much higher dose for fertility issues. A low dose of this hormone does not increase fertility. Some other benefits that you can get from using HCG include:

HCG Diet can offer you a safe and rapid weight loss.

The HCG diet focuses on losing weight and to maintain the weight through the combination of the HCG injections and the very low calorie diet. In the very low calorie diet, one has to maintain only 500 calories per day while having the daily injections of the Human chorionic gonadotropin hormone. This combination help resets the brains hypothalamus allowing ones body to use the abnormal fats and converts these fats into energy. The combination also ensures a long-term weight loss. It was Dr. A.T.W Simeons, a British endocrinologist, who developed the HCG diet. It aidshis obese patients in losing weight in order to avoid any deadly health conditions. His years of research and thousands of cases have led to the concept of the HCG Diet. Unlike other over-hyped and cosmetic diets of today, the HCG Diet is a healthier interpretation and implementation of losing weight. The HCG Diet focuses ones attention on eating smaller portions of foods that are low in fats, carbohydrates and calories. This promotes a more long-term weight loss. The HCG Diet is not solely a diet for the purpose of losing weight but its a diet that is meant to promote a healthier lifestyle by making a careful choice of using foods that are low in fats. There are several protocols and variations of the original version of the HCG Diet. However, all the different variations have common limitations when it comes to food consumption. Those who are on the HCG Diet should either limit or omit foods such as starches, sweet fruits, milk and eggs when on the protocol. The use of products that contain a fatty substance such as lotion, conditioner and make-ups should be omitted.

Mental Preparations: Losing weight can be a very difficult task if you are not mentally prepared. Without a full understanding as to why you are doing the diet, you wouldnt likely to succeed. Likewise, it would be very hard to stay committed and focused throughout the entire protocol if you will not set your goals. Physical Preparations:

The HCG Diet Protocol

The 40 Day Cycle

PHASE 1 Days 1- 2

Gorging Days with hCG Injections

The HCG diet Gorging days and why? Gorging days or commonly known as loading days is phase 1 of the HCG diet.It includes a two day stretch where you consume calorie dense foods to satisfaction. This phase is very important because this phase will set your hypothalamus gland in balance. But do not worry because whatever youve gained during the gorging days will be lost very quickly! Check this blog out to know more about the what and hows of the HCG diet Gorging days. You may also use our quick list of allowable foods on the HCG dieat when you shop and prepare for your meals.

Here is a sample meal plan on phase 2 of the HCG diet. For breakfast: Coffee or tea. Other option includes water with lemon juice sweetened with Stevia For lunch: 100 grams or 3.5 oz of protein serving, 100 grams of vegetable choice, one fruit and one Melba toast or a Grissini stick Snack: Fruit, low carb choice For dinner: 100 grams or 3.5 oz of protein serving, 100 grams of vegetable choice, one fruit and one Melba toast or a Grissini stick

The HCG diet Phase 2: Day 3-23 or 46 day The phase 2 of the HCG diet is the most challenging yet exciting part of the diet. This phase is also known as the very low calorie diet phase where you will only consume 500 calories a day. During this phase, your body will get used with using those stored abnormal fats as a source of energy. The foods are specific. You can only consume the approved HCG diet foods. No bread, sugars and fatty foods allowed.Apples, oranges, lemons strawberries and lime are just some of the most common fruit youll turn into when youre hungry. Your protein components will mostly be white fish and chicken. Vegetables like tomatoes, lettuce, and spinach will give you fibers and vitamins. You can also have beef for your protein choice as long as it is extra lean. The HCG diet Phase 3: The Maintenance Phase Just like the gorging days and phase 2 of the HCG diet, this phase is very vital. The main goal of this phase is for your body to maintain a metabolic balance with your new weight. Phase 3 of the HCG diet lasts for 3 weeks right after your last day of the very low calorie diet. During the Phase 3 of the HCG diet, you will increase your calorie intake to 1500 calories per day. You may now begin to eat any meats, fruits and vegetables. You can now consume milk, cheese and low sugar dairy products as long as they are healthy foods. However, you should avoid consuming a significant amount of starches like potatoes and corn. Exercise is encouraged at this phase. You may begin to do some regular workout routine of both aerobic and anaerobic exercises. Try doing light weight exercises with higher repetitions and at least 30 minutes of cardio a day. If you wish to do vigorous activities, you must consult first with your physician. You can start reintroducing back healthy oils into your body like extra virgin olive oil, coconut oil and flaxseed oil. Avoid using unhealthy oils like shortening and vegetable oils. You may also consume butter lightly.During this phase, you are allowed to use make-up, moisturizers and lotions. Once this phase is complete, you may start consuming back foods with sugar, starches and carbs but in moderation.We recommend oats, grains and wheat bread. Avoid heavy sugar and starches like potatoes, yams and rice. Avoid hydrogenated oils too which are usually found in pastries and canned goods. As much as possible stay away from processed foods and high fructose syrup such as those found in soda, fruit drinks and canned fruits. Continue to weigh yourself daily. During and after this phase you should not gain weight. You can at least gain about 2 pounds within Phase 3. However, once you will gain more than 2 pounds, observed a steak day the day youll notice a weight gain. Check this article about for the steak day. The HCG diet Phase 4 Phase 4 of the HCG diet is a lifetime maintenance program. Introduce starches back into your diet slowly and remember to keep sugar to a minimum. Continue consuming protein but stay away from fast foods and processed foods. Continue to weight yourself every day and if you have gained weight beyond your set baseline weight, use the steak day.

The rest of the skinny on the hCG diet HCG diet actually starts after the 2nd day of injecting the hormone. This is the phase where you will consume only 500 calories per day. The HCG diet history begins with Dr. A.T.W Simeons of Rome, Italy. He graduated at the University of Heidelberg and settled in Rome at the Salvatore Mundi International Hospital. Dr. Simeon is an author, a scientist and a researcher who developed the HCG Diet. His research on HCG hormone as weight loss component covered forty years of grappling with the central problem of being overweight. He investigated every theory, method and promising lead. Dr. Simeon carefully experiments and evaluated each theory. Upon his death in 1970 he stated: The protocol [the hCG diet] was everything that I hoped it would be no hunger, no food cravings, no grumpiness, no feeling of deprivation, no fatigue, a dramatic reshaping of the body with the burning of the secure problem area fat deposits. He then wrote his findings in his book Pounds and Inches. His book can give readers a thorough understanding of how the diet came to be and what HCG diet is all about. As Dr. Simeons writes in the Foreword of his book: This book discusses a new interpretation of the nature of obesity and while it does not advocate yet another fancy slimming diet it does describe a method of treatment which has grown out of theoretical considerations based on clinical observation. He came up with a conclusion that all cases of weight loss measures like using a laxative, dieting, exercises, appetite-reducing drugs, baths, massage are all temporary. None of the measures corrects the basic disorder. Through the HCG diet, the basic disorder is addressed, targeted and finally controlled. Fats are the enemy of everyone trying to lose weight. Fats are not just fats. There are actually three kinds of fats and the HCG diet deals with these three.

