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Hrt Hormones Transgender

SEINE AUSERWÄHLTE GEFÄHRTIN

"Sie wurde auserwählt, weil sie von Anfang an sein Recht war..." Einmal bei einer seltenen Gelegenheit, in der Nacht eines blauen Vollmonds, wird ein Mädchen aus einem Haushalt entführt, um den Bestien zu dienen, die sich Werwölfe nennen. Die Werwölfe waren es, die die Stadt beherrschten und alles kontrollierten. Sie sahen menschlich aus, aber unter ihrer menschlichen Fassade verbarg sich ein rücksichtsloses Monster, das nur darauf aus war, zu zerstören. Alle versuchten, sich zu schützen, aber tief im Inneren wussten sie, dass sie den Werwölfen nicht gewachsen waren. Arianne war ein kleines Mädchen, das anders als die anderen Menschen in der Stadt geboren wurde. Sie hatte lange rote Haare und wurde mit verschiedenfarbigen Augen geboren. Ein grünes und ein braunes. Niemand wusste genau, warum sie so geboren wurde, und es war nicht erblich bedingt. Auch ihre Mutter starb bei ihrer Geburt, und deshalb distanzierte sich ihr Vater Massimo von ihr und beschloss, stattdessen wieder zu heiraten. Er heiratete eine Frau namens Christine, die bereits ein außereheliches Kind, Rissa, hatte. Gemeinsam beschlossen Rissa und Christine, Arianne das Leben zur Hölle zu machen, wovor ihr Vater die Augen verschloss, was sich auf Arianne auswirkte und sie dazu brachte, sich von ihrer Familie und der Gesellschaft zurückzuziehen. Der Tag der Auswahl kam und Rissa wurde ausgewählt, um den Werwölfen zu dienen. Aus Angst um ihr Leben beschloss Rissa, ihre Mutter zu überreden, Massimo davon zu überzeugen, Arianne für die Auswahl vorzuschlagen. Ungeachtet ihrer schreienden Bitten und Tränen bot Massimo Arianne an, den Werwölfen zu dienen. Niemand weiß wirklich, was mit den ausgewählten Mädchen geschieht, und niemand hat sich die Mühe gemacht, danach zu fragen. Ohne zu wissen, welches Schicksal sie erwartet, beschloss Arianne, dem Werwolf Ivan Giovanni zu dienen, einem Alphatier, das für seine Skrupellosigkeit bekannt ist. Kann Arianne das Leben unter Werwölfen überleben? Was passiert, wenn sie mehr über ihre Identität herausfindet und die einzige Person, die ihr helfen könnte, Ivan ist? Was glaubst du, wird passieren, wenn sie herausfindet, dass Ivan der Junge war, den sie vor all den Jahren vor dem Tod bewahrt hat? HINWEIS: DAS UMSCHLAGBILD DIESES BUCHES GEHÖRT MIR NICHT. DAS BILD WURDE AUF PINTEREST GEFUNDEN.
DA_Aloera · 125.1K Views

