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Sample records for progestogen-only oral contraceptives

  1. Slovenian guidelines for progestogen-only oral contraceptive use

    Directory of Open Access Journals (Sweden)

    Bojana Pinter

    2012-05-01

    Full Text Available In the manuscript the Slovenian guidelines for progestogen-only oral contraceptive use are presented. They are based on WHO, FSRH and CDC guidelines, and were approved in January 2012.

  2. "EFFECT OF PROGESTOGEN-ONLY CONTRACEPTIVES ON HUMAN MILK COMPOSITION"

    Directory of Open Access Journals (Sweden)

    Sh. Ghazizadeh P. Pasalar

    2004-08-01

    Full Text Available Different contraceptive methods are used by breastfeeding mothers. To investigate the effects of progestogen - only contraceptives on human milk components, a non-randomized, follow-up study was carried out in Iran (Varamin on 140 breastfeeding women, 51 of whom used progestogenonly contraception including progestogen-only pills (POP or depo-medroxyprogesterone acetate (DMPA, and 89 used non-hormonal contraception methods, starting at 6 weeks after delivery. Human milk components were compared between the groups after 26 weeks. There were no statistically significant differences between groups, in terms of protein, sodium, calcium, phosphorus and potassium concentration of milk, but triglycerides in the hormonal group and magnesium in the non-hormonal group were higher than the other group (P< 0.05. It seems that progestogen-only methods (POP and DMPA do not have an adverse effect on human milk composition, and are safe contraceptives during lactation.

  3. Clinical experience with injectable progestogen- only contraceptives at University of Ilorin teaching hospital: a five year review.

    Science.gov (United States)

    Balogun, O R; Raji, H O

    2009-12-01

    This is a retrospective study of 1,042 new acceptors of injectable progestogen-only contraceptives at the family planning clinic of the University of Ilorin Teaching Hospital over a five year period from 1st January 2001 to 31st December 2004. The total number of new clients seen during this period was 4,752. 41.1% of these new clients chose condoms as a contraceptive method, 32.2% accepted IUCD, 21.9% accepted injectable progestogen-only contraceptive 08% accepted implants, 3.9% combined oral contraceptive pills and 0.1% bilateral tubal ligation. Of the acceptors of injectable progestogen, 59.5% used depo medroxyprogesterone acetate while 40.5% used norethisterone enanthate. 59.5% of the acceptors belonged to the 30 - 39 years age bracket and 36.2% were grandmultiparous women Injectable progestogen-only contraceptives are among the safest and most effective contraceptive methods available. The two commonly available types are Depot Medroxyprogesterone acetate and Norethisterone enanthate. This study looked at the clinical experience with this form of contraceptive at University of Ilorin Teaching Hospital (UITH). The case notes of new clients that accepted injectable progestogen-only contraceptive at the family planning clinic of the UITH between June 2001 and December 2004 were analysed. Injectable progestogen-only contraceptive was the third most commonly accepted method of contraception at UITH during the study period. 59.5% of clients belonged to the 30-39 year age group, 63.5% of them were para 1-4 and 36.2% were grandmultiparous women. 59.8% of the clients were educated up to the secondary level or above. There was no pregnancy reported during the study period. 29.9% of clients experienced various forms of side effects, the commonest of which was menstrual irregularities. Injectable progestogen-only contraceptive is widely accepted by women in this centre. Its use cuts across women of all age groups, parities, religion and level of education.

  4. Continuation rates, bleeding profile acceptability, and satisfaction of women using an oral contraceptive pill containing estradiol valerate and dienogest versus a progestogen-only pill after switching from an ethinylestradiol-containing pill in a real-life setting: results of the CONTENT study

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    Briggs P

    2016-09-01

    Full Text Available Paula Briggs,1 Marco Serrani,2 Kai Vogtländer,3 Susanne Parke4 1Sexual and Reproductive Health, Southport and Ormskirk Hospital NHS Trust, Merseyside, UK; 2Global Medical Affairs Women’s HealthCare, Bayer Pharma AG, Berlin, 3Global Integrated Analysis & Life Cycle Management Statistics, Bayer Pharma AG, Wuppertal, 4Global Clinical Development Women’s HealthCare, Bayer Pharma AG, Berlin, Germany Background: Oral contraceptives are still associated with high discontinuation rates, despite their efficacy. There is a wide choice of oral contraceptives available, and the aim of this study was to assess continuation rates, bleeding profile acceptability, and the satisfaction of women in the first year of using a contraceptive pill containing estradiol valerate and dienogest (E2V/DNG versus a progestogen-only pill (POP in a real-life setting after discontinuing an ethinylestradiol-containing pill.Methods and results: In this prospective, noninterventional, observational study, 3,152 patients were included for the efficacy analyses (n=2,558 women in the E2V/DNG group and n=592 in the POP group (two patients fulfilled the criteria of the efficacy population, but the used product was not known. Women had been taking an ethinylestradiol-containing pill ≥3 months before deciding to switch to the E2V/DNG pill or a POP. Overall, 19.8% (n=506 of E2V/DNG users and 25.8% (n=153 of POP users discontinued their prescribed pill. The median time to discontinuation was 157.0 days and 127.5 days, respectively. Time to discontinuation due to bleeding (P<0.0001 or other reasons (P=0.022 was significantly longer in the E2V/DNG group versus the POP group. The E2V/DNG pill was also associated with shorter (48.7% vs 44.1%, lighter (54% vs 46.1%, and less painful bleeding (91.1% vs 73.7% and greater user satisfaction (80.7% vs 64.6% than POP use, within 3–5 months after switch.Conclusion: The E2V/DNG pill was associated with higher rates of continuation

  5. Clinical experience with progestogen only injectable contraceptive ...

    African Journals Online (AJOL)

    %) women. Eight hundred and fifty six (79.6%) were lost to follow up while 57 discontinued POIC use due to desire for pregnancy, implant insertion and complications such as weight gain, giving a discontinuation rate of 5.30%. No pregnancy ...

  6. Controversies in postpartum contraception: when is it safe to start oral contraceptives after childbirth?

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    Jackson, Emily

    2011-02-01

    The timely initiation of contraception postpartum is an important consideration for breastfeeding and non-breastfeeding women; many women prefer oral contraceptive pills to other methods. In breastfeeding women, combined hormonal pills are not recommended prior to 6 weeks postpartum, due to effects on milk production. Although progestogen-only pills do not adversely affect milk, lack of data regarding possible effects on infants exposed to progestogens in breastmilk renders timing of initiation of this method controversial. In non-breastfeeding women, elevated risk of venous thromboembolism restricts use of combined hormonal pills prior to 21 days postpartum. From 21 to 42 days, use of combined hormonal pills should be assessed based on a woman's personal venous thromboembolism risk profile; after 42 days postpartum there is no restriction in the use of combined hormonal pills for otherwise healthy women. Non-breastfeeding women may safely use progestogen-only pills at any time during the postpartum. © 2011 Elsevier Ltd. All rights reserved.

  7. Progestogen-only injectable contraceptive: Experience of women in ...

    African Journals Online (AJOL)

    intramusculaire pour assurer une protection contre les grossesses non désirées pour une période de 2 ou 3 mois, selon le type. ... Aucune grossesse a été signalée chez les femmes qui est venu pour suivre alors que sur la méthode. Conclusion: Short durée .... [9,12] The young adolescents (age: 19 years and below) did ...

  8. Oral steroid contraception.

    Science.gov (United States)

    Sech, Laura A; Mishell, Daniel R

    2015-11-01

    Oral steroid contraception is a popular method of family planning worldwide. Over the past several decades, this method of contraception has changed significantly by decreasing the estrogen dose, changing the progestin component, and reducing the hormone free interval. Despite the popularity of oral steroid contraception, there has been much criticism regarding the associated risks of venous thromboembolism and stroke. Despite these established, yet uncommon risks, oral steroid contraception has many important health benefits. This review highlights the available formulations of oral contraceptives along with their evidence-based associated risks and benefits. Highlights regarding future directions for development of novel oral contraceptives are also addressed.

  9. Oral contraceptives induced hepatotoxicity

    OpenAIRE

    B. Akshaya Srikanth; V. Manisree

    2013-01-01

    Oral Contraceptives are the pharmacological agents used to prevent pregnancy. These are divided as the combined and progestogen methods and are administered orally, transdermally, systemically and via vaginal route. All these methods contain both oestrogen and progestogen. Vigorous usage of oral contraceptives and anabolic steroids as associated with cholestasis, vascular lesions and hepatic neoplasm. Benign hepatic neoplasms are clearly associated with oral contraceptives. In this article we...

  10. Oral Contraceptives and Cancer Risk

    Science.gov (United States)

    ... Cancer Genetics Services Directory Cancer Prevention Overview Research Oral Contraceptives and Cancer Risk On This Page What types of oral contraceptives are available in the United States today? ...

  11. Hormonal contraception and risk of venous thromboembolism: national follow-up study

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind; Løkkegaard, Ellen; Svendsen, Anne Louise

    2009-01-01

    .22), with gestodene 1.86 (1.59 to 2.18), with drospirenone 1.64 (1.27 to 2.10), and with cyproterone 1.88 (1.47 to 2.42). Compared with non-users of oral contraceptives, the rate ratio for venous thromboembolism in users of progestogen only oral contraceptives with levonorgestrel or norethisterone was 0.59 (0.33 to 1...... and the same length of use, oral contraceptives with desogestrel, gestodene, or drospirenone were associated with a significantly higher risk of venous thrombosis than oral contraceptives with levonorgestrel. Progestogen only pills and hormone releasing intrauterine devices were not associated with any...

  12. Oral contraception for women of middle age.

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    Ruan, Xiangyan; Mueck, Alfred O

    2015-11-01

    Women at middle age have decreased fertility and their pregnancies are higher risk. Combined oral contraceptives (COC) are effective but confer increased risk of age-related diseases, especially cardiovascular diseases. These risks are lower, however, with progestogen-only pills (POP). Therefore, other than the levonorgestrel intrauterine device (LNG-IUD), POP are usually the first choice, even though they do often lead to bleeding problems, which are already frequent in the perimenopause. However, the main risk of COC, venous thromboembolism, seems not to be relevant in (non-hospitalized) Chinese women and perhaps also other Asian women. COC may therefore be in fact a better choice than POP for these groups. In contrast to POP and IUDs, they have a variety of benefits especially important for middle-aged women, including a large decrease of the risk of ovarian, endometrial and colorectal cancer, an improvement in bleeding irregularities, a reduction of climacteric symptoms and some protection against bone loss. Further research is needed into individualized and safe contraception that takes into account ethnicity, as well as other factors. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. La contraception orale

    OpenAIRE

    Maheux, Rodolphe

    1983-01-01

    Oral contraceptives containing high doses of estrogen and progesterone have been associated with several harmful side effects. In contrast, the new low dose contraceptives, although effective, do not present the same risks; in fact their use seems beneficial in certain conditions. The female population was frightened during the 1970s: several patients stopped taking the pill following publication of articles in the non-medical press about the dangers of using the pill. The family physician mu...

  14. Quick starting hormonal contraception after using oral emergency contraception: a systematic review.

    Science.gov (United States)

    Murphy, Lauren Ee; Chen, Zhong E; Warner, Valerie; Cameron, Sharon T

    2017-10-01

    Unprotected intercourse after oral emergency contraception (EC) significantly increases pregnancy risk. This underlies the importance of promptly starting effective, ongoing contraception - known as 'quick starting'. However, theoretical concern exists that quick starting might interact with EC or hormonal contraception (HC) potentially causing adverse side effects. A systematic review was conducted, evaluating quick starting HC after oral EC [levonorgestrel 1.5 mg (LNG) or ulipristal acetate 30 mg (UPA)]. PubMed, EMBASE, The Cochrane Library, ICTRP, ClinicalTrials.gov and relevant reference lists were searched in February 2016. A lack of comparable studies prevented meta-analysis. Three randomised controlled trials were identified. Two biomedical studies suggested HC action was unaffected by quick starting after UPA; one study examined ovarian quiescence (OR 1.27; 95% CI 0.51-3.18) while taking combined oral contraception (COC). Another assessed cervical mucus impenetrability (OR 0.76; 95% CI 0.27-2.13) while taking progestogen-only pills (POP). Quick starting POP reduced the ability of UPA to delay ovulation (OR 0.04; 95% CI 0.01-0.37). Side effects (OR 1.22; 95% CI 0.48-3.12) and unscheduled bleeding (OR 0.53; 95% CI 0.16-1.81) were unaffected by quick starting COC after UPA. Another study reported higher self-reported contraceptive use at 8 weeks among women quick starting POP after LNG, compared with women given LNG alone (OR 6.73; 95% CI 2.14-21.20). © Faculty of Sexual and Reproductive Healthcare of the Royal College of Obstetricians and Gynaecologists (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Adolescents and oral contraceptives.

    Science.gov (United States)

    Sanfilippo, J S

    1991-01-01

    Oral contraceptive (OC) options for adolescents are provides. Clarification for those desiring a birth control method is necessary and the benefits of decreased acne and dysmenorrhea with low dose OCs should be stressed along with the importance of compliance. A community effort is suggested to communicate the sexual and contraceptive alternatives, including abstinence and outercourse (sexual stimulation to orgasm without intercourse). Attention is given to concerns associated with teenage sexual activity, prevention of adolescent pregnancy, contraceptive options for the adolescent patient, adolescent attitudes toward birth control OCs, management of the adolescent OC user, manipulation of steroid components of OCs to respond to adolescent concerns, and other hormonal contraceptive options such as minipills or abstinence. The text is supplemented with tables: the % of US women by single years of age for 1971, 1976, 1979, and 1982; comparative pregnancy and abortion rates for the US and 5 other countries; federal cost for teen childbearing; adolescent nonhormonal contraceptive methods (advantages, disadvantages, and retail cost); checklist to identify those at risk for noncompliance with OCs; hormonal side effects of OCs; risks from OCs to adolescents; and benefits of OCs. Concern about adolescent pregnancy dates back to Aristotle. A modern profile shows girls form single-parent families are sexually active at an earlier age, adolescent mothers produce offspring who repeat the cycle, victims of sexual abuse are more likely to be sexually active, and teenagers in foster care are 4 times more likely to be sexually active and 8 times more likely to become pregnant. Prevention involves a multifaceted approach. OCs are the most appropriate contraceptive choice for adolescents. Frequency of intercourse is closely associated with OC use after approximately 15 months of unprotected sexual activity. At risk for noncompliance variables are scales of personality development

  16. Oral contraception and risk of a cerebral thromboembolic attack: results of a case-control study.

    Science.gov (United States)

    Lidegaard, O

    1993-01-01

    OBJECTIVE--To assess the risk of cerebral thromboembolism in women using low dose oral contraceptives. DESIGN--A retrospective case-control study. SETTING--All Danish medical, neurological, neurosurgical, and gynaecological departments. SUBJECTS--All 794 women in Denmark aged 15-44 who had suffered a cerebral thromboembolic attack during 1985-9 and 1588 age matched randomly selected controls. RESULTS--Of 692/1584 case/control questionnaires sent out, 590/1396 (85.3%/88.1%) were returned. Among the cases, 15 refused to participate, 69 had a revised or unreliable diagnosis, 40 had had thromboembolic disease previously, 13 were pregnant, and 152 had a disease predisposing to a cerebral thromboembolic attack. Of the 323 cases without a known predisposition, 320 reported use or non-use of oral contraception. Among the 1396 controls, eight refused to participate, were mentally retarded, or lived abroad; 18 returned an uncompleted questionnaire; 17 had had thromboembolic disease previously; 31 were pregnant; and 130 had a disease predisposing to a cerebral thromboembolic attack. Thus 1198 non-predisposed controls were available, among whom 1197 reported use or non-use of oral contraception. Among the 320 cases, 116 (36.3%) were oral contraceptive users at the time of the cerebral thromboembolic attack. By comparison there were 191 users (16.0%) among the 1197 controls, giving a crude odds ratio of 3.0. After multivariate analysis, including confounder control for age, smoking, years of schooling, and trend in use of different types of oral contraceptives during 1985-90, pills containing 50 micrograms oestrogen were associated with an odds ratio for cerebral thromboembolic attack of 2.9 (95% confidence interval 1.6 to 5.4), those containing 30-40 micrograms oestrogen an odds ratio of 1.8 (1.1 to 2.9), those containing progestogen only an odds ratio of 0.9 (0.4 to 2.4). The odds ratio did not change with increasing age or with duration of oral contraceptive use. A 50

  17. Oral contraception and risk of a cerebral thromboembolic attack: results of a case-control study.

    Science.gov (United States)

    Lidegaard, O

    1993-04-10

    To assess the risk of cerebral thromboembolism in women using low dose oral contraceptives. A retrospective case-control study. All Danish medical, neurological, neurosurgical, and gynaecological departments. All 794 women in Denmark aged 15-44 who had suffered a cerebral thromboembolic attack during 1985-9 and 1588 age matched randomly selected controls. Of 692/1584 case/control questionnaires sent out, 590/1396 (85.3%/88.1%) were returned. Among the cases, 15 refused to participate, 69 had a revised or unreliable diagnosis, 40 had had thromboembolic disease previously, 13 were pregnant, and 152 had a disease predisposing to a cerebral thromboembolic attack. Of the 323 cases without a known predisposition, 320 reported use or non-use of oral contraception. Among the 1396 controls, eight refused to participate, were mentally retarded, or lived abroad; 18 returned an uncompleted questionnaire; 17 had had thromboembolic disease previously; 31 were pregnant; and 130 had a disease predisposing to a cerebral thromboembolic attack. Thus 1198 non-predisposed controls were available, among whom 1197 reported use or non-use of oral contraception. Among the 320 cases, 116 (36.3%) were oral contraceptive users at the time of the cerebral thromboembolic attack. By comparison there were 191 users (16.0%) among the 1197 controls, giving a crude odds ratio of 3.0. After multivariate analysis, including confounder control for age, smoking, years of schooling, and trend in use of different types of oral contraceptives during 1985-90, pills containing 50 micrograms oestrogen were associated with an odds ratio for cerebral thromboembolic attack of 2.9 (95% confidence interval 1.6 to 5.4), those containing 30-40 micrograms oestrogen an odds ratio of 1.8 (1.1 to 2.9), those containing progestogen only an odds ratio of 0.9 (0.4 to 2.4). The odds ratio did not change with increasing age or with duration of oral contraceptive use. A 50% increased risk of a cerebral thromboembolic attacks

  18. Combined oral contraceptives: health benefits beyond contraception.

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    Caserta, D; Ralli, E; Matteucci, E; Bordi, G; Mallozzi, M; Moscarini, M

    2014-09-01

    It has been recognized for over 50 years that combined oral contraceptives (COCs) are also capable of offering health benefits beyond contraception through the treatment and prevention of several gynaecological and medical disorders. During the last years a constant attention was given to the adverse effects of COCs, whereas their non-contraceptive benefits were underestimated. To date, most women are still unaware of the therapeutic uses of hormonal contraceptives, while on the contrary there is an extensive and constantly increasing of these non-contraceptive health benefits. This review summarizes the conditions of special interest for physicians, including dysmenorrhoea, menorrhagia, hyperandrogenism (acne, hirsutism, polycystic ovary syndrome), functional ovarian cysts, endometriosis, premenstrual syndrome, myomas, pelvic inflammatory disease, bone mineral density, benign breast disease and endometrial/ovarian and colorectal cancer. The benefits of COCs in rheumatoid arthritis, multiple sclerosis, menstrual migraine and in perimenopause have also been treated for more comprehensive information. Using COCs specifically for non-contraceptive indications is still outside the product licence in the majority of cases. We strongly believe that these aspects are not of minor relevance and they deserve a special consideration by health providers and by the mass media, which have the main responsibility in the diffusion of scientific information. Thus, counseling and education are necessary to help women make well-informed health-care decisions and it is also crucial to increase awareness among general practitioners and gynaecologists.

  19. Maintenance of ovulation inhibition with a new progestogen-only pill containing drospirenone after scheduled 24-h delays in pill intake.

    Science.gov (United States)

    Duijkers, Ingrid J M; Heger-Mahn, Doris; Drouin, Dominique; Colli, Enrico; Skouby, Sven

    2016-04-01

    Traditional progestogen-only pills (POPs) have stringent daily timing and missed pill rules that might affect contraceptive reliability. A new-generation oestrogen-free pill has been developed, containing 4-mg drospirenone with a unique regimen of 24 active treatment days followed by four placebo tablets. A previous study showed that this new drospirenone-only pill effectively inhibited ovulation. Clinical efficacy, however, can be affected by compliance, and delayed or forgotten pill intake often occurs in daily life. The aim of this study was to investigate if inhibition of ovulation was maintained after four scheduled 24-h delays in tablet intake. One hundred thirty healthy women with proven ovulatory cycles were randomized, and 127 were treated with the drospirenone-only pill during two cycles. In treatment Group A (n=62), 24-h delays in tablet intake were scheduled on days 3, 6, 11 and 22 during Cycle 2 and, in treatment Group B (n=65) during Cycle 1, respectively. Ovulation was defined as disappearance or persistence of a large follicle and progesterone levels higher than 5 ng/mL for at least 5 consecutive days. The overall ovulation rate was 0.8%; only one subject in Group A fulfilled the ovulation criteria in Cycle 2. Follicular diameters in the regular-intake and the delayed-intake cycles were similar. Despite the 4-day hormone-free period and multiple intentional 24-h delays in tablet intake, ovulation inhibition was maintained. This property distinguishes this new-generation oestrogen-free pill from traditional POPs by allowing the same "safety window" or flexibility in intake as combined oral contraceptives without compromising contraceptive reliability. Delayed or forgotten pill intake is very common. Ovulation inhibition by the new-generation oestrogen-free pill, containing 4-mg drospirenone for 24 days followed by a 4-day treatment-free period, was maintained despite four 24-h delays in tablet intake, so the impact of delayed intake on contraceptive

  20. Combined oral contraception.

    Science.gov (United States)

    Miller, C; Murtagh, J

    1992-12-01

    The purpose of prescribing combined oral contraceptives (OCs) is achievement of good cycle control and effective contraception with the least side effects, using an OC with the lowest possible dose of estrogen. Triphasil, Triquilar, Nordette, Microgynon 30, and Brevinor are good 1st choices because of the low estrogen dose (30-35 mcg). Women who probably cannot tolerate breakthrough bleeding and who need simple packaging should use a monophasic, more progestogenic OC, e.g., Nordette or Microgynon 30. Physicians should suggest a low dose estrogen and low dose antiandrogenic progestogen (OC) (e.g., Diane-35 ED) for women who have acne. They should advise patients that when they take OCs, their menstrual periods usually become shorter, regular, and lighter. Women need not take a break from OC usage. Vitamin C, antibiotics, griseofulvin, rifampicin, and anticonvulsants (except sodium valproate) interact with OCs. Women using warfarin and oral hypoglycemics and wanting to start using OCs need to consult their physician about changing requirements for warfarin and oral hypoglycemics. The effectiveness of OCs can be diminished by diarrhea and vomiting. Absolute contraindications to OCs include pregnancy, use during the first 2 weeks postpartum, history of thromboembolism, undiagnosed abnormal vaginal bleeding, focal migraine, coronary heart disease, steroid-dependent tumors, recent impaired liver function, and cardiovascular accidents. Some relative contraindications are older than 35 years old and smoking, breast feeding, and hypertension. This article provides a section on how to manage common side effects. For example, if the side effect is acne, the physician should prescribe an OC with increased estrogen and reduced progestogen (e.g., Triphasil/Triquilar to Biphasil/Sequilar). This article lists trade names of various OCs and their estrogen and progestogen doses, e.g., Nordette has 30 mcg ethinyl estradiol and 150 mcg levonorgestrel.

  1. [The statement of Polish Gynecological Society experts on oral use of contraceptive 75 microg desogestrel minipill in different clinical cases--state of art in 2008].

    Science.gov (United States)

    Debski, Romuald; Kotarski, Jan; Paszkowski, Tomasz; Pawelczyk, Leszek; Skrzypulec, Violetta; Tomaszewski, Jacek

    2009-01-01

    Recent epidemiologic studies indicate that use of combined oral contraception is associated with a increase in the incidence of cardiovascular disease (venous thromboembolism, pulmonary embolism, myocardial infarction and stroke). The risk of cardiovascular disease is strongly related to estrogen dose, progestogen type and other factors for example thrombogenic mutations and cigarette smoking among female over age 35. The progestogen only contraception is safe alternative to combined hormonal contraception. Progestogen only pill (POP) has different levels of action (local and/or central) which may vary from one drug to another. As for the cardiovascular disease risk, progestogens are not considered to be risk factors. Desogestrel containing POP is advised in the following cases: bad tolerance of exogenous oestrogens; in order to counteract an endogenous hyperoestrogenosis; medical, metabolic or cardiovascular contraindications to estroprogestogen contraception. Lastly, POP should be used as a prime contraception in some particular situations (breast feeding, endometriosis, adenomyosis, cigarette smoking, contraception for older women). These recommendations present the actual system of care in that population of women in Poland.

  2. Non-contraceptive benefits of oral contraceptives

    Directory of Open Access Journals (Sweden)

    Dhont M

    2011-10-01

    Full Text Available Marc Dhont Department of Obstetrics and Gynecology, Ghent University Hospital, Ghent, Belgium Abstract: The health benefits of the oral contraceptive (OC pill are numerous and outweigh the risks of OC use. There are unintended but useful preventive side effects and potential therapeutic uses of OCs apart from contraception itself. Unequivocal evidence for the protective influence of combined OCs against ovarian and endometrial cancers, and colon cancer to a lesser extent, has been found. The pill also reduces the incidence of benign breast disease, functional ovarian cysts, pelvic inflammatory disease requiring hospitalization, ectopic pregnancy, and iron-deficiency anemia. The pill can be used for the treatment of several gynecologic disorders such as dysmenorrhea, irregular or excessive bleeding, acne, hirsutism, and endometriosis-associated pain, whether prescribed solely to treat these symptoms or prescribed to treat them in addition to providing contraception. These health benefits are often underestimated, as they get too little attention from the mass media. Keywords: the pill, estrogens, progestogens, safety, contraception

  3. [Oral contraception: users' questions].

    Science.gov (United States)

    Prolongeau, J F

    1993-02-01

    Answers are provided to common questions about the safety and use of oral contraceptives (OCs). Amenorrhea during OC use has no pathologic significance. It is related to endometrial atrophy resulting from insufficient estrogen after longterm pill use. A formulation with a higher estrogen content may be used for one or two cycles to regenerate the endometrium. If amenorrhea persists for more than a few months after discontinuation of pills, pituitary adenoma should be ruled out. Bromocriptine may be indicated in cases of moderate hyperprolactinemia if pregnancy is desired. All intermenstrual bleeding in pill users should be investigated for organic cause. Once endometrial polyps and other pathologies are ruled out, the cause may be assumed to be functional metrorrhagia due to endometrial atrophy identical to that causing amenorrhea in OC users. Intermenstrual bleeding may occasionally result from interactions with specific classes of drugs. Minor bleeding in the first cycles of pill use is common and usually temporary. Accidentally taking two pills in one day is without consequence. If the interval between pill cycles exceeds one week, there is risk of follicular maturation and a different contraceptive method should be used until the next cycle. Forgetting a combined pill is without consequence for delays of under twelve hours. Another method should be used until the next cycle if two pills are forgotten. Low-dose oral progestins rapidly lose efficacy if not taken at the same time every day. "Morning-after" pills may be used up to 72 hours after unprotected intercourse. The current generation of OCs entails no teratogenic risks. The cause of any pill failure should be sought. There is no increased risk of multiple pregnancy after discontinuation of pills, and fecundity does not decline after longterm pill use. OCs should be avoided by users of some antiepileptic drugs or of drugs that increase hepatic toxicity or act as enzyme inductors. All conditions accompanied

  4. Oral contraception following abortion

    Science.gov (United States)

    Che, Yan; Liu, Xiaoting; Zhang, Bin; Cheng, Linan

    2016-01-01

    Abstract Oral contraceptives (OCs) following induced abortion offer a reliable method to avoid repeated abortion. However, limited data exist supporting the effective use of OCs postabortion. We conducted this systematic review and meta-analysis in the present study reported immediate administration of OCs or combined OCs postabortion may reduce vaginal bleeding time and amount, shorten the menstruation recovery period, increase endometrial thickness 2 to 3 weeks after abortion, and reduce the risk of complications and unintended pregnancies. A total of 8 major authorized Chinese and English databases were screened from January 1960 to November 2014. Randomized controlled trials in which patients had undergone medical or surgical abortions were included. Chinese studies that met the inclusion criteria were divided into 3 groups: administration of OC postmedical abortion (group I; n = 1712), administration of OC postsurgical abortion (group II; n = 8788), and administration of OC in combination with traditional Chinese medicine postsurgical abortion (group III; n = 19,707). In total, 119 of 6160 publications were included in this analysis. Significant difference was observed in group I for vaginal bleeding time (P = 0.0001), the amount of vaginal bleeding (P = 0.03), and menstruation recovery period (P abortion (P abortion, and reduce the risk of complications and unintended pregnancies. PMID:27399060

  5. Immediate postpartum oral contraception.

    Science.gov (United States)

    Gambrell, R D

    1970-07-01

    Oral contraceptives were administered on Postpartum Day 5 to 363 patients, 83 of whom were breast-feeding, to determine if bleeding quantity could be reduced and menstrual periods established earlier in the puerperium, to evaluate the effect on lactation, and to note if side effects could be minimized by initiating pill usage earlier postpartum; 245 patients, of whom 91 were breast-feeding, served as controls. All of the women were patients at the U.S. Air Force Hospital in Wiesbaden, West Germany. 54% of the lactating mothers on the pill were successfully breast-feeding at 6 weeks compared with 59% of the controls. 87% of the patients taking pills had their 1st menstrual period before 6 weeks postpartum compared with 23% of the controls. No significant decrease in quantity of bleeding was noted. Patients taking the pill did report a weight gain. The uterus returned to normal size sooner in the group taking the pill and there was less breast tenderness. 65% of the multigravida mothers taking the pill thought they had a more favorable postpartum course, 24% saw no difference, and 11% thought their postpartum experience was less favorable. Patient acceptance was excellent and no major porblems were encountered.

  6. Maintenance of ovulation inhibition with a new progestogen-only pill containing drospirenone after scheduled 24-h delays in pill intake

    DEFF Research Database (Denmark)

    Duijkers, Ingrid J M; Heger-Mahn, Doris; Drouin, Dominique

    2016-01-01

    OBJECTIVES: Traditional progestogen-only pills (POPs) have stringent daily timing and missed pill rules that might affect contraceptive reliability. A new-generation oestrogen-free pill has been developed, containing 4-mg drospirenone with a unique regimen of 24 active treatment days followed...... of ovulation was maintained after four scheduled 24-h delays in tablet intake. STUDY DESIGN: One hundred thirty healthy women with proven ovulatory cycles were randomized, and 127 were treated with the drospirenone-only pill during two cycles. In treatment Group A (n=62), 24-h delays in tablet intake were...... inhibition by the new-generation oestrogen-free pill, containing 4-mg drospirenone for 24 days followed by a 4-day treatment-free period, was maintained despite four 24-h delays in tablet intake, so the impact of delayed intake on contraceptive reliability will be low....

  7. Oral contraception in Denmark 1998-2010

    DEFF Research Database (Denmark)

    Wilson, Nadia M; Laursen, Maja; Lidegaard, Øjvind

    2012-01-01

    Oral contraceptives (OC) are the most popular contraception in Denmark. Overall figures on use are well described, but more detailed use patterns according to type and age need to be updated.......Oral contraceptives (OC) are the most popular contraception in Denmark. Overall figures on use are well described, but more detailed use patterns according to type and age need to be updated....

  8. Oral Contraceptives after Bariatric Surgery

    OpenAIRE

    Joël Schlatter

    2017-01-01

    Objective: Bariatric surgery offers a highly effective mode of treatment for obese patients. Some procedures such as bypass cause an alteration in normal gastrointestinal tract with possible consequences for the uptake of orally administered drugs. Methods: We assessed the literature to ascertain whether the use of oral drugs and especially oral contraceptives is effective and adequate after bariatric surgery. Results: The bioavailability of drugs could be affected by the solubility and pH of...

  9. Oral contraceptives and benign breast disease: an update of findings in a large cohort study.

    Science.gov (United States)

    Vessey, Martin; Yeates, David

    2007-12-01

    This report is an update of findings, first reported in 1981, on the relationship between oral contraceptives (OCs) and benign breast disease with special reference to OCs containing fibroadenoma (FA), 185 cases; chronic cystic disease (CCD), 1361 cases; breast lump with no specific diagnosis (BL), 650 cases]. Hospital referral rates for FA and CCD (but not BL) declined with increasing duration of OC use, with the effect being strongest among recent users. The apparent protective effect was present for women using OCs containing >50 mcg, 50 mcg and <50 mcg estrogen but not for progestogen-only OCs. Low-dose combined OCs containing <50 mcg estrogen appear to reduce the risk of hospitalization for FA and CCD as well as older preparations containing higher doses of estrogen.

  10. Oral Contraceptives after Bariatric Surgery

    Directory of Open Access Journals (Sweden)

    Joël Schlatter

    2017-04-01

    Full Text Available Objective: Bariatric surgery offers a highly effective mode of treatment for obese patients. Some procedures such as bypass cause an alteration in normal gastrointestinal tract with possible consequences for the uptake of orally administered drugs. Methods: We assessed the literature to ascertain whether the use of oral drugs and especially oral contraceptives is effective and adequate after bariatric surgery. Results: The bioavailability of drugs could be affected by the solubility and pH of the modified medium after bariatric surgery and by the loss of gastrointestinal transporters. Bariatric surgery could potentially result in a transient change in the absorption of drugs such as analgesics, antibiotics, antiarrhythmics, anticoagulants, psychotropic, and oral contraceptive drugs. Effective contraception is especially critical in the postoperative period, and implants might be representing a safe contraceptive method in women undergoing bariatric surgery. Conclusion: Each drug will have to be evaluated with respect to its site of absorption and its mechanism of absorption, with special attention on parameters influencing the effectiveness of the absorption processes.

  11. Estrogen and Progestin (Oral Contraceptives)

    Science.gov (United States)

    ... past, you should avoid exposure to real or artificial sunlight while you are taking oral contraceptives. Wear protective clothing, sunglasses, and sunscreen.tell your doctor and pharmacist if you wear contact lenses. If you notice changes in vision or ability to wear your lenses while taking ...

  12. Epidemiology of the contraceptive pill and venous thromboembolism.

    Science.gov (United States)

    Hannaford, Philip C

    2011-02-01

    Current users of combined oral contraceptives have an increased risk of venous thromboembolism. The risk appears to be higher during the first year of use and disappears rapidly once oral contraception is stopped. There is a strong interaction between hereditary defects of coagulation, combined oral contraceptive use and venous thromboembolism. Nevertheless, the routine screening of women before they use combined oral contraception is not recommended. Venous thromboembolism seems to be higher in overweight users, and after air, and possibly other forms of, travel. Both the oestrogen and progestogen content of combined oral contraceptives have been implicated in differences in venous thrombotic risk between products. Even if real, the absolute difference in risk between products is small, because the background incidence of venous thromboembolism in young women is low. All currently available combined oral contraceptives are safe. Progestogen-only oral contraceptives are not associated with an increased risk of venous thromboembolism. © 2011 Elsevier Ltd. All rights reserved.

  13. Triphasic versus monophasic oral contraceptives for contraception.

    Science.gov (United States)

    Van Vliet, Huib A A M; Grimes, David A; Lopez, Laureen M; Schulz, Kenneth F; Helmerhorst, Frans M

    2011-11-09

    Side effects of oral contraceptive (OC) pills discourage adherence to and continuation of OC regimens. Strategies to decrease adverse effects led to the introduction of the triphasic OC in the 1980s. Whether triphasic OCs have higher accidental pregnancy rates than monophasic pills is unknown. Nor is it known if triphasic pills give better cycle control and fewer side effects than the monophasic pills. To compare triphasic OCs with monophasic OCs in terms of efficacy, cycle control, and discontinuation due to side effects. We searched the computerized databases of the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE, POPLINE, EMBASE, and LILACS, as well as clinical trials databases (ClinicalTrials.gov and the World Health Organization Clinical Trials Registry Platform (ICTRP)) in May 2011. Additionally, we searched the reference lists of relevant articles. We also contacted researchers and pharmaceutical companies to identify other trials not found in our search. We included randomized controlled trials (RCTs) comparing any triphasic OC with any monophasic pill used to prevent pregnancy. Interventions had to include at least three treatment cycles. We assessed the studies found in the literature searches for possible inclusion and for their methodological quality. We contacted the authors of all included studies and of possibly randomized trials for supplemental information about the methods used and outcomes studied. We entered the data into RevMan and calculated odds ratios for the outcome measures of efficacy, breakthrough bleeding, spotting, withdrawal bleeding and discontinuation. Of 23 trials included, 19 examined contraceptive effectiveness. The triphasic and monophasic preparations did not differ significantly. Several trials reported favorable bleeding patterns, that is less spotting, breakthrough bleeding or amenorrhea, in triphasic versus monophasic OC users. However, meta-analysis was generally not possible due to

  14. Contraception with combined oral contraceptive pills in Port ...

    African Journals Online (AJOL)

    Background: Millions of women worldwide use the combined oral contraceptive pill (COCP) as an effective form of contraception. This has contributed immensely to population control and improvement of maternal wellbeing. Aim: To determine the acceptability, efficacy and side effect of COCP in Port Harcourt and compare ...

  15. Effect of Oral Contraceptives on Urinary Porphyrins

    Directory of Open Access Journals (Sweden)

    J G Arora

    1981-01-01

    Full Text Available Urinary porphyrins were measured in thirty women on oral contraceptives who constituted the study group and in ten women using conventional methods of contraception who constituted the control group. The difference of theme an so furinary copro and uroporphyrin in the two groups.was found to be statistically insignificant. Further, the effect of duration of treatment of females using oral contraceptives was also studied. The difference of means was not significant a the cases oral contraceptives for a period Of less than six months and cases using the same for more than six months.

  16. Oral contraceptive marketing in Ibadan, Nigeria.

    Science.gov (United States)

    Bamgboye, E A; Ladipo, O A

    1992-10-01

    The demographic transition in Nigeria is gradually moving towards the second stage. There is clear evidence of a declining mortality but the fertility rate remains exceptionally high. A realistic approach towards reducing fertility rate is the use of oral contraceptive. This study assesses the distribution system of oral contraceptive in Ibadan, the second largest city in Nigeria. The findings revealed that the people are aware of modern oral contraceptives as they purchase them freely at chemist shops. But effective distribution is hampered by existing channels and high costs. A local source recommended is the proprietary medicine stores, often at convenient locations to the potential users of contraceptives. The current cost which is between $1.3 and $19.5 per couple-years of protection is exorbitant, consuming 0.5-7.8% of the gross annual income of the average individual. Therefore, the government should subsidize the prices of oral contraceptives, to facilitate freedom from the tyranny of excessive fertility.

  17. Biochemical effects of oral contraceptives.

    Science.gov (United States)

    Briggs, M

    1976-01-01

    Literature on the biochemical effects of oral contraceptives (OCs) is reviewed. The effects of OCs on concentrations of mineral elements ( calcium, phosphorus, magnesium, iron, copper, and zinc), vitamins (ascor bic acid, folic acid, and Vitamins-B6, B12, and E), hormones, (gonadotro pins, progesterone, estrogens, androgens, corticosteroids, aldosterone, renin-angiotensin, insulin, growth hormone, thyroid hormones, catecholamines, and prolactin), amino acids and proteins (free amino acids, tryptophan, metalloproteins, hormone-binding proteins, miscellaneous serum proteins, and blood coagulation factors), carbohydra tes (glucose tolerance tests, glucose metablism and other carbohydrates) , lipids (total serum lipids, triglycerides, phospholipids, fatty acids, and cholesterol), and enzymes (aminotransfereases, alkaline phosphatase, and glutamyltransferase) are reviewed. Changes induced by combined, sequential, and low-dose OCs in 116 biochemical parameters are summarized in a table.

  18. Residual ovarian activity during oral contraception

    NARCIS (Netherlands)

    A.M. van Heusden

    2003-01-01

    textabstractThe study objectives in this thesis focus on pituitary-ovarian activity in women using oral contraceptive steroids. Contraceptive steroids influence the hypothalamic-pituitary-ovarian axis in order to interfere with normal follicular development and ovulation. Additional effects on

  19. Selected aspects of oral contraception side effects

    National Research Council Canada - National Science Library

    Wolski, Hubert

    2014-01-01

    The first hormonal pill was approved in the 60s of the twentieth century Since that time, oral contraception has been used worldwide by dozens of women due to its high availability as well as relative...