Abnormal fat is not available to the body duringa nutritional emergency like Normal Fat. The body cannot access abnormal fat easily that is why it is so difficult to lose this kind of fat even with exercise. When one goes on a diet by starving, they will lose their normal fat first. When this fat is exhausted, the body starts to burn the structural fat next. Then as a last resort, the body will yield the abnormal fat. When this happens, the dieter feels weak, tired, famished, haggard and hungry. But their hips, belly, thigh and upper arm only shows little improvement because they lose only the normal fat. The abnormal fat remains the same. Their skin becomes wrinkled and they look miserable. Dr. Simeons believed that this experience is one of the most depressing and frustrating experiences. Being overweight too has psychological effects. Those who are overweight can only feel physically well if they are not gaining any weight at all. They may, however, feel horrified by the appearances of their body when on a tight-fitting clothes or when they are nude. Being overweight is a vicious cycle. When you are overweight, you need more food to keep your body warm. But when you are just lean, you only need a small amount of food to keep your body at a certain temperature. That means to say if an overweight person eats only the foods that his body requires then hell be able to keep the weight stationary. However, this wasnt through at all. Many physicians have studied overweight patients under controlled conditions found out that overweight patients actually gain weight on a diet. At this, Dr. Simeons concluded that there was something missing. There must be some other mechanism at work. In an effort to unravel the mystery of the other condition, several studies have been conducted but were later abandoned. There were also a lot of theories regarding why someone is overweight but it was not the missing piece of the puzzle that Dr. Simeons was looking for. He then traveled to India. There he found doctors giving hCG to overweight patients with large hips, thigh and buttocks. He became curious and begin his first study of hCG.He observed that the Indian doctors were giving their patients small daily doses of the hormone. The result showed that their ravenous appetite disappeared and their hips also change. The abnormal fat deposit from their hips disappeared. Their body was slowly using the abnormal fats as fuel. For Dr. Simeons, HCG was the other mechanism. Its the secret to the diets success story. Medically defined, HCG or Human Chorionic Gonadotropin is a naturally occurring hormone produced in the placenta of pregnant women.Dr. Simeons found out that by restricting the diet to 500 calories combined with a small dose of hormone, patients can achieve the best results. In fact, patients can lose an average of 1 pound a day. They have reduced appetite and could go comfortably with their normal routines. It was also perfectly evident that only the abnormal fats were consumed. There were no signs of normal fat depletion. Their figures became entirely normal and their skin does not sag. Dr. Simeons also explained that women who are pregnant do not become obese. This is because their bodies are under the influence of an enormous amount of hormone that circulates around their bodies. Therefore, abnormal fat deposit does not form. Right after giving birth, the body becomes deprived of hCG and abnormal fats start to deposit. It was initially used to diagnose an early pregnancy by testing the urine. It has now been medically used for more than eighty years. It has no effects on normal sex glands of male and female. Its not a sex hormone. Pregnant women produce hormone for more than one million IUs (International unit) a day. On the HCG diet, dieters use only around 125 IU to 200 IU a day. This dosage does not change whether you weigh more or less than 150 pounds. Patients who weigh more or less than 150 pounds also follow the same very low calorie diet intake per day. Now the toughest and the most essential part to your success- the strict adherence to the 500 calorie diet. Here, only approved diet foods are allowed to eat. But whats good with this diet, you will NOT be hungry! The HCG hormone will reduce your food craving. The minimum HCG diet treatment is 26 days even if you need to lose just 5 pounds. Here, you will receive 23 injections followed by 3 days of diet but without injections. If you have more pounds to lose, you may continue the diet up to 43 days until you lose 34 pounds. You can do another cycle of 23 or 43 days but you need to rest for 6 weeks before you can start. Just follow the protocol exactly as instructed and you will be more than satisfied with the result.

The needle used in injecting the hormone is so small that it does not reach the muscle. It can only penetrate the skin and into the fats. There are several areas that you can inject yourself. These are:

Week 1 to 3 after the HCG Diet This is the maintenance phase. After completing the 23-day or the 43-day diet plan, you can eat all foods except sugars and starches because your body needs to adjust to your Abnormal Fat Loss. While on this phase, continue weighing yourself every morning. Week 4 to 6 after the Diet Continue with the maintenance phase but start introducing back sugar and starches. However, they should be in a small quantity only. Continue weighing yourself in the morning. 6 weeks after the Diet If you were not able to reach your weight loss goal after the 1st cycle of the HCG diet you can continue with the 2nd cycle. This is just the same with the 1st cycle. You can continue with another cycle until you reach your weight loss goal. Just make sure that you have your HCG diet break of 6 weeks in between each cycle.

Very Lean Beef (average of 52 calories) 93/7 Lean Ground Beef (3.5 oz) 150 calories Sirloin Tip Side Steaks (3.5 oz) 130 calories Bison (3 oz) 98 calories Cube Steak (3.5 oz) 160 calories Top Round Steak (3.5 oz) 166 calories Veal (avg 114 calories) Tri-Tip Steak (3.5 oz) 154 calories Veal, loin chop (3.5 oz) 117 calories Veal, sirloin (3.5 oz) 110 calories Seafoods (average of 98 calories) Cod (3.5 oz) 83 calories Flounder (3.5 oz) 90 calories Crab Meat (3.5 oz) 100 calories Haddock (3.5 oz) 88 calories Lobster (3.5 oz) 98 calories Halibut (3.5 oz) 110 calories Red Snapper (3.5 oz) 110 calories Tilapia (3.5 oz) 94 calories Shrimp (3.5 oz) 110 calories Chicken (average of 87 calories) Chicken Breast (3.5 oz) 87 calories Vegetables (average of 18.8 calories) Asparagus (3.5 oz) 20 calories Asparagus (2 tip) 1 calories Asparagus (small spear) 2 calories Asparagus (medium spear) 3 calories Asparagus (large spear) 4 calories Beet Greens (1 cup raw)-8 calories Broccoli- 34 calories Cauliflower- 22 calories Celery (3.5 oz) 15 calories Celery (medium stalk) 6 calories Cabbage (3.5 oz) 24 calories Cabbage (1 cup shredded) 17 calories Chard, Swiss raw (1 cup)-7 calories Chicory (1 head)- 9 calories Cucumber (3.5 oz) 12 calories Cucumber (small) 19 calories Cucumber (medium) 24 calories Cucumber (large) 34 calories Cucumber (English long) 60 calories Fennel (1 cup,sliced)- 27 calories Green beans (3/4 cup, cut)- 20 calories Green onions- 25 calories Green sweet pepper- 20 calories Lettuce, all varieties (3.5 oz) 10 cal. Lettuce, all varieties (1 cup) 8 cal. Lettuce, all varieties (small head) 32 calories Onions (medium yellow, raw)- 64 calories Red Radishes (3.5 oz) 12 calories Red Radishes (one medium) 1 cal. Spinach, raw (3.5 oz) 20 calories Spinach, raw (1 cup) 7 calories Spinach, frozen (3.5 oz) 23 calories Spinach, frozen (1 cup) 41 calories Spinach, cooked (3.5 oz) 31 calories Spinach, cooked (1 cup) 48 calories Tomato (3.5 oz) 20 calories Tomato (cherry) 3 calories Tomato (plumb) 11 calories Tomato (small) 16 calories Tomato (medium) 22 calories Tomato (large) 33 calories Fruit Apple (small) 55 calories Apple (medium) 72 calories Apple (large) 110 calories Blackberries (1 cup)- 62 calorie Blue Berries (1 cup)- 83 calories Grapefruit (1/2 cup)- 40 calories Lemon- 24 calories Lime- 20 calories Orange (navel) 69 calories Orange (Florida) 65 calories Orange (California) 59 calories Strawberries, 12 large 72 calories Strawberries, 20 medium 80 calories Pink Grapefruit (1/2 large) 53 calories Pink Grapefruit (1/2 med.) -41 calories Pink Grapefruit (Florida) 74 calories Bread Grissini Breadstick (3 g) 12 calories Melba Toast (3 gram) 12 calories Melba Toast (5 gram) 20 calories

Here is the original post:
HCG Online: Buy HCG Injection 1 Month Kit for Weight Loss

Important note : Not everybody will react to in the same way to hCG (Human Chorionic Gonaditropin) in other words what is true for one person might not work for another- as such do not get discourage if you dont see the same pronounced results as in others on the same hCG diet all the information provided here is based on peoples testimony and documentation gather from reputable sources online - the before and after pictures are submitted from our most successful customers and they were offered 20% discount incentive to show the very positive results not everyone will achieve this This being said the hCG diet works well , give it a try and see for yourself.

Statement from the FDA : HCG has not been demonstrated to be effective adjunctive therapy in the treatment of obesity. There is no substantial evidence that it increases weight loss beyond that resulting from caloric restriction, that it causes a more attractive or normal distribution of fat, or that it decreases the hunger and discomfort associated with calorie-restricted diets.

Continue reading here:
Buy HCG Injections Online: Pharmaceutical Grade Freeze Dry HCG

Oral cancer also known as mouth cancer is an umbrella term for cancer that affects the oral cavity, the insides and outsides of a humans mouth including lips, gums, tongue, the roof and floor of the mouth, and the oropharynx. According to World Health Organization, the global occurrence of cancers in the oral cavity and lip is estimated to be 4 per 10,000 people. It is likely that oral cancer affects men more and is generally seen in older people. There are several symptoms seen in the human body that indicates the presence of oral cancer.

Be it patches in the mouth, sudden bleeds that last longer, sore mouth, any sudden growth in the mouth area, and many more. If left untreated, oral cancer can spread throughout the mouth and then extend to the throat and other areas of the neck and head. Hence, it is utterly essential to seek immediate medical attention if any of the symptoms occur in the mouth. Here, we have curated everything that you need to know about the symptoms, causes, and prevention of oral cancer.

Oral Cancer Symptoms

As per Mayo Clinic, the common symptoms of oral cancer include soreness in the mouth or lip area that doesnt heal, a red or white patch inside the mouth, loosening of teeth, a sudden growth or lump forming inside the mouth, difficulty in swallowing, and bleeding.