Vom Rebellenkönig gestohlen

Als Prinzessin, die nicht zaubern konnte, bestand Prinzessin Daphnes einziger Wert für ihr Königreich in ihrer arrangierten Ehe. Die Aufgabe war einfach, aber als Daphne entführt und in die kalten Berge von Vramid gebracht wurde, wurde ihr klar, dass sie überfordert war. Sie hatte schon einmal von diesen verfluchten Bergen gehört - felsiges Gelände, eisige Temperaturen, und das Land wurde von einem Mann regiert, der von vielen auf dem Kontinent gefürchtet wurde. König Atticus Heinvres, der blutdürstige Herrscher des Nordens. Obwohl sie ihm noch nie begegnet war, erzählte man sich Geschichten über die Skrupellosigkeit von König Atticus. Manche sagten, er sei ein Ungeheuer, andere behaupteten, er sei der Teufel persönlich, aber wie auch immer die Geschichte lautete, jeder kannte den Mann, der über ungeahnte Kräfte verfügte. Er konnte Armeen stürzen und Nationen mit einer einzigen Handbewegung zerschmettern, unterstützt von einem Ring aus verfluchtem Obsidian, wie es hieß. Niemand außerhalb von Vramid war dem furchterregenden König je begegnet. Nicht bis Daphne. Bei der Begegnung mit dem furchterregenden Mann fand Daphne jedoch heraus, dass der König vielleicht gar nicht das Monster war, für das ihn andere gehalten hatten. Das, was sich unter dem Obsidianschild verbarg, könnte tatsächlich ein Rohdiamant sein. - [Auszug] "Also ... wo soll ich euch beide unterbringen?", fragte er beiläufig, ohne eine Antwort zu erwarten. "Es ist bedauerlich, dass ich nur einen Kronleuchter habe." "Unter meinem Bett? Nein, nein, zu schmutzig. Das haben meine Staubhasen nicht verdient", sinnierte Atticus vor sich hin. "Der Kaminsims? Wie wäre es mit dem Frisiertisch? Ich nehme an, wenn ich einen eurer Köpfe abschlagen würde, könnte ich ihn dort anbringen... Frau, welchen Kopf willst du anstarren, während du dir die Haare machst?" "Atticus!" Daphne schrie. "Ich will keine Köpfe! Lass sie los!" "Na gut." Atticus zuckte mit den Schultern und schnippte mit den Fingern. Es gab zwei identische Knackgeräusche, als beide Hälse auf einmal brachen. Daphne keuchte entsetzt auf. Dieser Mann, ihr Ehemann, hatte gerade zwei Männer mit einem Fingerschnippen getötet, als würde er Kerzen auslöschen. "Ich habe dir gesagt, du sollst sie gehen lassen!" Daphne schrie auf. "Ja, ich habe sie gehen lassen", sagte Atticus. Dann verfinsterten sich seine Augen. "Um das göttliche Urteil des Himmels zu empfangen." - Discord Server: https://discord.gg/7HAMK2bRYU
saltedpepper · 121.1K Views

I Will Kill The Extra

"He thought knowledge was power, but knowing the story won’t save him from me." ********** Extra Takes It All! True to its title, that hypocrite really does take it all. Opportunities? “Nah, the protagonist is too overpowered to even bother with them. I’ll take what he ignores—anything for my survival.” A harem? “I just help them a bit with their internal struggles, and somehow they keep clinging to me.” Items? “He barely uses them. They’re just lying around, so I’ll put them to good use.” And yet, that hypocrite keeps whining: *“I’m not supposed to be the protagonist. I don’t want to change the story’s outcome. I’ll just enjoy it from the sidelines.”* *Chuckle* Yeah, right. Somehow, I pushed through that mess of a plot. The other characters? They were decent. Well-developed. They felt real and believable. But that so-called “extra”? He was a walking contradiction. He started out on the sidelines, but gradually got more and more overpowered—until he himself became the story’s villain. As for the ending, don't even get me started. It really felt like the final battle was slapped together based on Authors hormones. The climax didn't make any sense at all, it was just a mess which totally twisted the logic that built up till this point of the story. So, what did I do wrong? I just cursed him a little, that’s all. And to be honest, he deserved it. Then, fate being fate, I ended up in that same novel that frustrated me. But unlike that Extra who cried about being thrown into a dangerous world and all, my situation is genuinely screwed. If I want to survive, there’s only one way: kill the extra. Yes, you heard me right. I won’t stop you, I will straight up kill. As your Professor, I’ll have plenty of chances.
YourAverage_Reader · 33.3K Views

Celestial Love : "A love across Worlds" (Season 1)