  20. A randomised study comparing the effect on ovarian activity of a progestogen-only pill (POP) containing desogestrel and a new POP containing drospirenone in a 24/4 regimen

    DEFF Research Database (Denmark)

    Duijkers, Ingrid J M; Heger-Mahn, Doris; Drouin, Dominique

    2015-01-01

    OBJECTIVES: Progestogen-only pills (POPs) are safer with respect to cardiovascular risks than contraceptives containing estrogens. Despite the increased contraceptive efficacy of a desogestrel-only pill compared with a traditional POP, POPs are still not widely used due to an unpredictable bleeding......, to assess the effects on cervical mucus permeability and bleeding. METHODS: Sixty-four healthy volunteers with proven ovulatory cycles were randomised and treated with either the drospirenone-only or the desogestrel-only pill during two 28-day cycles. Follicular diameter, endometrial thickness, and serum....... The median number of bleeding and spotting days was lower in the drospirenone group. CONCLUSIONS: The new drospirenone-only pill inhibited ovulation as effectively as the desogestrel-only pill despite the 4-day hormone-free interval....

  1. Safety, efficacy and patient satisfaction with continuous daily administration of levonorgestrel/ethinylestradiol oral contraceptives

    Directory of Open Access Journals (Sweden)

    Giuseppe Benagiano

    2009-04-01

    Full Text Available Giuseppe Benagiano, Sabina Carrara, Valentina FilippiDepartment of Gynaecology and Obstetrics, Sapienza University, Rome, ItalyAbstract: The progestational steroid norgestrel was synthesized and tested between 1960 and 1965 through an international cooperation between Wyeth, USA and Schering, Berlin. It is a mixture of two “enantiomers,” with only one form (designated as levonorgestrel biologically active. When taken orally, it is rapidly absorbed, not subjected to a “first-pass” effect and is approximately 90% bioavailable, with a circulating half-life around 15 hours. Its contraceptive action is exerted at the central (hypothalamic and peripheral (cervical mucus and endometrium levels. Levonorgestrel (LNG, alone or in combination with ethinyl estradiol (EE, is the most widely employed contraceptive progestin: it is used in combined oral contraceptives, progestogen-only pills, long-acting contraceptive implants, intrauterine contraceptive systems and in emergency contraception. It is also the steroid of choice for new oral contraceptive regimens aimed at reducing the frequency of bleeding episodes. This novel approach, already tried more than 30 years ago, gained interest around the year 2000 when surveys of women’s attitudes toward monthly menstrual bleeding started to show a major change: more and more women declared that they would welcome a hormonal contraceptive method that reduced bleeding episodes to 4, 2 or even 1 per year. At this point, while the debate on the significance and “usefulness” of menstruation went on, attention focused on new regimens. The first new modality consisted of changing the 7-day medication-free interval, either shortening it to fewer than 7 days, or by the administration of low-dose estrogens during the interval between packages. Then, continuous administration regimens started to be investigated. This, however, did not happen suddenly, since, in specific situations, doctors had for years

  2. Oral and injectable contraceptive use and HIV acquisition risk among women in four African countries: a secondary analysis of data from a microbicide trial.

    Science.gov (United States)

    Balkus, Jennifer E; Brown, Elizabeth R; Hillier, Sharon L; Coletti, Anne; Ramjee, Gita; Mgodi, Nyaradzo; Makanani, Bonus; Reid, Cheri; Martinson, Francis; Soto-Torres, Lydia; Abdool Karim, Salim S; Chirenje, Zvavahera M

    2016-01-01

    To assess the effect of oral and injectable contraceptive use compared to nonhormonal contraceptive use on HIV acquisition among Southern African women enrolled in a microbicide trial. This is a prospective cohort study using data from women enrolled in HIV Prevention Trials Network protocol 035. At each quarterly visit, participants were interviewed about self-reported contraceptive use and sexual behaviors and underwent HIV testing. Cox proportional hazards regression was used to assess the effect of injectable and oral hormonal contraceptive use on HIV acquisition. The analysis included 2830 participants, of whom 106 became HIV infected (4.07 per 100 person-years). At baseline, 1546 (51%) participants reported using injectable contraceptives and 595 (21%) reported using oral contraceptives. HIV incidence among injectable, oral and nonhormonal contraceptive method users was 4.72, 2.68 and 3.83 per 100 person-years, respectively. Injectable contraceptive use was associated with a nonstatistically significant increased risk of HIV acquisition [adjusted hazard ratio (aHR)=1.17; 95% confidence interval (CI) 0.70, 1.96], while oral contraceptive use was associated with a nonstatistically significant decreased risk of HIV acquisition (aHR=0.76; 95% CI 0.37,1.55). In this secondary analysis of randomized trial data, a marginal, but nonstatistically significant, increase in HIV risk among women using injectable hormonal contraceptives was observed. No increased HIV risk was observed among women using oral contraceptives. Our findings support the World Health Organization's recommendation that women at high risk for acquiring HIV, including those using progestogen-only injectable contraception, should be strongly advised to always use condoms and other HIV prevention measures. Among Southern African women participating in an HIV prevention trial, women using injectable hormonal contraceptives had a modest increased risk of HIV acquisition; however, this association was

  3. Hormonal contraception and bone metabolism: a systematic review.

    Science.gov (United States)

    Nappi, Carmine; Bifulco, Giuseppe; Tommaselli, Giovanni A; Gargano, Virginia; Di Carlo, Costantino

    2012-12-01

    Although a large amount of studies in the literature evaluated the effects of hormonal contraception on bone, many questions remained still unclear, such as the effect of these therapies on fracture risk. We performed a systematic search of the published studies from January 1975 through January 2012 on the effects of hormonal contraceptives on bone metabolism. We analyzed the overall effect on bone mineral density (BMD) and on fracture risk of combined oral contraceptives (COCs), progestogen-only contraceptives, transdermal contraceptives and vaginal ring. COC therapy does not seem to exert any significant effect on BMD in the general population. In adolescents, the effects of COCs on BMD seem to be mainly determined by estrogen dose. The use of COCs in perimenopausal women seems to reduce bone demineralization and may significantly increase BMD even at a 20-mcg dose. Use of depot medroxyprogesterone acetate is associated with a decrease in BMD, although this decrease seems to be partially reversible after discontinuation. Data on other progestogen-only contraceptives, transdermal patch and vaginal ring are still limited, although it seems that these contraceptive methods do not exert any influence on BMD. Hormonal contraceptives do not seem to exert any significant effect on bone in the general population. However, other randomized controlled trials are needed to evaluate the effects on fracture risk since the data available are derived from studies having the effects on BMD as the primary end point, and BMD may not accurately reflect the real fracture risk. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Bone-sparing properties of oral contraceptives.

    Science.gov (United States)

    DeCherney, A

    1996-01-01

    Postmenopausal osteoporosis is a major health care problem that affects 20 million women in the United States and accounts for > 1 million fractures per year. Hormone replacement therapy is effective for reducing bone loss in the postmenopausal women. However, intervention before menopause may delay or prevent the decline in bone mass that begins between ages 30 and 40 years. The effects of oral contraceptives on bone mass have been investigated, and a positive association between oral contraceptive use and bone mass that is directly related to the duration of oral contraceptive use was observed. The effects of oral contraceptives on bone mass may be related to the specific formation. The effect of estrogens is dose related, and the optimal dose appears to be 25 to 35 micrograms of ethinyl estradiol or its equivalent. Results from several studies show that norethindrone has a positive effect on bone mass. An oral contraceptive may offer optimal birth control for the older premenopausal woman who currently uses other forms of birth control.

  5. Safety, efficacy and patient satisfaction with continuous daily administration of levonorgestrel/ethinylestradiol oral contraceptives.

    Science.gov (United States)

    Benagiano, Giuseppe; Carrara, Sabina; Filippi, Valentina

    2009-11-03

    The progestational steroid norgestrel was synthesized and tested between 1960 and 1965 through an international cooperation between Wyeth, USA and Schering, Berlin. It is a mixture of two "enantiomers," with only one form (designated as levonorgestrel) biologically active. When taken orally, it is rapidly absorbed, not subjected to a "first-pass" effect and is approximately 90% bioavailable, with a circulating half-life around 15 hours. Its contraceptive action is exerted at the central (hypothalamic) and peripheral (cervical mucus and endometrium) levels. Levonorgestrel (LNG), alone or in combination with ethinyl estradiol (EE), is the most widely employed contraceptive progestin: it is used in combined oral contraceptives, progestogen-only pills, long-acting contraceptive implants, intrauterine contraceptive systems and in emergency contraception. It is also the steroid of choice for new oral contraceptive regimens aimed at reducing the frequency of bleeding episodes. This novel approach, already tried more than 30 years ago, gained interest around the year 2000 when surveys of women's attitudes toward monthly menstrual bleeding started to show a major change: more and more women declared that they would welcome a hormonal contraceptive method that reduced bleeding episodes to 4, 2 or even 1 per year. At this point, while the debate on the significance and "usefulness" of menstruation went on, attention focused on new regimens. The first new modality consisted of changing the 7-day medication-free interval, either shortening it to fewer than 7 days, or by the administration of low-dose estrogens during the interval between packages. Then, continuous administration regimens started to be investigated. This, however, did not happen suddenly, since, in specific situations, doctors had for years empirically utilized various continuous administration regimens. The first extended-cycle oral contraceptive regimen introduced in clinical practice is an 84-day regimen that

  6. Progestational potency of oral contraceptives: a polemic.

    Science.gov (United States)

    Edgren, R A

    1978-01-01

    Dickey and Stone have attempted an evaluation of progestational potencies of oral contraceptives based upon such uterine criteria as subnuclear vacuolization and delay of menses. Their review, unfortunately, is marred by numerous errors which vitiate the potency estimates. The actions of progestagens in target organs depend upon the specific binding of the compounds to a protein receptor that is produced by estrogen treatment. Potency of hormones depends ultimately upon this binding. Since it seems unlikely that specific binding occurs in such nontarget sites as the blood vessels, direct potency relationships are highly improbable between diverse phenomena. Possible relationships between oral contraceptives and specific side effects must be studied in relationship to individual side effects and particular contraceptive products. Possible coincidental activities, no matter how analyzed, are unlikely to contribute meaningfully to our understanding of these drugs.

  7. Oral contraceptives in the treatment of acne.

    Science.gov (United States)

    Tan, J K; Degreef, H

    2001-02-01

    Oral contraceptives (OCs) can reduce acne by lowering the production of adrenal and ovarian androgens, by inhibiting 5-alpha-reductase, which in turn, reduces the levels of dihydrotestosterone, and by stimulating sex hormone binding globulin (SHBG), thus reducing the levels of free testosterone. In newer OCs, such as Tricyclen and Diane-35, the progestin component is minimally androgenic and anti-androgenic respectively, thereby enhancing the favorable profile of these products in the treatment of hyperandrogenic disorders, including acne. The efficacy of these agents and their long-term safety profile supports their use in various grades of acne in females: * As adjunctive therapy to topical agents for women with mild non-scarring acne desiring oral contraception * As primary therapy for patients with moderate non-scarring acne in combination with topical therapy and systemic antibiotics * As one of two preferred methods of contraception in patients with scarring and severe inflammatory acne being treated with systemic isotretinoin.

  8. An Oral Contraceptive Drug Interaction Study

    Science.gov (United States)

    Bradstreet, Thomas E.; Panebianco, Deborah L.

    2004-01-01

    This article focuses on a two treatment, two period, two treatment sequence crossover drug interaction study of a new drug and a standard oral contraceptive therapy. Both normal theory and distribution-free statistical analyses are provided along with a notable amount of graphical insight into the dataset. For one of the variables, the decision on…

  9. The use of oral contraception by adolescents for contraception, menstrual cycle problems or acne

    NARCIS (Netherlands)

    Hooff, M.H.A. van; Hirasing, R.A.; Kaptein, M.B.M.; Koppenaal, C.; Voorhorst, F.J.; Schoemaker, J.

    1998-01-01

    Background. Oral contraceptives are prescribed as contraception but also as therapy for menstrual cycle disturbances and acne. We studied the prevalence of oral contraceptive (OC) use and the indications to start OC use among adolescents. Methods. A cohort consisting of ninth grade secondary school

  10. Pattern of use of emergency oral contraception among Portuguese women.

    Science.gov (United States)

    Fontes, E; Guerreiro, J; Costa, T; Miranda, A

    2010-08-01

    This study describes the purchasers' profile and characterizes the pattern of use of emergency oral contraception among pharmacy users. The study was carried out in 455 Portuguese pharmacies. A cross-sectional study was undertaken in which pharmacists selected the first six purchasers of emergency oral contraception between May and June of 2006. Only user-purchasers were eligible to answer the questions about emergency oral contraception use. Participants completed a questionnaire on sociodemographic data and variables concerning contraceptive methods (including the emergency oral contraceptive acquired, the source of information about the availability of this emergency contraceptive method, prior use of emergency oral contraception, the frequency of use in the current cycle, the frequency of use in the preceding year, the time elapsed between unprotected sexual intercourse and the acquisition of emergency oral contraception, the reason for use and the regular method of contraception used). Although these drugs are available outside pharmacies--in some shops and supermarkets--their pattern of use was only assessed among pharmacy users. Descriptive statistics were used to characterize data. Prevalence of correct use, which was defined as the proportion of user-purchasers who acquired emergency oral contraception up to 72 h after unprotected sexual intercourse and had never used it in the current cycle. The sample comprised 1466 user-purchasers (72.6%) and 552 purchasers for another person's use (27.4%). Levonorgestrel-only contraceptives represented 96.1% of the emergency oral contraception acquired. User-purchasers aged between 18 and 30 represented 65.2% and 42.3% had attended secondary school. The majority of them (79.5%) were using a regular method of contraception and 62.6% were first-time users of emergency oral contraception. In 59.0% of the situations the reason for use was failure of the contraceptive used. Emergency oral contraception was used correctly by

  11. Risk of venous thromboembolism from use of oral contraceptives containing different progestogens and oestrogen doses: Danish cohort study, 2001-9.

    Science.gov (United States)

    Lidegaard, Øjvind; Nielsen, Lars Hougaard; Skovlund, Charlotte Wessel; Skjeldestad, Finn Egil; Løkkegaard, Ellen

    2011-10-25

    To assess the risk of venous thromboembolism from use of combined oral contraceptives according to progestogen type and oestrogen dose. National historical registry based cohort study. Four registries in Denmark. Non-pregnant Danish women aged 15-49 with no history of thrombotic disease and followed from January 2001 to December 2009. Relative and absolute risks of first time venous thromboembolism. Within 8,010,290 women years of observation, 4307 first ever venous thromboembolic events were recorded and 4246 included, among which 2847 (67%) events were confirmed as certain. Compared with non-users of hormonal contraception, the relative risk of confirmed venous thromboembolism in users of oral contraceptives containing 30-40 µg ethinylestradiol with levonorgestrel was 2.9 (95% confidence interval 2.2 to 3.8), with desogestrel was 6.6 (5.6 to 7.8), with gestodene was 6.2 (5.6 to 7.0), and with drospirenone was 6.4 (5.4 to 7.5). With users of oral contraceptives with levonorgestrel as reference and after adjusting for length of use, the rate ratio of confirmed venous thromboembolism for users of oral contraceptives with desogestrel was 2.2 (1.7 to 3.0), with gestodene was 2.1 (1.6 to 2.8), and with drospirenone was 2.1 (1.6 to 2.8). The risk of confirmed venous thromboembolism was not increased with use of progestogen only pills or hormone releasing intrauterine devices. If oral contraceptives with desogestrel, gestodene, or drospirenone are anticipated to increase the risk of venous thromboembolism sixfold and those with levonorgestrel threefold, and the absolute risk of venous thromboembolism in current users of the former group is on average 10 per 10,000 women years, then 2000 women would need to shift from using oral contraceptives with desogestrel, gestodene, or drospirenone to those with levonorgestrel to prevent one event of venous thromboembolism in one year. After adjustment for length of use, users of oral contraceptives with desogestrel, gestodene, or

  12. Do oral contraceptives increase epileptic seizures?

    Science.gov (United States)

    Reddy, Doodipala Samba

    2017-02-01

    Hormonal contraceptives are used by over 100 million people worldwide. Recently, there has been an emerging interest in studying the potential impact of oral contraceptives (OCs) on certain neurological conditions. It has been suspected for some time that hormonal birth control increases seizure activity in women with epilepsy, but there is little supportive data. Areas covered: Literature from PubMed and online sources was analyzed with respect to hormonal contraception and epilepsy or seizures. New evidence indicates that OCs can cause an increase in seizures in women with epilepsy. The epilepsy birth control registry, which surveyed women with epilepsy, found that those using hormonal contraceptives self-reported 4.5 times more seizures than those that did not use such contraceptives. A preclinical study confirmed these outcomes wherein epileptic animals given ethinyl estradiol, the primary component of OCs, had more frequent seizures that are more likely to be resistant. Expert commentary: OC pills may increase seizures in women with epilepsy and such refractory seizures are more likely to cause neuronal damage in the brain. Thus, women of child bearing age with epilepsy should consider using non-hormonal forms of birth control to avoid risks from OC pills. Additional research into the mechanisms and prospective clinical investigation are needed.

  13. Intracranial venous thrombosis complicating oral contraception

    Science.gov (United States)

    Dindar, F.; Platts, M. E.

    1974-01-01

    Four days after the onset of a severe headache a 22-year-old woman who had been taking oral contraceptives for less than three weeks had a convulsion, followed by right hemiparesis. Other focal neurologic signs and evidence of raised intracranial pressure appeared, and she became comatose on the seventh day. A left craniotomy revealed extensive cerebral venous thrombosis. She died the next day. On postmortem examination extensive thrombosis of the superior sagittal sinus and draining cerebral veins, and multiple areas of cerebral hemorrhage and hemorrhagic infarction were seen. Some of the superficial cerebral veins showed focal necrosis of their walls, and the lateral lacunae of the superior sagittal sinus contained proliferating endothelial cells. The adrenal veins were also thrombosed. The significance of these findings is discussed. The literature on cerebrovascular complications of oral contraception, particularly cerebral venous thrombosis, is reviewed. ImagesFIG. 1FIG. 2FIG. 3FIG. 4FIG. 5FIG. 6 PMID:4413961

  14. Contraception for adolescents.

    Science.gov (United States)

    Broome, M

    1984-05-01

    This article suggests guidelines for counseling and providing contraception to adolescents. Often adolescents begin sexual intercourse before seeking contraception. They tend to seek help from family planning clinics rather than the family physician. Contraception provided to adolescents should be effective but harmless to future fertility. Oral contraceptives (OCs) are the most popular method among adolescents, followed by condoms. Vaginal diaphragms are often impractical, and pelvic inflammatory disease tends to occur more frequently among young users of IUDs. Although medical contraindications to OC use are rarely encountered among OC users, information should be obtained on smoking habits, menstrual irregularities, and family history of diabetes mellitus, cardiovascular disease, and cancer. Low-dose OCs containing 30-35 mcg of ethinyl estradiol are generally prescribed. The pregnancy rate of the progestogen only pill makes it inadvisable for young, unmarried women. Adolescents should return to the clinic 2-3 months after their initial visit and then 6 months. Postcoital contraception should be provided in crisis situations. Adolescents attending family planning clinics should be provided the opportunity to discuss anxieties they may have about their sexuality. The request for contraception often conceals a need for help with sexual relationships. These anxieties tend to center around a concern about whether they are sexually normal and able to perform sexually to their partners's satisfaction. Physicians are urged ot listen carefully to adolescents and to be sensitive to unspoken messages as well.

  15. Communication about Contraception and Knowledge of Oral Contraceptives amongst Norwegian High School Students.

    Science.gov (United States)

    Hansen, Thomas; Skjeldestad, Finn Egil

    2003-01-01

    Examines communication about contraception and specific knowledge of oral contraceptives (OCs) in a sample of Norwegian high school students. More females than males discussed contraception at least monthly. Discussions were predominantly held with peers and not adults. Females were far more knowledgeable about OCs than males. The most significant…

  16. Effects of Administration of Fostamatinib on Blood Concentrations of an Oral Contraceptive in Healthy Female Subjects

    Science.gov (United States)

    2012-02-17

    Scientific Terminology Rheumatoid Arthritis, Healthy Female Volunteers, Pharmacokinetics, Oral Contraceptive, Drug-drug Interaction; Laymen Terminology Level of Oral Contraceptive in Blood, Oral Contraceptive, Rheumatoid Arthritis, Drug -Drug Interaction

  17. [Headache and oral contraceptives (author's transl)].

    Science.gov (United States)

    Farias Da Silva, W; Benicio, G

    1978-01-01

    175 patients using oral contraceptives (OCs) for periods from 2 months-6 years were studied. A survey was made of the secondary effects of the treatment. Among the total group, 101 of them had not presented headache before the use of contraceptives, and the remaining 75 patients had previously complained of chronic headaches which were considered due to different etiologies. 50 patients from the group without previous headache claimed that OC treatment marked the initiation of the headaches. 25 had vascular headaches and 25 had tension headaches. Among the 75 patients included in the other group as complainers of chronic headache prior to treatment, 30 had a worsening of the symptoms after use of the OCs. The authors compare their results with those referred to in the literature. (author's)

  18. Effect of oral contraceptive progestins on serum copper concentration

    DEFF Research Database (Denmark)

    Berg, Gabriele; Kohlmeier, L; Brenner, H

    1998-01-01

    contraceptives. DESIGN: Cross-sectional epidemiologic study. Examinations included a detailed questionnaire on medical history and lifestyle factors, a seven day food record, and blood samples. SETTING: National health and nutrition survey among healthy people living in private homes in West Germany in 1987...... types of oral contraceptives, elevation was more pronounced among women taking oral contraceptives with antiandrogen effective progestins like antiandrogens or third generation oral contraceptives containing desogestrel. Further investigation is required to shed light on the possible role of high serum...

  19. Evaluation of smartphone oral contraceptive reminder applications.

    Science.gov (United States)

    Gal, Noga; Zite, Nikki B; Wallace, Lorraine S

    2015-01-01

    Oral contraceptives (OCs) are the most widely used contraceptive method among women of reproductive age in the United States (US). Routine download and use of health-related smartphone applications (apps) continues to increase. The purpose of this study was to evaluate the utility of English-language, smartphone-platform OC reminder apps currently available for download in the US. During June-July 2013, official Internet-based, mobile app platforms for the two major smartphone operating systems in the US-Android (Google Play Store) and iPhone (iTunes)-were searched. "Birth control," "the pill," and "contraception" were entered into the search-bar of each Smartphone store. Apps were assessed for the following: cost, health care professionals' involvement in app development, reminder mechanisms, and functionality. Of the 39 unique OC reminder apps meeting inclusion criteria, 7 (18%) did not operate as intended when downloaded. Most apps functioned without an Internet connection (97%) and included pop-up notifications (84%). Certain app features overcome common causes of missing an alarm, and hypothetically, may minimize likelihood of an OC user missing a daily pill. Health care providers should inform users of potential pitfalls and advise them that an OC reminder app should be not be used as a sole reminder method. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Use of combined oral contraceptives post abortion.

    Science.gov (United States)

    Gaffield, Mary E; Kapp, Nathalie; Ravi, Anita

    2009-10-01

    Providing combined oral contraceptives (COCs) following surgical or medical induced abortion offers women an opportune moment to initiate a reliable contraceptive method. We conducted a systematic review, searching MEDLINE and The Cochrane Library for articles in any language concerning COC use following spontaneous, induced (medical or surgical) or septic abortion, from 1966 through June 2008. Seven articles were identified and evaluated using the United States Preventive Services Task Force system. Immediate COC initiation after first-trimester medical or surgical induced abortion did not increase side effects or prolong vaginal bleeding compared with use of a placebo, copper-bearing intrauterine device (IUD), nonhormonal contraceptive method or COC initiation at a later time. Initiating COCs after first-trimester surgical abortion produced small increases in coagulation parameters compared with IUD use; although they are statistically significant, their clinical relevance is unlikely. No study examined second-trimester induced or spontaneous abortion, or septic abortion. Evidence shows that COCs can be safely initiated immediately following surgical and medical abortion in the first-trimester of pregnancy.

  1. Oral contraception and risk of endometrial cancer

    Directory of Open Access Journals (Sweden)

    Mueck AO

    2011-10-01

    Full Text Available Alfred O Mueck1, Harald Seeger1, Xiangyan Ruan2 1Department of Endocrinology and Menopause, University Women's Hospital of Tuebingen, Tuebingen, Germany; 2Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China Abstract: No placebo-controlled studies concerning hormonal contraception in general have been published, and only investigations on biological mechanisms and observational clinical studies are available. Thus, associations can be described but not their causality. Experimental studies strongly suggest protective effects of the progestagen component of hormonal contraception against development of estrogen-related (type 1 endometrial cancer. In light of this research, it seems biologically plausible that, in more than 20 published studies, a reduction in endometrial cancer risk was achieved in up to 50% of users of combined oral contraceptives (COC, compared with nonusers. Few data exist for progestin-only oral preparations. However, in view of the mechanisms involved, a reduction in cancer risk should also be expected. Whereas hormonal dose-dependency has been investigated in only a few studies, which showed a stronger risk reduction with increasing progestagenic potency, a decreased risk dependent on duration of use has been clearly demonstrated, and after stopping COC this effect has persisted for up to 20 years. Possible confounders, including family history, parity, and smoking, have been investigated in a few studies, with only a minor impact on hormonal effect of endometrial cancer risk, with the exception of obesity, which was a strong risk factor in most but not all studies. There are obvious differences in the incidence of endometrial cancer in women using COC when evaluated in absolute numbers for Western and Asian countries, being about 3–5-fold higher in the US than in Asia. Further research should include the noncontraceptive benefit of COC

  2. Affective and Physical Changes Associated with Oral Contraceptive Use.

    Science.gov (United States)

    Wiener, Alane L.; And Others

    Although investigations of the physiological effects of oral contraceptives suggest that affective changes may accompany their use, empirical documentation of these effects has not been consistent. This study examined physiological and affective changes accompanying use of a low-dosage oral contraceptive while controlling for possible expectancy…

  3. Effects of oral contraceptives on total serum proteins, albumin ...

    African Journals Online (AJOL)

    Total serum, albumin, globulin, albumin/globulin ratio and cholesterol levels were determined in 25 subjects on oral contraceptives and 25 controls. The mean serum total protein, globulin and cholesterol levels were significantly increased in oral contraceptive and their control counterparts. The albumin/globulin ratio in ...

  4. Effects of oral contraceptives on total serum proteins, albumin,

    African Journals Online (AJOL)

    rum total protein, globulin and cholesterol levels were sig-. nificantly increased in oral contraceptive and their control counterparts. The albumin/globulin ratio in subjects on oral contraceptives users is significantly decreased compared with controls. In view of the findings of this study, it is suggested that the biochemical ...

  5. Nomegestrol acetate-17b-estradiol for oral contraception

    Directory of Open Access Journals (Sweden)

    Burke A

    2013-06-01

    Full Text Available Anne Burke Johns Hopkins University School of Medicine, Baltimore, MD, USAAbstract: Oral contraceptives remain a popular method of contraception over 50 years after their introduction. While safe and effective for many women, the failure rate of oral contraception is about 8%. Concerns about the risk of venous thromboembolism continue to drive the search for the safest oral contraceptive formulations. The oral contraceptive NOMAC-E2 contains nomegestrol acetate (NOMAC 2.5 mg + 17b-estradiol (E2 1.5 mg. The approved dosing regimen is 24 days of active hormone, followed by a 4-day hormone-free interval. NOMAC is a progestin derived from testosterone, which has high bioavailability, rapid absorption, and a long half-life. Estradiol, though it has a lower bioavailability, has been successfully combined with NOMAC in a monophasic oral contraceptive. Two recently published randomized controlled trials demonstrate that NOMAC-E2 is an effective contraceptive, with a Pearl Index less than one pregnancy per 100 woman-years. The bleeding pattern on NOMAC-E2 is characterized by fewer bleeding/spotting days, shorter withdrawal bleeds, and a higher incidence of amenorrhea than the comparator oral contraceptive containing drospirenone and ethinyl estradiol. The adverse event profile appears to be acceptable. Few severe adverse events were reported in the randomized controlled trials. The most common adverse events were irregular bleeding, acne, and weight gain. Preliminary studies suggest that NOMAC-E2 does not seem to have negative effects on hemostatic and metabolic parameters. While no one oral contraceptive formulation is likely to be the optimum choice for all women, NOMAC-E2 is a formulation with effectiveness comparable with that of other oral contraceptives, and a reassuring safety profile.Keywords: oral contraception, nomegestrol acetate, estradiol

  6. Maternal use of oral contraceptives and risk of fetal death

    DEFF Research Database (Denmark)

    Jellesen, R.; Strandberg-Larsen, Katrine; Jørgensen, Torben

    2008-01-01

    Intrauterine exposure to artificial sex hormones such as oral contraceptives may be associated with an increased risk of fetal death. Between 1996 and 2002, a total of 92 719 women were recruited to The Danish National Birth Cohort and interviewed about exposures during pregnancy. Outcome.......2%) women took oral contraceptives during pregnancy. Use of combined oestrogen and progesterone oral contraceptives (COC) or progesterone-only oral contraceptives (POC) during pregnancy was not associated with increased hazard ratios of fetal death compared with non-users, HR 1.01 [95% CI 0.71, 1.45] and HR...... 1.37 [95% CI 0.65, 2.89] respectively. Neither use of COC nor POC prior to pregnancy was associated with fetal death. Stratification by maternal age and smoking showed elevated risks of fetal death for women oral contraception during pregnancy, but the interactions were...

  7. Importance of levonorgestrel dose in oral contraceptives for effects on coagulation

    NARCIS (Netherlands)

    Kluft, C.; Maat, M.P.M. de; Heinemann, L.A.J.; Spannagl, M.; Schramm, W.

    1999-01-01

    Combined oral contraceptives show clear differences in effect on the tissue factor-initiated coagulation test of activated protein C resistance, which is dependent on the presence and dosage of levonorgestrel. Multiphasic levonorgestrol oral contraceptives differ from monophasic contraceptives and

  8. [Cardiovascular risks of combined oral contraceptives - beyond the French controversy].

    Science.gov (United States)

    Gronier, H; Gronier-Gouvernel, H; Robin, G

    2014-03-01

    Combined hormonal contraceptive is the most used contraceptive method in France among childbearing-aged women. Following the temporary delisting of oral contraception containing a 3rd generation progestin and following the market withdrawal of oral pills containing cyproterone acetate in combination with ethynil-estradiol (35μg), the impact of these events on our prescribing practice remains to determine. We will especially discuss the cardiovascular risk associated with combined hormonal contraceptives in the light of the most recent publications either with epidemiological or biological data. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  9. Mortality among contraceptive pill users: cohort evidence from Royal College of General Practitioners' Oral Contraception Study.

    Science.gov (United States)

    Hannaford, Philip C; Iversen, Lisa; Macfarlane, Tatiana V; Elliott, Alison M; Angus, Valerie; Lee, Amanda J

    2010-03-11

    To see if the mortality risk among women who have used oral contraceptives differs from that of never users. Prospective cohort study started in 1968 with mortality data supplied by participating general practitioners, National Health Service central registries, or both. 1400 general practices throughout the United Kingdom. 46 112 women observed for up to 39 years, resulting in 378 006 woman years of observation among never users of oral contraception and 819 175 among ever users. Directly standardised adjusted relative risks between never and ever users for all cause and cause specific mortality. 1747 deaths occurred in never users of oral contraception and 2864 in ever users. Compared with never users, ever users of oral contraception had a significantly lower rate of death from any cause (adjusted relative risk 0.88, 95% confidence interval 0.82 to 0.93). They also had significantly lower rates of death from all cancers; large bowel/rectum, uterine body, and ovarian cancer; main gynaecological cancers combined; all circulatory disease; ischaemic heart disease; and all other diseases. They had higher rates of violent deaths. No association between overall mortality and duration of oral contraceptive use was observed, although some disease specific relations were apparent. An increased relative risk of death from any cause between ever users and never users was observed in women aged under 45 years who had stopped using oral contraceptives 5-9 years previously but not in those with more distant use. The estimated absolute reduction in all cause mortality among ever users of oral contraception was 52 per 100 000 woman years. Oral contraception was not associated with an increased long term risk of death in this large UK cohort; indeed, a net benefit was apparent. The balance of risks and benefits, however, may vary globally, depending on patterns of oral contraception usage and background risk of disease.

  10. Mechanisms of action of oral emergency contraception.

    Science.gov (United States)

    Gemzell-Danielsson, Kristina; Berger, Cecilia; Lalitkumar, P G

    2014-10-01

    This review gives an overview of the mechanisms of action of oral emergency contraception pills (ECPs), focusing on the levonorgestrel (LNG) and ulipristal acetate (UPA) containing ECPs. In vivo and in vitro studies have addressed the effect of EC on various possible targets. Based on these studies as well as on clinical trials it is clear that the efficacy of ECPs to prevent an unintended pregnancy depends on their mechanism of action as well as on their use in relation to the fertile window. While the main effect of both available ECPs is to prevent or delay ovulation the window of action for UPA is wider than that of LNG. This provides the biological explanation for the difference observed in clinical trials and the higher efficacy of UPA. Neither LNG nor UPA impairs endometrial receptivity or embryo implantation. Correct knowledge on the mechanism of action of ECPs is important to avoid overestimating their effectiveness and to advise women on correct use.

  11. Combined oral contraceptives affect liver mitochondrial activity.

    Science.gov (United States)

    Jonderko, Krzysztof; Skałba, Piotr; Kamińska, Magdalena; Kasicka-Jonderko, Anna; Galas, Ewa; Biały, Aleksandra

    2013-10-01

    To examine liver mitochondrial function in women using combined oral contraceptives (COCs) containing ethinylestradiol. A breath test after oral administration of 1 mg/kg (13)C-alpha-ketoisocaproic acid ((13)C-KICA) and 20 mg/kg L-leucine was performed twice: (i) in 15 women on day 14, 15, 16, 17 or 18 of COC intake, and between day 1 and 5 of the withdrawal bleeding; and (ii) in 15 regularly menstruating females not taking hormonal contraceptives: during the luteal phase, between the 18th and the 22nd day of the cycle, and again between day 1 and 5 of the menstruation. In women on COCs the maximum (13)C elimination in breath air (Dmax) was higher (26.8 ± 1.6%/h) than during withdrawal bleeding (23.5 ± 1.2%/h; p = 0.012). The time to reach the Dmax was similar on the two study days: 33.3 ± 2.4 min during the phase of pill intake vs. 37.0 ± 2.5 min during the pill-free interval. The one-hour cumulative breath (13)C elimination was greater after two weeks of COC intake than during the withdrawal bleeding: 17.49 ± 1.03% vs. 15.32 ± 0.85% (p = 0.024). In the control group no menstrual cycle phase-dependent fluctuations in the results of the (13)C-KICA breath test were observed. The metabolism of (13)C-alpha-ketoisocaproic acid augments during the intake of COCs containing ethinylestradiol, reflecting enhanced liver mitochondrial metabolic activity.

  12. The cost-effectiveness of a long-acting reversible contraceptive (Implanon) relative to oral contraception in a community setting.

    Science.gov (United States)

    Lipetz, Clare; Phillips, Ceri J; Fleming, Charlotte F

    2009-04-01

    Within the setting of a UK community sexual health service, the cost-effectiveness of Implanon and oral contraception provision over a 36-month period was compared. A case-controlled retrospective cost-effectiveness study was done on a cohort of 493 Implanon users and 493 oral contraceptive users. The actual cost of provision of both methods was calculated. Cost-effectiveness was calculated based on provision of method and pregnancy costs of each cohort. Implanon provision is more cost-effective than oral contraception at all time points. After 12 months of use, Implanon is half the cost of oral contraception. Oral contraception reached similar annual cost to Implanon at 36 months of use. Long-acting reversible contraception is perceived to be expensive. It is reassuring to contraception providers that Implanon is, in fact, highly cost-effective when compared to oral contraception with typical use.

  13. What some women want? On-demand oral contraception.

    Science.gov (United States)

    Raymond, Elizabeth G; Shochet, Tara; Drake, Jennifer Kidwell; Westley, Elizabeth

    2014-08-01

    To summarize evidence regarding current demand for on-demand oral contraception. We used Medline and collegial contacts to find published and unpublished studies conducted or reported in the past 15 years with information assessing women's interest in using any oral drug preparation, including emergency contraceptive pills, in a coitus-dependent manner either repeatedly or as a primary or planned pregnancy prevention method. We found 19 studies with relevant information. The studies were conducted in 16 countries. Eight studies provided data on women's attitudes regarding a coitus-dependent oral contraceptive; all suggested substantial interest in using it. Nine studies assessed actual use of oral tablets on demand for primary contraception. In these studies, 9-97% of women in the analysis populations reported using the pills on demand as main method, although frequency and consistency of use varied. Reported reasons for interest in or use of this contraceptive approach included convenience, ease of remembering, ability to conceal use, lack of coital interruption, and infrequent sexual activity. Three studies were clinical trials of investigational on-demand oral contraceptives which reported Pearl indices ranging from 6.8 to 53 pregnancies per 100 woman-years. Data from a variety of settings suggest that demand for an on-demand oral contraceptive may be widespread. The effectiveness of this potential method is not established, however. Considering the seriousness of the unmet need for contraception, further development research into the public health benefits and risks of such a method would be worthwhile. Demand for an on-demand oral contraceptive may be widespread. Efforts should be made to further explore the possibility of developing such a method. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Oral Contraception: A Survey of College Women's Concerns and Experience.

    Science.gov (United States)

    Sawyer, Robin G.; Beck, Kenneth H.

    1989-01-01

    Results are reported from a study which examined attitudes, experiences, and concerns of college women (N=237) regarding oral contraception. Implications of the findings for health educators are discussed. (IAH)

  15. Oral Contraceptives and Bone Health in Female Runners

    National Research Council Canada - National Science Library

    Kelsey, Jennifer

    2000-01-01

    .... This study is a two-year randomized trial of the effects of oral contraceptives on bone mass and stress fracture incidence among 150 female competitive distance runners in the age range 18-25 years...

  16. Oral Contraceptives and Bone Health in Female Runners

    National Research Council Canada - National Science Library

    Kelsey, Jennifer

    1999-01-01

    .... This study is a two-year randomized trial of the effects of oral contraceptives on bone mass and stress fracture incidence among 150 female competitive cross country runners in the age range 18-25 years...

  17. RISKS AND BENEFITS OF ORAL HORMONAL CONTRACEPTION

    Directory of Open Access Journals (Sweden)

    Velimir Šimunić

    2018-02-01

    Full Text Available Background: Oral hormonal contraception (OC or the birth control pill that has been in use since 1960 is considered an efficient and reliable method of pregnancy prevention. In the early days the pill contained high doses of hormones, and the related complications were frequently reported. The composition of the pill has substantially changed, estrogen dose has been significantly decreased and so has the incidence of side effects. Despite the reduced estrogen dose, the risk for the development of vein thromboembolism has not significantly decreased, as the final effect depends on the interaction with the progestage+n component. The OC use is in itself an independent risk factor for the develop- ment of ischemic stroke event (RR = 1.5, and for the development of myocardial infarction (RR = 1.84. Recent studies show that second generation OC users were at a higher risk of cardiovascular disease than the third generation OC users. The risk of breast cancer is also marginally increased (RR = 1.09-fold increased risk. The discussion about an association between the development of cervical cancer and an increased incidence of the disease in OC users is inclined to attribute this increased incidence to human papilloma virus infec- tion rather than to OC use. Beneficial effects of OC use are manifested through decreased incidence of endometrial cancer, which is mostly true in women with a lower body mass index (BMI. Additionally, OC plays a protective role in the development of ovarian cancer; recent studies have reported that OC use has prevented 200 000 ovarian cancers and 100 000 deaths from the disease. Also, the risk of colorectal cancer is OC users is lower (RR = 0.72. Conclusions: Modern third generation OC preparations containing desogestrel and gestodene are a safe contraceptive method for all women except for those at increased risk of vein thrombosis.

  18. 21 CFR 310.501 - Patient package inserts for oral contraceptives.

    Science.gov (United States)

    2010-04-01

    ... comparing the effectiveness of oral contraceptives to other methods of contraception. (4) A boxed warning... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Patient package inserts for oral contraceptives... Patient package inserts for oral contraceptives. (a) Requirement for a patient package insert. The safe...

  19. Evaluation of extended and continuous use oral contraceptives

    Directory of Open Access Journals (Sweden)

    Kristen Page Wright

    2008-08-01

    Full Text Available Kristen Page Wright, Julia V JohnsonUniversity of Vermont College of Medicine and Reproductive Endocrinology and Infertility, Women’s Health Care Services, Fletcher Allen Health Care, Burlington, VT USAAbstract: Oral contraceptives are classically given in a cyclic manner with 21 days of active pills followed by 7 days of placebo. In the past 4 years, new oral contraceptives have been introduced which either shorten the placebo time, lengthen the active pills (extended cycle, or provide active pills every day (continuous. These concepts are not new; extended and continuous pills were first studied in the 1960s and 1970s and have been provided in an off-label manner by gynecologists to treat menstrual disorders, such as menorrhagia and dysmenorrhea, and gynecologic disorders, such as endometriosis. Now that extended and continuous combined oral contraceptives are available for all patients, it is critical for providers to understand the physiology, dosing, side effects, and benefits of this form of oral contraceptive. This article reviews the history and the potential uses of the new continuous combined oral contraceptive.Keywords: oral contraceptives, administration, dosage, adverse effects, menstrual disturbances

  20. [Social psychological and sexological aspects of oral contraception (author's transl)].