During an interaction with HT Lifestyle, Head and Neck Onco-surgeon at HCG Cancer Hospital in Mumbai, Dr. Ankit Mahuvakar, also highlighted that numbness, loss of feeling, chronic sore throat, change in voice, pain in the jaw or ear, sudden weight loss could also mean early signs of oral cancer.

Oral Cancer causes

According to Dr. Ankit Mahuvakar, excessive use of tobacco and consumption of alcohol become major factors in the development of the disease but unfortunately, it can also occur with no risk factors at all. Oral cancer develops when cells in the mouth or lips develop mutations in their DNA, as per Mayo clinic. These mutations lead to the multiplication of cancerous growth while healthy cells slowly begin to die. Reportedly, oral cancers begin in the flat, thin cells namely Squamous cells, the lining of your lip, and the inside of the mouth.

Medically, the cause of these cancerous mutations isnt clearly defined but health experts have identified several risk factors. Dr. Ankit Mahuvaker says, Unhealthy habits like excessive consumption of tobacco in cigarettes, pipes or chewing tobacco and heavy consumption of alcohol increase the chance of contracting oral cancer. If the face and thus the lips are exposed to the sun or if the person has a weak immune system is when the chances increase. Also, a sexually transmitted virus called human papillomavirus (HPV) is an established risk factor for oropharyngeal cancers.

Oral Cancer Prevention

The Onco-surgeon highlights oral cancer can be prevented if an individual plays an active role in staying away from the factors that put them at potential risk. Quitting smoking and chewing tobacco, avoiding dangerous chemicals away from the mouth area, and quitting alcohol, are some of the factors that prevent the risk of Oral cancer. In addition to this, he urged people to maintain a balanced diet and visit a dentist for regular inspection.

(Disclaimer: Information presented in the article is gathered from various sources. News18 doesnt guarantee the accuracy of the facts)

Read all the Latest Lifestyle News and Breaking News here

Original post:
What Are The Causes and Symptoms of Oral Cancer? Expert Answers - News18

A healthy body starts with a healthy mouth as it is a gateway into the bodys overall health and to maintain a healthy self, one has to regularly do self-check tests, ideally once every month to look out for signs and symptoms that could be an indication of oral cancer. Any sudden growth or sore or patches in the mouth that bleeds or lasts longer must be immediately brought to the notice of a medical practitioner as early detection is the key to fight oral cancer.

Cancer that occurs on the inside of the mouth (oral cavity), including lips, base of the tongue, inside of the cheeks, floor of the mouth, hard and soft palate, sinuses, tonsils, vallecula and pharynx (throat) is called oral cancer or oral cavity cancer. It is a type of cancer that is grouped under the category of head and neck cancers and when it is diagnosed early, it is much easier for doctors to treat but unfortunately, many people wait until the condition gets advanced to treat effectively.

In an interview with HT Lifestyle, Dr Ankit Mahuvakar, Head and Neck Onco-surgeon at HCG Cancer Hospital in Mumbai, explained, Oral cancer starts in the squamous cells, which are flat and when viewed under a microscope, looks like a fish scale. Squamous cell carcinoma is most common malignant neoplasm of oral cavity. Excessive use of tobacco and consumption of alcohol are the major risk factors of oral cancer. However, it can occur in patients with no known risk factors as well.

He added, Most of the times, oral cancer looks like a common problem with the lips or the mouth having white or red patches or sores that bleed. The only difference between a common problem and a potential cancer is that the latter does not go away within 2 weeks and if left untreated, it spreads to the other parts. For instance, if there is cancer of the cheeks which is left untreated, it gradually spreads to the muscles, then to the skin followed by the bone and so on.

Causes:

Dr Ankit Mahuvakar, shared, When cells on the lips or in the mouth develop changes (mutations) in their DNA is when they continue to grow and divide and cause healthy cells to die. The accumulation of abnormal cells can form a tumor. As time passes, this spreads inside the mouth. Generally, mouth cancers begin in flat, thin (squamous) cells that line the lips and inside the mouth. They are squamous cell carcinomas.

He cautioned, Unhealthy habits like excessive consumption of tobacco in cigarettes, pipes or chewing tobacco and heavy consumption of alcohol increase the chance of contracting oral cancer. If the face and thus the lips are exposed to the sun or if the person has a weak immune system is when the chances increase. Also, sexually transmitted virus called human papillomavirus (HPV) is an established risk factor for oropharyngeal cancers.

Symptoms:

Swelling or thickening, lumps or rough spots or eroded areas on the lips, gums, cheek or other areas inside the mouth

White or red patches in the mouth that look velvety

Unexplained bleeding in the mouth

Numbness, loss of feeling, pain or tenderness in any area of face, mouth or neck

Persistent sores on face, neck or mouth that bleed and do not heal within 2 weeks

Feeling that something is caught in the back of the throat

Difficulty chewing or swallowing, speaking or moving the jaw or tongue

Chronic sore throat or change in voice

Pain in the jaw or the ear

Sudden weight loss

Prevention:

According to Dr Ankit Mahuvakar, Oral cancer can be prevented provided the individual plays an active role in order to reduce the risk of contracting it. People who are used to smoking or chewing tobacco must try and discontinue it as it directly exposes the cells in the mouth to dangerous cancer-causing chemicals. Alcohol consumption must also be reduced as it can irritate the cells making them vulnerable to oral cancer. Drinking in moderation can help reduce the risk.

He advised, The skin on the lips must be protected from sun exposure at all times. Hence it is advisable to either wear a broad hat or carry an umbrella that will help cover the face. Also, sunscreen lip products must be a daily routine for sun protection. Getting vaccinated against the human papillomavirus (HPV) is also necessary. Having a balanced diet is the key to fight any cancer. It is also important to see a dentist regularly for a thorough inspection of the entire mouth to prevent pre-cancerous changes.

Treatment:

Highlighting that the treatment depends on the location, stage and type of cancer and the age and health of the patient, Dr Ankit Mahuvakar said, Brachytherapy is employed in the treatment of oral cancer. This includes, for instance, removal of a part of the tongue or the jawbone or the lymph nodes. These significantly change the persons appearance and their ability to talk or to eat. Detecting oral cancer early can reduce the possibility of it growing or spreading further. It is possible by simply doing a monthly self-examination where the lips, front of the gums and roof of the mouth must be examined by the finger.

He revealed, The neck and the area under the lower jaws must be examined for any lumps or enlarged lymph nodes. Using a bright light and a mirror, the inside of the mouth must be examined. Also, by tilting the head slightly the roof of the mouth must be observed. The cheeks must be pulled out to see the inside of the mouth, the lining of the cheeks and behind the gums and the tongue must also be pulled out to see if any changes are there on the top, bottom, sides or the floor of the mouth.

Oral health is equally important and it is not just about getting a cavity filled but it is about the overall health of the individual. The doctors strive for both complete cancer removal as well as preservation of the appearance and functions of the mouth, what we need to do is to regularly check the inside of the mouth for any changes and also immediately report those to the doctors to prevent its spread.

Visit link:
Oral cancer: Causes, symptoms, prevention and treatment - Hindustan Times

Introduction

As a hormone-dependent disease, endometriosis is observed in nearly 10% of women at reproductive age.1 Combined oral contraceptives (COCs) and progestins may be implemented as an alternative to surgery or a prevention of postoperative recurrence.2 They can be used alone or be recommended as add-back hormone therapies for patients using gonadotropin-releasing hormone (GnRH) analogues.35 Given that the efficacy of COCs and progestins have been widely acknowledged, they are suggested to be the reference comparator for randomized controlled trials on new endometriosis drugs.6

As suppressive solutions to endometriosis, COCs and progestins have similar efficacy in relieving pain and other symptoms,5 leaving them as the safest long-term treatment for endometriosis.79 However, patients tolerance could be highly personalized,10,11 not to mention that women with endometriosis have a higher rate of allergies on medication.12 In addition to painful symptoms, side effects may increase patients suffering.13,14 Patient compliance may be affected due to side effects, especially for the long courses of these hormone drugs,6 which could be detrimental to the management of the disease. There have been some real-world studies focusing on specific drugs for endometriosis, but they either produced negative result or concentrated on drug efficacy.1517 Pharmacovigilance evidence determining adverse reactions of long-term hormone drugs for endometriosis are still inadequate.

Post-marketing adverse events reports of drugs and therapeutic biologic products that were submitted to US Food and Drug Administration (FDA) are stored in the FDA Adverse Event Reporting System (FAERS), providing materials for drug safety surveillance. Adverse events and medication errors in FAERS are recorded using Preferred Terms (PTs) in the Medical Dictionary for Regulatory Activities (MedDRA) terminology.18,19 This study portrayed reports about long-term hormone therapies for endometriosis in FAERS and performed a disproportional analysis, aimed at investigating drug-type-specific adverse events and exploring their possible risk factors.