**Summary of the Novel:** *Alice, an alien girl from the distant "Cape Town Planet," finds herself stranded on Earth after losing her signal device. She is far from ordinary—Alice has superpowers and, when she inhales the hormones emitted by human males, she enters a "flowery state" that unlocks her deepest inhibitions. While trying to blend in with human society and repair her signal to return home, she encounters Edward, a powerful CEO who suffers from a mysterious condition: "rainy weather heterosexual amnesia." Whenever it rains, Edward forgets the women in his life, including Alice.* *Despite their otherworldly differences and Edward's strange affliction, a quirky and passionate romance blooms between them. Alice, using her alien abilities, helps Edward navigate the challenges of his life, while Edward finds in Alice something he’s been missing—a love that makes him feel truly valued. However, their budding relationship faces obstacles, including the rivalry between Edward and his brother Andrew for Alice’s affection, and Alice's inner conflict about staying on Earth versus returning to her home planet.* *As the rainstorms grow stronger and Edward's amnesia worsens, Alice becomes determined to help him, even as her own time on Earth grows short. The two share moments of love, laughter, and struggle, but in the end, Alice is forced to make the heartbreaking decision to return to her planet. Their love remains incomplete, leaving a sense of unfinished business between them.* *With Alice gone and Edward left with only fading memories of their time together, the story ends on a bittersweet note, promising that their love story will continue in a second season, where they will fight against the odds to reunite across the stars.*
Fantasy_World_8310 · 5.9K Views

Arch Mage’s Stress Free Life after Reincarnation

Marduk, a retired archmage of the Intergalactic Association of Mages and Witches, has lived for a thousand years. After centuries of mastering magic, his position as the dean of the Galactic Academy of Magic has only left him frustrated and bored, dealing with hormonal students and their overbearing parents. Desperate for something new, Marduk turns to experimenting with forbidden magic—dark magic of souls and light magic of reincarnation. In a catastrophic moment, he opens a black hole and is sucked into it, finding himself reincarnated in the body of a comatose nobleman’s son, Nolan Anderson. Nolan, the fifteen-year-old heir of the powerful Duke Alpheus Anderson, had been bedridden for months, his weak soul unable to withstand the immense natural power his body possessed. When Nolan’s soul fades away, Marduk’s strong soul takes over, reviving the body but leaving the archmage in a world both familiar and alien—a world where magic and technology coexist in harmony. Now living as Nolan in a society where monarchy still reigns supreme, Marduk is free from the shackles of his former responsibilities. He has a new life, a new body, and an opportunity to experience all the joys he was denied in his previous existence. Determined to live life to the fullest, Marduk—now Nolan—embarks on a journey to make friends, find love, and use his vast magical knowledge to aid his new family, while navigating the complexities of a society that thrives on equality, technological advancement, and magical power. However, this new world holds its own challenges and secrets. As Marduk adjusts to his new life, he finds himself drawn to Nova Bright, the brilliant yet emotionally distant grandson of the Grand Duke. Their paths cross, and what starts as a chance encounter at a party becomes the beginning of a slow-burning romance that will challenge both their hearts and the world around them. In a world where magic and science blend seamlessly, Marduk must balance his desire for a carefree life with the responsibility of his newfound identity, while discovering the possibilities of love that had eluded him for so long.
I_am_Lazzyyy · 8.9K Views