    Science.gov (United States)

    Van Keep, P A

    1976-01-01

    An inventory is made on the hindrances to the acceptance of contraception in general and oral contraception in particular. They are grouped as hindrances related to the social and psychological significance of "making children", hindrances related to the social and psychological significance of "having children" hindrances, related to the method of oral contraception itself, to be divided in social hindrances, psychological hindrances and medical hindrances and finally hindrances related to the provision of the pill to the individual user. Each of these is amply discussed, the author expresses the hope that by identification of these hindrances, lessons may be learned for the future, when other methods of contreception become available.

  1. Women's knowledge of taking oral contraceptive pills correctly and of emergency contraception: effect of providing information leaflets in general practice.

    OpenAIRE

    Smith, L F; Whitfield, M J

    1995-01-01

    BACKGROUND. About one third of all pregnancies are unplanned and 20% of all pregnancies end in abortion. More than 170,000 legal abortions are performed in the United Kingdom annually. Nearly all general practitioners provide contraceptive advice; the most commonly used form of reversible contraception is the oral contraceptive pill. AIM. The aim of this study was to determine factors associated with women's knowledge of taking the contraceptive pill correctly and of emergency contraception, ...

  2. [Individualization of low-dose oral contraceptives. Pharmacological principles and practical indications for oral contraceptives].

    Science.gov (United States)

    Cianci, A; De Leo, V

    2007-08-01

    The contraceptive pill has been a revolution of the last 40 years. In Italy, however, it is much less widely used than in other countries. Explanations for this phenomenon range from religious implications and customs to misinformation and word-of-mouth communication of negative experiences. The oral contraceptive pill is often used to correct menstrual disorders, leading to poor results and side-effects. Recent advances in oral contraception have led to a substantial reduction in doses and side-effects. Low-dose pills contain minimal doses of progesterones and estrogens and ensure good control of the menstrual cycle. Although reduction of ethinyl estradiol (EE) concentrations has reduced the incidence of negative systemic side effects such as water retention, edema and swollen breasts, the low estrogen dose may be associated with spotting and hypomenorrhea or amenorrhea in the long term, as well as dyspareunia due to reduced vaginal trophism, which may induce women to suspend use of the drug. It is also true that only one type of estrogen is used in the pill, albeit at different doses, whereas the progesterone may differ and in many cases is the cause of common side-effects. The choice of progesterone therefore involves not only its effect on the endometrium in synergy with estrogen, but also possible residual androgenic activity which may have negative metabolic repercussions. Indeed, addition of a progesterone, especially androgen-derived, attenuates the positive metabolic effects of estrogen. Two new monophasic oral contraceptives were recently released. They contain 30 microg (Yasmin) or 20 muicrog (Yasminelle) EE and a new progesterone, drospirenone, derived from spirolactone, which has antiandrogenic and antimineralcorticoid activity similar to endogenous progesterone. Like progesterone, the drospirenone molecule is an aldosterone antagonist and has a natriuretic effect that opposes the sodium retention effect of EE. It may, therefore, help to prevent the

  3. Teenagers' perceptions of unplanned adolescent pregnancies and oral contraceptive use.

    Science.gov (United States)

    White, J E; Kellinger, K G

    1989-01-01

    Adolescent women who are sexually active often do not use contraceptives consistently and correctly. Adolescents are sexually active for an average of 15 months before initiating regular contraceptive use and the majority of young women who initiate use discontinue within the first year after initiation. This study enrolled 50 young women who initiated oral contraceptive use and was designed to provide more understanding of their perceptions about the possibility of an unplanned pregnancy and about contraceptive use. They were again contacted 6 weeks after initiation of oral contraceptives to assess continuation. Findings revealed that 90% of the subjects were sexually active at the time of the first visit; the mean period of sexual activity was 15 months. Only 30% had used a nonprescription birth control method during this period. While perceiving themselves to be highly susceptible to pregnancy, many young women continue to have psychosocial barriers to contraceptive use. Follow-up contact revealed more than 10% of the subjects were not using oral contraceptives.

  4. Long acting methods of contraception.

    Science.gov (United States)

    Newton, J

    1993-01-01

    Long acting methods of contraception have been developed and refined over the last 10 years. From the classical long acting progestogen-only depot preparations we now have a range of delivery systems including both combined and progestogen only injection systems and vaginal rings also containing either progestogen only or oestrogen and progestogen in combination. Subcutaneous implants at present containing only a progestogen, offer a range of durations from 2-5 years. The efficacy of these methods is high, with failure rates as low as 0.1 per 100 woman years. However, with progestogen only systems a significant proportion of women develop unpredictable menstrual bleeding, which with counselling is acceptable. The commonest reason for discontinuation still remains menstrual disorders and recent WHO workshops have investigated the cause of this bleeding and refined the reference periods of analysis. The method of action of progestogen-only systems is primarily cervical mucus blockade and prevention of sperm penetration. However, they also tend to produce a thinned atrophic endometrium. Ovarian effects ranging from complete anovulation to disordered luteal phase, persistent follicles and disorganised hormone production add to the contraceptive effect in more than half of the treatment cycles, but cause some of the menstrual disturbance. All these long acting methods are essential to family planning programmes, offering highly acceptable, and in some cases novel methods with high efficacy.

  5. [Amenorrhea following the administration of oral contraceptives].

    Science.gov (United States)

    Gertrudis Diez, M A

    1984-04-01

    It is estimated that about 2.2% of women experience amenorrhea and anovulatory cycles after discontinuing use of oral contraceptives (OCs), although exact figures are lacking due to differences of definition and problems of diagnosis. Several possible mechanisms to explain the occurrence of postpill amenorrhea have been suggested, including endometrial atrophy and fibrosis, changes in the ovaries similar to those found in Stein-Levanthal syndrome, hypothalamic disorder, late menarche, irregular cycles, and periods of amenorrhea before or during OC use. Previous pregnancies, duration of pill use, and formulation utilized are apparently not related to occurrence of post-pill amenorrhea. Clinical diagnosis requires detection of ovulation by means of basal body temperature, cervical mucus changes, and vaginal smears. If amenorrhea persists after administration of a progestagen to induce bleeding, more complete examinations must be done to exclude pituitary tumor, Cushing's syndrome, thyroid problems, and possible precocious menopause or anorexia nervosa. X-rays, administration of thyroid or suprarenal hormones, gonadotropins, or estrogens, an endometrial biopsy, or laparoscopy may be necessary. Generally all test values are normal except that levels of estrogens, follicle stimulating hormone, and luteinizing hormone are usually reduced. Treatment of post-pill amenorrhea can take various forms. About 5% of cases appear to resolve spontaneouusly; efforts should therefore be made to detect ovulation through basal body temperature, cervical mucus and vaginal smears. Corticosteroids including prednisone and dexametasone may administrered, or if estrogen levels are low and the patient fails to respond to progestagens with withdrawal bleeding, clomiphene may be used. Human menopausal gonadotropin or human chorionic gonadotropin can be in patients with low estrogen levels who do not respond to clomiphene. Ergocriptine derivatives may be used in cases with associated

  6. the effect of oral contraceptive pills

    African Journals Online (AJOL)

    Uwaifoh

    2012-12-31

    Dec 31, 2012 ... In this regards, ESHRE Capri Workshop Group (2005) stated that “at a global level, contraception has played important role in helping to reduce overcrowding, pressures on resources, pollution, global warming, and a loss of animal species due to loss of habitat”. Although the prevalence of contraceptive ...

  7. Influence of combined oral contraceptives on the periodontal condition

    Directory of Open Access Journals (Sweden)

    Roberta Santos Domingues

    2012-04-01

    Full Text Available Most studies investigating the impact of oral contraceptives have been performed some years ago, when the level of sexual hormones was greater than the actual formulations. Objective: The aim of this study was to evaluate the effects of current combined oral contraceptives (COC on periodontal tissues, correlating the clinical parameters examined with the total duration of continuous oral contraceptive intake. Material and methods: Twenty-five women (19-35 years old taking combined oral contraceptives for at least 1 year were included in the test group. The control group was composed by 25 patients at the same age range reporting no use of hormone-based contraceptive methods. Clinical parameters investigated included pocket probing depth (PD, clinical attachment level (CAL, sulcular bleeding index (SBI and plaque index (Pl.I. Data were statistically evaluated by unpaired t test, Pearson’s correlation test and Spearman’s correlation test. Results: The test group showed increased PD (2.228±0.011 x 2.154±0.012; p<0.0001 and SBI (0.229±0.006 x 0.148±0.005, p<0.0001 than controls. No significant differences between groups were found in CAL (0.435±0.01 x 0.412±0.01; p=0.11. The control group showed greater Pl.I than the test group (0.206±0.007 x 0.303±0.008; p<0.0001. No correlation between the duration of oral contraceptive intake, age and periodontal parameters was observed. Conclusions: These findings suggest that the use of currently available combined oral contraceptives can influence the periodontal conditions of the patients, independently of the level of plaque accumulation or total duration of medication intake, resulting in increased gingival inflammation.

  8. Extended regimens of the contraceptive vaginal ring versus hormonal oral contraceptives: effects on lipid metabolism.

    Science.gov (United States)

    Guazzelli, Cristina Aparecida Falbo; Barreiros, Fernando Augusto; Barbosa, Ricardo; Torloni, Maria Regina; Barbieri, Marcia

    2012-04-01

    Combined oral contraceptives used in an extended regimen have been studied because of their potential benefits; however, there have been few publications on extended regimens of contraceptive vaginal rings. The aim of this study was to assess the effects of these two extended regimens on the lipid metabolism of women using these contraceptive methods during 1 year. This prospective study enrolled 150 women: 75 used a vaginal contraceptive ring (11.7 mg etonogestrel and 2.7 mg ethinyl estradiol), and 75 used oral contraceptives (30 mcg ethinyl estradiol and 150 mg desogestrel). Both groups used their respective method for 84 days followed by a 7-day pause during 1 year. At baseline and every 3 months during the study period, blood was collected to assess total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides and apolipoprotein (apo) A-I and B. The analysis of variance test was used to analyze differences in the results of these exams over time. A total of 62 vaginal ring and 61 oral contraceptive users completed the study. There were no significant differences in the discontinuation rate, mean total cholesterol and fraction levels, apo B concentration or apo A-I/apo B ratio. Vaginal ring users had significantly higher apo A-1 levels than oral contraceptive users. Despite the vaginal route of administration, the steroids released by the ring had the same effects on the lipid metabolism and lipoprotein levels typically seen with ethinyl estradiol given either by oral or parenteral routes. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. The oral contraceptive pill: a revolution for sportswomen?

    OpenAIRE

    Bennell, K.; White, S.; Crossley, K.

    1999-01-01

    OBJECTIVES: To determine the effects of the oral contraceptive pill (OCP) on skeletal health, soft tissue injury, and performance in female athletes. METHODS: A literature review was performed using literature retrieval methods to locate relevant studies. RESULTS: Most female athletes primarily choose to use the OCP for contraceptive purposes, but cycle manipulation and control of premenstrual symptoms are secondary advantages of its use. The effect of the OCP on bone density in normall...

  10. Colonic Crohn's disease and use of oral contraception.

    Science.gov (United States)

    Rhodes, J M; Cockel, R; Allan, R N; Hawker, P C; Dawson, J; Elias, E

    1984-01-01

    The prevalence of use of oral contraception before the onset of disease was established in 100 consecutive women attending follow up clinics for inflammatory bowel disease. A significant excess of women with Crohn's disease confined to the colon had taken oral contraceptives in the year before developing symptoms (10/16 (63%] compared with women with small-intestinal Crohn's disease (12/49 (24%); p less than 0.02) and women with ulcerative colitis (3/35 (9%); p less than 0.0005). When the patient groups were matched for age and year of onset of disease usage of oral contraception before the onset of disease was still more common among women with isolated colonic Crohn's disease (9/12, 75%) than among those with ulcerative colitis (2/12 (17%); p less than 0.02) and was also more common than would be expected from reported figures for oral contraception in England and Wales (31.4% of women aged under 41; p less than 0.005). A survey of current patient records showed that isolated colonic disease was at least twice as common among women with Crohn's disease (63/218, 29%) compared with men (25/181, 14%; p less than 0.001). These data support the suggestion made previously that oral contraceptives may predispose to a colitis that resembles colonic Crohn's disease. PMID:6421392

  11. Effect of oral contraceptives on haemostasis variables.

    Science.gov (United States)

    Kluft, C; Lansink, M

    1997-07-01

    Combined oral contraceptives (COCs) have effects on a large number of haemostasis variables. We have summarised literature data on effects of COCs containing 30-35 micrograms ethinyl estradiol for the third generation of progestogens (PGs): desogestrel, gestodene and norgestimate. It is concluded that about 15 variables show a shift in distribution of the order of magnitude of their interindividual variation coefficient. When comparing the third generation of PGs with the second one (norgestrel, levonorgestrel) stronger increases are noted for the former for some haemostatic variables. Also differences between desogestrel and gestodene for factor VII were apparent. It indicates that the role of PGs in the effects of COCs is significant and their design may in addition to reduction of oestrogen dosage be important in reducing haemostatic complications. The survey on molecular and cellular mechanisms by which the sex steroids might operate showed a great lack of knowledge. Only for factor XII has a functional oestrogen response element in the DNA definitely been identified. The study of molecular markers of coagulation and fibrinolysis have shown a distinct increased activation of coagulation (F 1 + 2, FPA) and fibrinolysis (PAP), and an increased fibrin turn-over (increased FDPs); platelet products are not found increased (beta TG, PF-4). The increase in fibrinolysis represent a counterforce, but individual changes in variables in coagulation and fibrinolysis do not correlate indicating independent effects and no evidence for a individually regulated balance. A first step in further research might be in understanding the increase in coagulation activation (F 1 + 2) which has so far not been satisfactorily related to changes in blood concentrations of haemostatic factors and possibly local factors.

  12. [Systemic lupus erythematosus and contraception: A systematic literature review].

    Science.gov (United States)

    Gensous, N; Doassans-Comby, L; Lazaro, E; Duffau, P

    2017-06-01

    The aim of our study was to evaluate the safety of contraceptive methods use among women with systemic lupus erythematosus (SLE). A systematic review of the literature was performed using the two databases MEDLINE and SCOPUS, in order to identify articles concerning the safety of contraceptive methods use among women with SLE, through May 2016. Information on study characteristics, objectives, population, contraception and outcomes were extracted. A total of 907 articles were identified and 21 were selected for the systematic review. Two randomised controlled trials found no worsening of disease activity with the use of combined oral contraceptive in women with stable or inactive SLE. Disease activity was not exacerbated with the use of progestogens-only contraceptive. There was an increased risk of thrombosis with the use of combined contraceptive, particularly in women with positive antiphospholipid antibodies and this must lead to a restriction of use in these patients. Use of oral combined hormonal contraceptives should be limited to patients with non-severe and stable disease, without thrombosis risk factors. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  13. Oral contraceptives and venous thromboembolism: a five-year national case-control study

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind; Edström, Birgitte; Kreiner, Svend

    2002-01-01

    Venous thromboembolism; Oral contraceptives; Pulmonary embolism; Third-generation; Second-generation; Pill Scare......Venous thromboembolism; Oral contraceptives; Pulmonary embolism; Third-generation; Second-generation; Pill Scare...

  14. Oral contraceptive use and hormone replacement therapy are associated with microalbuminuria

    NARCIS (Netherlands)

    Monster, TBM; Janssen, WMT; de Jong, PE; de Jong-van den Berg, LTW

    2001-01-01

    Background: Controversy exists regarding the adverse and beneficial effects of oral contraceptive use and hormone replacement therapy. Microalbuminuria is associated with increased risk of renal and cardiovascular disease. Objective: To examine the association between oral contraceptive use or

  15. Rational use of oral contraceptives in the perimenopausal woman.

    Science.gov (United States)

    Connell, E B

    1993-12-01

    Oral contraceptives have undergone extensive revision in their labeling over the past 10 years to remove warnings about cardiovascular and other risks and to highlight their noncontraceptive benefits. While these changes are becoming better known, the potential bone-sparing effects of oral contraceptives in the premenopausal and perimenopausal woman remain under-appreciated. Osteoporosis is a major health care problem worldwide in terms of both its associated morbidity and mortality and its economic impact. Although the benefits of postmenopausal hormone replacement therapy for the prevention and treatment of osteoporosis are generally recognized, little attention has been paid to strategies that might be used to maintain bone mass up to the time of menopause, at which time bone loss accelerates. An additional noncontraceptive benefit of oral contraceptives may be to maintain and build bone mass up to the time of menopause.

  16. Lifetime cancer risk and combined oral contraceptives: the Royal College of General Practitioners' Oral Contraception Study.

    Science.gov (United States)

    Iversen, Lisa; Sivasubramaniam, Selvaraj; Lee, Amanda J; Fielding, Shona; Hannaford, Philip C

    2017-06-01

    Oral contraceptives have been used by hundreds of millions of women around the world. Important questions remain regarding the very long-term cancer risks that are associated with oral contraception. Despite previous research, important questions remain about the safety of these contraceptives: (1) How long do endometrial, ovarian, and colorectal cancer benefits persist? (2) Does combined oral contraceptive use during the reproductive years produce new cancer risks later in life? (3) What is the overall balance of cancer among past users as they enter the later stages of their lives? The purpose of this study was to examine the very long-term cancer risks or benefits associated with the use of combined oral contraceptives, including the estimated overall life-time balance. The 46,022 women who were recruited to the UK Royal College of General Practitioners' Oral Contraception Study in 1968 and 1969 were observed for up to 44 years. Directly standardized rates of specific and any cancer were calculated for "ever" and "never" users of combined oral contraceptives; data were standardized for age, parity, social class, and smoking. Attributable risk and preventive fraction percentages were calculated. Poisson regression that adjusted for the same variables was used to estimate incidence rate ratios between ever and never users and to examine effects by time since last oral contraceptive use. There were 4661 ever users with at least 1 cancer during 884,895 woman-years of observation and 2341 never users with at least 1 cancer during 388,505 woman-years of observation. Ever use of oral contraceptives was associated with reduced colorectal (incidence rate ratio, 0.81; 99% confidence interval, 0.66-0.99), endometrial (incidence rate ratio, 0.66; 99% confidence interval, 0.48-0.89), ovarian (incidence rate ratio, 0.67; 99% confidence interval, 0.50-0.89), and lymphatic and hematopoietic cancer (incidence rate ratio, 0.74; 99% confidence interval, 0.58-0.94). An increased

  17. Hormonal contraception and risk of venous thromboembolism: national follow-up study

    Science.gov (United States)

    Løkkegaard, Ellen; Svendsen, Anne Louise; Agger, Carsten

    2009-01-01

    Objective To assess the risk of venous thrombosis in current users of different types of hormonal contraception, focusing on regimen, oestrogen dose, type of progestogen, and route of administration. Design National cohort study. Setting Denmark, 1995-2005. Participants Danish women aged 15-49 with no history of cardiovascular or malignant disease. Main outcome measures Adjusted rate ratios for all first time deep venous thrombosis, portal thrombosis, thrombosis of caval vein, thrombosis of renal vein, unspecified deep vein thrombosis, and pulmonary embolism during the study period. Results 10.4 million woman years were recorded, 3.3 million woman years in receipt of oral contraceptives. In total, 4213 venous thrombotic events were observed, 2045 in current users of oral contraceptives. The overall absolute risk of venous thrombosis per 10 000 woman years in non-users of oral contraceptives was 3.01 and in current users was 6.29. Compared with non-users of combined oral contraceptives the rate ratio of venous thrombembolism in current users decreased with duration of use (4 years 2.76, 2.53 to 3.02; Pgestodene 1.86 (1.59 to 2.18), with drospirenone 1.64 (1.27 to 2.10), and with cyproterone 1.88 (1.47 to 2.42). Compared with non-users of oral contraceptives, the rate ratio for venous thromboembolism in users of progestogen only oral contraceptives with levonorgestrel or norethisterone was 0.59 (0.33 to 1.03) or with 75 μg desogestrel was 1.12 (0.36 to 3.49), and for hormone releasing intrauterine devices was 0.90 (0.64 to 1.26). Conclusion The risk of venous thrombosis in current users of combined oral contraceptives decreases with duration of use and decreasing oestrogen dose. For the same dose of oestrogen and the same length of use, oral contraceptives with desogestrel, gestodene, or drospirenone were associated with a significantly higher risk of venous thrombosis than oral contraceptives with levonorgestrel. Progestogen only pills and hormone releasing

  18. Hormonal contraception decreases bacterial vaginosis but oral contraception may increase candidiasis: implications for HIV transmission

    NARCIS (Netherlands)

    van de Wijgert, Janneke H. H. M.; Verwijs, Marijn C.; Turner, Abigail Norris; Morrison, Charles S.

    2013-01-01

    A 2012 WHO consultation concluded that combined oral contraception (COC) does not increase HIV acquisition in women, but the evidence for depot medroxyprogesterone acetate (DMPA) is conflicting. We evaluated the effect of COC and DMPA use on the vaginal microbiome because current evidence suggests

  19. Benefits and risks of hormonal contraception for women

    OpenAIRE

    Hagen, Anja; Schönermark, Matthias P.; Gorenoi, Vitali

    2007-01-01

    Scientific background: A large proportion of women of reproductive age in Germany use various methods of pregnancy prevention (contraception), among them various hormone-based methods. Hormonal contraceptives may be divided into combined estrogen-progestogen contraceptives (pills, skin patches, vaginal rings), progestogen-only contraceptives (pills, injections, implants, hormone spirals) and emergency contraceptives. Research questions: The evaluation addressed the question of benefits and ri...

  20. Residual ovarian activity during oral steroid contraception

    NARCIS (Netherlands)

    A.M. van Heusden; B.C.J.M. Fauser (Bart)

    2002-01-01

    textabstractSteroid drugs with contraceptive properties have been available in the clinical setting for over four decades and are still subject to improvement. Estrogens, progestins and anti-progestins have been used alone or in various combinations, regimens and routes of

  1. Benefits and risks of hormonal contraception for women

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2007-08-01

    Full Text Available Scientific background: A large proportion of women of reproductive age in Germany use various methods of pregnancy prevention (contraception, among them various hormone-based methods. Hormonal contraceptives may be divided into combined estrogen-progestogen contraceptives (pills, skin patches, vaginal rings, progestogen-only contraceptives (pills, injections, implants, hormone spirals and emergency contraceptives. Research questions: The evaluation addressed the question of benefits and risks of hormonal contraceptives, their economic effects as well as their ethical-social and legal implications.MethodsA systematic literature search was conducted in April 2006 starting from 2000. The evaluation is primarily based on systematic reviews. Results: In perfect use, all hormonal contraceptives excluding emergency contraceptives proved to be the most effective reversible contraceptive methods (rate of unintended pregnancies 0.05% to 0.3%. However, the typical use of oral contraceptives, injections, skin patches, and vaginal rings, which also considers possible application errors, showed a lower contraceptive efficacy (rate of unintended pregnancies 3% to 8%. It was lower than that of copper spirals. The risk of venous thromboembolism increased three to six times in users of hormonal contraceptives, the risks of stroke and myocardial infarction two to three times. The risk declined after discontinuation of use. The effects were estrogen-dose and progestogen-type dependent. The use of hormonal contraceptives showed a relative risk of ovarian and endometrial carcinomas of approximately 0.5 or 0.7, of breast and cervical cancer of approximately 1.2 or 1.6. The effect remained several years after discontinuation of use. The results concerning hepatocellular carcinoma suggested a carcinogenic effect. In women with acne, an improvement due to use of hormonal contraceptives was proven. Cervical chlamydial infections were more frequent in users of hormonal

  2. Contraception methods, beyond oral contraceptives and tubal ligation, and risk of ovarian cancer.

    Science.gov (United States)

    Ness, Roberta B; Dodge, Rhiannon C; Edwards, Robert P; Baker, Julie A; Moysich, Kirsten B

    2011-03-01

    Few studies have examined methods of contraception, beyond oral contraceptives (OCs) and tubal ligation, in relation to ovarian cancer risk. Nine hundred two cases with incident ovarian/peritoneal/tubal cancer were compared with 1800 population-based control subjects. Women self-reported all methods of contraception by using life calendars. Each of the contraceptive methods examined reduced the risk of ovarian cancer as compared with use of no artificial contraception. Comparing ever versus never use, after adjustment for potentially confounding factors and all other methods of contraception, the methods of contraception that emerged as protective were OCs (adjusted odds ratio [adj OR] 0.75, 95% confidence interval [CI] 0.61-0.93); tubal ligation (adj OR 0.63, 95% CI 0.51-0.77); intrauterine devices (IUDs) (adj OR 0.75, 95% CI 0.59-0.95); and vasectomy (adj OR 0.77, 95% CI 0.61-0.99). Although for OCs and tubal ligation we found that the longer the duration of use, the greater the effect, for IUDs the pattern was reversed: significant protection occurred with short duration and progressively greater risk (albeit nonsignificant) was seen with longer duration of use. In the largest case-control study to date, a range of effective methods of contraception reduced the risk for ovarian cancer. OCs and tubal ligation reduced ovarian cancer risk with lower odds ratios with longer duration of use, whereas IUDs reduced risk overall, having the greatest impact with short duration of use. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. [Place of persistence trouble during oral contraception and subsequent use of emergency contraception].

    Science.gov (United States)

    Jamin, C; Lachowsky, M

    2015-10-01

    In order to improve the understanding of hormonal contraceptive failures, this study evaluates the persistence of oral contraception and the use of emergency contraception (EC) during persistence incidents. We made the hypothesis of the existence of a strong link between the risk of unplanned pregnancies and these two parameters. In this study, we also evaluated women's perception of EC in order to elucidate the reasons of EC insufficient use. One survey was carried out on Internet on a representative sample of women, aged 16-45. In this survey, 3775 French women were interviewed (source-population). We defined a target population of 2415 fertile women who had heterosexual intercourse during the last 12 months, and a population of 760 women at risk of unintended pregnancy who had unprotected sexual intercourse during the last 12 months(risk-population). A little more than 30% of the target population, meaning 20% of the source-population (n=745) stopped their contraceptive method temporarily for an average time of two months. Almost 60% of women had a risk of unwanted pregnancy during this period without contraception, which is 59% of the risk-population. Only 20% of women among the population at risk used EC. The main reasons given for EC insufficient use were the misperception of the risk of pregnancy, the lack of knowledge about EC and its way of use. For the first time, this survey shows that 13% of women (of the source population) decide to stop temporarily their contraceptive method for an average time of two months per year. Fifty-nine percent of unplanned pregnancy situations are due to this poor contraception persistence. Although there is a need to reduce the risk of women being at risk, it seems also highly desirable to overcome the consequences of this poor persistence. Giving information about EC and a systematic prescription during contraception consultations would lead to an increased use of EC. Copyright © 2014 Elsevier Masson SAS. All rights

  4. Changes of hemostatic variables during oral contraceptive use

    NARCIS (Netherlands)

    Tans, Guido; Bouma, Bonno N.; Büller, Harry R.; Rosing, Jan

    2003-01-01

    The use of oral contraceptives (OCs) has been known for many years to affect significantly almost all hemostatic parameters, but the challenge to relate these changes in a meaningful way to OC-induced increased venous thrombotic risk has not been met. New insights indicate that at least part of the

  5. Advance provision of oral contraceptives to family planning clients in ...

    African Journals Online (AJOL)

    Objective: In sub-Saharan Africa, many family planning programmes do not encourage advance provision of oral contraceptives to clients who must wait until menses to initiate pill use. Since some resistance to advance provision of pills is due to provider fears that the practice may be harmful, we conducted a study in Kenya ...

  6. [Use of oral contraceptives and increased risk of cervical cancer

    NARCIS (Netherlands)

    Schmeink, C.E.; Lenselink, C.H.; Bekkers, R.L.M.

    2008-01-01

    A recently published meta-analysis and a large cohort study showed independently that use of oral contraceptives (OC) leads to an increased relative risk (RR) of cervical cancer. This RR increased with the duration of OC use and was 1.90 after 5 years or more (95% CI: 1.69-2.13). The increased RR

  7. No effect of oral contraceptives on the metabolism of levetiracetam

    DEFF Research Database (Denmark)

    Sabers, Anne; Christensen, Jacob

    2011-01-01

    The effect on clearance of levetiracetam (LEV) was estimated in women with epilepsy of childbearing potential using oral contraceptives (OCs). The estimated clearance (plasma concentration/daily dose) was 39 nmol/L/mg (range 14-88 nmol/L/mg) among women who did not use OC (n=30) and 38 nmol/L/mg ...

  8. Effect of Combined Oral contraceptive Steroids on Plasma Lipids ...

    African Journals Online (AJOL)

    Oral contraceptive (OC) usage is associated with increased cardiovascular risk. The present study investigated the effect of combined OC on plasma lipids, lipid peroxidation, and biosynthesis of nitric oxide (NO). Female Sprague – Dawley rats were treated with OC steroids (10mg/kg ethinyloestradiol + 100mg/kg norgestrel) ...

  9. Stress, serotonergic function, and mood in users of oral contraceptives

    NARCIS (Netherlands)

    Tuiten, A; Panhuysen, G; Koppeschaar, H; Fekkes, D; Pijl, H; Frölich, M; Krabbe, P; Everaerd, W

    1995-01-01

    The relationship between stress and changes in insulin levels, plasma ratio of tryptophan to other large neutral amino acids (LNAAs), mood, and food intake was investigated in women taking monophasic oral contraceptives containing progestagens. Subjects experiencing high levels of stress displayed

  10. Laryngeal Aerodynamics Associated with Oral Contraceptive Use: Preliminary Findings

    Science.gov (United States)

    Gorham-Rowan, Mary; Fowler, Linda

    2009-01-01

    The purpose of this study was to examine possible differences in laryngeal aerodynamic measures during connected speech associated with oral contraceptive (OC) use. Eight women taking an OC, and eight others not taking an OC, participated in the study. Three trials of syllable /p[subscript alpha] /repetitions were obtained using a…

  11. Melasma and other skin manifestations or oral contraceptives.

    Science.gov (United States)

    Resnik, S S

    1967-01-01

    Pigmentary anomalies are among the least serious but most frequent skin changes resulting from oral contraceptive use. A pseudo "mask of pregnancy" called chloasma or melasma may be produced. It is a blotchy hyperpigmentation of the face which can be a disfiguring cosmetic and emotional problem. Melasma most often appears 1-4 months after taking the pill. Of 13 such patients closely studied, melasma of pregnancy had previously been present in 10. Only minimal improvement was noted in 7 even up to 4 years after stopping the drug. Histological examination of 10 biopsy specimens showed normal appearing epidermis with pigment in the basal cell layer of the skin. Of 199 patients taking oral contraceptives in one study, 24% had melasma; of 212 patients in a second study, 29% developed this problem. A history of temporary melasma during pregnancy is an important predictor. Reduced exposure to sunlight is recommended. Use of a hydroquinone cream as a bleaching agent results in only slight improvement. Changing the type of pill has had little effect but reducing the amount of progesterone may help. Other skin manifestations with oral contraceptives include: 1) acne vulgaris, which may be improved or aggravated; 2) alopecia or diffuse thinning of the entire scalp hair, which may be reversible; 3) treatment of aphthous stomatitis, which is controlled by estrogen therapy; and 4) erythema nodosum, which subsides when oral contraceptives are stopped. Urticarial reactions represent an allergic response to special drugs.

  12. Acute opthalmologic complications during the use of oral contraceptives.

    Science.gov (United States)

    Friedman, S; Golan, A; Shoenfeld, A; Goldman, J

    1974-12-01

    This is a report of 3 cases of ocular damage which occurred during t he use of oral contraceptives. A 21-year-old woman experienced sudden loss of vision in her right eye after 4 months of combination type oral contraceptive therapy. Ocular tension was normal; the fundus showed occlusion of the central retinal artery. The other eye was normal. Anticoagulant medications were given iv and orally. The next day vision was improved and some restoration of circulation to the retina was noted. After 18 months vision and visual fields were normal in both eyes. In another case a 42-year-old patient experienced sudden loss of vision in her left eye. She had been taking contraceptive pills for 14 months. The right eye was normal. The fundus of the left eye showed evidence of acute occlusion of the central artery of the retina with only the temporal side of the field of vision retained. The oral contraceptive was discontinued and anticoagulation medication given. No improvement occurred. After 6 months total occlusion of the lower temporal artery remained. The third case, 1 21-year-old woman, complained of progressive blurring vision in the right eye for 2 weeks. She had taken oral contraceptives following a normal delivery 7 months previously but had stopped medication 1 month before admission. The affected eye showed a central scotoma and a markedly restricted visual field. Anticoaguland drugs and vitamin-B were given. After 7 days vision was markedly improved and the central scotoma had decreased in size. After another week vision and visual fields were normal. In this case an optic neuritis due to occlusion of a branch of the retinal artery was thought to have been present. Immediate therapy for such cases is important. Since estrogens have been implicated in the etiology of thromboembolic disease, smaller doses of this steroid (50 instead of 80 mcg) are recommended.

  13. Oral contraceptives induce lamotrigine metabolism: evidence from a double-blind, placebo-controlled trial

    DEFF Research Database (Denmark)

    Christensen, Jakob; Petrenaite, Vaiva; Attermann, Jørn

    2007-01-01

    and taking combination-type oral contraceptives, were randomized to treatment with placebo or a standard combination-type contraceptive pill. The dose-corrected trough plasma concentration of LTG and the ratio of N-2-glucuronide/unchanged LTG on urine after 21 days of concomitant placebo treatment...... was analyzed versus those after 21 days of concomitant treatment with the oral contraceptive pill. RESULTS: The mean dose-corrected LTG concentration after placebo treatment was 84%[95% confidence interval (CI), 45-134%] higher than after oral contraceptives, signifying an almost doubling of the concentration...... after cessation of oral contraceptives. Most of this increase took place within the first week after oral contraceptives were stopped. The N-2-glucuronide/LTG ratio in the urine was decreased by 31% (95% CI, -20-61%) when shifting from oral contraceptives to placebo. CONCLUSIONS: Cessation of oral...

  14. Clinical utility of folate-containing oral contraceptives

    Directory of Open Access Journals (Sweden)

    Lassi ZS

    2012-04-01

    Full Text Available Zohra S Lassi, Zulfiqar A BhuttaDivision of Women and Child Health, The Aga Khan University, Karachi, PakistanAbstract: Folate is a generic term for a water-soluble B-complex vitamin which plays an important role in protein synthesis and metabolism and other processes related to cell multiplication and tissue growth. Pregnant and lactating women are at increased risk of folic acid deficiency because generally their dietary folate is insufficient to meet their physiological requirements and the metabolic demands of the growing fetus. The evidence pertaining to the reduction of the risk of neural tube defects (NTDs due to folate is so compelling that supplementation with 400 µg of folic acid to all women trying to conceive until 12 weeks of pregnancy has been recommended by every relevant authority. A recent Cochrane review has also found protective effects of folate supplementation in occurrence and reoccurrence of NTDs. Despite food fortification and targeted public health campaigns promoting folic acid supplementation, 4,300,000 new cases occur each year worldwide resulting in an estimated 41,000 deaths and 2.3 million disability-adjusted life years (DALYS. This article will review the burden and risk factors of NTDS, and the role of folate in preventing NTDs. It will also describe different modes of supplementing folate and the newer evidence of the effectiveness of adding folate in oral contraceptives for raising serum and red blood cell folate levels.Keywords: folate, folate-containing oral contraceptives, oral contraceptives, contraceptives

  15. Effect of low-dose oral contraceptives on Lipid profile levels in ...

    African Journals Online (AJOL)

    Background: Oral contraceptives provide highly reliable contraceptive protection even though imperfect use is considered, and are widely used worldwide. Objective: This study aimed to assess the effect of low dose combined oral contraceptive pills use on lipid profile levels in Sudanese women, and to find its correlation ...

  16. Comparative Effects of Injectable and Oral Hormonal Contraceptives on Lipid Profile

    OpenAIRE

    Adebayor Adegoke; Pascal C. Eneh; Roseanne Okafor; Benjamin N. Okolonkwo; Braide, Solomon A.; Chukwubike U.Okeke; Holy Brown; Ngozika B. Okwandu

    2012-01-01

    Background and AimsThe continual use of hormonal contraceptives among women within reproductive age has been on the increase. The effects of these contraceptives on lipid metabolism vary depending on the type of hormonal contraceptive. This study was carried out among Nigerian women, to compare theeffects of injectable hormonal contraceptives to that of combined oral contraceptives on lipid profile (triglyceride, total cholesterol, high density lipoprotein-cholesterol and low density lipo-pro...

  17. Erythema multiforme limited to the oral mucosa in a teenager on oral contraceptive therapy.

    Science.gov (United States)

    Jawetz, Robert E; Elkin, Avigayil; Michael, Lisa; Jawetz, Sheryl A; Shin, Helen T

    2007-10-01

    Erythema multiforme has been linked to numerous drugs and infectious agents. A link to oral contraceptive use has been reported in the past in the adult population but thus far has not been reported in children or adolescents. We report the case of an 18-yr-old female who developed oral erosions consistent with erythema multiforme two and a half weeks after initiating therapy with an oral contraceptive agent. A thorough examination for other inciting factors was negative, and the lesions slowly resolved over the course of 3 weeks. This case illustrates that erythema multiforme should be considered in the differential diagnosis of adolescents with oral erosions who have been prescribed oral contraceptives.

  18. Hormonal versus non-hormonal contraceptives in women with diabetes mellitus type 1 and 2.

    Science.gov (United States)

    Visser, Jantien; Snel, Marieke; Van Vliet, Huib A A M

    2013-03-28

    studied contraceptives, participant characteristics and methodological quality, we could not combine the data in a meta-analysis. The trials were therefore examined on an individual basis and narrative summaries were provided. Four randomised controlled trials were included. No unintended pregnancies were reported during the study periods. Only one trial was of good methodological quality. It compared the influence of a levonorgestrel-releasing intrauterine device (IUD) versus a copper IUD on carbohydrate metabolism in women with type 1 diabetes mellitus. No significant difference was found between the two groups. The other three trials were of limited methodological quality. Two compared progestogen-only pills with different estrogen and progestogen combinations, and one also included the levonorgestrel-releasing IUD and copper IUD. The trials reported that blood glucose levels remained stable during treatment with most regimens. Only high-dose combined oral contraceptives and 30 µg ethinylestradiol + 75 µg gestodene were identified as slightly impairing glucose homeostasis. The three studies found conflicting results regarding lipid metabolism. Some combined oral contraceptives appeared to have a minor adverse effect while others appeared to slightly improve lipid metabolism. The copper IUD and progestogen-only oral contraceptives also slightly improved lipid metabolism and no influence was seen while using the levonorgestel-releasing IUD. Only one study reported on micro- and macrovascular complications. It observed no signs or symptoms of thromboembolic incidents or visual disturbances, however study duration was short. Only minor adverse effects were reported in two studies. The four included randomised controlled trials in this systematic review provided insufficient evidence to assess whether progestogen-only and combined contraceptives differ from non-hormonal contraceptives in diabetes control, lipid metabolism and complications. Three of the four studies were

  19. Over-the-Counter Access to Oral Contraceptives for Adolescents.

    Science.gov (United States)

    Upadhya, Krishna K; Santelli, John S; Raine-Bennett, Tina R; Kottke, Melissa J; Grossman, Daniel

    2017-06-01

    Oral contraceptives (OCs) are used by millions of women in the U.S. The requirement to obtain OCs by prescription from a clinician may serve as a barrier to contraceptive initiation and continuation for women, in particular adolescents. Over-the-counter (OTC) availability would reduce this barrier and could further reduce unintended pregnancy rates. This review explores the scientific issues and regulatory processes involved in switching OCs to OTC status for minor adolescents. We review: (1) the regulatory criteria for switching a drug to OTC status; (2) risk of pregnancy and safety during use of OCs including combined oral contraceptives and progestin-only pills for adolescents; (3) the ability of adolescents to use OCs consistently and correctly; (4) OTC access to OCs and potential effect on sexual risk behaviors; and (5) the potential for reduced opportunities for clinicians to counsel and provide recommended reproductive health care to adolescents. We find strong scientific rationale for including adolescents in any regulatory change to switch OCs to OTC status. OCs are safe and highly effective among adolescents; contraindications are rarer among adolescents compared to adult women. Ready access to OCs, condoms, and emergency contraception increases their use without increasing sexual risk behaviors. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  20. Anatomical and Functional Changes Induced by Oral Contraception

    Science.gov (United States)

    Lefebvre, Yves

    1970-01-01

    The hormonal contraceptives seem to have no direct effect on cervical carcinoma or dysplasia, but they are responsible for the appearance of glandular adenomatous hyperplasia of the endocervix. The long-term use of progestins is responsible for the inactive appearance of the ovaries, with thickening of the tunica albuginea, rare follicle growth, occasional fibrosis of the stroma and a decreased DNA formation. After stopping oral and injectable hormonal contraceptives the first cycle is usually long and cases of amenorrhea have been reported. The causes of secondary amenorrhea probably lie in the hypothalamus and/or the ovaries. The time lapse between cessation of oral contraception and conception is between 5.8 and 6.5 months. No increase in abortion has been noted, but abortuses and ova have an increased polyploid tendency and incidence of chromosome breaks. Further investigations of larger series are necessary to provide definite proof. Meanwhile it would seem advisable that after cessation of hormonal contraception there should be a time lapse of six to eight months before a patient becomes pregnant. ImagesFIG. 1FIG. 2 PMID:4908561

  1. Oral contraceptives: exploring the benefits, dispelling the myths.

    Science.gov (United States)

    Pereira, A; Jones, K P

    1996-01-01

    Oral contraceptives (OC) were first introduced in the US in the early 1960s as an efficient, convenient, and reversible method of contraception. The pill has since undergone many changes. Most OCs prescribed today contain 35 mcg of estrogen and 0.5-1 mg of progestin, approximately one-third the estrogen and one-tenth the progestin in the original OCs. Considerable scientific research, economic analysis, and social marketing have yielded invaluable data on how OCs, the most popular form of birth control in the US, have affected the lives of women, men, and society overall. Researchers have also investigated the health risks and benefits of OC use. Both truths and myths exist about the effects of OC use. A 1993 Gallup poll conducted for the American College of Obstetricians and Gynecologists found that 65% of patients believe oral pill use to be at least as dangerous as pregnancy. 58%, however, were unable to name one non-contraceptive benefit of the pill. A 1995 Harris poll conducted for the American Medical Association found that although 96% of reproductive-age women considered themselves to be knowledgeable or very knowledgeable about contraception, 56% incorrectly believed a woman periodically needs to give her body a rest from OC use. The authors discuss the benefits and risks of using OC.