FAERS reports from patients with endometriosis between Jan 1, 2014 and Sep 30, 2021 were retrieved (date of access: Mar 5, 2022). After removing duplicates, reports were filtered to select those whose diagnosis was coded as endometriosis or endometriosis ablation. Medications of interest in this study included COC, oral progestin, progestin-eluting intrauterine device (IUD), depot progestin, and progestin implant. Cases about these drugs and devices were extracted and were classified as the long-term hormone treatment group by filtering drug names and product active ingredients of the records. Cases whose indication were endometriosis but were treated without any of the drugs mentioned above were classified as the control group.

We calculated counts and rates of major baseline characteristics in the long-term hormone treatment group and the control group separately. GammaPoisson Shrinker (GPS) model was used for disproportional analysis and to detect overreported drug-event pairs.20,21 This model represented relative reporting ratios by Empirical Bayes Geometric Mean (EBGM) scores after Bayesian shrinkage. EBGM score, 5th percentile (EB05), and 95% percentile (EB95), i.e. lower and upper limit of 90% confidence interval (CI), were calculated with R (version 4.0.4; The R Foundation for Statistical Computing, Vienna, Austria) and R package openEBGM (version 0.8.3). EB05 2 was considered signal detected.22 According to MedDRA hierarchy,23 PTs whose signals were detected by disproportional analysis were presented in groups according to their primary System Organ Class (SOCs).

Considering the wide age distribution of the cases and that GnRH-analogue/antagonists, aromatase inhibitors, and analgesics are commonly co-administered, logistic regression analysis was performed to explore potential risk factors of the signals detected above. According to 10 events per variable recommendation on sample size for developing a clinical prediction model,24 events whose drug-event pair counts were greater than 20 were selected for logistic regression analysis. Logistic regression analysis was performed with R (version 4.0.4; The R Foundation for Statistical Computing, Vienna, Austria).

Between January 1, 2014 and September 30, 2021, there were 1823 reports on long-term hormone treatment and 6247 reports on other drugs applied for endometriosis. Long-term hormone treatment accounted for 501 (27.5%) reports on COCs, 924 (50.7%) reports on oral progestin, 102 (5.6%) reports on depot progestin, 255 (14.0%) reports on progestin-eluting IUD, and 41 (2.2%) reports on progestin implant.

Clinical features of reports are presented in Table 1. The majority of women included were at their reproductive age. In the long-term hormone treatment group, most of the cases were reported from the United States (75.0%), followed by other countries (9.7%) and France (3.2%). While in the control group, most of the cases were reported from the United States (84.5%), followed by Canada (6.0%) and other countries (4.7%). Apart from the category of Other serious event, the most common outcome of both groups was hospitalization (17.2% in long-term hormone treatment group and 9.8% in the control group), and disability came in second (3.6% and 2.6%, respectively).

Table 1 Baseline Characteristics of Patients with Endometriosis

In both COC and progestin groups, the most prevalent PT was off label use (N = 130 in the COC group, and N = 119 in progestin group), followed by product use in unapproved indication (N = 102 in the COC group, and N = 55 in progestin group). However, these 2 PTs were not overreported in progestin users (EB05 were 1.6 and 1.3, respectively). Overreported PTs among COC users were more diverse, while PTs among progestin users were mainly under the SOCs of injury, poisoning and procedural complications and product issues. Signals of some uncommon adverse events including eye disorders and nervous system disorders were detected, too (Table 2).

Table 2 Preferred Terms of Overreported Adverse Events and Medical Errors of Endometriosis Patients Receiving Long-Term Hormone Treatment

Disproportional analysis was also performed in different dosage forms of progestin (Table 3). All signals detected in overall progestin users were specified in subgroups, and signals of some new adverse events such as cardiac disorders, gastrointestinal disorders, metabolism and nutrition disorders, and musculoskeletal disorders emerged in subgroup analysis. Among oral progestin users, only PTs of hepatic adenoma (N = 14, EB05 = 2.3), meningioma (N = 11, EB05 = 4.0), and ulnar tunnel syndrome (N = 11, EB05 = 4.6) were overreported. PTs belonging to injury, poisoning and procedural complications and product issues were mainly reported among progestin-eluting IUD users and depot progestin users. Besides, plenty of nervous system disorders occurred in the depot progestin subgroup. Most overreported PTs in the progestin implant subgroup were under the SOC of general disorders and administration site conditions.

Logistic regression analysis indicated that among adverse events or medical errors that happened over 20 times, polytherapy was negatively associated with off label use (adjusted OR = 0.47, 95% CI 0.220.94) and product use in unapproved indication (adjusted OR = 0.36, 95% CI 0.150.76) for COC users. COC users aged greater than or equal to 30 were less likely to have product use issue (adjusted OR = 0.33, 95% CI 0.120.82) but were at higher risk of pulmonary embolism (adjusted OR = 4.04, 95% CI 1.3517.43). Meanwhile, age greater than or equal to 30 and polytherapy seemed to have no statistical association with adverse events or medical errors in progestin-eluting IUD users. Detailed data are presented in Table 4.

By reviewing FAERS data, this study comprehensively described reports of endometriosis patients treated with COCs and progestin on adverse event signals overall and in different dosage form subgroups. We also explored the possible effects of age and polytherapy on frequently reported adverse events.

During hormone treatment for endometriosis, change in hormone levels can lead to hormone-related adverse events. Besides, lifestyle and diet may affect symptoms, too.25 The broad spectrum of PTs detected in this study may result from individual variation in ER-alpha and PR distributions.26 It is reported that for patients with endometriosis who are intolerant of COC or norethisterone acetates side effects, shifting one to the other could improve their satisfaction.27 Since patients suffering from adverse effects of one drug may benefit from another, the regimen they receive should be adjusted in time once intolerable.

Common side effects of COC and progestins include bleeding, mastodynia, psychological disorders, weight gain, constipation, emotional fluctuation, galactorrhoea, thrombosis, decreased bone mineral density, libido changes, meningioma, hepatocellular adenoma, and some androgenic symptoms.2837 In this study, signals of similar PTs as well as their secondary outcomes: genital haemorrhage, mental disability, abnormal weight gain, constipation, pulmonary embolism, deep vein thrombosis, hemiplegia, bone disorder, osteopenia, loss of libido, libido increased, anhedonia, meningioma, and hepatic adenoma were detected by proportional analysis. Since there was no true control in our study, some minor discrepancies lied between this pharmacovigilance research and previous clinical trials.

Some medical therapies for endometriosis aim to create a hypoestrogenic environment to delay disease progression,26 leading to menopause-like side effects. While GnRH-analogues and aromatase inhibitors are well known for their hypoestrogenic effects,38,39 the effects of COC and progestins vary in different age groups and dosages.40,41 Several studies indicated that oral progestin and progestin-eluting IUDs had an unapparent hypoestrogenic effect,42 except that DMPA users may encounter more menopausal symptoms.40,43,44 In this study, we detected signals of heart rate irregular, bone disorder, osteopenia, and autonomic nervous system imbalance in depot progestin users. Signals of feeling hot, abnormal weight gain, and loss of libido were detected in progestin-eluting IUD users as well. To determine the effect of different dosage forms of progestin on estrogen level, further researches with larger sample size need to be conducted. Besides, the signal of decreased appetite was detected in depot progestin users in this study. Since progestin metabolites have been reported to modulate GABA-A receptors directly rather than lowering estrogen levels to regulate appetite and mood,45 exact mechanisms behind the effect of progestins remain to be further investigated.

We detected plenty of signals about procedural complications, product issues, and administration site conditions as well as their potentially secondary PT: abdominal pain lower. But no signal of more serious PTs such as uterine perforation or fat necrosis was detected. Perforation rates of levonorgestrel-releasing intrauterine systems (LNG-IUS) and copper IUDs in the literature were both approximately 1/1000,46 which is relatively low. And relevant fat necrosis was only reported in a case report.47 Lactation, atrophic uterus due to long-term administration of depot injectables, and mismatch between uterine cavity size and the size of the IUD could be risk factors for IUD dislocation.48 As infection remains a considerable cause of withdrawal from IUD use,49,50 and the reasons for these events are clear, they may be avoided by comprehensively assessing the patients condition, standardizing procedures, and improving perioperative care.

In this study, we found that the PT spectrum varied in different dosage forms of progestin. Therefore, patients tolerance should be considered before regimen recommendation. When choosing among these long-term hormone treatments with contraceptive effects, patients fertility desires should be taken into account, too. The techniques of ovarian stimulation and egg freezing have been quite advanced51,52 and have been applied in the early stage of malignancy.5355 Especially in cases of ovarian endometrioma that requires surgical intervention, fertility-sparing procedures and fertility preservation should be included in the therapy plan.

