QuestionI am a 52 year old female that has not had a period in over a year. Actually, it might should have been longer than that as I was on the "CombiPatch" to help me through Menopause but it didn't help me except for the hot flashes, etc. I actually had two periods a month for about 3 years yet the drs. kept saying I WAS going through menopause. (I have had trouble with my periods all my life - plus infertility - had polycystic ovaries and had to have three surgeries to get pg. then had another pg. on my own. After that one, I became regular as clockwork from age 33 - 49.) The dr. finally just took me off of the CombiPatch and I quit bleeding all together. Haven't bled in over a year. But...I have had problems for almost the last two years and was just diagnosed this past June with Multiple Sclerosis. I honestly think I have something besides MS going on as I have too many other symptoms (and my dr. tells me this ALL the time) to fit in with JUST MS. I have had diahreaa for the past 6 weeks but no appetite for the past year. Then I get this bladder infection plus a yeast infection. I bought some GyneLotrimin - which I have always used for that - but the last two nights, when I insert the applicator and withdraw it, I have blood all over it. I then bleed for the next day - on and off. My husband and I don't have sex very much at all with all the different medications I'm on (my libido is shot) and the interferon I'm on so I would have no idea if "anything" would do that or what! I would tell my MS dr. but I'm sure he would tell me to go to another dr. - and I've been to so many in the past 16 months, I just hate to start looking for yet another specialist.
Have you ever heard of this happening? Is it something I should be worried about and go see another dr.? With this deep feeling that I have that something else IS going on, too, it does sort of worry me. I've only been on the interferon for 7 weeks now, but it really makes me sick - and I have no idea of how it affects me anywhere else.
Thank you so much.
AnswerI do not think that this problem is interferon related unless liver damage but more trauma from the insertion since the problem started with the insertion and did not stop since.
I suggest you to see a gyn , to evaluation either a trauma problem or something else that start to bleed by touching it as a tumor .
you should not wait and in the mean time do a pap smear after the bleeding stop.
Most Common Adverse Events in a Recent Large Trial of Patients Treated With Consensus Interferon (CIFN) or
Interferon Alfa 2b (3 MU=15 ug) (percentage)
Preferred Term CIFN 3ug CIFN 9ug IFN a-2b 15ug
Headache 75 82 82
Fatigue 58 69 67
Fever 30 60 45
Rigors 22 57 44
Myalgia 46 57 55
Pain 39 54 44
Arthralgia 43 50 44
Back pain 33 41 36
Abdominal pain 37 40 39
Nausea 41 40 35
Insomnia 26 38 30
Pharyngitis 28 33 31
Nervousness 26 31 28
Infection upper 32 31 33
Diarrhea 25 28 24
Pain limb 20 26 25
Depression 21 26 25
Anorexia 17 23 17
Granulocytopenia 9 23 25
Erythema 22.2 22.5 15.3
Dizziness 25 22 24
Cough 14 22 17
Dyspepsia 22 20 18
Anxiety 15 19 18
Thrombocytopenia 11 18 16
Sinusitis 15 17 22
Influenza like 22.6 15 11
Leukopenia 7 14 12
Pain neck 10 14 12
Pain skeletal 13 14 14
Alopecia 6 14 25
Paraesthesia 10 13 9
Pruritus 13 13 13
Rash 12 13 14
Chest pain 15 12 14
Hot flushes 6 12 7.2
Emotional lability 8 12 11
Rhinitis 12 12 15
Increased sweating 5 12 11
Vomiting 12 11 10
Resp tract congestion 11 10 14
Dysmenorrhea 7.8 9.4 9.4
Thyroid testabnormal 3 9 4
Conjunctivitis 6.1 8.2 8.1
Constipation 10 8 5
Thinking abnormal 10 7.8 12
Hypertriglyceridemia 6 6 6
Tinnitus 3 5 4
Pain eye 2.6 4.8 5.5
Earache 10 4 6
TABLE 2. Laboratory Variables
Value Phase Observation 3ug CIFN 9 ug CIFN 15 ug IFN
alpha-2b
Hemoglobin End Rx Median change (%) -2.6 -4.8 -4.5
White blood cells End Rx Median change (%) -9.7 -18.5 -22.8
Treatment period Incid low WBC (%) 19.20% 35.20% 35.20%
Neutrophil count End Rx Median change (%) -13.7 -22.9 -33.4
Treatment period Incid low neutrophils (%) 20.10% 42.60% 40.10%
Segmented neutrophil count End Rx Median change (%) -13.6 -22.8 -33.2
Basophil count End Rx Median change (%) -7.7 -13 -29
Eosinophil count End Rx Median change (%) 14 -3.2 -19
Lymphocyte count End Rx Median change (%) -0.3 -9.4 -42
Monocyte counts End Rx Median change (%) 9.7 10.1 13.4
Platelet counts End Rx Median change (%) -7.5 -15.6 -18.9
Treatment period Incid low platelets (%) 38 46.1 45.3
Serum calcium End observation Median change (%) -1.03 -0.3 0.07
Treatment period Incid low calcium (%) 7.4 8.7 9.5
Serum triglyceride End Rx Median change (%) 11.6 40.8 27.4
Immune Disorders
Interferon has important immunomodulatory properties. Non-organ-specific antibody titers may increase, and indeed may be associated with autoimmune thyroiditis, hypothyroidism, and hyperthyroidism. (10-15) Other autoimmune endocrine diseases have been induced, but thyroid disease is particularly important. (16) Thyroid disorders have been reported in 2.5-20 percent of patients. This may not be reversible after stopping therapy, unless therapy is stopped early, and long-term thyroid replacement may be required. (17-19) It is possible that underlying thyroid disease is more common in chronic hepatitis C infection.
