High doses of various hormones have been used for many years to prevent pregnancy after unprotected coitus. Diethylstilbestrol (DES), a synthetic estrogen, was once approved for this purpose by the US Food and Drug Administration (Medical Letter 15:58, 1973), but no drug is now approved for such use. Ovral, an oral contraceptive containing 50 g of the estrogen ethinyl estradiol and 0.5 mg of the progestin norgestrel, has been recommended as a 'morning-after' pill by some physicians (RA Hatcher et al, Contraceptive Technology 1988-1989, 14th ed., New York:Irvington, 1988, page...

The most important prognostic variable in early breast cancer is axillary lymph node involvement. Based on past experience, after 10 years about 70% of node-negative patients will be alive and apparently free of disease; about 30% will have relapsed or died. Patients with positive nodes may have a 30% to 60% relapse rate, depending on the number of positive nodes and other prognostic factors, such as the presence of estrogen receptors (IC Henderson et al, in VT DeVita, Jr et al, eds, Cancer: Principles and Practice of Oncology, 3rd ed, Philadelphia:Lippincott, 1989, p 1197). Which of...

Urofollitropin (Metrodin - Serono), a human gonadotropin, is the latest drug to be approved by the US Food and Drug Administration (FDA) for induction of ovulation in various clinical situations, including in vitro fertilization (IVF).

The antiestrogen toremifene (Fareston - Schering) and the selective aromatase inhibitor letrozole (Femara - Novartis) have been approved by the FDA for treatment of advanced breast cancer in postmenopausal women.

The results of a large randomized controlled trial of estrogen plus a progestin to prevent heart disease in postmenopausal women were recently reported (Writing Group for the Women's Health Initiative Investigators, JAMA 2002; 288:321).

PC Spes, a dietary supplement sold for "prostate health", is being used increasingly to treat prostate cancer.

In recent years, many women have become concerned about the safety of pharmaceutical replacement hormones for treatment of menopausal symptoms. “Bioidentical” hormone preparations, which are not approved by the FDA, are heavily promoted in popular books and on TV as alternatives; these are derivatives of soy or plant extracts, chemically modified to be structurally identical to endogenous hormones. Most FDA-approved single-entity hormones are also derivatives of soy or plant extracts and are structurally identical to hormones produced by the ovary.

Two new drugs alendronate (Fosamax - Merck) and salmon calcitonin nasalspray (Miacalcin - Sandoz) are now available in the USA for treatment of postmenopausalosteoporosis. A third drug for treatment of osteoporosis, a slow-release fluoridepreparation (Slow Fluoride -Mission Pharmacal), has been recommended for approvalby an advisory committee of the US Food and Drug Administration (FDA). Various formulationsof fluoride have been available in Europe for this indication for many years.

An FDA Advisory Committee has recommended over-the-counter (OTC) marketing of Plan B (Barr), an emergency contraceptive "pill pack" that contains two 0.75-mg tablets of levonorgestrel to be taken 12 hours apart (Medical Letter 2000; 42:10). Plan B is one of two FDA-approved products for this indication. The Preven Emergency Contraceptive Kit (Medical Letter, 40:102, 1998) includes four tablets, each containing 0.25 mg of levonorgestrel and 50 ╡g of ethinyl estradiol; these are taken 2 at a time 12 hours apart (the "Yuzpe regimen") and are available only by...

Lybrel (Wyeth) is the first FDA-approved low-dose combination oral contraceptive taken 365 days a year without a placebo or pill-free interval. All tablets contain low doses of levonorgestrel (0.09 mg) and ethinyl estradiol (20 mcg). Most oral contraceptives are packaged as a 21/7 cycle (21 days of active tablets and 7 days of placebo), resulting in 13 withdrawal bleeding episodes each year. Two formulations are taken for 24 days followed by 4 days of inert tablets (Yaz and Loestrin 24). Two others (Seasonique and Seasonale) have a 91-day cycle with only 4 withdrawal bleeds per...