There were signals of some uncommon adverse effects, too. This study identified increased risk of meningioma with oral progestin treatment. Estrogen receptors (ER) and progesterone receptors (PR) are both expressed in meningioma tissue,56,57 the association between progestin and meningioma remains to be explored in large-sample clinical trials.

We found that atopic keratoconjunctivitis (AKC) and ocular discomfort cases were elevated in COC users (EB05 = 2.5). As an allergic conjunctival disease, inflammatory cells play an important role in the pathophysiology of AKC.58 Estrogen and progesterone receptors have been found positive in conjunctival biopsies from vernal keratoconjunctivitis (VKC), which is another subtype of the allergic conjunctival disease, and the majority of positive cells were eosinophils.59 Therefore, it is possible that the altered sex hormone level of COC users is related to AKC, which should raise concerns in future clinical practice and research.

Other nonspecific PTs, such as Uhthoffs phenomenon, ulnar tunnel syndrome, mitral valve prolapse, chromatopsia, throat tightness, and mental disability were also detected in this study. None of them has reported relationship with sex hormones. A study which included more than 4000 patients with surgically diagnosed endometriosis reported no higher mitral valve prolapse prevalence in endometriosis patients than in general population.60 These nonspecific signals were detected possibly because of some underlying pathophysiological mechanisms or even entry errors. Though some of them may have already existed before drug administration, they still require proper treatment.

Product use issue in COC users was associated negatively with users age older than 30, which was observed on similar PTs of off label use and product use issue in unapproved indication. It is estimated that pregnancies caused by incorrect use of contraceptives are 9 times the rate of pregnancies with perfect use of contraceptives.61,62 There are over 1 million unintended pregnancies associated with the use, misuse, or discontinuation of oral contraceptives each year in the United States.63 In a national survey involving almost 2000 women in 2004,61 almost all oral contraceptive users set a daily reminder about taking the pill, but 38% had missed at least one pill within 3 months before the survey. In different age subgroups, users younger than 24 years old had a higher inconsistent use rate than older participants, too.61 Another study focusing on college and graduate students demonstrated that stress, long hours of paid employment, and living with a sex partner were associated positively with missed doses.64 As our study also revealed age-related differences in drug adherence, possible hidden factors behind the age, such as understanding of contraception, work/study pressure, medical insurance status, should be considered in future research.

We also found that age greater or equal to 30 was associated positively with pulmonary embolism in COC users. Age as a risk factor for thrombosis in COC users has been the consensus of medical professionals.32,33,65 Unfortunately, our regression analysis failed to demonstrate more associations between drug users characteristics and adverse events. Much of the age information of cases in our study was missing, resulting in a very limited number of valid data for regression analysis. The numbers of some drug-event pairs were inadequate for regression analysis, too. Due to these sampling errors, the results of regression analysis may not reflect the true situation of all patients with endometriosis in FAERS.

The FAERS provides sufficient reports from multiple countries for pharmacovigilance research. Not only manufacturers but also healthcare practitioners and users can report adverse events and medical errors to the FAERS. The MedDRA terminology helps to standardize the description of adverse events and diagnoses, making it easier for researchers to process and summarize these real-world data in batches. Meanwhile, this FAERS-based pharmacovigilance study has some drawbacks, too. Firstly, some identical events might be reported as similar but different PTs such as off label use and off label use of device according to the reporters understanding of the MedDRA terminology. Some other events which were different might be coded as the same general PT. For example, libido decreased and libido increased could both be coded as libido disorder. These coding inaccuracies could lead to imprecise results of statistical analysis. Secondly, one PT may have multiple different SOCs. MedDRA terminology has assigned a primary SOC for each PT.66 In this study, we grouped PTs by their primary SOCs. However, primary SOC may only indicate manifestation site rather than aetiology of the PT in some circumstances, which may mislead pathophysiological investigations. For example, the primary SOC of throat tightness is respiratory, thoracic and mediastinal disorders, while its secondary SOC is psychiatric disorders. These two SOCs are quite different. Thirdly, demographic information and detailed clinical records of these reports were limited for regression analysis, and existing variables including age had lots of missing values. Therefore, the regression analysis in our research could only yield preliminary results. Fourthly, information about drug or medical device users who never encounter any adverse event or medical error cannot be accessed from the FAERS, leaving it impossible to calculate the rates of the events. What is more, submitting reports by consumers, patients and health professionals are not mandatory, leaving some events missed by the FAERS. Reporting awareness of consumers, patients and healthcare professionals should be encouraged so that more comprehensive information can be collected.

Both COCs and progestin products are relatively safe for patients with endometriosis. Polytherapy was negatively associated with some medical errors for COC users, while patients older than or equal to 30 had more pulmonary embolisms, but fewer product use issues were reported. Newly detected signals in this pharmacovigilance study should be monitored in clinical practice and need to be validated in future research. When choosing hormone treatment regimens, gynaecologists should consider the patients satisfaction and fertility desire, and assess efficacy, costs, and side effects comprehensively.

COC, combined oral contraceptive; GnRH, gonadotropin-releasing hormone; FDA, US Food and Drug Administration; FAERS, the FDA Adverse Event Reporting System; PT, preferred term; MedDRA, Medical Dictionary for Regulatory Activities; IUD, intrauterine device; GPS, Gamma-Poisson Shrinker; EBGM, Empirical Bayes Geometric Mean; CI, confidence interval; SOC, System Organ Class; DMPA, depot medroxyprogesterone acetate; LNG-IUS, levonorgestrel-releasing intrauterine system; PRL, prolactin; ER, estrogen receptor; PR, progesterone receptor; AKC, atopic keratoconjunctivitis; VKC, vernal keratoconjunctivitis.

All raw data used in this study have been released on FAERS website (https://www.fda.gov/drugs/questions-and-answers-fdas-adverse-event-reporting-system-faers/fda-adverse-event-reporting-system-faers-latest-quarterly-data-files) and are available to the public.

Exemption from the ethical review has been granted by the Ethics Committee of Shanghai First Maternity and Infant Hospital since the FAERS is an anonymized publicly available database.

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

This work was supported by the Science and Technology Commission of Shanghai Municipality (grant number 19411960300), the Shanghai Municipal Health Commission (grant number 2019SY002), the Shanghai Hospital Development Center (grant number SHDC12019113), and the Shanghai Municipality: Shanghai Outstanding Academic Leaders Plan (Year 2019).

The authors report no conflicts of interest in this work.

1. Shafrir AL, Farland LV, Shah DK, et al. Risk for and consequences of endometriosis: a critical epidemiologic review. Best Pract Res Clin Obstet Gynaecol. 2018;51:115. doi:10.1016/j.bpobgyn.2018.06.001

2. Mechsner S. Endometriosis, an ongoing pain-step-by-step treatment. J Clin Med. 2022;11(2):467. doi:10.3390/jcm11020467

3. Casper RF. Progestin-only pills may be a better first-line treatment for endometriosis than combined estrogen-progestin contraceptive pills. Fertil Steril. 2017;107(3):533536. doi:10.1016/j.fertnstert.2017.01.003

4. Mehdizadeh Kashi A, Niakan G, Ebrahimpour M, et al. A randomized, double-blind, placebo-controlled pilot study of the comparative effects of dienogest and the combined oral contraceptive pill in women with endometriosis. Int J Gynaecol Obstet. 2022;156(1):124132. doi:10.1002/ijgo.13677

5. Bedaiwy MA, Allaire C, Alfaraj S. Long-term medical management of endometriosis with dienogest and with a gonadotropin-releasing hormone agonist and add-back hormone therapy. Fertil Steril. 2017;107(3):537548. doi:10.1016/j.fertnstert.2016.12.024

6. Vercellini P, Crosignani P, Somigliana E, Vigan P, Frattaruolo MP, Fedele L. Waiting for Godot: a commonsense approach to the medical treatment of endometriosis. Hum Reprod. 2011;26(1):313. doi:10.1093/humrep/deq302

7. Armstrong C. ACOG Practice Bulletin No. 110: noncontraceptive uses of hormonal contraceptives. Obstet Gynecol. 2010;115(1):206218. doi:10.1097/AOG.0b013e3181cb50b5

8. Cibula D, Gompel A, Mueck AO, et al. Hormonal contraception and risk of cancer. Hum Reprod Update. 2010;16(6):631650. doi:10.1093/humupd/dmq022