An aggravation of the chronic hepatitis may occur. Patients may be genetically predisposed to this complication and can be recognized by prior autoantibody measurement and HLA haplotyping. An exacerbation of psoriasis may be part of this syndrome. Discontinuation may be required, particularly for hyperthyroidism, unless transient hyperthyroidism followed by hypothyroidism is recognizable. Autoimmune hepatitis usually necessitates discontinuation of therapy. Interferon may promote the development of systemic lupus erythematosus.
Cardiovascular Side Effects
Both benign and severe cardiac manifestations have been reported. Cardiac arrhythmias, including supraventricular tachycardia but also sudden death and ventricular arrhythmias, have been reported. There are single case reports of dilated cardiomyopathy. Hypotension has been reported in large trials.
Renal Side Effects
Proteinuria is relatively common, but is usually benign and not nephrotic. lnterstitial nephritis and acute renal failure have been reported. Interferon alpha is, however, reasonably tolerated in hemodialyzed patients. (20) Renal impairment occurs in kidney transplant patients. (21)
Hepatic Side Effects
Serum aminotransferases may increase during interferon alpha treatment. These are generally mild and resolve with continued treatment in responsive patients. Exacerbations occur in hepatitis B infection; these severe cytolytic episodes may presage a response, but are poorly tolerated in patients with cirrhosis. Hepatic decompensation may occur in patients with cirrhosis, and these patients are more susceptible to infections. (22,23) Autoimmune hepatitis should not be misdiagnosed as hepatitis C infection, as severe exacerbation of the disease with cholestasis and severe liver injury can occur. Patients with documented hepatitis C infection may deteriorate after interferon alpha treatment if an underlying autoimmune diasthesis is present. This has been observed in LKM antibody-positive individuals. These patients require careful monitoring if interferon is considered the first line of treatment. (24) Rejection may occur if interferon is used after liver transplantation. (25)
Gastrointestinal Side Effects
Nausea, vomiting, dyspepsia, diarrhea, and abdominal pain are relatively frequent.
Dermatologic Side Effects
A variety of rashes including erythema multiforme have been noted. Pruritus can be troublesome. Mild hair loss is relatively common but is reversible. Local erythema is common. Psoriasis can develop de novo, or be aggravated, and is usually difficult to treat. Vitiligo has been reported. (26)
Myelosuppression
Granulocytes, thrombocytes, and red blood cell counts are commonly decreased during treatment. These are usually mild if normal counts are present initially, but can be dose limiting in the presence of low counts, for example in patients with hypersplenism. Patients may be predisposed to infections. The mechanism of granulocytopenia is unknown, but inhibition of cell release from the bone marrow has been suggested.
Hormonal and Metabolic Side Effects
A sustained increase in serum triglyceride levels has been reported. Diabetes mellitus may worsen or develop.
Rare Adverse Events
Ocular: Retinopathy has been reported in Japanese patients. (27) Lung: interstitial fibrosis of the lung and hearing impairment have been found. (7) The cases of pneumonitis may also be due to the use of Sho-Saiko and interferon. (28)
the numbers are references
hope this answer your question
please keep me posted on the finding
thanks
dan