Der Aufstieg des dunklen Alphas

[KOMPLETT - SILBER $8.000USD GEWINNER: Werwolf-Wettbewerb 2022] Zev stürmte auf sie zu, in strahlender, brutaler Schönheit, das Kinn gesenkt und mit diesen unglaublichen, stechenden Augen auf sie gerichtet. Er blieb nicht stehen, bis sie auf Augenhöhe waren und er ihr die Sicht auf alle anderen Männer im Kreis versperrte. Seine Augen wanderten zu ihrem Mund, als er sich zu ihr beugte und sein Flüstern auf ihrer Haut spielte. "Du. Bist. Mein." Seine tiefe Stimme klang in ihrem Bauch, als das Heulen des Wolfsrudels hinter ihm aufstieg und über die Berge von Thana hallte, während die anderen Chimären gegen seinen Anspruch protestierten. Gegen den Drang ankämpfend, mit ihren zitternden Händen über seine breite, nackte Brust zu streichen, zwang sich Sasha, den Kopf zu neigen und eine Augenbraue zu heben. "So mutig für einen Welpen, der gerade seine Reißzähne gefunden hat. Die anderen Männchen brüllten vor Lachen. Zev ignorierte ihren Spott, seine Augen funkelten und er lehnte sich noch näher an sie heran, wobei sein Kinnhaar ihre Wange kitzelte, als er lächelte. "So mutig für einen Menschen, der bereits das Vergnügen kennt, meinen Namen zu rufen. Sie erschauderte, als seine Zähne ihr Ohr streiften. ***** Nur wenige Tage nachdem Sasha sich ihrer Jugendliebe hingegeben hatte, verschwand er. Fünf Jahre später kehrte Zev auf einer dunklen Straße in der Stadt zurück - mit der Gefahr im Nacken. Zev ist eine Chimäre: Halb Mensch, halb Wolf. In einem sicheren Forschungslabor erschaffen, ist seine Existenz ein Geheimnis. Doch als die mächtigen Männer, die ihn erschaffen haben, versuchen, die einzige Frau zu töten, die sein Herz je zum Singen gebracht hat, reißt Zev an ihrer Leine und entführt sie in die brutale, verborgene Welt der Chimera-Clans. Hin- und hergerissen zwischen der Anziehungskraft ihrer ersten Liebe und dem schmerzhaften Verrat seines Verschwindens, versucht Sasha, Zev auf Distanz zu halten. Doch als sie diese geheimnisvolle Welt erreichen, entdeckt Zev, dass die Menschen während seiner Abwesenheit die Kontrolle übernommen und fast alle Weibchen gestohlen haben. Die Chimären sterben - und Zev ist nicht mehr der Alpha. Jetzt muss Zev gegen sein eigenes Volk kämpfen, um das Recht zu erlangen, seine einzige Liebe zu paaren. Kann er ihr beweisen, dass sein lang zurückliegendes Versprechen, ihr Herz und ihren Körper zu schützen, wahr ist? Oder werden die Menschen die Welten durchqueren, um den Wolf zu jagen und die Liebenden für immer auseinander zu reißen? [Erwachsener Inhalt, keine sexuellen Übergriffe] Das Titelbild stammt von Aenaluck und wird mit Erlaubnis und gegen Bezahlung verwendet. Sehen Sie mehr wunderschöne Kunst und unterstützen Sie den Künstler auf www.patreon.com/aenaluck
AimeeLynn · 56.8K Views

Fated Baby of The Alpha (English Version)

Disclaimer: it's brand new story about werewolf and vampire that wrap in a different packaging. Different and still interesting! "Oh look, you're in a nice costume! You're hairy, and I like that," Marionette Alsen sighed, tracing the body of a man who was now above her. And the next day, she woke up without a single cloth and with scratches on several parts of her body. Unexpectedly, after that incident, Marion was chosen as William Reynz's personal assistant, and had to sign a strange contract. Since then, she has been forced to live an unconventional life, faced with William's strong sense of belonging to her, one of which is that she must always be with him wherever he is. Unfinished business as William's personal assistant which seems strange to her, the presence of Drake Wilmer disturbs Marion's life with his obsession and gentle demeanor, treating Marion like a Queen. Getting this treatment, made Marion lost in the charms and spells that Drake cast on her, made her fall in love with the man, until the relationship between them was too far away for William to know. A few weeks later Marion felt something different about her body. Morning sickness, cravings, even the uncontrollable gurgling of hormones she always felt whenever she was around William Reynz instead of Drake. Until a fact was revealed that she was pregnant, followed by another fact that the baby she was carrying might not be an ordinary baby. Who is the father of the baby? And will Marion be able to live a normal life after knowing all secrets in her life? #Werewolf #Vampire #hybrid #Billionaire #CEO #contractmarriage #harem *** Find my english work on GOODNOVEL. I working on Maximillian and Mirielle Reynz there, guys! Check it out! *** Where to reach me? Discord: Kennie Re #4440 IG: @kennie_r89 FB: Kennie Re Fanpage: Kennie Re - Author
Kennie_Re · 31.2K Views