9. Hannaford PC, Iversen L, Macfarlane TV, Elliott AM, Angus V, Lee AJ. Mortality among contraceptive pill users: cohort evidence from Royal college of general practitioners oral contraception study. BMJ. 2010;340:c927. doi:10.1136/bmj.c927

10. Bedaiwy MA, Alfaraj S, Yong P, Casper R. New developments in the medical treatment of endometriosis. Fertil Steril. 2017;107(3):555565. doi:10.1016/j.fertnstert.2016.12.025

11. TmotEGC G, Becker CM, Bokor A, et al. ESHRE guideline: endometriosis. Human Reproduction Open. 2022. doi:10.1093/hropen/hoac009

12. Matalliotakis I, Cakmak H, Matalliotakis M, Kappou D, Arici A. High rate of allergies among women with endometriosis. J Obstet Gynaecol. 2012;32(3):291293. doi:10.3109/01443615.2011.644358

13. Vercellini P, Somigliana E, Vigano P, Abbiati A, Barbara G, Crosignani PG. Endometriosis: current therapies and new pharmacological developments. Drugs. 2009;69(6):649675. doi:10.2165/00003495-200969060-00002

14. Vercellini P, Somigliana E, Vigano P, Abbiati A, Daguati R, Crosignani PG. Endometriosis: current and future medical therapies. Best Pract Res Clin Obstet Gynaecol. 2008;22(2):275306. doi:10.1016/j.bpobgyn.2007.10.001

15. Moehner S, Becker K, Lange JA, von Stockum S, Heinemann K. Risk of depression and anemia in users of hormonal endometriosis treatments: results from the VIPOS study. Eur J Obstet Gynecol Reprod Biol. 2020;251:212217. doi:10.1016/j.ejogrb.2020.05.049

16. Techatraisak K, Hestiantoro A, Soon R, et al. Impact of long-term dienogest therapy on quality of life in Asian women with endometriosis: the prospective non-interventional study ENVISIOeN. Reprod Sci. 2022;29(4):11571169. doi:10.1007/s43032-021-00787-w

17. Kitawaki J, Koga K, Kanzo T, Momoeda M. An assessment of the efficacy and safety of dydrogesterone in women with ovarian endometrioma: an open-label multicenter clinical study. Reprod Med Biol. 2021;20(3):345351. doi:10.1002/rmb2.12391

18. MedDRA; [Updated May 2, 2022]. Available from: https://www.meddra.org/.

19. Questions and answers on FDAs Adverse Event Reporting System (FAERS). U.S. Food and Drug Administration; [Updated April 6, 2018]. Available from: https://www.fda.gov/drugs/surveillance/questions-and-answers-fdas-adverse-event-reporting-system-faers. Accessed May 2, 2022.

20. Dumouchel W. Bayesian data mining in large frequency tables, with an application to the FDA spontaneous reporting system. Am Stat. 1999;53(3):177190. doi:10.1080/00031305.1999.10474456

21. DuMouchel W, Pregibon D. Empirical Bayes screening for multi-item associations. presented at: Proceedings of the seventh ACM SIGKDD international conference on Knowledge discovery and data mining; 2001; San Francisco, California. doi:10.1145/502512.502526.

22. Szarfman A, Machado SG, ONeill RT. Use of screening algorithms and computer systems to efficiently signal higher-than-expected combinations of drugs and events in the US FDAs spontaneous reports database. Drug Saf. 2002;25(6):381392. doi:10.2165/00002018-200225060-00001

23. MedDRA Hierarchy. The International council for harmonisation of technical requirements. Available from: https://www.meddra.org/how-to-use/basics/hierarchy. Accessed May 2, 2022.

24. Riley RD, Ensor J, Snell KIE, et al. Calculating the sample size required for developing a clinical prediction model. BMJ. 2020;368:m441. doi:10.1136/bmj.m441

25. Habib N, Buzzaccarini G, Centini G, et al. Impact of lifestyle and diet on endometriosis: a fresh look to a busy corner. Prz Menopauzalny. 2022;21(1):124132.

26. Brichant G, Laraki I, Henry L, Munaut C, Nisolle M. New therapeutics in endometriosis: a review of hormonal, non-hormonal, and non-coding RNA treatments. Int J Mol Sci. 2021;22(19):10498. doi:10.3390/ijms221910498

27. Vercellini P, Ottolini F, Frattaruolo MP, Buggio L, Roberto A, Somigliana E. Shifting from oral contraceptives to norethisterone acetate, or vice versa, because of drug intolerance: does the change Benefit women with endometriosis? Gynecol Obstet Invest. 2018;83(3):275284. doi:10.1159/000486335

28. Sharma SC, Basu NN. Galactorrhea/Galactocele after breast augmentation: a systematic review. Ann Plast Surg. 2021;86(1):115120. doi:10.1097/SAP.0000000000002290

29. Mishell DR Jr., Kletzky OA, Brenner PF, Roy S, Nicoloff J. The effect of contraceptive steroids on hypothalamic-pituitary function. Am J Obstet Gynecol. 1977;128(1):6074. doi:10.1016/0002-9378(77)90295-2

30. Momoeda M, Harada T, Terakawa N, et al. Long-term use of dienogest for the treatment of endometriosis. J Obstet Gynaecol Res. 2009;35(6):10691076. doi:10.1111/j.1447-0756.2009.01076.x

31. Dragoman MV, Gaffield ME. The safety of subcutaneously administered depot medroxyprogesterone acetate (104mg/0.65mL): a systematic review. Contraception. 2016;94(3):202215. doi:10.1016/j.contraception.2016.02.003

32. Sitruk-Ware R. Hormonal contraception and thrombosis. Fertil Steril. 2016;106(6):12891294. doi:10.1016/j.fertnstert.2016.08.039

33. Pfeifer S, Butts S, Dumesic D, Practice Committee of the American Society for Reproductive Medicine. Electronic address Aao, Practice Committee of the American Society for Reproductive M. Combined hormonal contraception and the risk of venous thromboembolism: a guideline. Fertil Steril. 2017;107(1):4351. doi:10.1016/j.fertnstert.2016.09.027

34. Welling LL. Psychobehavioral effects of hormonal contraceptive use. Evol Psychol. 2013;11(3):718742. doi:10.1177/147470491301100315

35. Bachrach LK. Hormonal contraception and bone health in adolescents. Front Endocrinol (Lausanne). 2020;11:603. doi:10.3389/fendo.2020.00603

36. Hage M, Plesa O, Lemaire I, Raffin Sanson ML. Estrogen and progesterone therapy and meningiomas. Endocrinology. 2022;163(2). doi:10.1210/endocr/bqab259

37. Edmondson HA, Henderson B, Benton B. Liver-cell adenomas associated with use of oral contraceptives. N Engl J Med. 1976;294(9):470472. doi:10.1056/NEJM197602262940904

38. Smitz J, Ron-El R, Tarlatzis BC. The use of gonadotrophin releasing hormone agonists for in vitro fertilization and other assisted procreation techniques: experience from three centres. Hum Reprod. 1992;7(Suppl 1):4966. doi:10.1093/humrep/7.suppl_1.49

39. Della Corte L, Barra F, Mercorio A, et al. Tolerability considerations for gonadotropin-releasing hormone analogues for endometriosis. Expert Opin Drug Metab Toxicol. 2020;16(9):759768. doi:10.1080/17425255.2020.1789591

40. Rocca ML, Palumbo AR, Bitonti G, Brisinda C, C DIC. Bone health and hormonal contraception. Minerva Obstet Gynecol. 2021;73(6):678696. doi:10.23736/S2724-606X.20.04688-2

41. Duijkers IJM, Klipping C, Rautenberg T, et al. Effect on ovarian activity and ovulation inhibition of different oral dosages of levonorgestrel. Contraception. 2022;110:615. doi:10.1016/j.contraception.2022.01.018

42. Kyvernitakis I, Kostev K, Thomasius F, Stumpf U, Hadji P. Effect of progestogen-only contraception on premenopausal fracture risk: a case-control study. Osteoporos Int. 2020;31(9):18011806. doi:10.1007/s00198-020-05437-6

43. Lopez LM, Chen M, Mullins Long S, Curtis KM, Helmerhorst FM. Steroidal contraceptives and bone fractures in women: evidence from observational studies. Cochrane Database Syst Rev. 2015;7:CD009849. doi:10.1002/14651858.CD009849.pub3

44. Raine-Bennett T, Chandra M, Armstrong MA, Alexeeff S, Lo JC. Depot medroxyprogesterone acetate, oral contraceptive, intrauterine device use, and fracture risk. Obstet Gynecol. 2019;134(3):581589. doi:10.1097/AOG.0000000000003414