  2. Androgens and sexual behaviour in women using oral contraceptives.

    Science.gov (United States)

    Bancroft, J; Davidson, D W; Warner, P; Tyrer, G

    1980-04-01

    Twenty women using oral contraceptives and complaining of impaired sexual function were compared with twenty women without sexual problems, matched for age and oral contraceptive. Whilst the sexual behaviour differed in the two groups, the plasma testosterone, androstenedione, oestradiol and SHBG concentrations were very similar. The total androgen levels were low in both groups. Plasma testosterone and oestradiol concentrations were correlated with measures of sexual interest in the no-problem group, but not in the problem group. Administration of exogenous androstenedione to women in the problem group, using a double blind cross-over comparison with a placebo, failed to improve their sexual function except in one case. The majority of women showed a rise in androgen and oestradiol between day 24 of one pill cycle and day 4 of the next. The possible behavioural indications of this pattern are discussed.

  3. Mineralocorticoid receptor haplotype, oral contraceptives and emotional information processing.

    Science.gov (United States)

    Hamstra, D A; de Kloet, E R; van Hemert, A M; de Rijk, R H; Van der Does, A J W

    2015-02-12

    Oral contraceptives (OCs) affect mood in some women and may have more subtle effects on emotional information processing in many more users. Female carriers of mineralocorticoid receptor (MR) haplotype 2 have been shown to be more optimistic and less vulnerable to depression. To investigate the effects of oral contraceptives on emotional information processing and a possible moderating effect of MR haplotype. Cross-sectional study in 85 healthy premenopausal women of West-European descent. We found significant main effects of oral contraceptives on facial expression recognition, emotional memory and decision-making. Furthermore, carriers of MR haplotype 1 or 3 were sensitive to the impact of OCs on the recognition of sad and fearful faces and on emotional memory, whereas MR haplotype 2 carriers were not. Different compounds of OCs were included. No hormonal measures were taken. Most naturally cycling participants were assessed in the luteal phase of their menstrual cycle. Carriers of MR haplotype 2 may be less sensitive to depressogenic side-effects of OCs. Copyright © 2015 IBRO. Published by Elsevier Ltd. All rights reserved.

  4. Mothers' attitude to the use of a combined oral contraceptive pill by their daughters for menstrual disorders or contraception.

    Science.gov (United States)

    Yiu, K W; Chan, S Sc; Chung, T Kh

    2017-04-01

    Mothers' attitude may affect use of combined oral contraceptive pills by their daughters. We explored Chinese mothers' knowledge of and attitudes towards the use of combined oral contraceptive pills by their daughters for menstrual disorders or contraception, and evaluate the factors affecting their attitude. This survey was conducted from October 2012 to March 2013, and recruited Chinese women who attended a gynaecology clinic or accompanied their daughter to a gynaecology clinic, and who had one or more daughters aged 10 to 18 years. They completed a 41-item questionnaire to assess their knowledge of and attitude towards use of the combined oral contraceptive pills by their daughters. The demographic data of the mothers and their personal experience in using the pills were also collected. A total of 300 women with a mean age of 45.2 (standard deviation, 5.0) years completed the questionnaire. Only 58.3% of women reported that they had knowledge about the combined oral contraceptive pills; among them, a majority (63.3%) reported that their source of knowledge came from medical professionals. Of a total possible score of 22, their mean knowledge score for risk, side-effects, benefits, and contra-indications to use of combined oral contraceptive pills was only 5.0 (standard deviation, 4.7). If the medical recommendation to use an oral contraceptive was to manage their daughter's dysmenorrhoea, menorrhagia, acne, or contraception needs, 32.0%, 39.3%, 21.0% and 29.7%, respectively would accept this advice. Women who were an ever-user of combined oral contraceptive pills or who were more knowledgeable about combined oral contraceptives had a higher acceptance rate. Chinese women had a low acceptance level of using combined oral contraceptive pills as a legitimate treatment for their daughters. This was associated with lack of knowledge or a high degree of uncertainty about their risks and benefits. It is important that health caregivers provide up-to-date information

  5. Evaluating the practice of Iranian community pharmacists regarding oral contraceptive pills using simulated patients

    National Research Council Canada - National Science Library

    Nazanin Foroutan; Fatemeh Dabaghzadeh

    2016-01-01

    Background: As oral contraceptive pills are available over the counter in pharmacies, pharmacists are professionally responsible for checking and informing patients about every aspect of taking these drugs...

  6. Effects on hemostatic variables of desogestrel- and gestodene-containing oral contraceptives in comparison with levonorgestrel-containing oral contraceptives: a review.

    Science.gov (United States)

    Winkler, U H

    1998-09-01

    In some studies third-generation oral contraceptives have been reported to be associated with a higher risk of venous thromboembolism than are second-generation oral contraceptives, whereas recent, more refined studies have not confirmed this. The reasons for the alleged differences are under discussion, and differential effects on hemostasis have been proposed. Eighteen studies comparing second- and third-generation oral contraceptives with respect to their effects on hemostasis were analyzed. Significant changes from baseline were reported for many variables with both second- and third-generation oral contraceptives without significant between-group differences. Also, in a combined analysis of nonsignificant changes, no consistent pattern of change emerged for any marker, with the exception of higher factor VII levels associated with third-generation oral contraceptives. However, factor VII is not related to venous thromboembolism risk. In addition, 1 cross-sectional study with an unvalidated assay reported a higher ratio of activated protein C sensitivity with third-generation oral contraceptives. Only 2 components of the hemostatic system (factor VII and activated protein C sensitivity ratio) emerged as potentially differentially affected by second- and third-generation oral contraceptives; the association with venous thromboembolism risk is questionable in the former case and unknown in the latter.

  7. Evaluation of a community pharmacy delivered oral contraception service.

    Science.gov (United States)

    Parsons, Judith; Adams, Christine; Aziz, Najia; Holmes, Jo; Jawad, Ruhi; Whittlesea, Cate

    2013-04-01

    In the UK half of all pregnancies are unplanned and half of teenage pregnancies terminated. Southwark and Lambeth have the highest teenage conception rates in London. In 2009, many teenage pregnancies in Southwark led to terminations. A contraception service was established where qualified pharmacists supplied oral contraception (OC) using a patient group direction (PGD). This service evaluation aimed to assess this service delivered in five community pharmacies. Monthly data were submitted by each pharmacy to the Primary Care Trust on consultations, pills supplied, initial or subsequent supply and client referral. For specified periods consultation time was collected and a clinical notes audit undertaken. Client satisfaction was determined using a structured questionnaire returned to the pharmacy. Mystery shoppers were employed to assess the service. A total of 741 consultations were undertaken by seven pharmacists at five community pharmacies (October 2009-June 2011) with many (45.5%) occurring following emergency contraception supply. The mean consultation time was 19 minutes . Combined OC was most commonly supplied with nearly half (46.1%) of initial supplies to first-time pill users. Most consultations (92.2%) were with women aged under 30 years, with 22.5% aged under 20. Most consultations were with black or black British clients. Of the 99 women who completed the satisfaction questionnaires, most clients were very satisfied or satisfied with the service and felt comfortable talking to the pharmacist about contraception. Trained pharmacists were clinically competent and provided OC in community pharmacy according to a PGD. This service was accessed by the target population; young women using emergency hormonal contraception who had not previously used OC. Clients were largely very satisfied with the service.

  8. Oral contraception and menstrual bleeding during treatment of venous thromboembolism

    DEFF Research Database (Denmark)

    Klok, F A; Schreiber, K; Stach, K

    2017-01-01

    INTRODUCTION: The optimal management of oral contraception and menstrual bleeding during treatment of venous thromboembolism (VTE) is largely unknown. We aimed to elicit expert opinion and compare that to current practice as assessed by a world-wide international web-based survey among physicians....... METHODS: 10 international thrombosis experts and 10 abnormal uterine bleeding experts independently completed a questionnaire containing three hypothetical patient cases each with four different scenarios, and additional queries covering different severities of VTE, patient circumstances, hormonal...... contraceptives and both thrombotic and bleeding complications. The consensus percentage was set a priori at ≥70%. The same questionnaire with randomized case scenarios was presented to international physicians via newsletters of the ISTH and national scientific communities. Differences between the expert groups...

  9. Contraception orale pour les kystes ovariens fonctionnels?

    OpenAIRE

    Belche, Jean

    2010-01-01

    Cette synthèse méthodique des RCTs évaluant l’intérêt d’un traitement contraceptif oral pour traiter un kyste fonctionnel de l’ovaire chez une femme en âge de procréer montre la faible qualité méthodologique des trop rares études originales et l’absence de preuve de l’intérêt d’un tel traitement pour une affection à résolution très fréquemment spontanée. Peer reviewed

  10. Risk of cancer with combined oral contraceptive use among Iranian women.

    Science.gov (United States)

    Vaisy, Afasaneh; Lotfinejad, Shirin; Zhian, Faegh

    2014-01-01

    Oral contraceptive use is the most common type of contraception. More than 300 million women worldwide take oral contraceptives every day. However, there is a concern about the relationship with the incidence of cancer. This analytical retrospective study aimed to investigate the relationship between the incidence of cervical and breast cancers and oral contraceptive use in 128 Iranian patients with cervical cancer, 235 with breast cancer and equal numbers of controls. Data were collected through interviews with an organized set of questions. Details were also extracted from patient files. Data were analyzed using Student's t-test, chi-square and Fisher's exact tests, and Pearson's correlation analysis. The result revealed correlations between both cervical and breast cancers and history of contraceptive pills use. While cervical cancer significantly correlated with duration of use of pills, breast cancer had significant correlations with the type of oral contraceptive and age at first use. No significant relationships were found between the two types of cancer and age at discontinuation of oral contraceptives, patterns of use, and intervals from the last use. The use of oral contraceptives may triple the incidence of cervical cancer and doubles the incidence of breast cancer. Therefore, performing Pap smears every six months and breast cancer screening are warranted for long-term oral contraceptive users.

  11. Injectable and oral contraceptive use and cancers of the breast, cervix, ovary, and endometrium in black South African women: case-control study.

    OpenAIRE

    Margaret Urban; Emily Banks; Sam Egger; Karen Canfell; Dianne O'Connell; Valerie Beral; Freddy Sitas

    2012-01-01

    Editors' Summary Background Hormonal contraceptives are among the most commonly used medications. Globally, more than 210 million women currently use either hormonal contraceptive pills or injectable contraceptives. Contraceptive pills usually contain manmade versions of the female sex hormones estrogen and progesterone (the combined oral contraceptive, or “pill”); most injectable hormonal contraceptives contain only manmade progesterone preparations. Hormonal contraceptives, which prevent pr...

  12. Use of oral contraceptives in the management of acne

    Directory of Open Access Journals (Sweden)

    Melis GB

    2011-11-01

    Full Text Available Gian Benedetto Melis, Marisa Orrù, Maria Francesca Marotto, Monica Pilloni, Mariagrazia Perseu, Stefano Lello, Anna Maria PaolettiClinica Ginecologica Ostetrica e di Fisiopatologia della Riproduzione Umana, Universita' di Cagliari, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, ItalyAbstract: The pathogenesis of acne (the most common disorder involving the sebaceous gland originates from increased sebum production by the sebaceous gland followed by colonization of the hair follicle with Propionibacterium acnes, hyperkeratinization of the upper follicle, and release of inflammatory mediators into the skin. Androgens are the main stimulators of sebum production. Androgens originate from the gonads and adrenal glands, but can also be locally produced within the sebaceous gland from dehydroepiandrosterone sulfate. In the presence of high androgen levels, which can be either a normal pattern of adolescence or a consequence of gonadal or adrenal disease, overproduction of sebum triggers the pathogenesis of acne which, mainly in adolescent women, has deleterious psychological consequences. Estrogens exert the opposite action on sebum production, probably due to the reduction of androgen availability, a direct consequence of estrogen-related increased production of hepatic sex hormone-binding globulin (SHBG. The inhibition of the hypothalamus-pituitary axis induced by oral contraceptives is followed by reduced androgen production. Oral contraceptives containing ethinyl estradiol, which has strong estrogenic activity, amplify the hypoandrogenic effect via estrogen-related stimulation of SHBG. The hypoandrogenic effect of oral contraceptives is modulated by the progestin compound. Progestins derived from 19-nortestosterone bind androgenic receptors, whereas others exert antiandrogenic properties by antagonizing the binding of androgens to their receptors, reduce 5α-reductase, and do not bind SHBG. Through this last effect, SHBG is freely

  13. Inflammatory Bowel Disease, the Oral Contraceptive Pill and Pregnancy

    Directory of Open Access Journals (Sweden)

    Robert N Allan

    1994-01-01

    Full Text Available This paper summarizes our current knowledge of the role of the oral contraceptive pill in the pathogenesis of inflammatory bowel disease (IBO, followed by a review of fertility in women and men. IBD and pregnancy, including the impact on the fetus and the mother with ulcerative colitis or Crohn’s disease, is considered. The safety of drug treatment during pregnancy, the outcome of surgical treatment during pregnancy and the problems that may be encountered during pregnancy in patients with an ileostomy or ileo-anal pouch are discussed, followed by a review of the short and long term prognosis of ulcerative colitis and Crohn’s disease partition.

  14. Effect of low dose oral contraceptives on exercise performance.

    OpenAIRE

    Bryner, R W; Toffle, R C; Ullrich, I H; Yeater, R A

    1996-01-01

    OBJECTIVE--to examine the effect of cycle phase or a low dose oral contraceptive on exercise performance in young women. METHODS--As controls, 15 men were tested twice by a maximal treadmill test (Vo2 max) and by an endurance run 14 d apart to determine performance variability from causes other than hormonal fluctuations. Ten women ages 18-30 were then tested for Vo2 max and endurance in the same way in both the follicular and the luteal phase (random order, ovulation assessed by sonography)....

  15. Factors associated with the contraindicated use of oral contraceptives in Brazil

    OpenAIRE

    Corrêa,Daniele Aparecida Silva; Felisbino-Mendes, Mariana Santos; Mendes,Mayara Santos; Malta, Deborah Carvalho; Velasquez-Melendez, Gustavo

    2017-01-01

    ABSTRACT OBJECTIVE To estimate the prevalence of the contraindicated use of oral contraceptives and the associated factors in Brazilian women. METHODS 20,454 women who answered the VIGITEL survey in 2008 also participated in this study, of which 3,985 reported using oral contraceptives. We defined the following conditions for the contraindicated use of contraceptives: hypertension; cardiovascular diseases such as heart attack, stroke/cerebrovascular accident; diabetes mellitus; being smok...

  16. Perceived side effects of oral contraceptives among adolescent girls.

    Science.gov (United States)

    Herold, E S; Goodwin, M S

    1980-11-22

    Knowledge and attitudes of adolescent females regarding the side effects of oral contraceptives were investigated. The data source was a large study of sexual and contraceptive attitudes and experience. The questionnaire responses of 486 single females attending 10 birth control and pregnancy counseling centers in Ontario, Canada were examined. The age range of the subjects was from 13-20; 71% were attending school and 69% were living at home. They were attending the centers in order to obtain contraceptives (55%), to renew OC prescriptions (20%), or to receive pregnancy counseling (25%). 29% of the subjects had used OCs before coming to the clinic, but 91% planned to use OC after their clinic visit. 8% were planning to use an IUD; 1% were planning to use a diaphragm; and less than 1% were planning to have their boyfriend use condoms. 85% of the subjects indicated that they had heard abut side effcts of OCs with weight gain as the best known side effect. Other side effects familiar to many included nausea, circulatory disorders, headaches, emotional changes, menstrual problems and cancer. About 1/2 of the subjects had learned about these side effects from the mass media or female friends, 25% from a school sex education class, 15% from their mothers, and 3% from a physician. Despite knowledge regarding side effects, most of the subjects had positive attitudes toward OCs with 59% believing that the advnatages outweighed any disadvantages.

  17. Effectiveness of oral contraceptive pills in a large U.S. cohort comparing progestogen and regimen.

    Science.gov (United States)

    Dinger, Jürgen; Minh, Thai Do; Buttmann, Nina; Bardenheuer, Kristina

    2011-01-01

    To estimate real-life effectiveness of oral contraceptive pills by progestogen, length of pill-free interval, and body mass index while focusing on the effect of progestogens with a long half-life and on 24-day oral contraceptive pills regimens. Outcome data from 52,218 U.S. participants in the International Active Surveillance of Women Taking Oral Contraceptives—a large, prospective, controlled, noninterventional, long-term cohort study with active surveillance of the study participants—were used to analyze contraceptive failure in association with oral contraceptive pills use. Low loss to follow-up is ensured by a comprehensive follow-up procedure. Contraceptive failure rates are described by Pearl Index and life-table analysis. Inferential statistics for contraceptive failure are based on Cox regression models. Analyses are based on 1,634 unintended pregnancies during 73,269 woman-years of oral contraceptive pills exposure. Life-table estimates of contraceptive failure for a 24-day regimen of drospirenone and ethinyl estradiol and 21-day regimens of other progestogens were 2.1% and 3.5% after the first study year, and 4.7% and 6.7% after the third year. The adjusted hazard ratio was 0.7 (95% confidence interval 0.6–0.8). Direct comparisons of the 24-day and 21-day regimens of drospirenone and norethisterone, respectively, showed also lower contraceptive failure rates for 24-day regimens. Contraceptive failure rates adjusted for age, parity and educational level showed a slight increase with higher body mass index. The 24-day oral contraceptive regimens containing a progestogen with a long half-life show higher contraceptive effectiveness under routine medical conditions compared with conventional 21-day regimens. Obesity seems to be associated with a slight reduction of contraceptive effectiveness. ClinicalTrials.gov, www.clinicaltrials.gov, NCT00335257. II

  18. Change to Either a Nonandrogenic or Androgenic Progestin-Containing Oral Contraceptive Preparation is Associated with Improved Sexual Function in Women with Oral Contraceptive-Associated Sexual Dysfunction

    DEFF Research Database (Denmark)

    Davis, Susan R; Bitzer, Johannes; Giraldi, Annamaria

    2013-01-01

    It is a commonly held belief that combined oral contraceptive (COC) pills containing an androgenic progestin may be less likely to impair sexual function than COCs containing an anti-androgenic progestin.......It is a commonly held belief that combined oral contraceptive (COC) pills containing an androgenic progestin may be less likely to impair sexual function than COCs containing an anti-androgenic progestin....

  19. Oral contraceptives worsen endotoxin-induced liver injury in rats.

    Science.gov (United States)

    Konno, Akira; Enomoto, Nobuyuki; Takei, Yoshiyuki; Hirose, Miyoko; Ikejima, Kenichi; Sato, Nobuhiro

    2002-08-01

    Oral contraceptives are widely used; however, these drugs occasionally cause liver injury. Recently, it was reported that estriol worsens alcoholic liver injury by the mechanism involving activation of Kupffer cells as a result of gut-derived endotoxin. However, the relationship between oral contraceptives and endotoxin-induced liver injury has not been elucidated. Here we show that oral contraceptives sensitize Kupffer cells via a mechanism dependent on increased gut permeability to endotoxin. Female Wistar rats (200-250 g) were given intraperitoneally a combination of estradiol (35 ng/kg of 17 alpha-Ethynylestradiol) and progesterone (2 microg/kg of Norethindrone), each dose being similar to that contained in oral contraceptives (EP treatment). After 24 hr, a sublethal dose of lipopolysaccharide (LPS; 5 mg/kg) was injected via the tail vein. In some experiments, antibiotics (150 mg/kg/day of polymyxin B and 450 mg/kg/day of neomycin) were administered orally for 4 days before EP treatment. Gut permeability was measured in isolated segments of ileum by translocation of horseradish peroxidase. Kupffer cells were isolated and cultured in RPMI 1640 + 10% fetal bovine serum for 24 hr. After addition of LPS (100 ng/ml) to the culture medium, intracellular calcium concentration ([Ca2+](i) ) was measured with fura-2. Liver histology in rats given EP treatment intraperitoneally followed by an injection of LPS (5 mg/kg) 24 hr later revealed pronounced liver damage with massive necrosis. Whereas mean values of alanine aminotransferase (ALT) in the control, nontreated rats were 30 +/- 6 IU/liter, ALT increased to 75 +/- 21 IU/liter 24 hr after LPS injection. This increase was aggravated 6-fold (483 +/- 118 IU/liter; p< 0.05) by EP treatment. The EP treatment-induced increase in ALT was completely blocked by antibiotics (82 +/- 26 IU/liter; p< 0.05). Gut permeability was increased approximately 10-fold with EP treatment. This increase in gut permeability was not altered by

  20. Evidence for Stress-like Alterations in the HPA-Axis in Women Taking Oral Contraceptives

    DEFF Research Database (Denmark)

    Hertel, Johannes; König, Johanna; Homuth, Georg

    2017-01-01

    Using oral contraceptives has been implicated in the aetiology of stress-related disorders like depression. Here, we followed the hypothesis that oral contraceptives deregulate the HPA-axis by elevating circulating cortisol levels. We report for a sample of 233 pre-menopausal women increased...... circulating cortisol levels in those using oral contraceptives. For women taking oral contraceptives, we observed alterations in circulating phospholipid levels and elevated triglycerides and found evidence for increased glucocorticoid signalling as the transcript levels of the glucocorticoid-regulated genes...... DDIT4 and FKBP5 were increased in whole blood. The effects were statistically mediated by cortisol. The associations of oral contraceptives with higher FKBP5 mRNA and altered phospholipid levels were modified by rs1360780, a genetic variance implicated in psychiatric diseases. Accordingly...

  1. Effect of Oral and Vaginal Hormonal Contraceptives on Inflammatory Blood Biomarkers

    Directory of Open Access Journals (Sweden)

    Afshin A. Divani

    2015-01-01

    Full Text Available The use of combined hormonal contraceptives has been reported to increase the level of C-reactive protein (CRP. We assessed the effect of hormonal contraceptive use on inflammatory cytokines including CRP, monocyte chemotactic protein-1, soluble tumor necrosis factor (sTNF, interleukin-6 (IL-6, and soluble CD40 ligand. We used 79 female subjects (19 to 30 years old who were combined oral contraceptives users (n=29, combined vaginal contraceptive users (n=20, and nonusers (n=30 with CRP values of ≤1 (n=46 or ≥3 (n=33. Information on medical history, physical activities, and dietary and sleeping habits were collected. Both oral and vaginal contraceptive users had higher levels of CRP (P<0.0001, compared to nonusers. Only oral contraceptive users exhibited elevated sCD40L (P<0.01. When comparing the groups with CRP ≤ 1 and CRP ≥ 3, levels of IL-6 and sTNF-RI were positively correlated with CRP among oral contraceptive users. We did not observe the same elevation for other inflammatory biomarkers for the CRP ≥ 3 group among vaginal contraceptive users. The clear cause of elevation in CRP level due to the use of different hormonal contraceptive formulations and methods is not well understood. Longitudinal studies with larger sample size are required to better assess the true cause of CRP elevation among hormonal contraceptive users.

  2. Pharmacists' knowledge and interest in developing counseling skills relating to oral contraceptives.

    Science.gov (United States)

    Amin, Mohamed E K

    2016-04-01

    Possessing correct therapeutic information on oral contraceptives is an important prerequisite for the provision of sound advice to women who are using these products. This study examines Egyptian pharmacists' knowledge of pharmacotherapeutic aspects of oral contraceptives as well as interest in developing skills in providing counseling on oral contraceptive pills. Community pharmacies throughout Alexandria, Egypt. A cross-sectional survey was self-administered by a random sample of community pharmacists in Alexandria, Egypt. Five multiple choice questions likely to arise when counseling women on oral contraceptives were constructed. Questions covered compatibility with breastfeeding, precautions, health risks and managing missed pills of oral contraceptives. Using ordered logistic regression, a model was estimated to predict pharmacists' interest in developing skills in providing counseling on oral contraceptives. Pharmacists' aggregate scores for knowledge questions and pharmacists' interest in developing skills in providing counseling on oral contraceptive pills. Of the 181 approached pharmacists, 92 % participated. Twenty one pharmacists (13 %) did not know the correct answer to any question, 122 (73 %) answered one-two correctly, 23 (14 %) answered three-four correctly. No pharmacist answered all five questions correctly. For pharmacists' interest in developing skills in providing counseling on oral contraceptives, the percentage values for answers were: not interested at all (10.2 %), slightly interested (27.0 %), somewhat interested (23.4 %), interested (30.0 %) and extremely interested (9.6 %). Pharmacists' interest in developing skills in providing counseling on oral contraceptives was significantly associated with the number of women who requested advice from the pharmacists on oral contraceptives (OR 1.54, CI 1.24-1.91). In terms of the learning method of preference, percentage values for answers were: attending a workshop (4 %), online course (18

  3. Women's knowledge of taking oral contraceptive pills correctly and of emergency contraception: effect of providing information leaflets in general practice.

    Science.gov (United States)

    Smith, L F; Whitfield, M J

    1995-01-01

    BACKGROUND. About one third of all pregnancies are unplanned and 20% of all pregnancies end in abortion. More than 170,000 legal abortions are performed in the United Kingdom annually. Nearly all general practitioners provide contraceptive advice; the most commonly used form of reversible contraception is the oral contraceptive pill. AIM. The aim of this study was to determine factors associated with women's knowledge of taking the contraceptive pill correctly and of emergency contraception, and to investigate if their knowledge could be improved in general practice by providing women with Family Planning Association information leaflets. METHOD. An uncontrolled intervention study was performed in one rural and one urban English general practice, using a self-completion questionnaire that was initially administered to women attending their general practitioner for oral contraception over six months from 1 October 1992. The questionnaire asked for: sociodemographic information; knowledge of how late women can be taking an oral contraceptive pill and still be protected against unplanned pregnancy; for how many days after being late with a pill they need to use other precautions; sources and methods of emergency contraception; and for how long the methods are effective after the primary contraceptive failure. After completing the questionnaire women were given two leaflets: one about how to take their prescribed contraceptive pill correctly and one about emergency contraception. Three to 12 months later the same questionnaire was administered in the same manner. RESULTS. Of 449 women completing the first questionnaire, 233 (52%) completed the second questionnaire. Initially 71% of 406 women taking an oestrogen/progestogen combined pill knew about the '12-hour rule' and 17% knew about the 'seven-day rule'; giving women information about the pill they were taking increased the extent of knowledge about these rules among 212 respondents to 82% (P emergency contraception

  4. The combined oral contraceptive pill in women over age forty.

    Science.gov (United States)

    Wong, M T; Singh, K

    2003-09-01

    By the age of 35 years, most women would have completed their families and contraception then becomes an important consideration. In the next one or two decades, other health concerns such as osteoporosis, dysfunctional uterine bleeding, ovarian, endometrial, colorectal and breast cancers and cardiovascular diseases will assume prominence in the lives of women. We review the role of the combined oral contraceptive (OC) pill in the older woman in the context of these important health concerns. A Medline search was made for possible interaction between OC use and the above conditions. An important criteria for citation was publication in a high impact factor journal; furthermore to represent the wider context from which there issues derive we choose, whenever appropriate, general journal with wide readership including, but not limited to the Lancet or New England Journal of Medicine; we also choose studies published in journals of other medical disciplines instead of purely gynaecological journals to reflect the multidisciplinary impact of the combined OC pills. Combined OC retards bone demineralisation which could translate clinically to a reduction in postmenopausal osteoporotic fractures; it affords good menstrual cyclicity and alleviation of perimenopausal vasomotor symptoms; it offers chemoporophylaxis against epithelial ovarian cancers and endometrial cancers. There is evidence that it could be protective against colorectal cancers. The combined OC may attenuate the disease progression of rheumatoid arthritis and reduces the risk of ectopic pregnancy and pelvic inflammatory disease. In an older woman who does not smoke and is in good health, the excess risk of stroke, myocardial infarcts and venous thromboembolism is minimal, if at all, as is the risk of breast neoplasm. In women with proven human papilomavirus infection of the cervix who are using OCs, regular cervical screening is especially important. The non-contraceptive health benefits of the combined OCs

  5. Carbohydrate metabolism after one year of using a gestodene containing monophasic oral contraceptive

    OpenAIRE

    Yıldırım, Ayşegül; Onganer, Efe; Erkal, Kemal

    2006-01-01

    Aim: To prospectively evaluate the effects of an oral contraceptive containing the progestin gestodene on carbohydrate metabolism in ordinary Turkish women Material / Method: Carbohydrate metabolism was prospectively evaluated in 53 normal women prior to and during their use of monophasic oral contraceptive containing the progestin gestodene plus ethinyl estradiol for one year. The women had a two hour oral glucose tolerance test using 75 gram glucose load, measuring serum glucose and ...

  6. Use of and access to oral and injectable contraceptives in Brazil

    Directory of Open Access Journals (Sweden)

    Mareni Rocha Farias

    Full Text Available ABSTRACT OBJECTIVE To analyze the prevalence of current use of oral and injectable contraceptives by Brazilian women, according to demographic and socioeconomic variables and issues related to access to those medicines. METHODS A cross-sectional, population-based analytical study with probability sampling based on data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines, carried out between September 2013 and February 2014 in 20,404 Brazilian urban households. Prevalence was calculated based on reports from non-pregnant women aged 15-49 on the use of oral or injectable contraceptives. The independent variables were gender, age, level of education, socioeconomic class, Brazilian region and marital status. Also analyzed were access, means of payment, sources, and reported medicines. Statistical analyses considered 95% confidence intervals (95%CI and Pearson Chi-square test to evaluate the statistical significance of differences between groups, considering a 5% significance level. RESULTS Prevalence of use was 28.2% for oral contraceptives (OC and 4.5% for injectable contraceptives (IC. The highest prevalence of oral contraceptives was in the South region (37.5% and the lowest in the North region (15.7%. For injectable contraceptives there was no difference between regions. Access was higher for oral contraceptive users (90.7% than injectable contraceptives users (81.2%, as was direct payment (OC 78.1%, IC 58.0%. Users who paid for contraceptives acquired them at retail pharmacies (OC 95.0% and IC 86.6% and at Farmácia Popular (Popular Pharmacy Program (OC 4.8% and IC 12.7%. Free of charge contraceptives were mostly obtained from the Brazilian Unified Health System – SUS (OC 86.7%; IC 96.0%. Free samples were reported by 10.4% of users who did not pay for oral contraceptives. Most of paying users did not try to

  7. Clinical risk factors for venous thromboembolus in users of the combined oral contraceptive pill

    Science.gov (United States)

    Black, Corri; Kaye, James A; Jick, Hershel

    2002-01-01

    Aims To estimate the risk of venous thromboembolism among women prescribed the oral contraceptive pill who have acute clinical conditions such as lower limb fractures, compared with women with idiopathic venous thromboembolism. Methods A nested case-control analysis using the General Practice Research Database, January 1993 to December 1999 was carried out. The participants were women aged 15–39 years, prescribed third generation oral contraceptives (gestodene and desogestrel) or oral contraceptives containing levonorgestrel. The main outcome measures were odds ratios as a measure of the relative risk estimate for venous thromboembolism in women with clinical conditions that predispose to VTE. Results The adjusted relative risk estimate for venous thromboembolism among patients with the acute clinical conditions, compared with those without such illness, and adjusted for oral contraceptive use, was 17 (95% CI 6.5, 46). Conclusions This paper documents the strong independent association between certain acute clinical conditions and venous thromboembolism in women prescribed oral contraceptives. Failure to accurately identify and exclude such patients from a study of the effect of oral contraceptives on the risk of venous thromboembolism would result in an underestimate of the risk of venous thromboembolism associated with oral contraceptives. PMID:12047488

  8. The gingival condition of oral contraceptives users at desa Hegarmanah, Kecamatan Jatinangor

    Directory of Open Access Journals (Sweden)

    Miduk Sibuea

    2010-03-01

    Full Text Available The change of hormonal condition is a systemic condition that affected the periodontium condition. Oral contraceptives is one of the systemic risk that can change hormonal condition. The purpose of the research was to evaluate gingival condition of oral contraceptives users and to find the difference of gingival condition between users and non users of oral contraceptives at Desa Hegarmanah, Kecamatan Jatinangor. The research method was descriptive analytic with purposive sampling, consist of 69 users and 30 non users of oral contraceptives. The gingival condition was scored by using Loe and Sillnes gingival index. The research showed that the average of gingival index in oral contraceptives users was 1.913 and non users was 1.707. The statistic analysis was U Mann Whitney non parametric test and the α was 5% showed that there was a significant difference of gingival condition between users and non users of oral contraceptives. The conclusion of the research was the gingival condition of oral contraceptives users was different with non users at Desa Hegarmanah Kecamatan Jatinangor but clinically was the same, that is in moderate gingivitis category.

  9. Effects of smoking and oral contraception on plasma beta-carotene levels in healthy women.

    Science.gov (United States)

    Palan, P R; Romney, S L; Vermund, S H; Mikhail, M G; Basu, J

    1989-10-01

    Oral contraceptive use and smoking have been known to affect plasma vitamin levels. Total carotenoids have been studied with spectrophotometry, a relatively insensitive technique. In this study plasma concentrations of beta-carotene and retinol were measured in coded samples by sensitive high-pressure liquid chromatography in a cross-sectional study of 149 normal healthy women attending a family planning clinic. At the time of recruitment in the morning, a general health questionnaire was administered for patient age, methods of contraception, smoking habits, and food intake at breakfast. Of the 149 enrolled volunteers, 88 were oral contraceptive users and 61 were not users. Among users, 21 smoked cigarettes, and there were 18 smokers among nonusers. Oral contraceptive users had significantly lower plasma concentrations of beta-carotene (p less than 0.001) and higher retinol levels (p less than 0.0001). Plasma beta-carotene or retinol levels did not differ among users of intrauterine contraceptive devices or barrier methods of contraception. No association was noted between the plasma levels of these two micronutrients and age greater than or less than 30 years. Cigarette smoking alone was associated with significantly reduced plasma beta-carotene levels in nonusers (p less than 0.001). Combined cigarette smoking and oral contraceptive usage were associated with low plasma beta-carotene levels; the results appear to be additive. These findings suggest a possible synergistic effect on plasma beta-carotene levels from the use of both cigarette smoking and oral contraception.

  10. Misconceptions about the side effects of combined oral contraceptive pills.

    Science.gov (United States)

    Küçük, Mert; Aksu, Hilmiye; Sezer, Selda Demircan

    2012-04-01

    Although combined oral contraceptive pills (COCPs) are one of the most commonly used methods of contraception in western countries, they are taken by only a minority of sexually active women in Turkey. The purpose of this research has been to define women's specific misconceptions with regard to the side effects of COCPs. This descriptive and cross-sectional research was conducted on 418 reproductive aged women who agreed to participate. Data were collected through face-to-face interviews with a questionnaire which assessed socio-demographic characteristics and women's beliefs about the side effects of COCPs. It is observed that 45.2% believed that the pills cause weight gain. Another 7.9% of the cases held the belief that COCPs cause cancer. A group of 13.4% of the subjects thought that COCPs lead to infertility, 28.7% believed that they cause headache, 41.1% believed that they cause acne and/or an increase in body hair, and 11.7% were afraid that they cause a decrease in libido. The present study has shown that misconceptions about the side effects of COCPs were considerably prevalent among this cohort group of Turkish women. Healthcare professionals have the potential of playing an important role in dispersing these misconceptions.

  11. Acceptability of the combined oral contraceptive pill among Hong Kong women.

    Science.gov (United States)

    Lo, S St; Fan, S Ys

    2016-06-01

    To evaluate the motivators and barriers to the use of the combined oral contraceptive pill among Hong Kong women. The Family Planning Association of Hong Kong commissioned the ESDlife to launch an online survey and invited its female members aged 18 to 45 years who had used contraceptives in the past 12 months to participate in this survey. The online survey was posted on the ESDlife website between April 2015 and May 2015. Measurements included contraceptive choice, and motivators and barriers to the use of a combined oral contraceptive pill. A total of 1295 eligible women with a median age of 32 years participated in this survey. In the past 12 months, 76.1% of them used a male condom, 20.9% practised coitus interruptus, 16.2% avoided coitus during the unsafe period, and 12.6% took a combined oral contraceptive pill. These women chose a combined oral contraceptive for convenience, effectiveness, and menstrual regulation, though 60.9% had stopped the pills because they were worried about side-effects, experienced side-effects, or consistently forgot to take the pills. Some women had never tried a combined oral contraceptive pill because they feared side-effects, they were satisfied with their current contraceptive method, or pill-taking was inconvenient. The combined oral contraceptive pill is underutilised by Hong Kong women compared with those in many western countries. A considerable proportion of respondents expressed concern about actual or anticipated side-effects. This suggests that there remains a great need for doctors to dispel the underlying myths and misconceptions about the combined oral contraceptive pill.

  12. Physiologic and psychologic symptoms associated with use of injectable contraception and 20 microg oral contraceptive pills

    National Research Council Canada - National Science Library

    Berenson, AB

    2008-01-01

    ... with a reduced pill-free interval and those not using hormonal contraception. A total of 608 women reported their experience regarding 17 symptoms prior to initiating contraception and every 6 months thereafter for 24 months...

  13. [Clinical experiences with a gestodene containing oral contraceptive (femoden)].

    Science.gov (United States)

    Gimes, G; Valent, S

    1998-09-01

    In order to reduce the side-effects (blood-lipid alterations, androgen effects etc.) new gestogens were introduced, while the ethinyl-estradiol component of the pill was unchanged. Authors report about clinical trial on monophasic oral contraceptive containing 0.030 mg ethinyl-estradiol and 0.075 mg gestodene. In a follow up of 92 women, in 1740 cycles no pregnancy and no cardivascular or thromboembolic complication was observed. The frequency of bleeding disorders was below 10% already in the first cycle. The quantity of withdrawal bleeding, as well the frequency of breakthrough bleeding and spotting decreased during the treatment. Significant alteration in body weight or blood pressure did not occur. Femoden containing third generation gestogen has an excellent cycle control and good patient compliance.

  14. Use of oral contraceptives and serum beta-carotene

    DEFF Research Database (Denmark)

    Berg, Gabriele; Kohlmeier, L; Brenner, H

    1997-01-01

    OBJECTIVE: Antioxidants, in particular carotenoids, may influence the risk for cardiovascular disease. This study investigates the influence of oral contraceptives (OC) on the serum concentration of beta-carotene, which may in turn affect the risk of cardiovascular diseases due to its antioxidative...... impact. DESIGN: Cross-sectional epidemiologic study. Examinations included a detailed questionnaire on medical history and lifestyle factors, a 7 day food record, and blood samples. SETTING: National health and nutrition survey among healthy people living in private homes in West Germany in 1987...... with higher estrogen content. CONCLUSIONS: OC use seems to be strongly related to serum beta-carotene levels, particularly among women above the age of 35. Further studies are needed to clarify the underlying mechanisms of this association and its implications for health risks of OC use....

  15. Factors associated with the contraindicated use of oral contraceptives in Brazil

    Directory of Open Access Journals (Sweden)

    Daniele Aparecida Silva Corrêa

    Full Text Available ABSTRACT OBJECTIVE To estimate the prevalence of the contraindicated use of oral contraceptives and the associated factors in Brazilian women. METHODS 20,454 women who answered the VIGITEL survey in 2008 also participated in this study, of which 3,985 reported using oral contraceptives. We defined the following conditions for the contraindicated use of contraceptives: hypertension; cardiovascular diseases such as heart attack, stroke/cerebrovascular accident; diabetes mellitus; being smoker and 35 years old or older. We estimated the prevalence and 95% confidence intervals of contraindicated use in users of oral contraceptives and the factors associated with contraindication by prevalence ratio and 95% confidence intervals. RESULTS In the total population, 21% (95%CI 19.7–21.9 of women showed some contraindication to the use of oral contraceptives, of which 11.7% (95%CI 10.6–13.7 belonged to the group of users of oral contraceptives. The most frequent contraindication in users of oral contraceptives was hypertension (9.1%. The largest proportion of women with at least one contraindication was aged between 45 and 49 years (45.8% and with education level between zero and eight years (23.8%. The prevalence of contraindication to oral contraceptives was higher in women less educated (zero to eight years of study (PR = 2.46; 95%CI 1.57–3.86; p < 0.05 and with age between 35-44 years (PR = 4.00; 95%CI 2.34–6.83 and 45-49 years (PR = 5.59; 95%CI 2.90–10.75. CONCLUSIONS Age greater than or equal to 35 and low education level were demographic and iniquity factors, respectively, in the contraindicated use of oral contraceptives.