Urasaria Academy

Decades of Cold War nuclear testing has led to the evolution of a new form of bacteria: Revenants that live upon the hearts of their hosts and grant them superpowers. In the following years, Urasaria Academy is formed to house crime-fighting students who are tasked with investigating and killing criminal hosts. In modern America, the young loner lesbian Mia Schultz is kidnapped by a headless man and given Worldwide, the ability to summon a swarm of fire scarabs. As she begins her new life at Urasaria Academy, she is soon pulled into a mystery of Worldwide's true origins. This story features a primarily-lesbian cast, although there are bisexual & transgender characters. Common themes in this character-based novel include emotional growth, loneliness and what it drives people to do, how memory alters perception, human selfishness, power and how it is wielded. If you are tired of self-insert harem isekai and want a mature story where realistic characters go through deep psychological drama (in-between murdering the absolute shit out of criminals), then Urasaria is for you. I also promise that the story is accepting of lesbians, bisexuals, and trans people. You will not be stereotyped or fetishized. If you would like to read other disclaimers for this work, continue on below. While this is an LGBT+ story, it does not feature: • Coming out: All female students are already assumed lesbians (although a few are bi). • Excess homo/bi/transphobia: Villains may use slurs, but hero students are generally accepting. • Gay burying: There are a few secondary characters who die, but couples are safe. • Grimdark: My approach to writing is that art should depict reality in its full spectrum of human emotion: laughter, anger, absurdity, seriousness, frustration, sadness, grief, and joy. What is silly should be treated sillily and what is serious should be treated seriously. What this work does feature: • Ultraviolence: Expect decapitations, ripping heads off, filling enemy's throats with scissors and snapping men as one snaps a wishbone. • Untagged 'dark' subjects: Please note that there are characters with backstories involving trauma, abuse, or addiction. I do not intentionally provoke negative emotions in readers nor attempt to shock with trauma -- I am just trying to faithfully render all contours of an inner emotional landscape. • I do not always agree with my characters & my characters do not always agree with me: I really shouldn't have to say this, but a character spouting an opinion does not equal me agreeing with their opinion. Read critically; sometimes, a character may be intentionally inconsistent or hypocritical to make a larger point about their character. If you would like to create fanwork based on Urasaria Academy, please feel free so long as you link back to here. Updates daily. Cover by Konorin!
RowPin · 571.1K Views

Darkness of Darkness-Vampire meets Vampire

Lee Shi Yi, common women in city A,used to be rich but all her grandfather assets were gone to Aunt Marie and nothing was left for her but until she found out about her parents identity.Her parents were the king and queen of the Dao Chao Vampires.Even though her parents were royalty,their death is still unknown.She also reopened Lee Cooperation. Ling Su Han, one of the richest people of city A, owning Ling Cooperation which is also one of the biggest and rich companies in the world. Being a straight guy, the media mistakes him as transgender as he has not met a woman for a long time.He is also royalty in blood as he is the prince of the Qing Ling Vampires but the truth is his parents already died in a car crash. Aunt Marie, Lee Shi Yi’s grandfather’s second wife, also the person who has been taking care of Shi Yi after her parent's death, is keeping many secrets from Shi Yi for a very long time regarding her parent's death and who she actually is. Wang Ying Yue,daughter of the Wang Cooperation which is also one of the biggest companies in City A,invites Lee Shi Yi and Ling Su Han to a party. Ling Su Han was her university friend and Lee Shi Yi was her childhood friend.She is also a Vampire,The Vampire of light. Lee Shi Yi and Ling Su Han meet each other in a friend’s party one day. When they first glanced,they felt something familiar like they knew each other before. As they walked outside together, they could not hear the party noise in the background.
minyi · 26.6K Views