45. Das R, Ragagnin G, Sjostedt J, et al. Medroxyprogesterone acetate positively modulates specific GABAA-receptor subtypes - affecting memory and cognition. Psychoneuroendocrinology. 2022;141:105754. doi:10.1016/j.psyneuen.2022.105754

46. Heinemann K, Reed S, Moehner S, Minh TD. Risk of uterine perforation with levonorgestrel-releasing and copper intrauterine devices in the European active surveillance study on intrauterine devices. Contraception. 2015;91(4):274279. doi:10.1016/j.contraception.2015.01.007

47. Kataoka Y, Wada M, Bito M, Asai J, Katoh N. Subcutaneous nodules at progesterone injection sites after fertility treatment. Australas J Dermatol. 2019;60(2):143144. doi:10.1111/ajd.12929

48. Wildemeersch D, Hasskamp T, Goldstuck N. Intrauterine devices that do not fit well cause side effects, become embedded, or are expelled and can even perforate the uterine wall. J Minim Invasive Gynecol. 2015;22(2):309310. doi:10.1016/j.jmig.2014.09.010

49. Aoun J, Dines VA, Stovall DW, Mete M, Nelson CB, Gomez-Lobo V. Effects of age, parity, and device type on complications and discontinuation of intrauterine devices. Obstet Gynecol. 2014;123(3):585592. doi:10.1097/AOG.0000000000000144

50. Bayer LL, Jensen JT, Li H, Nichols MD, Bednarek PH. Adolescent experience with intrauterine device insertion and use: a retrospective cohort study. Contraception. 2012;86(5):443451. doi:10.1016/j.contraception.2012.03.014

51. Gullo G, Petousis S, Papatheodorou A, et al. Closed vs. open oocyte vitrification methods are equally effective for blastocyst embryo transfers: prospective study from a sibling oocyte donation program. Gynecol Obstet Invest. 2020;85(2):206212. doi:10.1159/000506803

52. Prapas Y, Ravanos K, Petousis S, et al. GnRH antagonist administered twice the day before hCG trigger combined with a step-down protocol may prevent OHSS in IVF/ICSI antagonist cycles at risk for OHSS without affecting the reproductive outcomes: a prospective randomized control trial. J Assist Reprod Genet. 2017;34(11):15371545. doi:10.1007/s10815-017-1010-7

53. Tanos P, Dimitriou S, Gullo G, Tanos V. Biomolecular and Genetic prognostic factors that can facilitate Fertility-Sparing Treatment (FST) decision making in Early Stage Endometrial Cancer (ES-EC): a systematic review. Int J Mol Sci. 2022;23(5):2653.

54. Cavaliere AF, Perelli F, Zaami S, et al. Fertility sparing treatments in endometrial cancer patients: the potential role of the new molecular classification. Int J Mol Sci. 2021;22(22):12248. doi:10.3390/ijms222212248

55. Gullo G, Etrusco A, Cucinella G, et al. Fertility-sparing approach in women affected by stage I and low-grade endometrial carcinoma: an updated overview. Int J Mol Sci. 2021;22(21):11825. doi:10.3390/ijms222111825

56. Poisson M, Magdelenat H, Foncin JF, et al. [Estrogen and progestin receptors in meningiomas: a study in 22 cases]. Recepteurs doestrogenes et de progesterone dans les meningiomes. Etude de 22 cas. Rev Neurol (Paris). 1980;136(3):193203.

57. Donnell MS, Meyer GA, Donegan WL. Estrogen-receptor protein in intracranial meningiomas. J Neurosurg. 1979;50(4):499502. doi:10.3171/jns.1979.50.4.0499

58. Chen JJ, Applebaum DS, Sun GS, Pflugfelder SC. Atopic keratoconjunctivitis: a review. J Am Acad Dermatol. 2014;70(3):569575. doi:10.1016/j.jaad.2013.10.036

59. Bonini S, Lambiase A, Schiavone M, Centofanti M, Palma LA, Bonini S. Estrogen and progesterone receptors in vernal keratoconjunctivitis. Ophthalmology. 1995;102(9):13741379. doi:10.1016/s0161-6420(95)30861-5

60. Gemmill JA, Stratton P, Cleary SD, Ballweg ML, Sinaii N. Cancers, infections, and endocrine diseases in women with endometriosis. Fertil Steril. 2010;94(5):16271631. doi:10.1016/j.fertnstert.2009.07.1698

61. Frost JJ, Darroch JE. Factors associated with contraceptive choice and inconsistent method use, United States, 2004. Perspect Sex Reprod Health. 2008;40(2):94104. doi:10.1363/4009408

62. Kost K, Singh S, Vaughan B, Trussell J, Bankole A. Estimates of contraceptive failure from the 2002 National Survey of Family Growth. Contraception. 2008;77(1):1021. doi:10.1016/j.contraception.2007.09.013

63. Rosenberg MJ, Waugh MS, Long S. Unintended pregnancies and use, misuse and discontinuation of oral contraceptives. J Reprod Med. 1995;40(5):355360.

64. Hughey AB, Neustadt AB, Mistretta SQ, Tilmon SJ, Gilliam ML. Daily context matters: predictors of missed oral contraceptive pills among college and graduate students. Am J Obstet Gynecol. 2010;203(4):323 e17. doi:10.1016/j.ajog.2010.05.039

65. Teal S, Edelman A. Contraception selection, effectiveness, and adverse effects: a review. JAMA. 2021;326(24):25072518. doi:10.1001/jama.2021.21392

66. Multiaxiality. Medical dictionary for regulatory activities. Available from: https://www.meddra.org/multiaxiality. Accessed May 2, 2022.

Read more from the original source:
Analysis of Adverse Events and Medical Errors in Long-Term Hormone Tre | IJWH - Dove Medical Press

HCG Diet InformationWhat is Human Chorionic Gonadotropin or HCG?HCG stands for Human Chorionic Gonadotropin & is a very safe & mild hormone present in both males & females. This glycoprotein is composed of 244 amino acids.

Welcome to HCG Near Me, where access to a quality HCG Diet is always near you! If you do not live near the lovely Miami, FL area, no worries, we can ship your entire HCG Diet kit to you after a simple 10 to 15-minute telemedicine phone consultation. HCG Near Me is owned and operated by a licensed Health Care Clinic Establishment in Miami, Florida, and employs certified health professionals to ensure a quality medical weight loss program for all to benefit from.

The use of HCG for weight loss is not a new fly by night fad diet. This diet dates to the 1950s and has helped millions of people since then. It was created by a British endocrinologist named Albert Simeons. Dr. Simeons was studying pregnant women in third world countries and was absolutely fascinated at how these women, who were often malnourished, would give birth to regular sized babies. These women also had to work to survive and often walked everywhere burning plenty of calories.

Therefore, Dr. Simeons wanted to research how these women, who burned high calories and ate fewer calories, would still give birth to regular sized babies that Dr. Simeons assumed would be born malnourished. His research and observations led to the discovery of high levels of HCG in the bloodstream of pregnant women. Further research then led to the discovery of how the HCG helps the body to release adipose fatty acid into the bloodstream for immediate use and consumption. This means the fetus was being nourished by the mothers adipose body fat.

Dr. Simeons then tried using HCG injections with obese or overweight boys in India to see if the HCG injections together with a very low-calorie diet would help the boys lose adipose body fat. His studies concluded that while taking HCG injections and undergoing a low-calorie diet, specifically low in fats, his patients would lose high amounts of unwanted body fat and maintain lean muscle mass.

After many years of research and trial and error with many users of the HCG Diet, this magnificent diet has evolved. The internet is loaded with plenty of good information, but unfortunately, its also filled with plenty of bad and misleading information. The main things wed like to address briefly here is that this diet originally called for 500 calories per day. Our modern program advocates for higher calories that are consistent with a persons body mass index and body metabolic rate. We customize each persons daily caloric allowance!

Also, you may read online that the FDA does not approve or has made the HCG Diet illegal. This is not true; the FDA has made the sale of FAKE homeopathic HCG drops illegal. Yes, there are people out there selling fake drops of HCG and trying to claim its the real hormone. So, remember, the fake HCG drops are illegal, not the real prescription injections or oral tablets you can get through a licensed Health Care Clinic with certified physicians like the ones youll find at HCG Near Me.

HCG mobilizes the bad fat which we all know as adipose fatty tissue (abnormal fat). Basically, mobilizing bad fat is when the body releases fatty acid into the bloodstream as a mechanism to protect from starvation. There are 3 types of fat:

As mentioned earlier, pregnant females produce extremely high amounts of HCG, over 1 million IUs (International Units) to be exact. Note: this is way higher than the amount of HCG you receive for a 30-day weight loss program (6,000 IU). Everyone, male or female, will receive safe doses for their weight loss program. What the HCG actually does is mobilize the abnormal fat full of nutrients, vitamins, and minerals to nourish the unborn fetus.