  16. Is the oral contraceptive pill associated with fracture in later life? New evidence from the Royal College of General Practitioners Oral Contraception Study.

    Science.gov (United States)

    Memon, Sanam; Iversen, Lisa; Hannaford, Philip C

    2011-07-01

    Several studies, including an earlier analysis from the Royal College of General Practitioners (RCGP) Oral Contraception Study, have suggested that ever users of oral contraceptives have an increased risk of fracture when compared with never users. In this paper, we examined a subset of women in the RCGP study living in Scotland to determine whether this risk has persisted. A nested case-control study was carried out using data collected prospectively for the RCGP Oral Contraception Study. Cases were women with a first ever diagnosis of fracture (n=651), age-matched to two controls (n=1302). Adjustments were made for smoking, social class and parity. There was not a significant association between ever use of oral contraception and fracture (adjusted odds ratio 1.05, 95% confidence interval 0.86-1.29), compared with never users. Neither were significant associations found between fracture and smoking, social class and parity. The findings did not vary materially with age or type of fracture. Ever use of oral contraception was not associated with fracture in this study. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. Contraception.

    Science.gov (United States)

    Dean, Erin

    2016-12-07

    Essential facts Contraceptive services aim to help men and women choose a method of preventing pregnancy that best suits their needs and lifestyle, making it more likely that contraception will be used effectively. Almost nine out of ten women in heterosexual relationships report using at least one method of contraception. There were 184,571 abortions in England and Wales in 2014.

  18. The effects on ovarian activity of ulipristal acetate when 'quickstarting' a combined oral contraceptive pill: a prospective, randomized, double-blind parallel-arm, placebo-controlled study.

    Science.gov (United States)

    Cameron, S T; Berger, C; Michie, L; Klipping, C; Gemzell-Danielsson, K

    2015-07-01

    limitations of the study were that measurements of follicle size and blood tests were performed every 2-3 days and so it was not possible to determine the actual day that follicle rupture occurred for the women who ovulated. Furthermore, the ultrasonography was conducted by a number of investigators at the sites which may introduce error in the form of inter-observer variability in measurements of follicle growth. Finally, the findings of the study cannot be extrapolated to other combined hormonal methods of contraception such as the patch or ring, nor to progestogen- only methods of contraception. This study provides evidence to suggest that UPA does not affect the ability of the COC to induce ovarian quiescence. However, this study design cannot determine whether the COC affects the ability of UPA to delay ovulation. Funding was provided by HRA Pharma Paris, France. C.K., S.T.C. and K.G.D. have received funds for conducting research studies and lectures for HRA Pharma. C.K. is director of a contract research organization (Dinox). The remaining authors declare no conflicts of interests. Clinicaltrials.gov: NCT01569113. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. Experience with oral emergency contraception since the OTC switch in Germany.

    Science.gov (United States)

    Kiechle, Marion; Neuenfeldt, Miriam

    2017-03-01

    In March 2015, the oral emergency contraceptives levonorgestrel (LNG) and ulipristal acetate (UPA) were released from prescription-only status in Germany. The main research question is to analyse whether the OTC status of oral emergency contraceptives has an influence on the patterns of use. All information is based on searches for public domain sources on emergency contraception. Searches were made for scientific publications, statistics, and surveys. Due to additional active ingredient properties, UPA is superior to LNG in terms of ovulation-inhibiting effect. Since the OTC switch, demand for oral emergency contraceptives has risen by almost 50%, especially at weekends when sexual encounters and thus contraceptive failures are most frequent. However, the age distribution of the users has not changed as a result of the OTC switch. Doctors still play an important role in advising on emergency contraception after the removal of the prescription-only requirement. Pregnancies despite emergency contraception are terminated in more than half of the cases. In federal states with higher rates of use of the morning-after pill, fewer terminations of pregnancy were performed. As a result of the OTC switch, more women and girls use the morning-after pill after unprotected intercourse and the time between unprotected intercourse and taking the oral emergency contraceptive decreases. This is of great advantage in terms of the mechanism of action. UPA is used more frequently than LNG. Only half of all people aged between 16 and 39 years in Germany are aware of the morning-after pill and 94% of women who had a pregnancy terminated in 2015 did not use any emergency contraception after the unprotected intercourse. In the population, there is still a great need for information and education on contraception and emergency contraception.

  20. Hormonal contraception decreases bacterial vaginosis but oral contraception may increase candidiasis: implications for HIV transmission.

    Science.gov (United States)

    van de Wijgert, Janneke H H M; Verwijs, Marijn C; Turner, Abigail Norris; Morrison, Charles S

    2013-08-24

    A 2012 WHO consultation concluded that combined oral contraception (COC) does not increase HIV acquisition in women, but the evidence for depot medroxyprogesterone acetate (DMPA) is conflicting. We evaluated the effect of COC and DMPA use on the vaginal microbiome because current evidence suggests that any deviation from a 'healthy' vaginal microbiome increases women's susceptibility to HIV. We conducted a systematic review and reanalysed the Hormonal Contraception and HIV Acquisition (HC-HIV) study. Vaginal microbiome outcomes included bacterial vaginosis by Nugent scoring, vaginal candidiasis by culture or KOH wet mount and microbiome compositions as characterized by molecular techniques. Our review of 36 eligible studies found that COC and DMPA use reduce bacterial vaginosis by 10-20 and 18-30%, respectively. The HC-HIV data showed that COC and DMPA use also reduce intermediate microbiota (Nugent score of 4-6) by 11% each. In contrast, COC use (but not DMPA use) may increase vaginal candidiasis. Molecular vaginal microbiome studies (n=4) confirm that high oestrogen levels favour a vaginal microbiome composition dominated by 'healthy' Lactobacillus species; the effects of progesterone are less clear and not well studied. DMPA use does not increase HIV risk by increasing bacterial vaginosis or vaginal candidiasis. COC use may predispose for vaginal candidiasis, but is not believed to be associated with increased HIV acquisition. However, the potential role of Candida species, and vaginal microbiome imbalances other than bacterial vaginosis or Candida species, in HIV transmission cannot yet be ruled out. Further in-depth molecular studies are needed.

  1. The relationship of self-concept and autonomy to oral contraceptive compliance among adolescent females.

    Science.gov (United States)

    Neel, E U; Jay, S; Litt, I F

    1985-11-01

    Self-concept and autonomy are typically negotiated during adolescence, a time when many females also become sexually active. Nonuse and discontinuation of contraceptives by teenagers place them at high risk for pregnancy. The present study explores the relationship between these psychological factors and contraceptive noncompliance during adolescence. Fifty-five adolescent females beginning a contraceptive regimen were entered into the study. Compliance at four months after the initiation of an oral contraceptive was associated with scoring high on the Behavior Subscale of the Piers-Harris Self-Concept Scale and the Autonomy Scale modified from Eysenk.

  2. Why Iranian married women use withdrawal instead of oral contraceptives? A qualitative study from Iran

    National Research Council Canada - National Science Library

    Rahnama, Parvin; Hidarnia, Alireza; Shokravi, Farkhondeh Amin; Kazemnejad, Anoushiravan; Oakley, Deborah; Montazeri, Ali

    2010-01-01

    Withdrawal as a method of birth control is still used in Iran. The aim of this study was to explore married women's perspectives and attitudes on withdrawal use instead of oral contraceptive (OC) in Tehran, Iran...

  3. Oral Contraceptives after Myomectomy: A Short Term Trial

    Science.gov (United States)

    Luisi, Stefano; Ciani, Valentina; Gabbanini, Massimo; Sollazzi, Sofia; Torricelli, Michela; Calonaci, Francesco; Petraglia, Felice

    2009-01-01

    Following myomectomy the rate of fertility is restored and pregnancy may be attempted with a good outcome. In the present study a 3 month treatment with OCs in a group of women after a myomectomy was evaluated. The drug compliance and side effects, the benefits of OC in order to reduce symptoms, to increase post-surgical hemoglobin levels and to avoid an early pregnancy after myomectomy were analyzed. A group of women (n = 55) each with myoma ≥5 cm was recruited: they presented menorrhagia, pelvic pain, dyspareunia and dysmenorrhae. After laparotomic myomectomy the women were divided into 3 groups. Group 1: women (n = 16) treated with pill A (15 mcg of ethynilestradiol + 60 mcg of gestodene); group 2: women (n = 23) treated with pill B (20 mcg of ethynilestradiol + 100 mcg of levonorgestrel); group 3: women (n = 16) treated with a placebo (oral calcium). After three months from myomectomy and treatment patients in each group reported a reduced menorrhagia, dismenorrhea and pelvic pain. Serum haemoglobin levels increased in all women (P < .05). No pregnancy occurred in any group and the compliance was good. A post surgery treatment by using oral contraceptives guarentees pregnancy prevention, associated with reduction of pain, and improvement of haematologic conditions. PMID:19946429

  4. The oral contraceptive pill: a revolution for sportswomen?

    Science.gov (United States)

    Bennell, K; White, S; Crossley, K

    1999-08-01

    To determine the effects of the oral contraceptive pill (OCP) on skeletal health, soft tissue injury, and performance in female athletes. A literature review was performed using literature retrieval methods to locate relevant studies. Most female athletes primarily choose to use the OCP for contraceptive purposes, but cycle manipulation and control of premenstrual symptoms are secondary advantages of its use. The effect of the OCP on bone density in normally menstruating women is unclear, with some studies reporting no effect, others a positive effect, and some even a negative effect. The OCP is often prescribed for the treatment of menstrual disturbances in female athletes, and improvements in bone density may result. Whether the OCP influences the risk of stress fracture and soft tissue injuries is not clear from research to date. Effects of the OCP on performance are particularly relevant for elite sportswomen. Although a reduction in Vo2MAX has been reported in some studies, this may not necessarily translate to impaired performance in the field. Moreover, some studies claim that the OCP may well enhance performance by reducing premenstrual symptoms and menstrual blood loss. A fear of weight gain with the use of the OCP is not well founded, as population studies report no effect on weight, particularly with the lower dose pills currently available. Overall, the advantages of the pill for sportswomen would appear to outweigh any potential disadvantages. Nevertheless, there is individual variation in response to the OCP and these should be taken into account and monitored in the clinical situation. Women should be counselled as to the range of potential benefits and disadvantages in order to make an informed decision based on individual circumstances.

  5. The effect of fluconazole on circulating ethinyl estradiol levels in women taking oral contraceptives.

    Science.gov (United States)

    Sinofsky, F E; Pasquale, S A

    1998-02-01

    This open-label, two-period, crossover study was conducted to evaluate the effect of a single 150 mg dose of fluconazole on the pharmacokinetics of ethinyl estradiol in healthy female subjects. Ten subjects regularly taking Ortho-Novum 7/7/7 (Ortho Pharmaceutical, Raritan, N.J.) and 10 subjects regularly taking Triphasil (Wyeth-Ayerst Laboratories, Philadelphia), which contain ethinyl estradiol 35 microg and 30 microg during days 1 to 6, respectively, were randomly assigned to receive a single 150 mg dose of fluconazole 2 hours before the oral contraceptive, on pill day 6 of one of two menstrual cycles. Ethinyl estradiol serum concentrations were measured at baseline and up to 24 hours after oral contraceptive intake. No fluconazole was administered during the other menstrual cycle, which served as the control. Mean serum concentrations of ethinyl estradiol were increased after fluconazole administration in both oral contraceptive groups. Maximum observed serum concentration and area under the concentration-time curve values were significantly (p < 0.05) greater during the fluconazole regimens (vs regimens without fluconazole) for both oral contraceptive groups and for combined values of the two oral contraceptive groups. The mean time to reach the maximum concentration was not altered by concomitant fluconazole administration. These findings suggest that there is a potential for a clinically significant interaction between coadministration of fluconazole and ethinyl estradiol in oral contraceptives.

  6. [Treatment of diminished sexual response associated with the use of oral contraceptives (author's transl)].

    Science.gov (United States)

    Fucs, G B; Coutinho, E M

    1975-01-01

    Loss of libido associated with the use of oral contraceptives has been studied in 113 women of reproductive age who had taken a combined pill for periods ranging from 1 to 3 years. The patients were divided in four groups. In the first group (I) of 24 women oral contraceptive treatment was discontinued and all women received in intra-uterine contraceptive device (IUCD). The second group (II) of 36 patients, the brand of oral contraceptive was changed. Women in group (III) had their oral contraceptive maintained receiving in addition a mixture of an androgen and an estrogen (methyltestosterone 4 mg and ethynilestradiol 0.002 mg) daily. To women of group (IV) the oral contraceptive was discontinued but the androgen-estrogen mixture was given. All women in this group received an IUCD. Evaluation of the psyco-sexual parameters included changes in libido, time to reach an orgasm, duration and intensity or orgasms. Frequency of intercourse and response to autostimulation was also investigated. Libido was restored in 94.2% of patients in group II, in 97.3% of group III and in 92.8% of group IV. In group I only 55.6% of patients had libido fully restored. In view of the prompt restoration of libido in all groups except in patients discontinuing oral contraceptive therapy, it is suggested that loss of libido in oral contraceptive users has an important physological component which can be overcome probably by psychotherapy. Short term treatment with a mixture of methyltestosterone and ethynilestradiol seems to be highly effective in restoring libido in all patients.

  7. A Survey of Teenagers' Attitudes Toward Moving Oral Contraceptives Over the Counter.

    Science.gov (United States)

    Manski, Ruth; Kottke, Melissa

    2015-09-01

    Evidence suggests that over-the-counter access to oral contraceptives may help expand use among adult women. Teenagers may particularly benefit from this approach, as they experience disproportionately high rates of unintended pregnancy and face unique challenges accessing contraceptives. However, limited research has explored teenagers' attitudes toward over-the-counter access. In 2014, a sample of 348 females aged 14-17, recruited via Facebook advertisements, participated in an online survey assessing teenagers' attitudes toward over-the-counter access and their understanding of how to use oral contraceptives after reading a prototype over-the-counter product label. Differences by participants' characteristics were assessed in bivariate analyses (Pearson chi-square and Fisher's exact tests for categorical measures, and independent t tests and one-way analyses of variance for continuous measures). Seventy-three percent of participants supported over-the-counter access, and 61% reported that they would likely use oral contraceptives available through this approach. Few subgroup differences were found. Notably, sexually experienced participants were significantly more likely than others both to support this approach (85% vs. 63%) and to be interested in obtaining oral contraceptives this way (77% vs. 48%). Participants understood an average of 7.1 of eight key concepts that the prototype product label was intended to convey; no significant differences were found among subgroups. Over-the-counter access may be a promising approach for providing oral contraceptives to teenagers. Additional research is needed to evaluate whether teenagers can screen themselves for contraindications to oral contraceptive use and correctly use oral contraceptives obtained over the counter. Copyright © 2015 by the Guttmacher Institute.

  8. Adolescent girls in Denmark use oral contraceptives at an increasingly young age, and with more pauses and shifts

    DEFF Research Database (Denmark)

    Løkkegaard, Ellen; Nielsen, A. K.

    2014-01-01

    , adolescent girls have more pauses and shifts between types of hormonal contraceptives. Since 2010 there has been a shift toward use of second generation oral contraceptives away from third and fourth generation contraceptives. CONCLUSION: Adolescent girls tend to initiate their use of oral contraceptives...... at a younger age than the older cohorts do. Furthermore, they have more pauses and shift between products more frequently than older cohorts. The type of oral contraceptive used has shifted since 2010 towards older products with second generation progestins. FUNDING: The study was funded by salaries from North......INTRODUCTION: Use of hormonal contraceptives for birth control is commonplace in the Western World. In Europe, there is considerable variety in the frequency of use of hormonal contraceptives and in the age at which these contraceptives are initiated. The purpose of the present study...

  9. Sexual Dysfunction in Two Types of Hormonal Contraception: Combined Oral Contraceptives versus Depot Medroxyprogesterone Acetate

    Directory of Open Access Journals (Sweden)

    Nourossadat Kariman

    2017-01-01

    Full Text Available Background & aim: Sexual health is an essential element of quality of life, affecting both physical and psychological domains. Hormones used in contraceptive methods have contradictory effects on sexual function. In this study, we aimed to compare sexual function in women using combined oral contraceptives (COC and depot medroxyprogesterone acetate (DMPA, referred to healthcare centers affiliated to Shahid Beheshti University of Medical Sciences in Tehran, Iran in 2013. Methods: This descriptive, comparative study was performed on 240 women (n=120 per group, selected through multistage sampling in Tehran, Iran. A questionnaire consisting of three parts, General Health Questionnaire (GHQ-28, demographic characteristics, and Female Sexual Function Index (FSFI, was completed through interviews. For data analysis, descriptive statistics were calculated, and independent t-test, Mann-Whitney test, Chi-square, and Fisher's exact test were performed, using SPPS version 16. P-value less than 0.05 was considered statistically significant. Results: The mean age at marriage in women using DMPA was lower than those using COC (18.55±3.61 vs. 19.92±3.98 years. Based on the findings, the menstrual status in the majority of DMPA users was irregular (46.7% in DMPA group vs. 8.3% in COC group. The difference in sexual function between the COC and DMPA groups was significant. Sexual arousal and lubrication were more favorable in the COC group in comparison with the DMPA group; also, pain in this group was lower than the DMPA group. Scores of total sexual function (27.35±5.22 in DMPA group vs. 29.15±6.13 in COC group, sexual arousal (4.11±0.90 in DMPA group vs. 4.51±1.39 in COC group, and vaginal lubrication (4.82±1.30 in DMPA group vs. 5.26±1.35 in COC group were lower in the DMPA group, compared to the COC group. Pain scores (4.91±1.25 in DMPA group vs. 5.28±1.19 in COC group were higher in the DMPA group in comparison with the COC group (P

  10. Headache induced by the use of combined oral contraceptives.

    Science.gov (United States)

    Allais, Gianni; Gabellari, Ilaria Castagnoli; Airola, Gisella; Borgogno, Paola; Schiapparelli, Paola; Benedetto, Chiara

    2009-05-01

    Although combined oral contraceptives (COCs) are a safe and highly effective method of birth control, they may also give rise to problems of clinical tolerability in migraine patients. Indeed, headache is among the most common side effects reported with the use of COCs, frequently leading to their being discontinued. The latest International Classification of Headache Disorders identified at least two entities evidently related to the use of COCs, i.e., exogenous hormone-induced headache and estrogen-withdrawal headache. As to the former, the newest formulations of COCs are generally well tolerated by migraine without aura patients, but can worsen headache in migraine with aura patients. Headache associated with COCs, generally, tends to improve as their use continues. However, although it is not yet clear if there is an association between headache and the composition of COCs (both in the type and amount of hormones), it has been observed that the incidence of headache during COC use seems greater if migraine is associated with menstrual trigger. The estrogen-withdrawal headache is a headache that generally appears within the first 5 days after cessation of estrogen use and resolves within 3 days, even if in some cases it may appear on the sixth or seventh day after pill suspension and lasts more than 3 days.

  11. Do Oral Contraceptives Alter Knee Ligament Damage with Heavy Exercise?

    Science.gov (United States)

    Lee, Haneul; Petrofsky, Jerrold S; Yim, JongEun

    2015-09-01

    Hormones such as estradiol have an effect on human connective tissue, making women more susceptible to knee injuries. Indeed, women have a greater risk for non-contact injuries of anterior cruciate ligament (ACL) compared to men when participating in the same sports. The purpose of the present study was to examine the difference in ACL laxity after an eccentric exercise in the lower limbs in young healthy women between oral contraceptive pill (OCP) users and non-OCP users to see the effect of OCP on ACL laxity. Forty young healthy women participated in the experiments (25 with normal menstrual cycle and 15 with taking OCP). ACL laxity and a visual analog pain scale were measured before and after a bout of squat. OCP users had more pain than non-OCP users after heavy exercise (p day after exercise (p 0.05). We found that there was no statistically significant difference in ACL laxity recovery over time in response to the delayed onset muscle soreness after a bout of squat between two groups. However, health professionals working with young female adults should recognize that OCP users with less ACL laxity are at higher risk for having knee injuries because of ACL stiffness when doing exercise.

  12. Process, cost, and clinical quality: the initial oral contraceptive visit.

    Science.gov (United States)

    McMullen, Michael J; Woolford, Samuel W; Moore, Charles L; Berger, Barry M

    2013-01-01

    To demonstrate how the analysis of clinical process, cost, and outcomes can identify healthcare improvements that reduce cost without sacrificing quality, using the example of the initial visit associated with oral contraceptive pill use. Cross-sectional study using data collected by HealthMETRICS between 1996 and 2009. Using data collected from 106 sites in 24 states, the unintended pregnancy (UIP) rate, effectiveness of patient education, and unit visit cost were calculated. Staff type providing education and placement of education were recorded. Two-way analysis of variance models were created and tested for significance to identify differences between groups. Sites using nonclinical staff to provide education outside the exam were associated with lower cost, higher education scores, and a UIP rate no different from that of sites using clinical staff. Sites also providing patient education during the physical examination were associated with higher cost, lower education scores, and a UIP rate no lower than that of sites providing education outside of the exam. Through analyzing process, cost, and quality, lower-cost processes that did not reduce clinical quality were identified. This methodology is applicable to other clinical services for identifying low-cost processes that do not result in lower clinical quality. By using nonclinical staff educators to provide education outside of the physical examination, sites could save an average of 32% of the total cost of the visit.

  13. Effects of oral contraceptives on peak exercise capacity.

    Science.gov (United States)

    Casazza, Gretchen A; Suh, Sang-Hoon; Miller, Benjamin F; Navazio, Franco M; Brooks, George A

    2002-11-01

    We examined the effects of menstrual cycle phase and oral contraceptive (OC) use on peak oxygen consumption (VO(2 peak)). Six moderately active, eumenorrheic women (25.5 +/- 1.5 yr) were studied before and after 4 mo of OC. Subjects were tested during the follicular and luteal phases before OC and the inactive and high-dose phases after OC. Before OC, there were no significant differences between the follicular and luteal phases in any of the variables studied. There were also no differences between the inactive and high-dose phases. Dietary composition, exercise patterns, and peak heart rate, minute ventilation, and respiratory exchange ratio did not change with OC use. However, OC use significantly (P VO(2 peak) (-11%, 2.53 +/- 0.21 to 2.25 +/- 0.18 l/min). In conclusion, 1) endogenous ovarian steroids have little effect on VO(2 peak), but 2) the exogenous ovarian steroids in OC decrease peak exercise capacity in moderately physically active young women.

  14. Oxidative Stress in Female Athletes Using Combined Oral Contraceptives.

    Science.gov (United States)

    Cauci, Sabina; Buligan, Cinzia; Marangone, Micaela; Francescato, Maria Pia

    2016-12-01

    Oxidative stress in female athletes is understudied. We investigated oxidative stress in sportswomen of different disciplines according to combined oral contraceptive (OC) use and lifestyle/alimentary habits. Italian sportswomen (n = 144; mean age 23.4 ± 4.2 years; body mass index 21.2 ± 2.2 kg m-2; sport activity 9.2 ± 4.1 h week-1) were analyzed; 48 % were volleyball players, 12.5 % soccer players, 10.4 % track-and-field sports, and followed by other disciplines' athletes. Oxidative stress was evaluated by free oxygen radical test (FORT) assessing blood hydroperoxides and free oxygen radical defense (FORD) assay evaluating antioxidant capacity in OC users (n = 42) compared to non-OC users. Elevated oxidative stress levels (≥310 FORT units) were found in 92.9 % of OC users and in 23.5 % of non-OC users (crude OR = 42, 95 % CI 12-149, p defense, and to elucidate the potential effects on athletic performance. OC use should be considered when developing gender-focused strategies against oxidative stress.

  15. Inconsistent use of oral contraceptives in rural Bangladesh.

    Science.gov (United States)

    Khan, M Asaduzzaman; Trottier, Dorace A; Islam, M Ataharul

    2002-06-01

    The purpose of this study is to explore predictors of inconsistent use of oral contraceptives (OCs) in rural Bangladesh. A total of 801 rural OC users were included in the study, about half of them (49%) missed one or more active pill(s) during the 6 months before the survey.Multivariate analysis revealed that Muslim women were 60% more likely to be inconsistent OC users compared to their non-Muslim counterparts. Women who lacked knowledge about contraindications were 60% more likely to take the pill inconsistently than were women who had the knowledge. Women who were not visited by family planning workers or did not have access to mass media were 40% more likely to be inconsistent OC users.OC users need increased information about correct OC use, which could be provided via improved access to mass media with specific messages on how to use OCs properly. Better access to the community clinics could improve the pill-taking behaviors of rural Bangladeshi women.

  16. The relationship between oral contraceptives and adolescent sexual behavior.

    Science.gov (United States)

    Garris, L; Steckler, A; McIntire, J R

    1976-05-01

    The desire to investigate whether use of oral contraceptives (OCs) by female adolescents leads to sexual promiscuity and to analyze the expressed attitudes on family and peer relationships, religiousness, self-esteem, and sex before and after OC use led to a study of 192 females ages 15-20 attending a youth medical clinic to obtain OCs in Los Angeles. 96 had been using OCs for 6-8 months (After group) and 96 were just beginning to use (Before group). The after group exhibited a higher frequency of sexual intercourse (p greater than .05). However, both groups desired the same number of sexual partners. While subjects in both groups were neutral about peers and religion, they both expressed positive feelings about theri family. 72% of the before group and 56% of the after group subjects indicated that their parents would disapprove of their sexual behavior (p less than .05). 85% of the former and 90.6% of the latter had positive feelings about their sexual behavior. Subjects in this study demonstrated by their responses positive feelings supporting restraint as opposed to permissiveness of sexual activity during OC activity.

  17. The impact of combined oral contraceptives on ocular tissues: a review of ocular effects

    Directory of Open Access Journals (Sweden)

    Marilita M. Moschos

    2017-10-01

    Full Text Available The aim of this manuscript is to review the action and adverse effects of combined oral contraceptives (COCs on ocular tissues. The percentage of unwanted pregnancies and the subsequent abortions make contraception crucial worldwide. Over 100 million women around the world use common contraceptive methods, including intrauterine devices, combined estrogen and progestin oral contraceptives, as well as progestin only preparations (oral contraceptives, implants or injections. COCs are widely used for contraception, but they are also indicated in menorrhagia, endometriosis, acne and hirsutism, fibroid uterus and premenstrual syndrome. However, they have been associated with high rates of cardiovascular events, venous thromboembolic disease, ischemic strokes and breast cancer. The incidence of COCs-related ocular complications is estimated to be 1 in 230 000, including dry eye symptoms, corneal edema, lens opacities and retinal neuro-ophthalmologic or vascular complications. We may infer that the serious ocular complications of COCs can be prevented by eliminating the estrogen dosage and choosing third-generation progestins. In any case, doctors should take into consideration the systemic and ocular history of the patients before selecting any method of contraception.

  18. Continuous or extended cycle vs. cyclic use of combined oral contraceptives for contraception.

    Science.gov (United States)

    Edelman, A B; Gallo, M F; Jensen, J T; Nichols, M D; Schulz, K F; Grimes, D A

    2005-07-20

    The avoidance of menstruation through extended or continuous administration (greater than 28 days of active pills) of combination oral contraceptives (COCs) has gained legitimacy through its use in treating endometriosis, dysmenorrhea, and menstruation-associated symptoms. Avoidance of menstruation through continuous use of COCs for reasons of personal preference may have additional advantages to women, including improved compliance, greater satisfaction, fewer menstrual symptoms, and less menstruation-related absenteeism from work or school. To determine the differences between COCs dosed continuously (greater than 28 days of active pills) compared with traditional cyclic dosing (21 days of active pills and 7 days of placebo). Our hypothesis was that continuously administered COCs have equivalent efficacy and safety but improved bleeding profiles, amenorrhea rates, adherence, continuation, participant satisfaction, and menstrual symptoms compared with cyclic COCs. We searched computerized databases (Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, POPLINE, LILACS) for trials using continuous or extended COCs during the years 1966 to 2005. We also searched the references in review articles and publications identified for inclusion in the protocol. Investigators were contacted regarding additional references. All randomized controlled trials in any language comparing continuous (greater than 28 days of active pills) versus traditional cyclic administration (21 days of active pills and 7 days of placebo) of COCs for contraception. Titles and abstracts identified from the literature searches were assessed for potential inclusion. Data were extracted onto data collection forms and then entered into RevMan 4.2. Peto odds ratios with 95% confidence intervals were calculated for all outcomes for dichotomous outcomes. Weighted mean difference was calculated for continuous outcomes. The trials were critically appraised by examining the following factors

  19. Reproductive Health Outcomes of Insured Women Who Access Oral Levonorgestrel Emergency Contraception

    Science.gov (United States)

    Raine-Bennett, Tina; Merchant, Maqdooda; Sinclair, Fiona; Lee, Justine W.; Goler, Nancy

    2015-01-01

    Objectives To assess the level of risk for women who seek emergency contraception through various clinical routes and the opportunities for improved care provision. Methods This study looked at a retrospective cohort to assess contraception and other reproductive health outcomes among women aged 15-44 who accessed oral levonorgestrel emergency contraception through an office visit or the call center at Kaiser Permanente Northern California from 2010 to 2011. Results Of 21,421 prescriptions, 14,531(67.8%) were accessed through the call center. In the subsequent 12 months, 12,127(56.6%) women had short-acting contraception (pills, patches, rings, depot medroxyprogesterone) dispensed and 2,264(10.6%) initiated very effective contraception (intrauterine contraception, implants, sterilization). Initiation of very effective contraception was similar for women who accessed it through the call center -1,569(10.8%) and office visits – 695(10.1%) (adjusted OR 1.02 95% confidence interval (CI) 0.93-1.13). In the subsequent 6 months, 2,056(9.6%) women became pregnant. Women who accessed emergency contraception through the call center were less likely to become pregnant within 3 months of accessing emergency contraception than woman who accessed it through office visits (adjusted OR 0.82 95% CI 0.72-0.94); however they were more likely to become pregnant within 4-6 months (adjusted OR 1.37 95%CI 1.16-1.60). Among women who were tested for chlamydia and gonorrhea, 689(7.8%) and 928(7.9%) were positive in the 12 months before and after accessing emergency contraception, respectively. Conclusions Protocols to routinely address unmet need for contraception at every call for emergency contraception and all office visits including visits with primary care providers should be investigated. PMID:25751211

  20. Reproductive health outcomes of insured adolescent and adult women who access oral levonorgestrel emergency contraception.

    Science.gov (United States)

    Raine-Bennett, Tina; Merchant, Maqdooda; Sinclair, Fiona; Lee, Justine W; Goler, Nancy

    2015-04-01

    To assess the level of risk for adolescents and women who seek emergency contraception through various clinical routes and the opportunities for improved care provision. This study looked at a retrospective cohort to assess contraception and other reproductive health outcomes among adolescents and women aged 15-44 years who accessed oral levonorgestrel emergency contraception through an office visit or the call center at Kaiser Permanente Northern California from 2010 to 2011. Of 21,421 prescriptions, 14,531 (67.8%) were accessed through the call center. In the subsequent 12 months, 12,127 (56.6%) adolescents and women had short-acting contraception (pills, patches, rings, depot medroxyprogesterone) dispensed and 2,264 (10.6%) initiated very effective contraception (intrauterine contraception, implants, sterilization). Initiation of very effective contraception was similar for adolescents and women who accessed it through the call center-1,569 (10.8%) and office visits-695 (10.1%) (adjusted odds ratio [OR] 1.02, 95% confidence interval [CI] 0.93-1.13). In the subsequent 6 months, 2,056 (9.6%) adolescents and women became pregnant. Adolescents and women who accessed emergency contraception through the call center were less likely to become pregnant within 3 months of accessing emergency contraception than woman who accessed it through office visits (adjusted OR 0.82, 95% CI 0.72-0.94); however, they were more likely to become pregnant within 4-6 months (adjusted OR 1.37, 95% CI 1.16-1.60). Among adolescents and women who were tested for chlamydia and gonorrhea, 689 (7.8%) and 928 (7.9%) were positive in the 12 months before and after accessing emergency contraception, respectively. Protocols to routinely address unmet needs for contraception at every call for emergency contraception and all office visits, including visits with primary care providers, should be investigated.

  1. Oral contraceptive use before and after the latest pill scare in the Netherlands - Changes in oral contraceptive use and how users change

    NARCIS (Netherlands)

    de Vries, CS; van den Berg, PB; de Jong-vandenBerg, LTW

    In October 1995, a "pill scare" developed in Europe. In the Netherlands, the recommendations given were 1) to not alarm women without risk for deep vein thrombosis (DVT), and 2) to be reserved in prescribing third generation oral contraceptives (OC) for young women who were beginning OC use. To

  2. Body composition is improved during 12 months' treatment with metformin alone or combined with oral contraceptives compared with treatment with oral contraceptives in polycystic ovary syndrome

    DEFF Research Database (Denmark)

    Glintborg, Dorte; Altinok, Magda Lambaa; Mumm, Hanne

    2014-01-01

    Context: Central obesity in polycystic ovary syndrome (PCOS) is associated with increased inflammatory markers and increased risk for type 2 diabetes. Objective: The objective of the study was to evaluate whether treatment with metformin (M) or M combined with oral contraceptive pills (OCPs...

  3. Evaluation of Cardiometabolic Parameters among Obese Women Using Oral Contraceptives.

    Science.gov (United States)

    Ferreira, Júnia Raquel Dutra; Aleluia, Milena Magalhães; Figueiredo, Camylla Vilas Boas; Vieira, Larissa Castro de Lima; Santiago, Rayra Pereira; da Guarda, Caroline Conceição; Barbosa, Cynara Gomes; Oliveira, Ricardo Riccio; Adorno, Elisângela Vitória; Gonçalves, Marilda de Souza

    2017-01-01

    Combined oral contraceptive (COC) use has been associated with an unfavorable impact on carbohydrate and lipid metabolism in diverse populations of normal weight and obese women. The present study aimed to evaluate the cardiometabolic and inflammatory profiles of women in northeastern Brazil with respect to COC use and obesity. We performed a cross-sectional study to verify cardiovascular parameters, including blood pressure (BP), fasting serum glucose, lipid, and inflammatory profile, in a population of women aged 15-45 years, considering obesity and COC use. Our sample consisted of 591 women, 481 women who were COC users, and 110 age-matched women who were COC non-users, classified as obese and non-obese according to BMI. COC use and obesity were associated with increased systolic (p ≤ 0.001) and diastolic BP (p = 0.001), blood glucose (p ≤ 0.001), total cholesterol (p = 0.008), low-density lipoprotein cholesterol (p ≤ 0.001), very low-density lipoprotein cholesterol (p ≤ 0.001), triglycerides (p ≤ 0.001), ferritin (p = 0.006), C-reactive protein (CRP) (p ≤ 0.001), and nitric oxide metabolites (p ≤ 0.001), as well as decreased high-density lipoprotein cholesterol (HDL-c) (p ≤ 0.001) in comparison to controls. CRP and HDL-c levels in obese COC users were determined to be outside reference range values. The odds of having lower levels of HDL-c and elevated CRP increased among obese COC users. COC use was independently associated with low levels of HDL-c, especially second-generation progestins (p < 0.001; OR = 8.976; 95% CI 2.786-28.914). Obesity and COC use were associated with alterations in lipid and inflammatory cardiometabolic parameters, particularly increased CRP levels and decreased HDL-c, which are considered markers of cardiovascular disease (CVD) risk. Given the need to prevent unintended pregnancy among obese women, together with weight loss counseling, it is important to evaluate the

  4. The use of contraception for patients after bariatric surgery.

    Science.gov (United States)

    Ostrowska, Lucyna; Lech, Medard; Stefańska, Ewa; Jastrzębska-Mierzyńska, Marta; Smarkusz, Joanna

    2016-01-01

    Obesity in women of reproductive age is a serious concern regarding reproductive health. In many cases of infertility in obese women, reduction of body weight may lead to spontaneous pregnancy, without the need for more specific methods of treatment. Bariatric surgery is safe and is the most effective method for body weight reduction in obese and very obese patients. In practice there are two bariatric techniques; gastric banding, which leads to weight loss through intake restriction, and gastric bypass, leads to weight loss through food malabsorption. Gastric bypass surgery (the more frequently performed procedure), in most cases, leads to changes in eating habits and may result in vomiting, diarrhea and rapid body mass reduction. There are reliable data describing the continuous increase in the number of women who are trying to conceive, or are already pregnant, following bariatric surgery. Most medical specialists advise women to avoid pregnancy within 12-18 months after bariatric surgery. This allows for time to recover sufficiency from the decreased absorption of nutrients caused by the bariatric surgery. During this period there is a need for the use of reliable contraception. As there is a risk for malabsorption of hormones taken orally, the combined and progestogen-only pills are contraindicated, and displaced by non-oral hormonal contraception or non-hormonal methods, including intrauterine devices and condoms.

  5. Case-control study of oral contraceptives and risk of thromboembolic stroke: results from International Study on Oral Contraceptives and Health of Young Women.

    Science.gov (United States)

    Heinemann, L A; Lewis, M A; Thorogood, M; Spitzer, W O; Guggenmoos-Holzmann, I; Bruppacher, R

    1997-12-06

    To determine the influence of oral contraceptives (particularly those containing modern progestins) on the risk for ischaemic stroke in women aged 16-44 years. Matched case-control study. 16 Centres in the United Kingdom, Germany, France, Switzerland, and Austria. Cases were 220 women aged 16-44 who had an incident ischaemic stroke. Controls were 775 women (at least one hospital and one community control per case) unaffected by stroke who were matched with the corresponding case for 5 year age band and for hospital or community setting. Information on exposure and confounding variables were collected in a face to face interview. Odds ratios derived with stratified analysis and unconditional logistic regression to adjust for potential confounding. Adjusted odds ratios (95% confidence intervals) for ischaemic stroke (unmatched analysis) were 4.4 (2.0 to 9.9), 3.4 (2.1 to 5.5), and 3.9 (2.3 to 6.6) for current use of first, second, and third generation oral contraceptives, respectively. The risk ratio for third versus second generation was 1.1 (0.7 to 2.0) and was similar in the United Kingdom and other European countries. The risk estimates were lower if blood pressure was checked before prescription. Although there is a small relative risk of occlusive stroke for women of reproductive age who currently use oral contraceptives, the attributable risk is very small because the incidence in this age range is very low. There is no difference between the risk of oral contraceptives of the third and second generation; only first generation oral contraceptives seem to be associated with a higher risk. This small increase in risk may be further reduced by efforts to control cardiovascular risk factors, particularly high blood pressure.