It Doesn't Matter, 'Cause Nothing Matters

Back home, War-torn!Tom (Mid-20th century Brighton), only fourteen, would've had his family to build him back up if it weren't for the zombie apocalypse and the jarring teleportation to another universe. He was a teenager, and he came as an imperfect package to the Watsons, with a crackwhore birth mom and genetic, hormonal depression because of her. They didn't even learn of his condition before he was forcibly separated from them, his mom, dad, and two brothers, in a crowd of panicked people. He makes friends, plenty of them, and survives as best as he can, just holding out until he finds every member of his family, safe and sound, hopefully. All he has is hope, which is thin in a war-torn world. Until he's transported another dimension. Back home, Vampiric-sight!Thomas (18th century Great Britain), sixteen, would try to escape his possessive family at any cost, but they wouldn't even give him the mercy of killing him. He was handicapped from birth, blind and regarded as weak, until he met a strangely kind and warm Wilbur. He only learns that him and his kin are cold-blooded ones when he's forcibly turned and hoarded in their coven. The Micrafes are a powerful family, and he has no chance of escaping, even with his new gift of sight. Sight of truth. He knows that his new family are not lying when they say they love him, but not in a way anyone would prefer. They use violence and manipulation as means of getting people to stay, and even Tommy sees that Wilbur and Technoblade used to be like him, that Phil used to be like all of them. He's too scared and focused on his survival to sympathise, though. Who he becomes because of them is broken, and not bright, and who he once was starts to fade. Until he's transported somewhere he doesn't know. In the here and now, Aishite!Tommy (22nd century Manburg), seventeen and counting, would give anything to see his family look at him. Truly look at him and see who he is, and love him for it. He lives a modern life in a futuristic world, with advanced technology, space exploration, and even superpowers granted by government issued scientists, to create better (or perhaps more efficient) law enforcement. Unfortunately for them, criminals get ahold of these experiments and serums and turn themselves into supervillains. Soon everyone with money or means to steal can become powerful, and passed through genes, generations become more enhanced and powerful. His family, with no recorded last names in order to remain hidden, are government issued heroes, and he's cannon fodder, adopted in order to appear kind and gracious in public eye. But Tommy has only ever felt love from the Crafts when they first met, and wants it back, deep down. He puts on the suit of a vigilante and tries to live up to becoming a hero, disguising himself as a hero in training and gaining their favour. They have no idea who he is, and don't keep tabs on their black sheep in order to figure it out. But as stakes rise and Tommy begins to realise they'll never see who he is under the mask without hating him forever, he loses hope of having a family.  Until two kids his age who look a lot like him appear out of nowhere in his secret base (which is really just a small backyard shed one of his vigilante friends procured for him). Both as scared as him, both with similar names and derivatives, and similar family, yet so different. As Aishite-Tommy struggles to keep them secret and get them back home, they eventually have to work together and better understand each other in order to juggle everything that's going on, on top of the government's dictator, or President Schlatt, planning to tip the economy in favour of the rich, mostly himself, and destroy anyone that gets in his way.
NotASnaccImAMel · 3.7K Views