Dr. Simeons states, In pregnancy, it would be most undesirable if the fetus was offered ample food only when there is a high influx from the intestinal tract. Ideal nutritional conditions for the fetus can only be achieved when the mothers blood is continually saturated with food, regardless of whether she eats or not, as otherwise, a period of starvation might hamper the steady growth of the embryo.

So how does the HCG work for someone taking injections? Basically, a person taking HCG injections and undergoing a low-calorie diet will lose weight because the presence of HCG in their system will cause the body to mobilize adipose body fat and release fatty acid into the bloodstream. HCG does this in a pregnant female to protect the fetus. If you were to do the HCG Diet, since you are now eating a low-calorie diet, you become like the fetus that the HCG is protecting. The HCG ensures you do not starve while you are undergoing a low caloric daily intake. It is for this reason HCG also controls hunger for those taking the injections. Even though you are eating much less, the release of this adipose body tissue into the bloodstream helps keep you nourished and not feeling starved.

When you give yourself the HCG injections, you will also incorporate a specific very low-calorie diet (VLCD) with detailed phases and rules. The actual diet and allowed foods will really reshape your body and provide tremendous health benefits. Your body does need good fats such as reserve and structural to survive but can function without the abnormal adipose fat. Therefore, HCG shots or injections coupled with our 4 phase VLCD will trigger rapid weight loss that is primarily comprised of bad fat.

Absolutely! In fact, men perform better on the HCG Diet than women, sorry ladies. HCG injections have been used in men for years to help treat low testosterone. Physicians have prescribed HCG to men while taking testosterone therapy because HCG helps men to not shut down their own natural testosterone production. If a man took HCG injections alone without testosterone, they would likely increase their own testosterone naturally and gradually with the HCG injection alone. So aside from the benefits of weight loss, HCG injections in men would also help increase natural testosterone levels safely. HCG has also been used in treatments for men who are no longer fertile due to long term drug or steroid abuse. The HCG helps these men produce sperm again after long periods of being shut down.

Dr. Simeons stated years ago, When a male patient hears that he is about to be put into a condition which in some respects resembles pregnancy, he is usually shocked and horrified. The physician must therefore carefully explain that this does not mean that he will be feminized and that HCG in no way interferes with his sex. He must be made to understand that in the interest of the propagation of the species, nature provides for perfect functioning of the regulatory headquarters in the diencephalon during pregnancy and that we are merely using this natural safeguard as a means of correcting the diencephalic disorder which is responsible for his being overweight.

If you undergo a very low-calorie diet long term you will definitely lose weight. The problem is that you will undoubtedly lose high amounts of muscle mass in the process and this spells bad news for your metabolism. If just reducing calories were the simple solution, then why has it not worked in the past? If you landed on our website and are researching the HCG Diet, wed say youve tried other diets with poor or no success at all. The two most obvious reasons one should avoid just reducing calories to lose weight are:

These two simple and straightforward reasons are why so many people fail at weight loss attempts. A combination of HCG injections and the modern VLCD can mobilize and reduce your abnormal fat without hurting your metabolic rate.

The HCG Diet is the hottest medical weight loss program in existence today. If this is your first time learning about it, congratulations, your life is about to change. The original HCG Diet by Dr. Simeons dates back to the 1950s. The original rules called for 500 calories per day for everyone on the diet! This simply does not work for todays society. Everyone has a different engine and motor.

At HCG Near Me, we will customize your daily caloric need and you will be on a Very Low-Calorie Diet thats right for you. Another thing to keep in mind is the evolution of the human body, we are bigger, faster, and stronger than we were almost 70 years ago. We simply all need more calories! We also process foods much different today than foods were processed 70 years ago. Foods were way more organic back then. For these reasons, we have modernized and perfected the HCG Diet for todays patient.

For anyone researching the best way to lose weight with HCG injections, two fantastic sources of updated information as of 2020, are HCG Near Me and HCG Diet Miami. Both these licensed health care clinics are owned and operated by the same weight loss consulting group. They employ only licensed health professionals to bring you the very best weight loss information and medications necessary for a successful HCG Diet program.

Located in Miami, FL, these two clinics can serve both the local Miami population and anyone located in the United States. With the use of telemedicine, our clinics can ship your HCG kit with all supplies to you after a simple and legal 10 to 15-minute Telemed or Telehealth consultation. If you searched HCG Diet Near Me and landed on our page, you should be glad you did. HCG Near Me is Near You!

Many clinics in the United States offering the HCG Diet are completely overpriced. For this reason, we get many patients from all around the United States. The HCG Diet is our niche. We have very low costs compared to other spas or clinics that offer other treatments with expensive machinery and other high-cost items. These other spas or clinics must factor in these high expenses when deciding what to charge for their services.

Our clinic has the very best medications from some of the top compounding pharmacies in the country. We provide all of our patients with information on the pharmacies we use. If you are considering working with us, ask us about our FDA approved compounding pharmacies.

We encourage you to navigate our site further to learn about doing the HCG Diet, starting the program, and learning how to effectively keep the weight off after the diet. A detailed diet plan is provided with information about every phase of the program and our customer service is the best youll find around.

See the rest here:
HCG Near Me. #1 Online or Local U.S. HCG Diet Clinic. We ship HCG fast.

If youve been working hard to lose weight but havent been seeing the results you want, it may be time to consider one of these weight-loss procedures. Its important to consult with your doctor to see if any of these procedures are right for you.

From gastric sleeve surgery to the keto diet, there are a variety of options available that can help you finally reach your goals. Here are six weight-loss procedures to consider if youre having trouble losing weight.

.

If youre a man struggling to lose weight, low testosterone may be to blame. Testosterone replacement therapy can help increase your levels of this hormone, leading to improved metabolism and increased muscle mass. This can help you burn more calories and finally start seeing results from your weight-loss efforts. You can google trt clinics near me to find out who offers this kind of therapy.

Your doctor may also recommend other lifestyle changes such as eating a healthier diet and exercising more to help you lose weight. Its important to speak with your doctor about whether testosterone replacement therapy is right for you.

Gastric sleeve surgery is a type of weight-loss surgery that involves removing a portion of the stomach. By reducing the amount of food you can eat and also leads to hormones being released that help promote feelings of fullness, gastric sleeve surgery can be an effective way to lose a significant amount of weight and keep it off long-term.

However, this is a major surgery with some risks involved so it is important to speak with your doctor about whether it is right for you before making a decision. It is also important to be aware that this surgery is not reversible.

.

The keto diet is a high-fat, low-carbohydrate diet that can help promote weight loss. When following this diet, your body enters a state of ketosis, which means it starts using fat for energy instead of carbohydrates, which can lead to rapid weight loss in some people.

Since the keto diet is not for everyone, you have to speak with your doctor before starting this or any other type of diet. This diet can be difficult to stick to long-term so be prepared before starting it.

.

Intermittent fasting is an eating pattern that involves cycles of fasting and eating. There are a variety of different ways to do intermittent fasting, but one common method is to fast for 16 hours and eat only during an 8-hour window.

By increasing levels of human growth hormone and helping the body burn more fat, intermittent fasting can help promote weight loss. It can also help improve insulin sensitivity. This is also not for everyone so a consultation with your doctor is a must.

.

The human chorionic gonadotropin (hCG) diet is a low-calorie diet that involves taking this hormone that is normally only found in pregnant women. When taken as part of the hCG diet, this hormone is said to help promote weight loss.

However, the hCG diet is not FDA-approved and there is no scientific evidence to support its claims. Its also important to be aware that the long-term effects of taking hCG are unknown.

.

Also called bariatric surgery, weight-loss surgery is a type of surgery that helps promote weight loss. There are a variety of different types of this surgery but they all work by helping to reduce the amount of food you can eat or the absorption of nutrients from food or both.

Weight-loss surgery is a major decision. It is not a quick fix so it is important to be prepared for a lifelong commitment to healthy eating and exercise after the surgery.

These are just a few of the many weight-loss procedures and diets available. Its important to speak with your doctor about which options are right for you before starting any type of weight-loss plan. Keep in mind that any weight-loss plan requires a lifelong commitment to healthy eating and exercise. There is no magic pill or surgery that will make the weight come off and keep it off long-term. The key to successful weight loss is making sustainable changes to your lifestyle.

Like Loading...

Related

More here:
6 weight loss procedures to consider if youre having trouble losing weight - CONAN Daily