  6. Risk of venous thromboembolism among users of third generation oral contraceptives compared with users of oral contraceptives with levonorgestrel before and after 1995: cohort and case-control analysis

    Science.gov (United States)

    Jick, Hershel; Kaye, James A; Vasilakis-Scaramozza, Catherine; Jick, Susan S

    2000-01-01

    Objective To compare the risk of idiopathic venous thromboembolism among women taking third generation oral contraceptives (with gestodene or desogestrel) with that among women taking oral contraceptives with levonorgestrel. Design Cohort and case-control analyses derived from the General Practice Research Database. Setting UK general practices, January 1993 to December 1999. Participants Women aged 15-39 taking third generation oral contraceptives or oral contraceptives with levonorgestrel. Main outcome measures Relative incidence (cohort study) and odds ratios (case-control study) as measures of the relative risk of venous thromboembolism. Results The adjusted estimates of relative risk for venous thromboembolism associated with third generation oral contraceptives compared with oral contraceptives with levonorgestrel was 1.9 (95% confidence interval 1.3 to 2.8) in the cohort analysis and 2.3 (1.3 to 3.9) in the case-control study. The estimates for the two types of oral contraceptives were similar before and after the warning issued by the Committee on Safety of Medicines in October 1995. A shift away from the use of third generation oral contraceptives after the scare was more pronounced among younger women (who have a lower risk of venous thromboembolism) than among older women. Fewer cases of venous thromboembolism occurred in 1996 and later than would have been expected if the use of oral contraceptives had remained unchanged. Conclusions These findings are consistent with previously reported studies, which found that compared with oral contraceptives with levonorgestrel, third generation oral contraceptives are associated with around twice the risk of venous thromboembolism. PMID:11073511

  7. Use of combined oral contraceptive pills among teenage girls in Calabar, Nigeria

    Directory of Open Access Journals (Sweden)

    Iklaki CU

    2012-07-01

    Full Text Available Christopher U Iklaki,1 John E Inaku,2 John E Ekabua,1 Patience O Odusolu,1 Charles O Njoku11Department of Obstetrics and Gynaecology, University of Calabar, Calabar, Nigeria; 2Department of Obstetrics and Gynaecology, University of Calabar Teaching Hospital, Calabar, NigeriaAbstract: The objective of this study was to find out about the use of combined oral contraceptive pills by women in Calabar, Nigeria, with a particular interest in single nulliparous teenage women. During the period from 2006 to 2010, a total of 1980 women seen in the University of Calabar Teaching Hospital's family planning unit used various methods of contraception. Of these, 316 (15.96% used combined oral contraceptive pills. Twenty girls aged between 13 and 19 years accounted for 6.3% of those who used combined oral contraceptive pills. There were 296 (93.6% women between the ages of 20 and 34 years who accounted for the remaining users. Of these women, 195 (61.5% were educated to the secondary level, and 34 (10.8% were educated to primary level. No women without formal education used combined oral contraceptive pills during the period of study. The majority of the users were nulliparous (128; 40.4%; the rest had parity values of at least one to more than four. One hundred thirty-seven (43.4% of the users were single, 112 (35.4% were married, and the remaining 67 (21.1% were separated, divorced, or widowed. There is a growing need to educate young Nigerian women about the use of combined oral contraceptive pills; this medication is suitable and effective for most young women, and it also has additional noncontraceptive health benefits.Keywords: combined, oral, contraception, pills

  8. Influence of hormonal contraceptives and the occurrence of stroke: integrative review.

    Science.gov (United States)

    Lima, Adman Câmara Soares; Martins, Larissa Castelo Guedes; Lopes, Marcos Venícios de Oliveira; Araújo, Thelma Leite de; Lima, Francisca Elisângela Teixeira; Aquino, Priscila de Souza; Moura, Escolástica Rejane Ferreira

    2017-01-01

    To identify scientific evidence regarding the influence of hormonal contraceptive use and the occurrence of stroke. Integrative review of the literature, through database search using the descriptors "contraceptive agents", "contraceptive devices", "contraceptives, Oral" and "Stroke". Original studies in Portuguese, Spanish and English, published in full and available online were included. Studies that did not answer our guiding questions and duplicated studies were excluded. Women using combined oral contraceptives have higher risk of stroke, even with a lower hormonal dosage and different types of progestogen, regardless of the duration of use. The use of contraceptives associated with smoking, hypertension, migraine, hypercholesterolemia, obesity and sedentary lifestyle increases the chance of stroke. Contraceptive patch and vaginal ring are associated to increased risk. Use of combined hormonal contraceptives, except for the injectable and the transdermal ones, increases the chance of occurrence of the event. Progestogen-only contraceptives were considered safe. Identificar evidências científicas acerca da influência do uso de anticoncepcionais hormonais na ocorrência do acidente vascular cerebral (AVC). Revisão integrativa da literatura, com pesquisa em bases de dados, utilizando os descritores "contraceptive agents", "contraceptive devices", "contraceptives, Oral" e "stroke". Foram incluídos artigos originais nos idiomas português, espanhol e inglês, publicados na íntegra e disponíveis eletronicamente. Foram excluídos artigos que não respondiam às questões norteadoras e repetidos. Usuárias de anticoncepcional oral combinado apresentam risco maior de AVC, mesmo com dosagem hormonal menor e diferentes tipos de progestágeno, independente do tempo de uso. A presença associada de tabagismo, hipertensão arterial, enxaqueca, hipercolesterolemia, obesidade e sedentarismo aumenta a chance desse desfecho. Adesivo anticoncepcional e anel vaginal s

  9. Impact of oral contraceptive pills on central corneal thickness in young women

    OpenAIRE

    Bengi Ece Kurtul; Besime Inal; Pinar Altiaylik Ozer; Emrah Utku Kabatas

    2016-01-01

    Objectives: Hormonal changes during oral contraceptive pill (OCP) use may affect central corneal thickness (CCT) values. We aimed to evaluate the impact of OCP use on CCT values in healthy young women. Materials and Methods: Fifty women subjects who use OCP for contraception (Group 1) and forty control subjects (Group 2) who do not use OCP were included in this prospective study. None of the patients had any history of systemic or ocular diseases. The CCT values measured by ultrasonic pach...

  10. Effects of menstrual cycle and oral contraceptive use on serum levels of lipid-soluble antioxidants.

    Science.gov (United States)

    Palan, Prabhudas R; Magneson, Amy T; Castillo, Monique; Dunne, James; Mikhail, Magdy S

    2006-05-01

    The purpose of this study was to examine the influence of menstrual cycle and oral contraceptive use on serum levels of lipid-soluble antioxidants. In this cross-section study, nonfasting blood samples were collected twice from 10 healthy premenopausal women during the follicular phase (between days 8 and 11) and the luteal phase (between days 18 and 22) of their same menstrual cycle. In addition, blood samples from 15 premenopausal women who used oral contraceptive for at least 6 months and 40 women who did not use oral contraceptive were collected randomly at any day of the menstrual cycle. Serum levels of coenzyme Q10, alpha-tocopherol, gamma-tocopherol, beta-carotene, alpha-carotene, and lycopene were determined using high pressure liquid chromatography. Serum coenzyme Q10 and alpha-tocopherol levels were significantly lower during the follicular phase compared with the luteal phase of the same menstrual cycle (P < .05). Oral contraceptive use also significantly decreased coenzyme Q10 and alpha-tocopherol (P < .001). Other antioxidant levels were comparable. Alterations in coenzyme Q10 and alpha-tocopherol levels during the menstrual cycle and in oral contraceptive users should be taken into consideration, concerning the future antioxidant research in premenopausal women. Further studies are needed to investigate the potential role of endogenous and exogenous ovarian hormones on oxidative stress in women.

  11. The influence of humidity, temperature, and oral contraceptive in tear

    Science.gov (United States)

    Sousa, Raul A. R. C.; Ribeiro, Tânia L. C.; Moreira, Sandra M. B.; Baptista, António M. G.

    2013-11-01

    The aim of this study is to ascertain whether the quantity and quality of tear and eye subjective comfort are influenced by the temperature, humidity and oral Contraceptives Taking or Non-taking (CTNT). Forty-one students, females, from the University of Minho, Braga, Portugal, aged (mean+/-1standard deviation) of 21.51+/-1.85 years, ranging from 20 to 30 years, participated in this study. The McMonnies Questionnaire (MMQ), Break Up Time (BUT) and Phenol Red Test (PRT) were accessed between 14-17 hours in four sets of visits throughout the year: Visit 1, Visit 2, Visit 3 and Visit 4. The PRT and BUT values (mean+/-1standard deviation) for Visit 1, Visit 2, Visit 3 and Visit 4 were respectively 23.88+/-6.50mm, 22.29+/-8.00mm, 23.61+/-6.75mm, 22.88+/-7.00mm and 6.02+/-1.58s, 5.62+/-1.22s, 5.23+/-0.88s, 5.53+/-1. 42s. The MMQ scores for Visit 1, Visit 2, Visit 3 and Visit 4 ranged from 2-13, 2-15, 1-14 and 2-14 with medians of 6, 7, 6 and 6, respectively. The influence of temperature, humidity and CTNT on PRT, BUT and MMQ were evaluated using generalized linear mixed model. For BUT and MMQ statistical significant effects were found regarding temperature and humidity. The temperature and humidity influenced the tear quality and subjective comfort but did not influence the tear quantity. The CTNT did not influence tear quantity, quality or subjective eye comfort.

  12. Thrombotic risk during oral contraceptive use and pregnancy in women with factor V Leiden or prothrombin mutation: a rational approach to contraception

    NARCIS (Netherlands)

    van Vlijmen, Elizabeth F. W.; Veeger, Nic J. G. M.; Middeldorp, Saskia; Hamulyák, Karly; Prins, Martin H.; Büller, Harry R.; Meijer, Karina

    2011-01-01

    Current guidelines discourage combined oral contraceptive (COC) use in women with hereditary thrombophilic defects. However, qualifying all hereditary thrombophilic defects as similarly strong risk factors might be questioned. Recent studies indicate the risk of venous thromboembolism (VTE) of a

  13. Thrombotic risk during oral contraceptive use and pregnancy in women with factor V Leiden or prothrombin mutation : a rational approach to contraception

    NARCIS (Netherlands)

    van Vlijmen, Elizabeth F. W.; Veeger, Nic J. G. M.; Middeldorp, Saskia; Hamulyak, Karly; Prins, Martin H.; Buller, Harry R.; Meijer, Karina

    2011-01-01

    Current guidelines discourage combined oral contraceptive (COC) use in women with hereditary thrombophilic defects. However, qualifying all hereditary thrombophilic defects as similarly strong risk factors might be questioned. Recent studies indicate the risk of venous thromboembolism (VTE) of a

  14. [Effect of combined hormonal oral contraception on the somatic and psychic status of women of reproductive age].

    Science.gov (United States)

    Vertkin, A L; Nosova, A V

    2012-01-01

    The paper is devoted to the topical problem of maintaining somatic and psychic health of the women of reproductive age by rational pregnancy planning and prevention of abortions by modern methods of contraception including combined oral hormonal contraception. Unfortunately, this approach is rarely employed in this country (5-6%). Results of retrospective analysis of medical documentation, clinical efficacy and safety of modern combined oral hormonal contraception are presented.

  15. A study of the influence of a gestodene-containing triphasic oral contraceptive on endometrial morphology.

    Science.gov (United States)

    Rabe, T; Leppien, G; Fossman, W G; Hessing, C; Vladescú, E; Runnebaum, B

    1997-09-01

    The objective of the study was to investigate histological changes in the endometrium in 20 volunteers treated with a low-dose, gestodene-containing triphasic oral contraceptive. Endometrial biopsy specimens were taken before, during a 6-month period of oral contraceptive use and in a post-treatment period. These specimens were evaluated using light microscopy, scanning and transmission electron microscopy. In addition, ultrasound examinations of the uterus, endometrial thickness and ovaries were performed. The low-dose, gestodene-containing triphasic oral contraceptive had no adverse effects on the endometrium (e.g. no proliferation, no polyps, no inflammatory processes), was well tolerated and showed a low side-effect profile. The inhibition of endometrial transformation was demonstrated both by endometrial morphology as well as by endometrial thickness, as measured by transvaginal ultrasound examination.

  16. [The effectiveness and acceptability of oral contraceptives (Logest), containing 20 micrograms ethinylestradiol and 75 micrograms gestodene].

    Science.gov (United States)

    Lech, Medard M; Swiatek, Ewa J

    2004-03-01

    The aim of the study was to evaluate the efficacy and acceptability of the use of oral contraceptives Logest, containing 20 micrograms ethinylestradiol and 75 micrograms gestodene (in one tablet). Observational study (during the period of six months) on the healthy women visiting gynecological clinics and asking for establishment of contraception with the use of oral contraceptives. The observation was carried out on 800 patients who were included (with use including/excluding criteria) to the study. The study was carried out during the period of October 1999-March 2001. Patients were asked to use the Logest intermittently during the period of 6 months (21 days of administration followed by 7 days break, and than again 21 days of administration etc). The administration of Logest was followed up. Basic examination and qualification for the use of oral contraceptive was taken during the first visit. Re-examinations were taken after 3 and 6 month of usage of the study drug. High efficacy, good tolerance and acceptability of Logest administration was observed. Neither cases of non effectiveness, nor serious adverse events, during the Logest administration were reported. 95.7% of the patients which completed the study, declared that the oral contraception with use of Logest was "very well accepted" or "well accepted".

  17. Does hormone replacement therapy and use of oral contraceptives increase the risk of non-melanoma skin cancer?

    DEFF Research Database (Denmark)

    Birch-Johansen, Fatima; Jensen, Allan; Olesen, Anne Braae

    2012-01-01

    We aimed to examine whether use of hormone replacement therapy (HRT) and oral contraceptives (OC) affect the risk of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in women.......We aimed to examine whether use of hormone replacement therapy (HRT) and oral contraceptives (OC) affect the risk of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in women....

  18. Oral contraceptive use and impact of cumulative intake of estrogen and progestin on risk of ovarian cancer

    DEFF Research Database (Denmark)

    Faber, M T; Jensen, A; Frederiksen, K

    2013-01-01

    Oral contraceptive use decreases the risk of ovarian cancer, but no previous studies have assessed the impact of cumulative intake of estrogen and progestin on ovarian cancer risk.......Oral contraceptive use decreases the risk of ovarian cancer, but no previous studies have assessed the impact of cumulative intake of estrogen and progestin on ovarian cancer risk....

  19. Adolescent girls in Denmark use oral contraceptives at an increasingly young age, and with more pauses and shifts

    DEFF Research Database (Denmark)

    Løkkegaard, Ellen; Nielsen, Anne Kristine

    2014-01-01

    was to describe the use of hormonal contraceptives among the Danish adolescent female population, focusing on age, period and cohort effects and including types of hormonal contraceptives. MATERIAL AND METHODS: All women aged 14-50 years during the 1995-2012 period were identified through the Central Person...... Register. Furthermore, the National Registry of Medicinal Products Statistics provided information on redeemed prescriptions for hormonal contraceptives characterised by Anatomical-Therapeutic-Chemical (ATC) classification codes. RESULTS: At the age of 17 years, more than 50% of the Danish adolescent......, adolescent girls have more pauses and shifts between types of hormonal contraceptives. Since 2010 there has been a shift toward use of second generation oral contraceptives away from third and fourth generation contraceptives. CONCLUSION: Adolescent girls tend to initiate their use of oral contraceptives...

  20. Generalised peliosis hepatis mimicking metastases after long-term use of oral contraceptives.

    Science.gov (United States)

    Kootte, A M M; Siegel, A M; Koorenhof, M

    2015-01-01

    Peliosis hepatis (PH) is a rare vascular condition of the liver characterised by the presence of cystic blood-filled cavities distributed randomly throughout the liver parenchyma. PH should be considered in the differential diagnosis of women with a long history of use of oral contraceptives with suspected hypervascular lesions diagnosed by imaging, but with an unknown primary tumour. Because of the extensive use of oral contraceptives in the general female population worldwide, PH should be added to the differential diagnosis of suspected hypervascular liver lesions.

  1. Portal vein thrombosis and fatal pulmonary thromboembolism associated with oral contraceptive treatment.

    Science.gov (United States)

    Capron, J P; Lemay, J L; Muir, J F; Dupas, J L; Lebrec, D; Gineston, J L

    1981-09-01

    We report a 33-year-old woman who took oral contraceptives for 8 years, and who developed gastrointestinal bleeding from esophageal varices. Celiac and mesenteric angiography demonstrated a portal vein thrombosis. Because of several episodes of dyspnea, a pulmonary angiogram was also performed, and showed partial or complete obstruction of both inferior pulmonary arteries with "pruning" of lower lobes. Despite immediate anticoagulant therapy, the patient died suddenly some days later. We believe that oral contraceptive treatment could have induced thromboembolic disease both in portal and pulmonary circulations in this patient.

  2. Cluster headache in women: relation with menstruation, use of oral contraceptives, pregnancy, and menopause

    Science.gov (United States)

    van Vliet, J A; Favier, I; Helmerhorst, F M; Haan, J; Ferrari, M D

    2006-01-01

    In contrast with migraine, little is known about the relation between cluster headache and menstrual cycle, oral contraceptives, pregnancy, and menopause. A population based questionnaire study was performed among 224 female cluster headache patients, and the possible effect of hormonal influences on cluster headache attacks studied. For control data, a similar but adjusted questionnaire was sent to healthy volunteers and migraine patients. It was found that menstruation, use of oral contraceptives, pregnancy, and menopause had a much smaller influence on cluster headache attacks than in migraine. Cluster headache can, however, have a large impact on individual women, for example to refrain from having children. PMID:16407458

  3. Partner choice, relationship satisfaction, and oral contraception: the congruency hypothesis.

    Science.gov (United States)

    Roberts, S Craig; Little, Anthony C; Burriss, Robert P; Cobey, Kelly D; Klapilová, Kateřina; Havlíček, Jan; Jones, Benedict C; DeBruine, Lisa; Petrie, Marion

    2014-07-01

    Hormonal fluctuation across the menstrual cycle explains temporal variation in women's judgment of the attractiveness of members of the opposite sex. Use of hormonal contraceptives could therefore influence both initial partner choice and, if contraceptive use subsequently changes, intrapair dynamics. Associations between hormonal contraceptive use and relationship satisfaction may thus be best understood by considering whether current use is congruent with use when relationships formed, rather than by considering current use alone. In the study reported here, we tested this congruency hypothesis in a survey of 365 couples. Controlling for potential confounds (including relationship duration, age, parenthood, and income), we found that congruency in current and previous hormonal contraceptive use, but not current use alone, predicted women's sexual satisfaction with their partners. Congruency was not associated with women's nonsexual satisfaction or with the satisfaction of their male partners. Our results provide empirical support for the congruency hypothesis and suggest that women's sexual satisfaction is influenced by changes in partner preference associated with change in hormonal contraceptive use. © The Author(s) 2014.

  4. Myths about oral contraceptives. Does OC availability result in increased sexual activity among teens?

    Science.gov (United States)

    Chaney

    1993-11-01

    Parents, educators, public health officials, health-care providers, religious organizations, and advocacy groups are very concerned about the rise in teenage pregnancy and the increase in sexually transmitted diseases among the young. Some say the increased availability and acceptance of oral contraceptives is directly related to an increase in sexual activity among teens. Less than 50% of women use a contraceptive method at first intercourse. Use is much lower in Hispanic and African-American women than among White women; women with low socioeconomic status, living in one-parent households, or having sex at an early age are the least likely to use a contraceptive method at first intercourse. According to the National Survey of Family Growth, teens engaging in sexual intercourse for the first time, who use a contraceptive method, typically choose the condom. Oral contraceptive use is very low and use at first intercourse has not increased over time. It is only after the establishment of routine sexual intercourse that the pill becomes the preferred method. The use of a condom has more than doubled for the period from 1982 to 1988. Adolescents under age 16 are at greatest risk for unintended pregnancies because this group is the least likely to use any method of contraception. The increase in teen sexual activity over the years does not coincide with an increase in pill use. Education must begin in elementary schools, stressing abstinence, but also include facts about sex, contraception, and disease prevention, because 40% of teens are sexually active by 9th grade. Skills can focus on changing behavior, such as learning to delay intercourse, building self-esteem as well as proper use of contraceptives. Easy, nonthreatening access to medical care can prevent many unintended pregnancies and the spread of sexually transmitted diseases.

  5. A pilot study of the Copper T380A IUD and oral levonorgestrel for emergency contraception.

    Science.gov (United States)

    Turok, David K; Gurtcheff, Shawn E; Handley, Erin; Simonsen, Sara E; Sok, Christina; Murphy, Patricia

    2010-12-01

    This study evaluates the willingness of women presenting for emergency contraception (EC) to enroll in a study offering the copper intrauterine device (IUD) or oral levonorgestrel (LNG) and follows up the two groups for 6 months after EC administration to compare use of an effective method of contraception. This prospective observational study offered these two methods to women presenting for EC. The primary outcome was use of an effective method of contraception 6 months after presenting for EC. Thirty-four women (60%) chose oral LNG and 23 (40%) chose the copper IUD. One month after presenting for EC, 21 (96%) of 22 in the IUD group were still using the IUD and all 22 were using an effective method of contraception (efficacy ≥92%). In the LNG group, 13 (52%) of 25 were using an effective method of contraception (poral LNG EC users were using an effective method (p=NS). Women presenting for EC were willing to enroll in a study offering the copper IUD or oral LNG. Copyright © 2010 Elsevier Inc. All rights reserved.

  6. Effect of oral contraception on anemia in 12 low- and middle-income countries.

    Science.gov (United States)

    Bellizzi, Saverio; Ali, Mohamed M

    2017-11-10

    In low- and middle-income countries, anemia is a major public health issue in women of reproductive age for a series of factors including iron deficiency. To estimate prevalence of anemia and to assess the association of low level of hemoglobin versus duration of use of oral contraceptives (OC). Demographic and Health Surveys of 12 countries, conducted between 2005 and 2012, were analyzed. The status of anemia was separately evaluated for nonpregnant women using OC for at least 6 months, 1 year and 2 years, and for women using no method of contraception and/or using nonhormonal contraception. The total study population comprised 201,720 women, with 40% diagnosed with anemia; around 1 out of 25 women was using oral contraception. The current and continuous use of oral contraception was of benefit against anemia, with the risk for anemia decreasing from odds ratio (OR) 0.68 [95% confidence interval (CI) 0.64-0.73] for use of at least 6 months to OR 0.56 (95% CI 0.52-0.61) for use of at least 1 year and to OR 0.50 (95% CI 0.46-0.54) for use of at least 2 years. Findings reinforce evidence of the noncontraceptive benefit of long-term use of OC and provide valuable information for policy makers, family planning staff and clinicians working in low- and middle-income countries in efforts to control anemia. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Menstrual problems and contraception in women of reproductive age receiving oral anticoagulation.

    Science.gov (United States)

    Huq, Farah Yasmine; Tvarkova, Katerina; Arafa, Aliaa; Kadir, Rezan A

    2011-08-01

    Oral anticoagulation is associated with increased bleeding complications. The aim of this study was to assess the changes in menstrual loss and pattern in women taking anticoagulant treatment. Women on oral anticoagulant (OA) treatment at the Royal Free Hospital were interviewed and completed a questionnaire about their menstrual cycle before and after commencing oral anticoagulation treatment. They were then asked to complete a pictorial bleeding assessment chart (PBAC) during their next menstrual bleeding episode. Fifty-three women between the ages of 20 and 50 years participated in the study. Of these, 47 women completed a PBAC. The mean duration of menstruation increased from 5 days before starting OA therapy to 7 days after the commencement of treatment. Thirty-one (66%) of the 47 women who completed the PBAC had a score that was greater than 100. The number of women who experienced flooding or clots during menstruation and intermenstrual or postcoital bleeding also increased. In total, 29 (54.7%) women changed their method of contraception during OA treatment. Seventeen women who did not want to become pregnant were not using contraception, including 10 women who were on hormonal contraception prior to starting anticoagulant therapy. Women of reproductive age experience heavy and prolonged menstrual bleeding whilst on OA therapy. Women of reproductive age on OA therapy should be monitored for menstrual disorders to ensure that prompt and appropriate treatment is instituted. Advice about appropriate contraception should also be part of the medical care provided for these women. Barrier contraception, sterilization and progestin-only contraception are all suitable methods of contraception in this patient group. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. Novel oral contraceptive for heavy menstrual bleeding: estradiol valerate and dienogest

    Directory of Open Access Journals (Sweden)

    Rafie S

    2013-06-01

    Full Text Available Sally Rafie,1 Laura Borgelt,2 Erin R Koepf,3 Mary E Temple-Cooper,4 K Joy Lehman51Department of Pharmacy, University of California San Diego Health System, San Diego, CA, 2Departments of Clinical Pharmacy and Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 3Department of Pharmacy Practice, University of New England College of Pharmacy, Portland, ME, 4Department of Pharmacy, Hillcrest Hospital, Cleveland Clinic, Mayfield Heights, OH, 5Department of Pharmacy, Ohio State University Medical Center, Columbus, OH, USAAbstract: Abnormal uterine bleeding (AUB is associated with significant direct medical costs and impacts both society and the quality of life for individual women. Heavy menstrual bleeding, a subset of AUB, also referred to as menorrhagia, is defined as menstrual blood loss greater than 80 mL or the patient's perception of excessive blood loss. The newest treatment option available is a novel combination oral contraceptive product containing estradiol valerate (E2V and dienogest (DNG. As with other combination oral contraceptives, E2V/DNG works primarily by preventing ovulation. However, in contrast with other combination oral contraceptives, it is the progestin component of E2V/DNG that is responsible for endometrial stabilization. Use of E2V/DNG for six months has led to significant reductions in heavy menstrual bleeding with an average 65% reduction in mean blood loss. Approximately half of the women with heavy menstrual bleeding who received E2V/DNG for six months demonstrated an 80% reduction in mean blood loss. Additionally, significant improvements in hematologic indicators (ie, ferritin, hemoglobin, and hematocrit have been shown. Based on its chemical properties, E2V/DNG may have fewer adverse effects on lipid and glucose metabolism and reduced risk of thromboembolic complications compared with other combination oral contraceptives. This has not yet been shown in clinical trials and until then it

  9. New developments in oral contraception: clinical utility of estradiol valerate/dienogest (Natazia® for contraception and for treatment of heavy menstrual bleeding: patient considerations

    Directory of Open Access Journals (Sweden)

    Nelson AL

    2012-12-01

    Full Text Available Anita L NelsonObstetrics and Gynecology, David Geffen School of Medicine at UCLA, Harbor UCLA Medical Center, Torrance, California, USAAbstract: Natazia® is a new oral contraceptive with estradiol valerate and dienogest in a unique multiphasic formulation that includes a shortened hormone-free interval. This new formulation has been approved for both contraception and also as a treatment for heavy menstrual bleeding in women who desire to use oral contraceptives as their method of birth control. It is marketed in the US as Natazia® and elsewhere as Qlaira®. This article will review the properties of each of the major new features of this pill: estradiol used in place of ethinyl estradiol, dienogest as the progestin, and the unique dosing pattern of this product. It will also summarize the results of the pivotal clinical trials of contraceptive effectiveness, bleeding patterns, safety and tolerability. The lessons learned from the clinical trials about the effectiveness of this formulation in the treatment of excessive menstrual bleeding will be summarized. Also, results of trials comparing this new pill to other popular formulations for "menstrually-related" symptoms and for potential female sexual dysfunction related to use of oral contraceptives will be presented. This review will suggest how all this information might be used to counsel women about how to use this pill most successfully.Keywords: oral contraceptives, estradiol valerate, dienogest, heavy menstrual bleeding, menorrhagia, dynamic dosing

  10. Effects of the Menstrual Cycle and Oral Contraception on Singers' Pitch Control

    Science.gov (United States)

    La, Filipa M. B.; Sundberg, Johan; Howard, David M.; Sa-Couto, Pedro; Freitas, Adelaide

    2012-01-01

    Purpose: Difficulties with intonation and vibrato control during the menstrual cycle have been reported by singers; however, this phenomenon has not yet been systematically investigated. Method: A double-blind randomized placebo-controlled trial assessing effects of the menstrual cycle and use of a combined oral contraceptive pill (OCP) on pitch…

  11. Parity and Oral Contraceptive Use in Relation to Ovarian Cancer Risk in Older Women.

    Science.gov (United States)

    McGuire, Valerie; Hartge, Patricia; Liao, Linda M; Sinha, Rashmi; Bernstein, Leslie; Canchola, Alison J; Anderson, Garnet L; Stefanick, Marcia L; Whittemore, Alice S

    2016-07-01

    Several studies have suggested that the ovarian cancer risk reductions associated with parity and oral contraceptive use are weaker in postmenopausal than premenopausal women, yet little is known about the persistence of these reductions as women age. This question gains importance with the increasing numbers of older women in the population. We addressed the question using data from three large U.S. cohort studies involving 310,290 white women aged 50+ years at recruitment, of whom 1,815 developed subsequent incident invasive epithelial ovarian cancer. We used Cox regression, stratified by cohort, to examine age-related trends in the HRs per full-term pregnancy and per year of oral contraceptive use. The parity-associated risk reductions waned with age (Ptrend parity. However, we observed no such attenuation in the oral contraceptive-associated risk reductions (P = 0.79 for trend in HR with increasing age). These findings suggest that prior oral contraceptive use is important for ovarian cancer risk assessment among women of all ages, while the benefits of parity wane as women age. This information, if duplicated in other studies, will be useful to preventive counseling and risk prediction, particularly for women at increased ovarian cancer risk due to a personal history of breast cancer or a family history of ovarian cancer. Cancer Epidemiol Biomarkers Prev; 25(7); 1059-63. ©2016 AACR. ©2016 American Association for Cancer Research.

  12. The effect of oral contraception on macroprolactin levels in women with macroprolactinemia: A pilot study.

    Science.gov (United States)

    Krysiak, Robert; Kowalska, Beata; Szkróbka, Witold; Okopień, Bogusław

    2015-10-01

    Despite a high prevalence of macroprolactinemia in the population, the only drugs found to change macroprolactin (big-big prolactin) levels were dopamine receptor agonists. The aim of this study was to investigate the effect of oral contraceptive pills containing ethinyl estradiol and levonorgestrel on serum macroprolactin levels in patients with macroprolactinemia. The study population included 21 premenopausal women with isolated macroprolactinemia, 11 of whom were treated with oral contraceptive pills. Serum prolactin and macroprolactin levels were assessed at baseline and after 16 weeks of treatment. Oral contraceptive pills administered for 16 weeks slightly increased pre-polyethylene glycol serum prolactin levels and macroprolactin levels and the effect of this treatment correlated with their baseline values. Our results suggest that oral contraceptive pills containing ethinyl estradiol and levonorgestrel exhibit a stimulatory effect on macroprolactin production in women with basically high macroprolactin levels. Copyright © 2015 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  13. Agreement between oral contraceptive users and prescribers: implications for case-control studies

    NARCIS (Netherlands)

    F.E. van Leeuwen; C.M. van Duijn (Cornelia); M.H. Camps; B.A. Kempers; M.F. Mentjens; H.B. Mulder; E.G. Schouten (Evert); R.M.L. Zwijsen; M.A. Rookus (Matti)

    1992-01-01

    textabstractCase-control studies examining the effects of oral contraceptives (OC) are prone to misclassification bias due to errors in assessment of OC use. Concern about inaccurate exposure histories has increased since current studies require women to recall OC use over prolonged periods of time.

  14. Restoring testosterone levels by adding dehydroepiandrosterone to a drospirenone containing combined oral contraceptive : II. Clinical effects

    NARCIS (Netherlands)

    Zimmerman, Y.; Foidart, J. M.; Pintiaux, A.; Minon, J. M.; Fauser, B. C J M; Cobey, K.; Coelingh Bennink, H. J T

    2015-01-01

    Objectives Combined oral contraceptives (COCs) decrease androgen levels, including testosterone (T), which may be associated with sexual dysfunction and mood complaints in some women. We have shown that 'co-administration' of dehydroepiandrosterone (DHEA) to a drospirenone (DRSP)-containing COC

  15. Restoring testosterone levels by adding dehydroepiandrosterone to a drospirenone containing combined oral contraceptive : I. Endocrine effects

    NARCIS (Netherlands)

    Zimmerman, Y.; Foidart, J. M.; Pintiaux, A.; Minon, J. M.; Fauser, B. C J M; Cobey, K.; Coelingh Bennink, H. J T

    2015-01-01

    Objectives Combined oral contraceptives (COCs) decrease testosterone (T) levels. This study investigated restoration of T and other androgen concentrations during COC use by 'co-administration' of dehydroepiandrosterone (DHEA). Study design In this randomized, double-blind, placebo-controlled study

  16. Factors influencing the adrenocorticotropin test: role of contemporary cortisol assays, body composition, and oral contraceptive agents

    DEFF Research Database (Denmark)

    Klose, Marianne; Lange, Martin; Rasmussen, Aase Krogh

    2007-01-01

    -hormone levels; corticosteroid-binding globulin levels; and test conditions (fasting/nonfasting, rest/intermittent exercise). METHODS: A 250-microg ACTH test (0800-1000 h) was performed in 100 unmedicated subjects, 13 women taking oral contraception (OC), and six men with nephrotic syndrome. Tests were performed...

  17. Diminished nap effects on memory consolidation are seen under oral contraceptive use

    NARCIS (Netherlands)

    Genzel, L.K.E.; Baurle, A.; Potyka, A.; Wehrle, R.; Adamczyk, M.; Friess, E.; Steiger, A.; Dresler, M.

    2014-01-01

    Many young females take exogenous hormones as oral contraceptive (OC), a condition rarely controlled for in studies on sleep and memory consolidation even though sex hormones influence consolidation. This study investigated the effects of OCs on sleep-related consolidation of a motor and declarative

  18. Association of oral contraceptive use and human papillomaviruses in invasive cervical cancers.

    Science.gov (United States)

    Hildesheim, A; Reeves, W C; Brinton, L A; Lavery, C; Brenes, M; De La Guardia, M E; Godoy, J; Rawls, W E

    1990-05-15

    In a study of 197 cases of histologically confirmed invasive cervical cancer, 61% of biopsies were positive for human papillomavirus (HPV) DNA by Southern or dot-blot hybridization. An association between detection of HPV DNA and oral contraceptive use was observed when HPV-positive and -negative cases were compared. Women reporting recent or long-term (greater than 4 yrs) oral contraceptive use were at 2.3 and 2.9-fold increased risks of HPV positivity, respectively. An increased risk of HPV positivity was also associated with formal education and with urban residence, while long-term smoking was negatively associated with HPV detection. A non-significant trend of increasing risk of HPV positivity with increasing number of sexual partners of the women and of the male partners of monogamous women was observed. Detection of HPV DNA was not associated with other cervical cancer risk factors examined, including age at first coitus, number of pregnancies, and Pap smear screening history. Our findings suggest either an interaction between HPV infection and oral contraceptive use in the genesis of cervical cancer or an increased expression of HPV genome in neoplasms of oral contraceptive users. These observations also support a multifactorial model of cervical cancer causation.

  19. A study of the effects of oral contraceptives on plasma urea of Wistar ...

    African Journals Online (AJOL)

    Oral contraceptives such as Microgynon a combined pill (0.15mg levonorgestrel and 0.03mg ethinylestradiol) and Primolut -N a mini pill (5mg norethisterone) were investigated for their in-vivo effects on wistar albino rat rattus rattus plasma urea levels. Test results showed that the drugs had a lowering effect on plasma urea ...

  20. Therapeutic, prophylactic, untoward, and contraceptive effects of combined oral contraceptives: catholic teaching, natural law, and the principle of double effect when deciding to prescribe and use.

    Science.gov (United States)

    Casey, Murray Joseph; Salzman, Todd A

    2014-01-01

    Combined oral contraceptives (COC) have been demonstrated to have significant benefits for the treatment and prevention of disease. These medications also are associated with untoward health effects, and they may be directly contraceptive. Prescribers and users must compare and weigh the intended beneficial health effects against foreseeable but unintended possible adverse effects in their decisions to prescribe and use. Additionally, those who intend to abide by Catholic teachings must consider prohibitions against contraception. Ethical judgments concerning both health benefits and contraception are approached in this essay through an overview of the therapeutic, prophylactic, untoward, and contraceptive effects of COC and discussion of magisterial and traditional Catholic teachings from natural law. Discerning through the principle of double effect, proportionate reason, and evidence gathered from the sciences, medical and moral conclusions are drawn that we believe to be fully compliant with good medicine and Catholic teaching.

  1. Combining oral contraceptives with a natural nuclear factor-kappa B inhibitor for the treatment of endometriosis-related pain

    Science.gov (United States)

    Maia, Hugo; Haddad, Clarice; Casoy, Julio

    2014-01-01

    Endometriosis is a chronic disease in which a persistent state of heightened inflammation is maintained by nuclear factor-kappa B (NF-κB) activation. The progestins present in oral contraceptives are potent inhibitors of NF-κB translocation to cell nuclei, while Pycnogenol® (Pinus pinaster) acts by blocking post-translational events. In this study, the effects of Pycnogenol on pain scores were investigated in patients with endometriosis using oral contraceptives containing either gestodene or drospirenone in extended regimens. Pain scores were determined using a visual analog scale before and after 3 months of treatment. Oral contraceptives, used alone (groups 1 and 3) or in association with Pycnogenol (groups 2 and 4), resulted in significant decreases in pain scores after 3 months of treatment; however, this reduction was significantly greater in the groups using oral contraceptives + Pycnogenol (groups 2 and 4) compared with those using oral contraceptives alone (groups 1 and 3). In the groups using oral contraceptives alone, 50% of patients became pain-free by the end of the third month of treatment. These results suggest that Pycnogenol increases the efficacy of oral contraceptives for the treatment of endometriosis-related pain. PMID:24379702

  2. Efficacy, safety, and patient acceptability of the combined chlormadinone acetate-ethinylestradiol oral contraceptive

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    Serena Ferrari

    2010-09-01

    Full Text Available Serena Ferrari, Marianna Cannoletta, Matteo Generali, Lucia Cazzato, Angelo CagnacciDepartment of Obstetrics, Gynecology, and Pediatrics, Azienda Ospedaliero, Universitaria di Modena, ItalyAbstract: Since their introduction in 1959, development of hormonal contraceptives has been ongoing, with the ultimate aim of creating not only an effective and safe contraceptive method, but also a drug able to meet the need for treatment of other conditions, such as acne, seborrhea, and hirsutism, with few or no side effects. With this objective, a new progestin, chlormadinone acetate (CMA, has been developed as a derivative of progesterone for ­contraception. This new molecule has been introduced in combination with ethinylestradiol (EE 30 µg as a safe ­contraceptive with antiandrogenic properties. Many clinical studies have investigated this new oral combination and found it to be safe, with a Pearl Index similar to that of other combined hormonal contraceptives. CMA, because of its antiandrogenic properties, has been also considered effective for resolution of acne, seborrhea, and hirsutism. The data show it to be a safe molecule in terms of glucose and lipid metabolism. No major weight changes have been linked with its use, and it seems to be the only progestin able to reduce fat mass during use. The CMA-EE combination is well tolerated and acceptable to women. Adverse events related to its use are similar to those reported with other third-generation ­contraceptives. We can conclude that CMA-EE is an effective, safe, and well tolerated ­antiandrogenic hormonal contraceptive.Keywords: chlormadinone acetate, acne, weight, metabolism, safety, hormonal contraceptive

  3. The effect of oral contraception on cardiometabolic risk factors in women with elevated androgen levels.

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    Krysiak, Robert; Gilowska, Małgorzata; Okopień, Bogusław

    2017-02-01

    In unselected reproductive-aged women, use of combined estrogen-progestin oral contraceptive pills has been linked with an increased risk of vascular disease. The aim of this study was to investigate the effect of oral contraception on cardiometabolic risk factors in a population of women with hyperandrogenism. The study included 16 untreated women with elevated testosterone levels and 15 matched healthy women who were then treated with oral contraceptive pills containing ethinyl estradiol (30μg) and drospirenone (3mg). Plasma lipids, glucose homeostasis markers, circulating levels of androgens, uric acid, high-sensitivity C-reactive protein (hsCRP), fibrinogen and homocysteine, as well as urinary albumin-to-creatinine ratio (UACR) were assessed at baseline and after 12 weeks of treatment. Compared to healthy women, women with elevated androgen levels showed increased plasma levels of hsCRP, fibrinogen and homocysteine, as well as a higher value of UACR. Oral contraception reduced androgen levels only in hyperandrogenic women. In healthy women, ethinyl estradiol plus drospirenone increased plasma levels of insulin, hsCRP, fibrinogen and homocysteine, while in women with elevated androgen levels their effect was limited only to a small increase in hsCRP. Our results suggest that a deteriorating effect of oral contraceptive pills containing ethinyl estradiol and drospirenone in hyperandrogenic women is weaker than in healthy young women and that ethinyl estradiol/drospirenone combination therapy may be safely used in the former group of patients. Copyright © 2016. Published by Elsevier Urban & Partner Sp. z o.o.

  4. Evaluating the practice of Iranian community pharmacists regarding oral contraceptive pills using simulated patients.

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    Foroutan, Nazanin; Dabaghzadeh, Fatemeh

    2016-01-01

    As oral contraceptive pills are available over the counter in pharmacies, pharmacists are professionally responsible for checking and informing patients about every aspect of taking these drugs. Simulated patient method is a new and robust way to evaluate professional performance of pharmacists. The aim of the present study was to evaluate the pharmacy practice of Iranian pharmacists regarding over-the-counter use of oral contraceptive pills using simulated patient method. Simulated patients visited pharmacy with a prescription containing ciprofloxacin and asked for oral contraceptive pills. The pharmacist was expected to ask important questions for using these drugs and to inform the patient about them properly. Moreover, the Pharmacists should advise patients in regard to the possible interaction. Ninety four pharmacists participated in this study. In 24 (25.3%) visits, the liable pharmacist was not present at the time of purchase. Furthermore, In 13 (18.57 %) visits by the simulated patients, the liable pharmacists did not pay any attention to the simulated patients even when they asked for consultation. Twenty nine (41.43%) pharmacists did not ask any question during dispensing. Nausea was the most frequent described side effect by pharmacists (27 (38.57%)). Yet important adverse effects of oral contraceptive pills were not mentioned by the pharmacists except for few ones. Only twelve (17.14%) pharmacists mentioned the possible interaction. There was a significant relation between the pharmacists' gender and detection of possible interaction (p value= 0.048). The quality of the pharmacists' consultations regarding the over the counter use of oral contraceptive pills was not satisfactory and required improvement.

  5. Evaluating the practice of Iranian community pharmacists regarding oral contraceptive pills using simulated patients.

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    Foroutan N

    2016-12-01

    Full Text Available Background: As oral contraceptive pills are available over the counter in pharmacies, pharmacists are professionally responsible for checking and informing patients about every aspect of taking these drugs. Simulated patient method is a new and robust way to evaluate professional performance of pharmacists. Objective: The aim of the present study was to evaluate the pharmacy practice of Iranian pharmacists regarding over-the-counter use of oral contraceptive pills using simulated patient method. Methods: Simulated patients visited pharmacy with a prescription containing ciprofloxacin and asked for oral contraceptive pills. The pharmacist was expected to ask important questions for using these drugs and to inform the patient about them properly. Moreover, the Pharmacists should advise patients in regard to the possible interaction. Results: Ninety four pharmacists participated in this study. In 24 (25.3% visits, the liable pharmacist was not present at the time of purchase. Furthermore, In 13 (18.57 % visits by the simulated patients, the liable pharmacists did not pay any attention to the simulated patients even when they asked for consultation. Twenty nine (41.43% pharmacists did not ask any question during dispensing. Nausea was the most frequent described side effect by pharmacists (27 (38.57%. Yet important adverse effects of oral contraceptive pills were not mentioned by the pharmacists except for few ones. Only twelve (17.14% pharmacists mentioned the possible interaction. There was a significant relation between the pharmacists’ gender and detection of possible interaction (p value= 0.048. Conclusion: The quality of the pharmacists’ consultations regarding the over the counter use of oral contraceptive pills was not satisfactory and required improvement.