Fated Baby of The Alpha

Mature Content 21+! Bijaklah dalam memilih bacaan. "Oh, lihatlah, kau memakai kostum yang bagus. Kau berbulu, dan aku suka itu," desah Marionette Alsen, sembari menelusuri tubuh seorang pria yang kini tengah berada di atasnya. Dan keesokan harinya, ia terbangun tanpa sehelai kain pun dan dengan luka goresan di beberapa bagian tubuhnya. Tak disangka, setelah kejadian itu, Marion justru terpilih sebagai asisten pribadi William Reynz, dan harus menanda tangani sebuah kontrak yang aneh. Sejak itu, ia terpaksa menjalani kehidupan yang tidak biasa, dihadapkan pada rasa kepemilikan yang besar dari William terhadapnya, di mana salah satunya adalah harus selalu bersama dengan pria itu di mana pun ia berada. Belum selesai masalah sebagai asisten pribadi William yang terkesan aneh baginya, kehadiran Drake Wilmer mengusik kehidupan Marion dengan obsesi dan sikap yang lembut, memperlakukan Marion bak seorang Ratu. Mendapat perlakuan demikian, membuat Marion hanyut dalam pesona dan mantra yang ditiupkan Drake padanya, membuatnya jatuh cinta pada pria itu, hingga hubungan yang terjalin antara mereka terlalu jauh tanpa diketahui oleh William. Beberapa minggu kemudian Marion merasakan ada yang berbeda dari tubuhnya. Morning sickness, mengidam, bahkan gelegak hormon yang tak terkendali yang selalu ia rasakan setiap kali berada di dekat William Reynz, dan bukan Drake. Hingga sebuah kenyataan terkuak bahwa dirinya tengah mengandung, disusul kenyataan lain bahwa bayi yang dikandungnya mungkin saja bukan bayi biasa. Siapakah ayah dari bayinya? Dan akankah Marion bisa menjalani kehidupan dengan normal setelah mengetahui semua rahasia yang ada dalam hidupnya? #manusiaserigala #vampire #pernikahankontrak #CEO #Miliuner #hybrid #harem *** Check my another work on another platform! Find Kennie Re (Goodnovel, Dreame/Innovel, Noveltoon, Fizzo) Other penname on Noveltoon also - find Ginger Kim. *** Where to reach me? IG: @kennie_r89 FB: Kennie Re Fanpage: Kennie Re - Author
Kennie_Re · 138.9K Views

Pregnancy prevention

Postinor 2 Description 0.75 mg levonorgestrel in each tablet. Excipients/Inactive Ingredients: silica colloidal anhydrous, magnesium stearate, potato starch, talc, maize starch, lactose monohydrate. Action Pharmacotherapeutic Group: Sex hormones and modulators of the genital system, Emergency contraceptives. ATC Code: G03A Efficacy: It was estimated from the results of an earlier clinical study, that 750 micrograms of levonorgestrel (taken as two 750 microgram doses with a 12 hour interval) prevents 85% of expected pregnancies. Efficacy appears to decline with time of start of treatment after intercourse (95% within 24 hours, 85% 24-48 hours, 58% if started between 48 and 72 hours). Results from a recent clinical study showed that two 750 microgram tablets of levonorgestrel taken at the same time (and within 72 hours of unprotected sex) prevented 84% of expected pregnancies. There was no difference between pregnancy rates in case of women who were treated on the third or the fourth day after the unprotected act of intercourse (p>0.2).There is limited and inconclusive data on the effect of high body weight/high BMI on the contraceptive efficacy. In three WHO studies no trend for a reduced efficacy with increasing body weight/BMI was observed (Table 1), whereas in the two other studies (Creinin et al., 2006 and Glasier et al., 2010) a reduced contraceptive efficacy was observed with increasing body weight or BMI (Table 2). Both meta-analyses excluded intake later than 72 hours after unprotected intercourse (i.e. off-label use of levonorgestrel) and women who had further acts of unprotected intercourse. (See the recommended regimen, levonorgestrel is not expected to induce significant modification of blood clotting factors, and lipid and carbohydrate metabolism. Paediatric population: A prospective observational study showed that out of 305 treatments with levonorgestrel emergency contraceptive tablets, seven women became pregnant resulting in an overall failure rate of 2.3%. The failure rate in women under 18 years (2.6% or 4/153) was comparable to the failure rate in women 18 years and over (2.0% or 3/152).Pharmacokinetics: Orally administered levonorgestrel is rapidly and almost completely absorbed. The results of a pharmacokinetic study carried out with 16 healthy women showed that following ingestion of 1.5 mg levonorgestrel maximum drug serum levels of 18.5 ng/ml were found at 2 hours. After reaching maximum serum levels, the concentration of levonorgestrel decreased with a mean elimination half-life of about 26 hours.Levonorgestrel is not excreted in unchanged form but as metabolites. Levonorgestrel metabolites are excreted in about equal proportions with urine and faeces. The biotransformation follows the known pathways of steroid metabolism, the levonorgestrel is hydroxylated in the liver and the metabolites are excreted as glucuronide conjugates. No pharmacologically active metabolites are known.
Stephen_Moses_6913 · 1.5K Views
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