  6. Decreased maximal aerobic capacity with use of a triphasic oral contraceptive in highly active women: a randomised controlled trial.

    Science.gov (United States)

    Lebrun, C M; Petit, M A; McKenzie, D C; Taunton, J E; Prior, J C

    2003-08-01

    Oral contraceptives are commonly used by women athletes. However, their effect on athletic performance is unclear. To examine the effects of a moderate dose, triphasic oral contraceptive on measures of athletic performance in highly trained women athletes. This is a double blind, placebo controlled trial in 14 women with ovulatory menstrual cycles and maximal aerobic capacity (VO(2)MAX) >/==" BORDER="0">50 ml/kg/min. Four measures of athletic performance were tested: VO(2)MAX, anaerobic capacity (anaerobic speed test), aerobic endurance (time to fatigue at 90% of VO(2)MAX), and isokinetic strength (Cybex II dynamometer). Height, weight, and six skinfold measurements were also recorded. All these observational tests were completed during both the follicular and mid-luteal phases of an ovulatory menstrual cycle. Cycle phases were confirmed by assaying plasma oestradiol and progesterone. Participants were subsequently randomly assigned to either a tricyclic oral contraceptive or placebo and retested in identical fashion (oral contraceptive phase). Absolute and relative changes in VO(2)MAX from follicular to oral contraceptive phase decreased in the oral contraceptive group by 4.7%, whereas the placebo group showed a slight increase (+1.5%) over the same time period. Two of the women taking oral contraceptive had decreases of 4 and 9 ml/kg/min. In contrast, most women in the placebo group improved or maintained VO(2)MAX. There was also a significant increase in the sum of skinfolds in women taking oral contraceptive compared with those taking placebo (pVO(2)MAX that occurs when oral contraceptive is taken may influence elite sporting performance in some women. Further studies are required to determine the mechanisms of this change.

  7. Decreased maximal aerobic capacity with use of a triphasic oral contraceptive in highly active women: a randomised controlled trial

    Science.gov (United States)

    Lebrun, C; Petit, M; McKenzie, D; Taunton, J; Prior, J

    2003-01-01

    Background: Oral contraceptives are commonly used by women athletes. However, their effect on athletic performance is unclear. Objectives: To examine the effects of a moderate dose, triphasic oral contraceptive on measures of athletic performance in highly trained women athletes. Methods: This is a double blind, placebo controlled trial in 14 women with ovulatory menstrual cycles and maximal aerobic capacity (VO2MAX) ≥50 ml/kg/min. Four measures of athletic performance were tested: VO2MAX, anaerobic capacity (anaerobic speed test), aerobic endurance (time to fatigue at 90% of VO2MAX), and isokinetic strength (Cybex II dynamometer). Height, weight, and six skinfold measurements were also recorded. All these observational tests were completed during both the follicular and mid-luteal phases of an ovulatory menstrual cycle. Cycle phases were confirmed by assaying plasma oestradiol and progesterone. Participants were subsequently randomly assigned to either a tricyclic oral contraceptive or placebo and retested in identical fashion (oral contraceptive phase). Results: Absolute and relative changes in VO2MAX from follicular to oral contraceptive phase decreased in the oral contraceptive group by 4.7%, whereas the placebo group showed a slight increase (+1.5%) over the same time period. Two of the women taking oral contraceptive had decreases of 4 and 9 ml/kg/min. In contrast, most women in the placebo group improved or maintained VO2MAX. There was also a significant increase in the sum of skinfolds in women taking oral contraceptive compared with those taking placebo (pVO2MAX that occurs when oral contraceptive is taken may influence elite sporting performance in some women. Further studies are required to determine the mechanisms of this change. PMID:12893716

  8. Oral Contraceptives Attenuate Cardiac Autonomic Responses to Musical Auditory Stimulation: Pilot Study.

    Science.gov (United States)

    Milan, Réveni Carmem; Plassa, Bruna Oliveira; Guida, Heraldo Lorena; de Abreu, Luiz Carlos; Gomes, Rayana L; Garner, David M; Valenti, Vitor E

    2015-01-01

    The literature presents contradictory results regarding the effects of contraceptives on cardiac autonomic regulation. The research team aimed to evaluate the effects of musical auditory stimulation on cardiac autonomic regulation in women who use oral contraceptives. The research team designed a transversal observational pilot study. The setting was the Centro de Estudos do Sistema Nervoso Autônomo (CESNA) in the Departamento de Fonoaudiologia at the Universidade Estadual Paulista (UNESP) in Marília, SP, Brazil. Participants were 22 healthy nonathletic and nonsedentary females, all nonsmokers and aged between 18 and 27 y. Participants were divided into 2 groups: (1) 12 women who were not taking oral contraceptives, the control group; and (2) 10 women who were taking oral contraceptives, the oral contraceptive group. In the first stage, a rest control, the women sat with their earphones turned off for 20 min. After that period, the participants were exposed to 20 min of classical baroque music (ie, "Canon in D Major," Johann Pachelbel), at 63-84 dB. Measurements of the equivalent sound levels were conducted in a soundproof room, and the intervals between consecutive heartbeats (R-R intervals) were recorded, with a sampling rate of 1000 Hz. For calculation of the linear indices, the research team used software to perform an analysis of heart rate variability (HRV). Linear indices of HRV were analyzed in the time domain: (1) the standard deviation of normal-to-normal R-R intervals (SDNN), (2) the root-mean square of differences between adjacent normal R-R intervals in a time interval (RMSSD), and (3) the percentage of adjacent R-R intervals with a difference of duration greater than 50 ms (pNN50). The study also analyzed the frequency domain-low frequency (LF), high frequency (HF), and LF/HF ratio. For the control group, the musical auditory stimulation reduced (1) the SDNN from 52.2 ± 10 ms to 48.4 ± 16 ms (P = .0034); (2) the RMSSD from 45.8 ± 22 ms to 41.2

  9. Efficacy and acceptability of two monophasic oral contraceptives containing ethinylestradiol and either desogestrel or gestodene.

    Science.gov (United States)

    Halbe, H W; de Melo, N R; Bahamondes, L; Petracco, A; Lemgruber, M; de Andrade, R P; da Cunha, D C; Guazelli, C A; Baracat, E C

    1998-09-01

    To assess the contraceptive efficacy, cycle control and acceptability of two monophasic oral contraceptives containing either 30 micrograms ethinylestradiol plus 150 micrograms desogestrel or 30 micrograms ethinylestradiol plus 75 micrograms gestodene. In a randomized, open-label, six-cycle, group-comparative, multicenter study performed in Brazil, pregnancies, cycle-control parameters, incidence of side-effects and the presence and severity of acne vulgaris were assessed, and blood pressure and body weight were measured at pretreatment and after one, three and six cycles of oral contraceptive use. Of the 595 women enrolled, 274 (86.7%) in the desogestrel/ethinylestradiol group and 227 (81.4%) in the gestodene/ethinylestradiol group completed the six cycles, providing data for 1753 and 1487 treatment cycles, respectively. Two pregnancies occurred, one of which (in the desogestrel/ethinylestradiol group) was attributed to user failure, whilst the other (in the gestodene/ethinylestradiol group) was thought to result from method failure. Cycle control was observed to be excellent; the incidences of irregular bleeding and minor side-effects were low in both groups and decreased after an initial increase in the first cycle. Pre-existing acne improved in both groups, whereas blood pressure and body weight remained essentially unchanged. Both desogestrel/ethinylestradiol and gestodene/ethinylestradiol provide effective oral contraception with comparable cycle control and acceptability.

  10. Using daily text-message reminders to improve adherence with oral contraceptives: a randomized controlled trial.

    Science.gov (United States)

    Hou, Melody Y; Hurwitz, Shelley; Kavanagh, Erin; Fortin, Jennifer; Goldberg, Alisa B

    2010-09-01

    To estimate whether women receiving daily text-message reminders have increased oral contraceptive pill adherence compared with women not receiving reminders. This randomized controlled trial estimated whether there was an effect of daily text-message reminders on oral contraceptive pill adherence of new oral contraceptive pill users. Pill-taking was tracked for 3 months by an electronic monitoring device with wireless data collection. During the study period, participants assigned the intervention received a daily reminder text message. Eighty-two women were assigned randomly to detect a 1.6+/-2.0 pill difference (90% power, 5% alpha, 15% dropout). Participants were 79% white, non-Hispanic, 99% high school graduates, and 99% nulliparous with a mean age of 22 years. Most reported condom use with past coital activity, and more than half reported prior emergency contraception use. The mean number of missed pills per cycle did not differ significantly between the groups: 4.9+/-3.0 for the text-message group and 4.6+/-3.5 for the control group (P=.60). The number of missed pills per cycle increased over the course of the study, but this pattern did not increase differentially between the groups. Adherence recorded by the electronic monitoring device indicated much poorer adherence than that recorded by patient diaries. Despite poor pill-taking, there were no pregnancies. Daily text-message reminders did not improve oral contraceptive pill adherence. Although the lack of benefit may be attributed to the frequent use of alternative reminder systems in the control group, the rate of missed pills when measured objectively was still very high in both groups. Clinicaltrials.gov, www.clinicaltrials.gov, NCT00733707. I.

  11. [Residual function in the ovary during low-dose oral contraceptive treatment].

    Science.gov (United States)

    Pearson, S; Skouby, S O

    1989-06-05

    Development in oral contraceptives during the past 20 years has involved continued reduction in the total quantity of hormone and alterations in the oestrogen/gestagen ratio and in the steroid structure for the gestagens employed. These changes have been undertaken primarily to counteract metabolic side effects and influence on the haemostatic system. Inhibition of the mechanism of ovulation is, however, also dependent on the steroid dosage and in cases where low-dosage oral contraception is employed, ultrasound investigations have demonstrated a risk of continued ripening of follicles during treatment. Correspondingly, hormone measurements during the pill-free week have demonstrated increase in the follicle-stimulating hormone, luteinizing hormone and the oestrogen concentration. The permissible margin of error in employing oral contraception has therefore diminished and is more dependent on the dosage and potency, particularly of gestagens. As the critical phase for failure of treatment is the first week of intake of oral contraceptives, it is important that treatment is commenced at the correct time not only at the commencement of treatment but also after the pill-free periods. If a pill is forgotten during the preovulatory oestrogen level and two pills are then taken, this may be interpreted by the organism as a positive oestrogen feed-back and, theoretically, this may result in increased gonadotropin production and thus further increase the risk of ovulation. In cases with the risk of malabsorption on account of gastro-intestinal disease and in cases with interaction with other medicaments, employment of alternative forms of contraception is recommended.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Advantages of the association of resveratrol with oral contraceptives for management of endometriosis-related pain

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    Maia Jr H

    2012-10-01

    Full Text Available Hugo Maia Jr,1,2 Clarice Haddad,2 Nathanael Pinheiro,3,4 Julio Casoy21Itaigara Memorial Day Hospital, 2Centro de Pesquisas e Assistência em Reprodução Humana, 3ImagePat, Pathology Laboratory, 4Department of Pathology and Forensic Medicine, Federal University of Bahia, Salvador, Bahia, BrazilBackground: The effect of resveratrol on the management of endometriosis-related pain was investigated in 12 patients who failed to obtain pain relief during use of an oral contraceptive containing drospirenone + ethinylestradiol.Methods and results: The addition of 30 mg of resveratrol to the contraceptive regimen resulted in a significant reduction in pain scores, with 82% of patients reporting complete resolution of dysmenorrhea and pelvic pain after 2 months of use. In a separate experiment, aromatase and cyclo-oxygenase-2 expression were investigated in the endometrial tissue of 42 patients submitted to laparoscopy and hysteroscopy for the management of endometriosis. Sixteen of these patients were using oral contraceptives alone prior to hospital admission, while the remaining 26 were using them in combination with resveratrol. Inhibition of both aromatase and cyclo-oxygenase-2 expression was significantly greater in the eutopic endometrium of patients using combined drospirenone + resveratrol therapy compared with the endometrium of patients using oral contraceptives alone.Conclusion: These results suggest that resveratrol potentiates the effect of oral contraceptives in the management of endometriosis-associated dysmenorrhea by further decreasing aromatase and cyclo-oxygenase-2 expression in the endometrium.Keywords: resveratrol, drospirenone, endometriosis, dysmenorrhea, cyclo-oxygenase-2

  13. The evolution of combined oral contraception: improving the risk-to-benefit ratio.

    Science.gov (United States)

    Burkman, Ronald; Bell, Carrie; Serfaty, David

    2011-07-01

    Since its introduction in 1960, the combined oral contraceptive (COC) pill has become one of the most widely and frequently used methods of contraception worldwide. Although highly effective, early COC formulations were associated with significant adverse effects and unacceptable cardiovascular risk. Improvements in tolerability and safety have been achieved, without compromises in effectiveness, primarily via hormone dosage reductions and the development of several new progestins. Multiphasic COCs and extended-/continuous-cycle COCs have also been introduced, although the clinical advantages of these formulations vs. traditional COCs have yet to be established. Inclusion of natural estrogens such as estradiol valerate and 17β-estradiol with selective progestins in new combinations that maintain good cycle control is the most recent evolutionary step designed to improve COC tolerability and safety. Vigorous research needs to continue to help guarantee that the unmet need for safe and effective contraception is satisfied in future generations. Copyright © 2011 Elsevier Inc. All rights reserved.

  14. Passage of decidual cast following poor compliance with oral contraceptive pill.

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    Malik, Mokerrum F; Adekola, Henry; Porter, William; Poulik, Janet M

    2015-04-01

    Decidual cast describes the spontaneous sloughing of endometrium as an entire piece while retaining the shape of the endometrial cavity. It may be associated with increased serum progesterone levels and must be considered as a differential diagnosis in a patient who passes tissue per vagina while on progesterone containing hormonal contraception. A 13-year-old adolescent with a history of menorrhagia since menarche, presented to the pediatric emergency room with worsening abdominal pain and heavy vaginal bleeding stopping her oral contraceptive pill 10 days prior to presentation. Her symptoms resolved spontaneously following passage of tissue per vagina which was later by histopathology to be a decidual cast. Decidual cast is a rare pathological entity that may be a side effect of progesterone-containing hormonal contraceptives, requiring patient education before use.

  15. Postponement of withdrawal bleeding in women using low-dose combined oral contraceptives.

    Science.gov (United States)

    Hamerlynck, J V; Vollebregt, J A; Doornebos, C M; Muntendam, P

    1987-03-01

    Postponement of menses is widely practised by women using oral contraceptives. One-hundred volunteers, consisting of three groups of women, each group using a different extensively used contraceptive regimen, were tested and compared. The test period consisted mainly of a double (monophasics) or extended (triphasics) pill cycle without a tablet-free interval. Based on daily records of vaginal bleedings as well as on the results of a questionnaire, it could be concluded that postponement of the withdrawal bleeding for twenty extra days was generally effective; the occurrence of the bleedings was related to the duration of postponement of menses and to the contraceptive regimen that was used. However, the introduction of a seven-week cycle pill is not yet a promising alternative since the majority of the volunteers preferred the inconvenience of a monthly withdrawal bleeding.

  16. Oral and injectable contraception use and risk of HIV acquisition among women in sub-Saharan Africa.

    Science.gov (United States)

    McCoy, Sandra I; Zheng, Wenjing; Montgomery, Elizabeth T; Blanchard, Kelly; van der Straten, Ariane; de Bruyn, Guy; Padian, Nancy S

    2013-03-27

    To evaluate the effect of oral and injectable hormonal contraception on the risk of HIV acquisition among women in South Africa and Zimbabwe. Secondary data analysis of 4913 sexually active women aged 18-49 years followed for up to 24 months in the Methods for Improving Reproductive Health in Africa (MIRA) phase III effectiveness trial of the diaphragm and lubricant gel for HIV prevention. Participants were interviewed quarterly about contraception and sexual behavior and were tested for pregnancy, HIV, and other sexually transmitted infections. We used a Cox proportional hazards marginal structural model, weighted by the inverse probability of hormonal contraception use, to compare the risk of HIV acquisition among nonpregnant women reporting use of combined oral contraceptive pills (COC), progestin-only pills (POP), and/or injectable hormonal contraception to women not using these methods. During the study, 283 participants seroconverted. Use of oral contraceptives (POP or COC) was not associated with HIV risk [adjusted hazard ratio (HRa) = 0.86, 95% confidence interval (CI) 0.32, 1.78]. Injectable hormonal contraception was associated with a small nonsignificant risk of HIV infection (HR(a) = 1.34, 95% CI 0.75, 2.37). The effect of injectable hormonal contraception was similar in the unweighted site-adjusted only (HR(a) = 1.32, 95% CI 1.00, 1.74) and baseline factor adjusted models (HR(a) = 1.27, 95% CI 0.94, 1.72). In this study, oral contraceptives were not associated with HIV acquisition. There is substantial uncertainty in the effect of injectable hormonal contraception on HIV risk. These findings underscore the importance of dual protection with condoms and the need for diverse contraceptive options for women at risk of HIV infection.

  17. A survey of bonobo (Pan paniscus) oral contraceptive pill use in North American zoos.

    Science.gov (United States)

    Agnew, Mary K; Asa, Cheryl S; Clyde, Victoria L; Keller, Dominique L; Meinelt, Audra

    2016-09-01

    Contraception is an essential tool in reproductive management of captive species. The Association of Zoos and Aquariums (AZA) Reproductive Management Center (RMC) gathers data on contraception use and provides recommendations. Although apes have been given oral contraceptive pills (OCPs) for at least 30 years, there have been no published reports with basic information on why the pill is administered, formulations and brands used, and effects on physiology and behavior. Here, we report survey results characterizing OCP use in bonobos (Pan paniscus) housed in North American zoos, as well as information accumulated in the RMC's Contraception Database. Of 26 females treated, there have been no failures and nine reversals. The most commonly administered OCP formulation in bonobos contained ethinyl estradiol (EE) 35 μg/norethindrone 1 mg. Few females on combined oral contraceptives (COCs) were given a continuous active pill regimen; a hormone-free interval of at least 5 days was allowed in most. Crushing the pill and mixing with juice or food was common. Females on COCs seldom experienced breakthrough estrus or bleeding, while these conditions were sometimes observed for females on continuous COCs. All females on COCs exhibited some degree of perineal swelling, with a mean score of 3 or 3+ most commonly reported. Behavioral changes included less sexual behavior, dominant females becoming subordinate, and a negative effect on mood. No appreciable change in weight was noted. Taken together, these results indicate that OCPs are an effective and reversible contraceptive option for bonobos that can be used by zoos and sanctuaries to limit reproduction. Zoo Biol. 35:444-453, 2016. © Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  18. The CORALIE study: improving patient education to help new users better understand their oral contraceptive.

    Science.gov (United States)

    de Reilhac, Pia; Plu-Bureau, Geneviève; Serfaty, David; Letombe, Brigitte; Gondry, Jean; Christin-Maitre, Sophie

    2016-10-01

    Combined oral contraceptives (COCs) are the most widely used contraceptive method in Europe. Paradoxically, rates of unintended pregnancy and abortion are still remarkably high. A lack of knowledge about COCs is often reported to lead to poor adherence, suggesting an unmet need for adequate contraceptive counselling. Our objective was to investigate the impact on the knowledge level of users of a structured approach to deliver contraceptive information for a first COC prescription. The Oral Contraception Project to Optimise Patient Information (CORALIE) is a multicentre, prospective, randomised study conducted in France between March 2009 and January 2013. The intervention involved providing either an 'essential information' checklist or unstructured counselling to new COC users. The outcome measure was a questionnaire that assessed whether the information provided to the new user by the gynaecologist had been correctly understood. One hundred gynaecologists and an expert committee used the Delphi method to develop an 'essential information' checklist, after which 161 gynaecologists were randomised to two groups. Group I (n = 81) used the checklist with 324 new COC users and group II (n = 80) delivered unstructured information to 307 new COC users. The average score for understanding the information delivered during the visit was significantly higher in women in group I than in the women in group II, even after adjustment for age and previous history of pregnancy: 16.48/20 vs 14.27/20 (p COC prescription is beneficial for understanding contraception. Our tool could ultimately contribute to increased adherence and should be investigated in a prospective study of long-term outcomes.

  19. Third generation oral contraceptives and risk of venous thromboembolic disorders: an international case-control study. Transnational Research Group on Oral Contraceptives and the Health of Young Women.

    Science.gov (United States)

    Spitzer, W. O.; Lewis, M. A.; Heinemann, L. A.; Thorogood, M.; MacRae, K. D.

    1996-01-01

    OBJECTIVE--To test whether use of combined oral contraceptives containing third generation progestogens is associated with altered risk of venous thromboembolism. DESIGN--Matched case-control study. SETTING--10 centres in Germany and United Kingdom. SUBJECTS--Cases were 471 women aged 16-44 who had a venous thromboembolism. Controls were 1772 women (at least 3 controls per case) unaffected by venous thromboembolism who were matched with corresponding case for age and for hospital or community setting. MAIN OUTCOME MEASURES--Odds ratios derived with stratified analyses and unconditional logistic regression to adjust for potential confounding variables. RESULTS--Odds ratios (95% confidence intervals) for venous thromboembolism were: for any oral contraceptives versus no use, 4.0 (3.1 to 5.3); for second generation products (low dose ethinyl-oestradiol, no gestodene or desogestrel) versus no use, 3.2 (2.3 to 4.3); for third generation products (low dose ethinyloestradiol, gestodene or desogestrel) versus no use, 4.8 (3.4 to 6.7); for third generation products versus second generation products, 1.5 (1.1 to 2.1); for products containing gestodene versus second generation products, 1.5 (1.0 to 2.2); and for products containing desogestrel versus second generation products, 1.5 (1.1 to 2.2). Probability of death due to venous thromboembolism for women using third generation products is about 20 per million users per year, for women using second generation products it is about 14 per million users per year, and for non-users it is five per million per year. CONCLUSIONS--Risk of venous thromboembolism was slightly increased in users of third generation oral contraceptives compared with users of second generation products. PMID:8555935

  20. Comparison of the pharmacologic and clinical profiles of new combined oral contraceptives containing estradiol

    Directory of Open Access Journals (Sweden)

    Jensen JT

    2013-11-01

    Full Text Available Jeffrey T Jensen,1 Johannes Bitzer,2 Marco Serrani3 1Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA; 2Department of Social Medicine and Psychosomatics, Women’s Hospital, University Hospital of Basel, Basel, Switzerland; 3Global Medical Affairs, Women’s Healthcare, Bayer HealthCare Pharmaceuticals, Berlin, Germany Abstract: Three estradiol (E2-containing oral contraceptives, estradiol valerate/cyproterone acetate (E2V/CPA, Femilar®, estradiol valerate/dienogest (E2V/DNG, Qlaira®/Natazia™, and estradiol/nomegestrol acetate (E2/NOMAC; Zoely®, have received approval for use in general practice. Only Finnish women currently have access to all three E2-based formulations. E2/NOMAC is currently approved only in Europe, while E2V/DNG is approved globally. To assist clinicians counseling women considering use of one of these formulations, we conducted a review of the published information about the current E2-containing oral contraceptives. A literature search was conducted using the Ovid interface and a combination of free search terms relevant to estradiol and oral contraception to identify suitable articles for inclusion in this review. The available data show that E2V/DNG, E2/NOMAC, and E2V/CPA are all effective oral contraceptives. While direct comparisons are lacking, indirect evidence suggests that E2V/DNG and E2/NOMAC may have better bleeding profiles than E2V/CPA. E2V/DNG is also approved for the treatment of heavy menstrual bleeding. Both E2V/DNG and E2/NOMAC have minimal influence on hemostatic, lipid, and carbohydrate metabolism parameters, or induce less change in these parameters relative to ethinylestradiol-based oral contraceptives. However, the predictive value of these surrogate parameters is a matter of debate, and whether these differences can be translated into meaningful clinical outcomes needs to be established in large-scale, post-marketing, prospective, Phase IV cohort

  1. Contraceptive Development.

    Science.gov (United States)

    Troen, Philip; And Others

    This report provides an overview of research activities and needs in the area of contraceptive development. In a review of the present state, discussions are offered on the effectiveness and drawbacks of oral contraceptives, intrauterine devices, barrier methods, natural family planning, and sterilization. Methods of contraception that are in the…

  2. Comparing the effects of low-dose contraceptive pills to control dysfunctional uterine bleeding by oral and vaginal methods

    National Research Council Canada - National Science Library

    Mehrabian, Ferdous; Abbassi, Fariba

    2013-01-01

    .... The vaginal use of these pills can reduce such complications. Our objective was to compare the efficacy and side effects of low dose contraceptive pills by oral and vaginal route in the management of dysfunctional uterine bleeding-(DUB) Methods...

  3. Changes in blood levels of proteinase inhibitors, pregnancy zone protein, steroid carriers and complement factors induced by oral contraceptives

    DEFF Research Database (Denmark)

    Nielsen, C H; Poulsen, H K; Teisner, B

    1993-01-01

    Three low-dose oral contraceptives Trinordiol, Gynatrol, and Marvelon, containing ethinylestradiol (EE) in combination with triphasic levonorgestrel (LNg), monophasic levonorgestrel, and monophasic desogestrel (DGS), respectively, were given to 65 healthy women, n = 21-22 in each group. Blood...

  4. Oral contraceptive pill, progestogen or oestrogen pretreatment for ovarian stimulation protocols for women undergoing assisted reproductive techniques

    NARCIS (Netherlands)

    Farquhar, C.; Rombauts, L.; Kremer, J.A.M.; Lethaby, A.; Ayeleke, R.O.

    2017-01-01

    BACKGROUND: Among subfertile women undergoing assisted reproductive technology (ART), hormone pills given before ovarian stimulation may improve outcomes. OBJECTIVES: To determine whether pretreatment with the combined oral contraceptive pill (COCP) or with a progestogen or oestrogen alone in

  5. Combined oral contraceptives' influence on weight, body composition, height, and bone mineral density in girls younger than 18 years

    DEFF Research Database (Denmark)

    Warholm, Lina; Petersen, Kresten R; Ravn, Pernille

    2012-01-01

    Combined oral contraceptives (COCs) are increasingly used by adolescents. The aim of this review is to investigate the evidence regarding COCs' influence on weight, height and bone mineral density (BMD) in girls younger than 18 years.......Combined oral contraceptives (COCs) are increasingly used by adolescents. The aim of this review is to investigate the evidence regarding COCs' influence on weight, height and bone mineral density (BMD) in girls younger than 18 years....

  6. Contraceptive failure

    DEFF Research Database (Denmark)

    Rasch, Vibeke

    2002-01-01

    Most studies focusing on contraceptive failure in relation to pregnancy have focused on contraceptive failure among women having induced abortions, thereby neglecting those women who, despite contraceptive failure, accept the pregnancy and intend to carry the fetus to term. To get a more complete...... picture of the problem of contraceptive failure, this study focuses on contraceptive failure among women with diverse pregnancy outcomes. In all, 3520 pregnant women attending Odense University Hospital were included: 373 had induced abortions, 435 had spontaneous abortions, 97 had ectopic pregnancies......, and 2614 received antenatal care. The variables studied comprise age, partner relationship, number of births, occupational and economical situation, and contraceptive use.Contraceptive failure, defined as contraceptive use (condom, diaphragm, IUD, oral contraception, or another modern method...

  7. Use of and access to oral and injectable contraceptives in Brazil.

    Science.gov (United States)

    Farias, Mareni Rocha; Leite, Silvana Nair; Tavares, Noemia Urruth Leão; Oliveira, Maria Auxiliadora; Arrais, Paulo Sergio Dourado; Bertoldi, Andréa Dâmaso; Pizzol, Tatiane da Silva Dal; Luiza, Vera Lucia; Ramos, Luiz Roberto; Mengue, Sotero Serrate

    2016-12-01

    To analyze the prevalence of current use of oral and injectable contraceptives by Brazilian women, according to demographic and socioeconomic variables and issues related to access to those medicines. A cross-sectional, population-based analytical study with probability sampling based on data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines), carried out between September 2013 and February 2014 in 20,404 Brazilian urban households. Prevalence was calculated based on reports from non-pregnant women aged 15-49 on the use of oral or injectable contraceptives. The independent variables were gender, age, level of education, socioeconomic class, Brazilian region and marital status. Also analyzed were access, means of payment, sources, and reported medicines. Statistical analyses considered 95% confidence intervals (95%CI) and Pearson Chi-square test to evaluate the statistical significance of differences between groups, considering a 5% significance level. Prevalence of use was 28.2% for oral contraceptives (OC) and 4.5% for injectable contraceptives (IC). The highest prevalence of oral contraceptives was in the South region (37.5%) and the lowest in the North region (15.7%). For injectable contraceptives there was no difference between regions. Access was higher for oral contraceptive users (90.7%) than injectable contraceptives users (81.2%), as was direct payment (OC 78.1%, IC 58.0%). Users who paid for contraceptives acquired them at retail pharmacies (OC 95.0% and IC 86.6%) and at Farmácia Popular (Popular Pharmacy Program) (OC 4.8% and IC 12.7%). Free of charge contraceptives were mostly obtained from the Brazilian Unified Health System - SUS (OC 86.7%; IC 96.0%). Free samples were reported by 10.4% of users who did not pay for oral contraceptives. Most of paying users did not try to obtain contraceptives from SUS. Monophasic

  8. Oral contraceptive use and BRCA penetrance: a case-only study.

    Science.gov (United States)

    Pasanisi, Patrizia; Hédelin, Guy; Berrino, Jacopo; Chang-Claude, Jenny; Hermann, Silke; Steel, Michael; Haites, Neva; Hart, Jacob; Peled, Ronit; Gafà, Lorenzo; Leggio, Laura; Traina, Adele; Amodio, Rosalba; Primic-Zakelj, Maja; Zadnik, Vesna; Veidebaum, Toomas; Tekkel, Mare; Berrino, Franco

    2009-07-01

    Women with deleterious mutations in BRCA genes are at increased risk of breast cancer. However, the penetrance of the genetic trait may be regulated through environmental factors. This multinational case-only study tested the interaction between oral contraceptive use and genetic susceptibility in the occurrence of breast cancer. We recruited 3,123 patients diagnosed with breast cancer before the age of 45 years. Participants were classified according to their probability of carrying a BRCA mutation on the basis of their family history of breast and ovarian cancer. According to a case-only approach, the frequency of relevant exposures among breast cancer cases with high probability of BRCA mutation ("genetic cases") was compared with the frequency of the same exposures among breast cancer cases with a low probability of BRCA mutation ("sporadic cases"). The interaction odds ratios (OR) and 95% confidence intervals (CI) for oral contraceptive use were estimated by unconditional logistic regression, after controlling for potentially confounding variables. The analysis was carried out comparing 382 "genetic" and 1,333 "sporadic" cases. We found a borderline significant interaction between genetic breast cancer and oral contraceptive use for ever users compared with never users (OR, 1.3; 95% CI, 1.0-1.7). The greatest interaction OR was found for women who started using pill at 18 to 20 years (OR, 1.6; 95% CI, 1.1-2.3). These results suggest that BRCA mutation carriers, as well as women with a significant family history of breast and ovarian cancer are more vulnerable to exogenous hormones in oral contraceptives.

  9. Use of combined oral contraceptive pills among teenage girls in Calabar, Nigeria

    OpenAIRE

    Iklaki CU; Inaku JE; Ekabua JE; Odusolu PO; Njoku CO

    2012-01-01

    Christopher U Iklaki,1 John E Inaku,2 John E Ekabua,1 Patience O Odusolu,1 Charles O Njoku11Department of Obstetrics and Gynaecology, University of Calabar, Calabar, Nigeria; 2Department of Obstetrics and Gynaecology, University of Calabar Teaching Hospital, Calabar, NigeriaAbstract: The objective of this study was to find out about the use of combined oral contraceptive pills by women in Calabar, Nigeria, with a particular interest in single nulliparous teenage women. During the period from ...

  10. Peculiar observations in measuring testosterone in women treated with oral contraceptives supplemented with dehydroepiandrosterone (DHEA).

    Science.gov (United States)

    Heijboer, Annemieke C; Zimmerman, Yvette; de Boer, Theo; Coelingh Bennink, Herjan; Blankenstein, Marinus A

    2014-03-20

    Total testosterone is considered to be decreased during the use of combined oral contraceptives. There is, however, considerable concern about the quality of testosterone assays, especially at low levels. We aimed to confirm testosterone levels measured by direct radioimmunoassay in a recent clinical trial with a state-of-the-art LC-MSMS method. Surplus specimens with known testosterone levels collected during the study (Clinical Trial Registration number ISRCTN06414473) were reanalyzed with an LC-MSMS method. This method was compared to another LC-MSMS method that had shown to concur excellently to a reference method. Follow-up experiments were designed to explain the results. In contrast to our expectation, LC-MSMS measurements did not corroborate the data obtained by radioimmunoassay. Subsequent experiments showed that this could be attributed to a strong dependency of the radioimmunoassay on SHBG. Testosterone results (n = 198) obtained by direct radioimmunoassay showed a negative correlation to SHBG levels (r = -0.676; p<0.001). By contrast, testosterone results obtained by LC-MSMS were not related to SHBG (r = 0.100; NS). In conclusion, our results indicate that total testosterone measurements during oral contraceptive use are unreliable when performed with assays sensitive to the SHBG concentration. The discrepancy with the literature can most likely be explained by the sensitivity of the immunoassay used to SHBG. Given the sharp increase in SHBG during the use of many oral contraceptives, total testosterone may not decrease, whereas its bioavailability, estimated by free testosterone levels, will be diminished. Studies aiming at restoration of testosterone homeostasis during oral contraception need to take this into account. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Clinical comparison of monophasic oral contraceptive preparations of gestodene/ ethinyl estradiol and desogestrel/ethinyl estradiol

    OpenAIRE

    Aguiar, Luis Fernando; Aldrighi, Jose Mendes; Andrade, Rosires Pereira de; Barbosa, Ione Cristina; Barreto, Cristina Maria Vasconcellos

    1994-01-01

    Texto completo: acesso restrito. p.201–214 The efficacy, cycle control, subjective complaints, and safety of monophasic preparations of the oral contraceptives containing gestodene 75 mcg plus ethinyl estradiol 30 mcg versus desogestrel 150 mcg plus ethinyl estradiol 30 mcg were compared in a 6-cycle, open-label, parallel, randomized, multicenter phase IV clinical study in Latin America. Of a total of 176 women in each group, 163 in the gestodene group and 160 in the desogestrel group comp...

  12. Oral contraceptive use and saliva diurnal pattern of metabolic steroid hormones in young healthy women.

    Science.gov (United States)

    Vibarel-Rebot, N; Rieth, N; Lasne, F; Jaffré, C; Collomp, K

    2015-03-01

    The impact of oral contraceptives (OCs) on the saliva diurnal pattern of metabolic steroid hormones remained unknown. Saliva samples were taken from young healthy women (11 OC users, 10 non-OC users) to analyze cortisol, dehydroepiandrosterone (DHEA) and testosterone 4 times (days 1, 8, 15 and 22) over one menstrual cycle. OC use decreased saliva testosterone concentrations (ppattern. The clinical relevance requires further study. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Diminished nap effects on memory consolidation are seen under oral contraceptive use

    OpenAIRE

    Genzel, Lisa; Bäurle, Anna; Potyka, Alina; Wehrle, Renate; Adamczyk, Marek; Friess, Elisabeth; Steiger, Axel; Dresler, Martin

    2014-01-01

    Many young females take exogenous hormones as oral contraceptive (OC), a condition rarely controlled for in studies on sleep and memory consolidation even though sex hormones influence consolidation. This study investigated the effects of OCs on sleep-related consolidation of a motor and declarative task, utilizing a daytime nap protocol. Fifteen healthy, young females taking OCs came to the sleep lab for three different conditions: nap with previous learning, wake with previous learning and ...

  14. Acceptability of emergency contraception in Brazil, Chile, and Mexico: 1 - Perceptions of emergency oral contraceptives

    Directory of Open Access Journals (Sweden)

    Díaz Soledad

    2003-01-01

    Full Text Available This article presents the results of a study on the acceptability of emergency contraception (EC in Brazil, Chile, and Mexico. Opinions of potential users and possible providers were obtained through discussion groups and those of authorities and policy-makers through semi-structured interviews. Most participants had a positive opinion of EC, based on the view that it can help reduce unplanned pregnancy, adolescent pregnancy, and unsafe abortion. Several interviewees felt that all women should be informed about EC, while others viewed it as a method for special situations such as rape and unprotected first sexual intercourse. Concern was expressed that its introduction might be associated with a decrease in condom use, increase in sexually transmitted diseases, and irresponsible or promiscuous sexual behavior among adolescents. The need for EC was clearly perceived by most participants, leading to the conclusion that health authorities have the responsibility of implementing programs for its introduction. Training of health care personnel should include the discussion of reproductive health problems that could be prevented by EC.

  15. Pharmacokinetic overview of ethinyl estradiol dose and bioavailability using two transdermal contraceptive systems and a standard combined oral contraceptive.

    Science.gov (United States)

    Hofmann, Birte; Reinecke, Isabel; Schuett, Barbara; Merz, Martin; Zurth, Christian

    2014-12-01

    To determine the relative bioavailability of ethinyl estradiol (EE) and gestodene (GSD) after application of a novel transdermal contraceptive patch vs. a standard combined oral contraceptive (COC) pill (study 1), and to evaluate the pharmacokinetics (PK) of EE after application of the EE/GSD patch compared with an EE/norelgestromin (NGMN) patch (study 2). Participants were healthy, nonobese women aged 18 - 45 years (study 1) or 18 - 35 years (study 2). Compositions of study treatments were as follows: 0.55 mg EE/2.1 mg GSD (EE/GSD patch); 0.02 mg EE/0.075 mg GSD (standard COC); 0.6 mg EE/6 mg NGMN (EE/NGMN patch). In study 1, which consisted of 3 treatment periods (each followed by 7 patch- or pill-free days), treatments were administered in one of two randomized orders: either P-M-E (EE/GSD patch (P) every 7 days for 28 days → COC (M) once-daily for 21 days → two 7-day patch-wearing periods followed by one 10-day patch-wearing phase (E)), or the same treatments administered in sequence M-P-E. For study 2, participants received either the EE/GSD patch or EE/NGMN patch for seven treatment cycles (one patch per week for 3 weeks followed by a 7-day patch-free interval). In study 1, average daily exposure to EE was similar for treatments P and M; the mean daily area under the concentration-time curve (AUC) ratio of treatment P vs. treatment M for EE was 1.06 (90% confidence interval (CI): 0.964 - 1.16), indicating average daily delivery similar to oral administration of 0.019 - 0.023 mg EE. For unbound GSD, average daily exposure was lower for treatment P vs. treatment M. The mean AUC ratio of treatment P vs. treatment M for unbound GSD was 0.820 (90% CI: 0.760 - 0.885), indicating average daily delivery from the patch of 0.057 - 0.066 mg GSD. Prolonged patch wearing did not result in a distinct decline in GSD and EE serum concentrations. In study 2, AUC at steady state (AUC0-168,ss), average steady-state serum concentration, and maximum steady-state serum

  16. Pharmacokinetic overview of ethinyl estradiol dose and bioavailability using two transdermal contraceptive systems and a standard combined oral contraceptive

    Science.gov (United States)

    Hofmann, Birte; Reinecke, Isabel; Schuett, Barbara; Merz, Martin; Zurth, Christian

    2014-01-01

    Objective: To determine the relative bioavailability of ethinyl estradiol (EE) and gestodene (GSD) after application of a novel transdermal contraceptive patch vs. a standard combined oral contraceptive (COC) pill (study 1), and to evaluate the pharmacokinetics (PK) of EE after application of the EE/GSD patch compared with an EE/norelgestromin (NGMN) patch (study 2). Materials: Participants were healthy, non-obese women aged 18 – 45 years (study 1) or 18 – 35 years (study 2). Compositions of study treatments were as follows: 0.55 mg EE/2.1 mg GSD (EE/GSD patch); 0.02 mg EE/0.075 mg GSD (standard COC); 0.6 mg EE/6 mg NGMN (EE/NGMN patch). Methods: In study 1, which consisted of 3 treatment periods (each followed by 7 patch- or pill-free days), treatments were administered in one of two randomized orders: either P–M–E (EE/GSD patch (P) every 7 days for 28 days → COC (M) once-daily for 21 days → two 7-day patch-wearing periods followed by one 10-day patch-wearing phase (E)), or the same treatments administered in sequence M–P–E. For study 2, participants received either the EE/GSD patch or EE/NGMN patch for seven treatment cycles (one patch per week for 3 weeks followed by a 7-day patch-free interval). Results: In study 1, average daily exposure to EE was similar for treatments P and M; the mean daily area under the concentration-time curve (AUC) ratio of treatment P vs. treatment M for EE was 1.06 (90% confidence interval (CI): 0.964 – 1.16), indicating average daily delivery similar to oral administration of 0.019 – 0.023 mg EE. For unbound GSD, average daily exposure was lower for treatment P vs. treatment M. The mean AUC ratio of treatment P vs. treatment M for unbound GSD was 0.820 (90% CI: 0.760 – 0.885), indicating average daily delivery from the patch of 0.057 – 0.066 mg GSD. Prolonged patch wearing did not result in a distinct decline in GSD and EE serum concentrations. In study 2, AUC at steady state (AUC0–168,ss

  17. [Effect of short-acting combined oral contraceptives on bleeding after induced abortion].

    Science.gov (United States)

    Wang, X F; Zhong, M; Liu, J

    2017-11-07

    Objective: To explore the effect of short-acting combined oral contraceptives on vaginal bleeding after induced abortion. Methods: A total of 726 patients, who had took induced abortion from July 2016 to September 2016 in obstetrics and gynecology outpatient department of Nanfang Hospital, Southern Medical University, were included and divided into the observation group and the control group according to whether they took short-acting combined oral contraceptives after induced abortion, with 312 cases, 414 cases respectively.The vaginal bleeding days, amounts of bleeding, the endometrial thickness 3 weeks later, and whether the patient had menstrual recovery on time were observed and analyzed. Results: The observation group had less bleeding days and amount of bleeding, compared with the control group.69.87% (218/312) patients of the observation group had more than 8mm of endometrial thickness on postoperative day 21, while 61.11% (253/414) of the observation group did, the difference was statistically significant ( P =0.034).90.06% (281/312) patients of the observation group had menstrual recovery on time, while 82.61% (342/414) of the observation group did, the difference was statistically significant ( P =0.004). Conclusion: Short-acting combined oral contraceptives after induced abortion can significantly shorten the vaginal bleeding days, reduce the amount of bleeding, promote endometrial repair and menstrual recovery.There fore, it has important clinical significance and application value.

  18. Oral contraceptives and breast cancer risk in the international BRCA1/2 carrier cohort study

    DEFF Research Database (Denmark)

    Brohet, Richard M; Goldgar, David E; Easton, Douglas F

    2007-01-01

    oral contraceptive use and risk of breast cancer among BRCA1/2 carriers. PATIENTS AND METHODS In the International BRCA1/2 Carrier Cohort study (IBCCS), a retrospective cohort of 1,593 BRCA1/2 mutation carriers was analyzed with a weighted Cox regression analysis. Results We found an increased risk...... of breast cancer for BRCA1/2 mutation carriers who ever used oral contraceptives (adjusted hazard ratio [HR] = 1.47; 95% CI, 1.16 to 1.87). HRs did not vary according to time since stopping use, age at start, or calendar year at start. However, a longer duration of use, especially before first full...... was found among BRCA1/2 mutation carriers that current use of oral contraceptives is associated with risk of breast cancer more strongly than is past use, as is found in the general population. However, duration of use, especially before first full-term pregnancy, may be associated with an increasing risk...

  19. Factors associated with the contraindicated use of oral contraceptives in Brazil.

    Science.gov (United States)

    Corrêa, Daniele Aparecida Silva; Felisbino-Mendes, Mariana Santos; Mendes, Mayara Santos; Malta, Deborah Carvalho; Velasquez-Melendez, Gustavo

    2017-01-12

    To estimate the prevalence of the contraindicated use of oral contraceptives and the associated factors in Brazilian women. 20,454 women who answered the VIGITEL survey in 2008 also participated in this study, of which 3,985 reported using oral contraceptives. We defined the following conditions for the contraindicated use of contraceptives: hypertension; cardiovascular diseases such as heart attack, stroke/cerebrovascular accident; diabetes mellitus; being smoker and 35 years old or older. We estimated the prevalence and 95% confidence intervals of contraindicated use in users of oral contraceptives and the factors associated with contraindication by prevalence ratio and 95% confidence intervals. In the total population, 21% (95%CI 19.7-21.9) of women showed some contraindication to the use of oral contraceptives, of which 11.7% (95%CI 10.6-13.7) belonged to the group of users of oral contraceptives. The most frequent contraindication in users of oral contraceptives was hypertension (9.1%). The largest proportion of women with at least one contraindication was aged between 45 and 49 years (45.8%) and with education level between zero and eight years (23.8%). The prevalence of contraindication to oral contraceptives was higher in women less educated (zero to eight years of study) (PR = 2.46; 95%CI 1.57-3.86; p uso de anticoncepcionais orais e os fatores associados em mulheres brasileiras. Participaram 20.454 mulheres que responderam ao inquérito Vigitel em 2008, das quais 3.985 reportaram uso de contraceptivos orais. Definiu-se como uso contraindicado de anticoncepcionais quando presente pelo menos uma condição: hipertensão; doenças cardiovasculares como infarto, derrame/acidente vascular encefálico; diabetes mellitus; ser tabagista e ter idade igual ou maior de 35 anos. Foram estimadas as prevalências e intervalos de 95% de confiança de uso contraindicado em usuárias de anticoncepcionais orais e fatores associados à contraindicação por meio de raz

  20. A comparative metabolic study of two low-estrogen-dose oral contraceptives containing desogestrel or gestodene progestins.

    Science.gov (United States)

    Crook, D; Godsland, I F; Worthington, M; Felton, C V; Proudler, A J; Stevenson, J C

    1993-11-01

    Our objective was to compare the effects of low-estrogen-dose oral contraceptives containing desogestrel or gestodene progestins on metabolic risk markers for coronary heart disease. A cross-sectional comparison of 70 women who used a formulation that contained 30 micrograms ethinyl estradiol and 150 micrograms desogestrel, 43 women who used a formulation that contained 30 micrograms ethinyl estradiol and 75 micrograms gestodene, and 54 women who did not use steroidal contraceptives was performed. Oral contraceptive users had higher concentrations of high-density lipoproteins than did women in the control group (+10% to +20%, p gestodene formulation than in those who used the desogestrel formulation. The metabolic profiles induced by these oral contraceptives were remarkably similar and may reflect the activity of the estrogen component.

  1. Pill-a-month as an oral contraceptive.

    Science.gov (United States)

    Hefnawi, F; Hassanein, M; Younis, N

    1972-06-01

    The first 600 cases of a 1200-case study of a monthly contraceptive pill at the Family Planning Clinic at Al-Azhar University Hospital in Cairo are described. The estrogen component, Quinestrol (17 alpha ethinyl estradiol-3-cyclopentyl ether) has prolonged activity. Quingestanol acetate (3 cyclopentyl ether derivative of norethindrone acetate), the progestogen component of the pill, induces withdrawal bleeding, and regulates the cycle. In Group A (96) the first pill was given on day 25 of the cycle to get withdrawal bleeding at the supposed date of the next flow; subsequent pills were given monthly on the same day of each calendar month. In Group B (504) the first pill was given on the first day of the menstrual flow and the second pill after 3 weeks; subsequent pills were given monthly on the same day of each calendar month. Follow-up was for 6 to 12 months. The total number of cycles was 3858. The flow began 6-15 days after taking the pill in 80.4% of the cycles. Treatment cycles were significantly longer than premedication cycles. During contraception the incidence of light flow decreased from 19.6 to 4.19% and the incidence of heavy flow increased from 10 to 12.4%. The mean duration of flow rose from 4.3 to 6.4 days. Percentages of cycles experiencing intermenstrual bleeding and amenorrhea were 5 and 2.6. Dysmenorrhea increased gradually to 20% at the ninth cycle. No significant changes were found in weight, libido, or breasts. Percentages of cycles getting various side effects were nausea and vomiting (6.95), headache (4.57), fatigue (4.05), and discharge (3.02). By the fourth cycle none of the 106 women originally lactating were still doing so. Ignoring pregnancies in the first cycle, when the pill is not yet effective, the pregnancy rate was 2.8/100 woman year. Endometrial biopsies indicated an anti-ovulatory effect after the first cycle. The drop-out rate was 21.3% in the first cycle, but no cases dropped out after the eighth cycle.

  2. Lack of interaction between orlistat and oral contraceptives

    NARCIS (Netherlands)

    Hartmann, D.; Güzelhan, C.; Zuiderwijk, P.B.M.; Odink, J.

    1996-01-01

    Objectives: Orlistat, a potent and selective inhibitor of gastrointestinal lipases, is designed for the treatment of obesity. A double-blind, randomised, placebo-controlled, 2-way crossover study investigated the possible influence of orlistat on the ovulation-suppressing action of combination oral

  3. Hormonal manipulation with finasteride or oral contraception does not influence incidence of renal cell carcinoma.

    Science.gov (United States)

    Kabra, Aashish; Gelfond, Jonathan; Liss, Michael A

    2017-03-23

    Androgens have been suspected to be involved in the initiation of renal cell carcinoma because of a two-fold increased risk in men compared with women. To investigate the role of self-reported finasteride or oral contraceptive use in the Prostate, Lung, Colorectal, and Ovarian (PCLO) to determine whether the androgen receptor reduces renal cancer development. We query the PCLO trial for predictor variables from the baseline questionnaire and follow-up questionnaires enquiring medication use, specifically the use of 5-α reductase inhibitors (dutasteride or finasteride) and oral contraceptive therapy. The primary outcome of this study was the incidence of renal cancer. Statistical analysis included Student's t-test for continuous variables, χ, or Fisher's exact tests for dichotomous or categorical variables, and multivariable analysis using Cox proportional hazards models. Eight percent (n=6117/73 694) of men in the PCLO trial reported the use of finasteride. 52 (10.6%) of the 492 men diagnosed with renal cancer had self-reported exposure to finasteride and this was not significant in univariable analysis (52/6169; 0.84% vs. 440/66 454; 0.67%, P=0.12) or multivariable main effects analysis (hazard ratio: 1.12; 95% confidence interval: 0.83-1.5; P=0.47). Approximately 54% of women (n=40 997/75 989) in the PCLO trial reported the use of oral contraceptives by questionnaire. 136 (52.1%) of the 261 women diagnosed with renal cancer had self-reported exposure to oral contraceptive therapy and this was not significant in univariable analysis (136/40 997; 0.33% vs. 125/34 992; 0.36%, P=0.36) or in multivariable main effects analysis (hazard ratio: 1.03; 95% confidence interval: 0.97-1.1; P=0.30). Self-reported use of finasteride or oral contraceptives is not associated with a reduced incidence of renal cancer.

  4. Supplementation with Vitamin B6 Reduces Side Effects in Cambodian Women Using Oral Contraception

    Directory of Open Access Journals (Sweden)

    Chivorn Var

    2014-08-01

    Full Text Available Hormonal contraceptives may produce side effects that deter women from their use as a method of family planning. In nutritionally vulnerable populations these effects may be more pronounced due to micronutrient deficiencies and health status. Previous studies have been unable to resolve whether micronutrient supplementation may reduce such side effects. Aim: In a longitudinal study, 1011 women obtaining oral contraception through the public health system in rural Cambodia were allocated to either intervention or control groups, receiving either daily Vitamin B6 supplement or care as usual (without placebo. Results: The intervention participants (n = 577 reported fewer side effects in three categories: nausea/no appetite, headache, and depression compared with control group participants (n = 434. Conclusion: Women taking Vitamin B6 supplement were less likely to report side effects in a nutritionally vulnerable population. Underlying nutrition status should be considered by clinicians and reproductive health policy makers in the context of providing contraceptive services. Further investigation into micronutrient supplementation, particularly with B6, in reproductive-aged women using hormonal contraception should be conducted in other settings to determine the potential for widespread adoption.

  5. Noncontraceptive use of oral combined hormonal contraceptives in polycystic ovary syndrome-risks versus benefits.

    Science.gov (United States)

    Dokras, Anuja

    2016-12-01

    The use of steroid sex hormones for noncontraceptive benefits has been endorsed by several medical societies. In women with polycystic ovary syndrome (PCOS), hormonal contraceptives are first-line therapy for concurrent treatment of menstrual irregularity, acne, and hirsutism. The association of PCOS with obesity, diabetes, and dyslipidemia frequently brings up the debate regarding risks versus benefits of hormonal contraceptives in this population. In women with PCOS, the lack of large-scale studies evaluating the risks with varying doses of ethinyl estradiol, types of progestins, and presence of confounding factors such as obesity, smoking, and other cardiometabolic comorbidities is a significant limitation in these deliberations. Although it is important to assess the absolute risk for major morbidities including cardiovascular events, currently, there are a paucity of long-term data for these outcomes in PCOS. Most of the current studies do not suggest an increase in risk of prediabetes/diabetes, clinically significant dyslipidemia, inflammatory changes, or depressive/anxiety symptoms with oral contraceptive pill use. Screening of women with PCOS for cardiometabolic and psychiatric comorbidities is routinely recommended. This information should be used by health care providers to individualize the choice of hormonal contraceptive treatment, adequately counsel patients regarding risks and benefits, and formulate an appropriate follow-up plan. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  6. Changes of mood and anxiety during the menstrual cycle with use of oral contraceptives

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    Gabriela Antunes

    2004-06-01

    Full Text Available Hormonal action is one of the main factors for behavioral change observed in women, during the menstrual cycle, and especially in the premenstrual period, most women report a variation of mood and anxiety. The aim of this work was to verify the degrees of anxiety during the menstrual cycle, charting their variation and the possible influence of oral contraceptive use. For this purpose 32 women, divided in two groups according to the use (B or not use (A of oral contraceptive, with selfapplication of the STAI (State-Trait Anxiety Inventory at three different times: before, during and after menstruation. The data was tabulated and analyzed statistically, indicating a variation of anxiety level for different menstrual periods, but with no significance as to anxiety type (trait or state or to the ingestion of contraceptive. For Trait-Anxiety, the post-test (Boferroni T-Test of variation among periods indicated significant difference for post-menstrual and other periods, in the A group; and between the premenstrual and menstrual periods, in the B group. For State Anxiety, the data indicated significant differences between the premenstrual and menstrual periods, in the A group, and between the premenstrual and menstrual periods and the menstrual and post-menstrual in the B group. The results indicate that: 1 the menstrual cycle is a generator of variations of related anxiety; 2 the use of oral contraceptives does not alter this relation; and 3 the correlated diminution of the Trait Anxiety may indicate alteration in self-perception of women during the menstrual cycle. Keywords: anxiety; mestrual cycle; STAI.

  7. [Clinical experience of combined oral contraceptives of low doses in Mexico].

    Science.gov (United States)

    Saldívar Rodríguez, Donato; Vázquez, Juanita; Lara, Roger; Ramos, Carlos; Lira, Josefina; Rodríguez, Ever; Romo, Jorge

    2006-11-01

    The combined oral contraceptives are one of the most prescribed medicines. Across the years they have given to more than 60 million women of the whole world a suitable method for the highly reliable and effective natal control. The oral contraceptives are different from other medicines; principally they are not in use for controlling any disease and have the potential of giving advantages. To evaluate the control of the cycle, tolerability and acceptance of an oral contraceptive of ultralow dose with gestodene (60 microg) and ethinylestradiol (15 microg) in a population of healthy women from 18 to 35 years. The study included adult healthy women, all the users signed assent of informed before being included to the study and of the beginning of any procedure in agreement with the declarations of Helsinki and its amendments. Descriptive statistics was used for the demographic information and the comparison between the initial and final visits of the variables of efficiency. There was used the test (Proof) of ranges of Wilcoxon's sign for related samples. There were included 113 women. The average of age was 26.08 years (SD = 4.43), weight of 62.02 kg (SD = 11.13) and height of 159.20 cm (SD = 6.06). The distribution in four centers was: 32 in the University Hospital (Monterrey), 21 in the Country 2000 (Guadalajara), 30 in in the Medical Center La Mora (Aguascalientes) and 30 in Perinatology National Institute (Mexico City). The contraceptive efficiency of the combination of 15 microg of ethinylestradiol and 60 microg of gestodene has been demonstrated in previous studies. This study ratifies the international results of efficiency and tolerability.

  8. [Contraception and breast feeding. Spacing of pregnancies. Present concepts].

    Science.gov (United States)

    Buitrón-García-Figueroa, Rafael; Malanco-Hernández, Luz María; Lara-Ricalde, Roger; García-Hernández, Alejandra

    2014-06-01

    The risk of pregnancy in breastfeeding should be a concern of women. Family planning programs in the postnatal period contraceptive choices offer high efficiency. Breastfeeding is a natural contraception method (LAM) as a contraceptive shield has 98 % efficiency. Women should consider using an alternate contraceptive method when feeding requirements for this method to be effective are not met. Some of contraceptive alternatives in lactation include hormonal methods. According to the Medical Eligibility Criteria for Contraceptive Use WHO combined hormonal methods are contraindicated during breast feeding, hormonal progestogen only method are considered only in Group 3 and Group 1 immediate postpartum after 6 weeks postpartum. There are modifications to these criteria by the CDC and the UK for the use of these hormones in early in lactation.

  9. Drospirenone-only oral contraceptive: results from a multicenter noncomparative trial of efficacy, safety and tolerability.

    Science.gov (United States)

    Archer, David F; Ahrendt, Hans-Joachim; Drouin, Dominique

    2015-11-01

    This study was performed to assess the contraceptive efficacy of the drospirenone (DRSP)-only pill and to provide information regarding its safety and cycle-control profile. This prospective, multicenter, noncomparative study was conducted at 41 European sites in healthy women at risk of pregnancy, aged 18 to 45 years. The study medication was DRSP 4.0mg daily for 24 days followed by a placebo for 4 days (DRSP 4 mg 24/4, Exeltis, Spain) for thirteen 28-day treatment cycles. The primary efficacy endpoint was the overall Pearl Index (PI). Bleeding patterns, changes in vital signs and changes in laboratory values were also analyzed. A total of 713 participants with 7638 DRSP treatment cycles were analyzed. The overall PI was 0.51 (95% confidence interval, 0.1053-1.4922). The proportion of participants with any bleeding decreased from 72.7% in Cycle 1 to 40% in Cycle 6 and 32.1% in Cycle 13. Unscheduled bleeding decreased from 49.1% in Cycle 1 to 27.8% in Cycle 6 and to 22.8% in Cycle 13. Prolonged bleeding was reported by 6.5% during Cycles 2 to 4 decreasing to 4.2% during Cycles 11 to 13. There were no reports of deep vein thrombosis, pulmonary embolism or hyperkalemia. No relevant changes were observed for laboratory parameters, body weight, body mass index, blood pressure or heart rate. Study drug acceptability was considered as "excellent/good" by over 82% of subjects. This new DRSP-only oral contraceptive provides clinical contraceptive efficacy similar to that of the currently marketed Combination estrogen plus progestin Oral Contraceptive, with a good safety profile, and favorable cycle control. A novel 4-mg DRSP-only pill taken daily for 24 days followed by a placebo for 4 days demonstrated contraceptive efficacy similar to that of currently marketed Combination estrogen plus progestin Oral Contraceptive, with a good safety profile, and favorable cycle control. Copyright © 2015. Published by Elsevier Inc.

  10. Effect of two low-dose gestodene containing monophasic oral contraceptives on hemostasis in Bulgarian women.

    Science.gov (United States)

    Uchikova, Ekaterina; Pehlivanov, Blagovest

    2008-08-01

    To compare the effects of two monophasic oral contraceptives upon coagulation, fibrinolysis and the system of natural inhibitors (anticoagulant pathways) in Bulgarian women. This prospective, open clinical study lasted 12 months and included 70 women, divided into two equal groups of 35 each. The women from group A received a contraceptive containing 20 microg ethinylestradiol/75 microg gestodene. The women from group B received a contraceptive containing 30 microg ethinylestradio l/75 microg gestodene. At the beginning and again at the end of the study, the following values were determined: prothrombin time (PT), activated partial thromboplastic time (aPTT), thrombin time (TT), fibrinogen (F), Factor VII (FVII), Factor X (FX), plasminogen, alpha 2-antiplasmin, tissue-type plasminogen activator (t-PA), D-dimers, protein C (Pr C), total Protein S (TPr S), antithrombin III (AT III) and heparin Cofactor II (HC II). We did not find any statistically significant differences in the global tests of hemostasis (PT, aPTT, TT) in either group compared with the baseline values. At the end of the study there was an increase in the levels of fibrinogen, FX, PrC and H II, and also diminution of t-PA in both groups in comparison with the baseline values. At the end of the study the activity of FVII, alpha2-antiplasmin and AT III was elevated only in group B. Although certain alterations in hemostasis parameters were observed, all of them were within the reference range. We did not observe or suspect any cases of vascular, thrombotic or other incidence in the observed groups of 840 cycles of hormonal contraception over the 12-month period. There is an increase in both procoagulant and fibrinolytic activity when using low-dose gestodene containing monophasic oral contraceptives. This can be interpreted as a shift to a higher equilibrium. There is no need for screening for thrombofilia in healthy, non-obese, non-smoking Bulgarian females, aged between 18 to 35 years, without a

  11. Combining oral contraceptives with a natural nuclear factor-kappa B inhibitor for the treatment of endometriosis-related pain

    Directory of Open Access Journals (Sweden)

    Maia H Jr

    2013-12-01

    Full Text Available Hugo Maia Jr,1–3 Clarice Haddad,3 Julio Casoy3 1Department of Gynecology and Obstetrics, School of Medicine, Federal University of Bahia, 2Itaigara Memorial Day Hospital, 3Centro de Pesquisas e Assistência em Reprodução Humana (CEPARH, Salvador, Bahia, Brazil Abstract: Endometriosis is a chronic disease in which a persistent state of heightened inflammation is maintained by nuclear factor-kappa B (NF-κB activation. The progestins present in oral contraceptives are potent inhibitors of NF-κB translocation to cell nuclei, while Pycnogenol® (Pinus pinaster acts by blocking post-translational events. In this study, the effects of Pycnogenol on pain scores were investigated in patients with endometriosis using oral contraceptives containing either gestodene or drospirenone in extended regimens. Pain scores were determined using a visual analog scale before and after 3 months of treatment. Oral contraceptives, used alone (groups 1 and 3 or in association with Pycnogenol (groups 2 and 4, resulted in significant decreases in pain scores after 3 months of treatment; however, this reduction was significantly greater in the groups using oral contraceptives + Pycnogenol (groups 2 and 4 compared with those using oral contraceptives alone (groups 1 and 3. In the groups using oral contraceptives alone, 50% of patients became pain-free by the end of the third month of treatment. These results suggest that Pycnogenol increases the efficacy of oral contraceptives for the treatment of endometriosis-related pain. Keywords: Pycnogenol®, aromatase, endometriosis, nuclear factor-kappa B

  12. The effect of pycnogenol on patients with dysmenorrhea using low-dose oral contraceptives

    Science.gov (United States)

    Maia, Hugo; Haddad, Clarice; Casoy, Julio

    2014-01-01

    Objective Menstrual symptoms such as dysmenorrhea usually occur during the hormone-free interval in oral contraceptive users. Progestin withdrawal activates NF-κB transcription factor, which upregulates both vascular endothelial growth factor (VEGF) and Cox-2 expression in the endometrium. The use of natural NF-κB inhibitors such as pycnogenol may block this response, improving dysmenorrhea. Patients and methods Twenty-four patients with severe dysmenorrhea were allocated to one of two treatment groups. In Group A (n=13), women were treated with an oral contraceptive containing 15 μg of ethinyl estradiol and 60 mg of gestodene (Adoless®) in a 24/4 regimen for three consecutive cycles. Women in Group B (n=11) used the same contraceptive regimen together with 100 mg of pycnogenol (Flebon®) continuously for 3 months. Pain scores were graded using a visual analog scale (VAS) before and during the hormone-free interval at the end of the third treatment cycle. Results Before treatment, VAS pain scores for dysmenorrhea were 8 and 9 in Groups A and B, respectively. However, by the end of the third treatment cycle, pain scores had decreased significantly (Pgestodene. PMID:25525393

  13. Does oral contraceptive pill increase the risk of abnormal Pap smear?

    Science.gov (United States)

    Binesh, Fariba; Akhavan, Ali; Pirdehghan, Azar; Davoodi, Mahnoosh

    2013-09-01

    It is noted that oral contraceptive pills increase the risk of abnormal Pap smear but results have been inconsistent across the populations. This study aimed to evaluate the association between oral contraceptive pill (OCP) consumption and abnormal Pap smear in women who referred to Shahid Sadoughi and Madar hospitals in Yazd. A cross sectional descriptive study was carried out and a database of all Pap smear reports from 2009-2011 at Cytopathology Department of Shahid Sadoughi and Madar hospitals in Yazd, Iran was reviewed. A total number of 1286 women with history of OCP consumption were selected as the case group and 1218 women applying other contraceptive methods were selected as control group for evaluation. Both case and control groups were matched by age, parity and socioeconomic status. All of the women in this study maintained a single partner as their husband and none of them were considered as smokers. The duration of OCP use was at least 5 years. Abnormal Pap smear results were observed in 0.4% of cases and 0.2% of controls. There was no significant association between OCP consumption and abnormal Pap smear (p=0.727). Our findings did not show any specific association between OCP consumption and abnormal Pap smear results. In addition, the number of abnormal Pap smears in women who consumed OCP was lower than that of western countries. More prospective studies are required.

  14. Effect of Oral Contraceptive Pills on the Blood Serum Enzymes and DNA Damage in Lymphocytes Among Users.

    Science.gov (United States)

    Naz, Falaq; Jyoti, Smita; Rahul; Akhtar, Nishat; Siddique, Yasir Hasan

    2016-07-01

    The continuous use of synthetic hormones as contraceptive pill or hormonal replacement therapy among women is increasing day by day. The widespread use of different formulations as oral contraceptives by women throughout their reproductive cycle has given rise to a serious concern for studying the effects of oral contraceptives on enzymatic profile and DNA damage in peripheral blood lymphocytes among users. The present study was carried out on women taking oral contraceptives. The study was based on the questionnaire having the information of reproductive history, fasting, age, health, nature of menstrual cycle, bleeding and other disease. The profile of the blood serum enzymes i.e. alkaline phosphatase (ALP), gamma glutamyl transferase (GGT), lactate dehydrogenase (LDH), aminotransferases (SGOT and SGPT), serum proteins (albumin and globulin) and DNA damage in lymphocytes was studied among users and non-users. The results of the present study suggest that OCs not only effects enzymatic activity but also results in DNA damage that may vary with the duration of using oral contraceptives. A significant increase in LDH, GGT, SGPT, SGOT, globulin and decrease in ALP as well as albumin was found among users as compared to non-users. The observed DNA damage was more in users as compared to non-users. Hormonal contraceptives seem to exert DNA damage and also have significant effects on blood serum enzymes.

  15. Clinical Trial of a Combination of Lynestrenol and Mestranol (Lyndiol) as an Oral Contraceptive Agent

    Science.gov (United States)

    Rice-Wray, Edris; Becerra, Carmen; Esquivel, Julio; Maqueo, Manuel

    1966-01-01

    Contraception with lynestrenol-mestranol (Lyndiol) was studied in 332 Mexican women during a period of two and one-half years. Side effects were minimal or transient. No pregnancies occurred in those who took the medication according to instructions. The women were followed with yearly pelvic examinations and Papanicolaou smears, serial endometrial biopsies and extensive studies of blood, liver and glandular function. Complete ophthalmological studies were done on 30 patients. No clinical or laboratory evidence of harmful effects could be demonstrated. Return to ovulation (using pregnanediol excretion and endometrial biopsies as parameters) occurred in all of 22 women studied in the first three post-treatment cycles. Eight posttreatment pregnancies and the resulting offspring were normal. The first post-treatment cycle, as with other oral contraceptives, was unpredictable and tended to be prolonged. It varied in length from 22 to 60 days. ImagesFig. 3Fig. 4 PMID:5332557

  16. Do oral contraceptives act as mood stabilizers? Evidence of positive affect stabilization.

    Science.gov (United States)

    Jarva, J A; Oinonen, K A

    2007-01-01

    Previous research has suggested that oral contraceptives (OCs) may provide a stabilizing effect on affect. The present study examined whether OC users and nonusers differ in their affect reactivity in response to four laboratory mood induction procedures. A sample of 107 undergraduate students (40 OC users, 36 nonusers, and 31 men) completed the Positive and Negative Affect Schedule (PANAS) before and after completing a series of four mood-induction procedures (i.e., positive affect, jealousy, social ostracism, and parental feelings affect inductions). OC users experienced a blunted positive affect response to the tasks when compared with nonusers and men. Women who used OCs for less than two years showed the lowest positive affect reactivity. The groups did not differ in terms of negative affect reactivity. The results suggest that hormonal contraceptives may reduce the degree of positive affect change that women experience in response to environmental events. Possible mechanisms for an OC-induced positive affect stabilization effect are discussed.

  17. Postponement of withdrawal bleeding with a monophasic oral contraceptive containing desogestrel and ethinylestradiol.

    Science.gov (United States)

    de Voogd, W S

    1991-08-01

    This study investigated the ability of a monophasic sub-50 oral contraceptive, containing desogestrel and ethinylestradiol, to postpone withdrawal bleeding in normal healthy women. In the analyzed group of 105 regular users of Marvelon, about 75% did not experience any vaginal bleeding during the 21 days of postponement. A 95% confidence interval was calculated which suggests that the percentage of women able to postpone their withdrawal bleeding successfully for 19 days ranges between 67.0% and 83.5%. Women with no vaginal blood loss in the postponement period were more willing to try this method of postponement again, compared to women who experienced vaginal blood loss in the postponement period. This difference was statistically significant. Nevertheless, the majority of women with vaginal blood loss were also willing to try this method again if necessary. The study results suggest that Marvelon offers an effective and acceptable method of postponing withdrawal bleeding for three weeks for most regular users of this contraceptive.

  18. Knowledge and attitudes of Latin American gynecologists regarding unplanned pregnancy and use of combined oral contraceptives

    Directory of Open Access Journals (Sweden)

    Bahamondes L

    2015-05-01

    Full Text Available Luis Bahamondes,1 Josefina Lira-Plasencia,2 Ricardo Martin,3 Victor Marin,4 Maria Y Makuch1 1Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP, Campinas, Brazil; 2Instituto Nacional de Perinatología, México, DF, México; 3Hospital Universitario, Fundación Santa Fe de Bogotá, Bogotá, Colombia; 4Hospital Central, Petróleos Mexicanos, México, DF, México Background: Unintended pregnancy is a public health problem and unmet medical need worldwide. It is estimated that in the year 2012, almost 213 million pregnancies occurred, and the global pregnancy rate decreased only slightly from 2008 to 2012. It was also estimated that 85 million pregnancies (40% of all pregnancies were unintended and that 38% ended in an unintended birth. Objectives: To assess knowledge and attitudes of Latin American (LA obstetricians and gynecologists (OBGYNs regarding unintended pregnancies and aspects of combined oral contraceptive (COC use. Methods: A survey was conducted during a scientific meeting about contraception in 2014, in which OBGYNs from 12 LA countries who provide attention in contraception were invited to respond to a multiple-choice questionnaire to assess their knowledge and attitudes regarding unplanned pregnancy and some aspects regarding COC use. Results: A total of 210 OBGYNs participated in the study. Their knowledge regarding COC failure was low. The participants reported they believed that their patients habitually forgot to take a pill and that their patients did not know what to do in these situations. They were aware of the benefits of COC use; however, they were less prone to prescribe COCs for the purpose of protecting against ovarian and endometrial cancer, and one-quarter of them had doubts about the association between COC use and cancer risk. Conclusion: The interviewed LA OBGYNs showed some flaws in terms of knowledge of COC failure rates and the non-contraceptive benefits and risks

  19. [The effect of two low dose oral contraceptive with gestodene on the systems of natural inhibitors of coagulation].

    Science.gov (United States)

    Uchikova, E; Terzhumanov, R; Milchev, N; Iacheva, T

    2004-01-01

    The authors investigated the influence of two monophasic oral contraceptives with 30 and 20 microg ethynilestradiol (EE) with combination with 75 microg gestodene (GSD) upon the system of natural inhibitors of coagulation. The study is prospective for a period of 12 months and was conducted upon 105 clinically healthy women, who use 30 microg EE/75 microg GSD (n = 35), 20 microg EE/75 microg GSD (n = 35) and a control group (n = 35). The continuous use of the contraceptive combination with 20 g EE/75 g GSD leads to statistically significant elevation of protein C (PrC), total protein S (TPrS) and Heparin Cofactor II (HCII). The use of the contraceptive combination with 30 microg EE/75 microg GSD is associated with statistically significant increase of Pr C and HC II. There were no statistically significant changes in the other variables. The use of both oral contraceptive combinations is associated with increased anticoagulant activity, which status prevents from thrombosis.

  20. Effects of menstrual cycle phase and oral contraceptives on alertness, cognitive performance, and circadian rhythms during sleep deprivation

    Science.gov (United States)

    Wright, K. P. Jr; Badia, P.; Czeisler, C. A. (Principal Investigator)

    1999-01-01

    The influence of menstrual cycle phase and oral contraceptive use on neurobehavioral function and circadian rhythms were studied in healthy young women (n = 25) using a modified constant routine procedure during 24 h of sleep deprivation. Alertness and performance worsened across sleep deprivation and also varied with circadian phase. Entrained circadian rhythms of melatonin and body temperature were evident in women regardless of menstrual phase or oral contraceptive use. No significant difference in melatonin levels, duration, or phase was observed between women in the luteal and follicular phases, whereas oral contraceptives appeared to increase melatonin levels. Temperature levels were higher in the luteal phase and in oral contraceptive users compared to women in the follicular phase. Alertness on the maintenance of wakefulness test and some tests of cognitive performance were poorest for women in the follicular phase especially near the circadian trough of body temperature. These observations suggest that hormonal changes associated with the menstrual cycle and the use of oral contraceptives contribute to changes in nighttime waking neurobehavioral function and temperature level whereas these factors do not appear to affect circadian phase.

  1. [The role of age, smoking habits, and oral contraceptives in the frequency of myocardial infarction in young women (author's transl)].

    Science.gov (United States)

    Goldzieher, J W

    1980-01-01

    Owing to the discussion aroused by different papers which have appeared in the last few years on the possible side-effects of oral contraceptives, an examination is made in this paper of the methods used in some of these studies, trying to elucidate to what extent we can trust the conclusions obtained, in order to decide whether oral contraceptives, by themselves, are a real and considerable risk to women's health, and analysing the role of oral contraceptives associated with other risk factors which can influence the frequency of myocardial infarction in young women. It is concluded that the use of oral contraceptives does not represent a statistically significant risk and, therefore, a causal inference cannot be attributed to them; but there exist other risk factors which prove to be of statistically demonstrable danger for myocardial infarction, such as smoking and obesity. Also, it seems evident that the combined effect of smoking and oral contraceptive use is synergistic. However, even though these two factors associated can increase the risk of myocardial infarction, we must not dismiss the possibility of this increment being influenced by other, equally logical circumstances.

  2. Effect of oral contraceptive with and without associated estriol on ultrasound measurements of breast fibroadenoma: randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Rodrigo Augusto Fernandes Estevão

    Full Text Available CONTEXT AND OBJECTIVE: Fibroadenomas are the most common benign tumors of the female breast. The aim of this study was to evaluate the proliferative activity of breast fibroadenoma as shown by ultrasound measurements, following administration of oral contraceptives with and without associated estriol. DESIGN AND SETTING: This was a randomized, double-blind, placebo-controlled clinical trial carried out in the Mastology Sector, Department of Gynecology, Universidade Federal de São Paulo. METHODS: We studied 33 women with fibroadenomas. Ten were placed in group 1 and took an oral contraceptive consisting of levonorgestrel and ethinyl estradiol together with placebo material in the same capsule, for four consecutive cycles with a seven-day interval between them. The other 23 patients constituted group 2 and took the oral contraceptive as above together with estriol in the same capsule, in the same way as done by the group 1 patients. We took ultrasound measurements of their tumors (in three dimensions before and after the intake of medication. At the end of the study, all the patients had their tumors removed by surgery. RESULTS: We observed decreased fibroadenoma width among the users of oral contraceptives with placebo, and this decrease was statistically significant. In the other group, we did not observe any changes (in width, length or height. CONCLUSION: The results confirm that estriol may block the protective effect of oral contraceptives on fibroadenomas, since we observed decreased fibroadenoma width among the group 1 patients but not the group 2 patients.

  3. Noncontraceptive benefits of the estradiol valerate/dienogest combined oral contraceptive: a review of the literature

    Directory of Open Access Journals (Sweden)

    Nappi RE

    2014-08-01

    Full Text Available Rossella E Nappi,1 Marco Serrani,2 Jeffrey T Jensen3 1Department of Obstetrics and Gynecology, Research Centre for Reproductive Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy; 2Global Medical Affairs Women's Healthcare, Bayer HealthCare Pharmaceuticals, Berlin, Germany; 3Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA Abstract: Combined oral contraceptives formulated to include estradiol (E2 have recently become available for the indication of pregnancy prevention. A combined estradiol valerate and dienogest pill (E2V/DNG, designed to be administered using an estrogen step-down and a progestin step-up regimen over 26 days of active treatment followed by 2 days of placebo (26/2-day regimen, has also undergone research to assess the potential for additional noncontraceptive benefits. Randomized, placebo-controlled studies have demonstrated that E2V/DNG is an effective treatment for heavy menstrual bleeding – a reduction in median menstrual blood loss approaching 90% occurs after 6 months of treatment. To date, E2V/DNG is the only oral contraceptive approved for this indication. Comparator studies have also demonstrated a reduction in hormone withdrawal-associated symptoms in users of E2V/DNG compared with a conventional 21/7-day regimen of ethinylestradiol/levonorgestrel. Other potential noncontraceptive benefits associated with E2V/DNG, like improvement in dysmenorrhea, sexual function, and quality of life, are comparable with those associated with other combined oral contraceptives and are discussed further in this review. Keywords: heavy menstrual bleeding, hormone withdrawal-associated symptoms, quality of life

  4. Influence of the menstrual cycle and oral contraceptives on thermoregulatory responses to exercise in young women.

    Science.gov (United States)

    Grucza, R; Pekkarinen, H; Titov, E K; Kononoff, A; Hänninen, O

    1993-01-01

    Thermoregulatory responses to exercise in relation to the phase of the menstrual cycle were studied in ten women taking oral contraceptives (P) and in ten women not taking oral contraceptives (NP). Each subject was tested for maximal aerobic capacity (VO2max) and for 50% VO2max exercise in the follicular (F) and luteal (L) phases of the menstrual cycle. Since the oral contraceptives would have prevented ovulation a quasi-follicular phase (q-F) and a quasi-luteal phase (q-L) of the menstrual cycle were assumed for P subjects. Exercise was performed on a cycle ergometer at an ambient temperature of 24 degrees C and relative air humidity of 50%. Rectal (Tre), mean skin (Tsk), mean body (Tb) temperatures and heart rate (fc) were measured. Sweat rate was estimated by the continuous measurement of relative humidity of air in a ventilated capsule placed on the chest, converted to absolute pressure (PH2Ochest). Gain for sweating was calculated as a ratio of increase in PH2Ochest to the appropriate increase in Tre for the whole period of sweating (G) and for unsteady-state (Gu) separately. The VO2max did not differ either between the groups of subjects or between the phases of the menstrual cycle. In P, rectal temperature threshold for sweating (Tre,td) was 37.85 degrees C in q-L and 37.60 degrees C in q-F (P menstrual phase-related differences were observed either in the dynamics of sweating or in G.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. The safety and contraceptive efficacy of a 24-day low-dose oral contraceptive regimen containing gestodene 60 microg and ethinylestradiol 15 microg.

    Science.gov (United States)

    1999-11-01

    The safety and contraceptive efficacy of a new 24-day regimen of an oral contraceptive combination containing gestodene (GTD) 60 microg and ethinylestradiol (EE) 15 microg was evaluated in an open-label, multicenter study. Adult women received GTD 60 microg/EE 15 microg from day 1 to 24 and 4 days of placebo during a 28-day cycle for either 13 or 19 cycles. Of the 1515 subjects enrolled, 1496 were included in the intent-to-treat analysis. A total of three pregnancies were reported during the 18 194 treatment cycles of the study, yielding a Pearl index of 0.21. Life-table analysis, based on 16 954 cycles, gave an accidental pregnancy rate of 0.0033. The most frequent adverse events were headache (reported in 35% of subjects), absence of bleeding (16%), flu-like syndrome (15%), pharyngitis (15%) and abdominal pain (15%). The most frequent reasons for withdrawal from the study were metrorrhagia, flu syndrome and absence of bleeding. Analyses of withdrawal and intermenstrual bleeding and spotting indicated acceptable cycle control. The 24-day GTD 60 microg/EE 15 microg regimen appears to be a well-tolerated and effective method for low-dose oral contraception. The current formulation offers an ultra-low steroidal dosage combined with a reduced pill-free interval to improve contraceptive efficacy.

  6. Strategies to improve compliance among oral contraceptive pill users: a review of the literature

    Directory of Open Access Journals (Sweden)

    Choi A

    2014-06-01

    Full Text Available Angela Choi, Angela DempseyDepartment of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USAAbstract: Oral contraceptive pills (OCPs remain the most commonly used reversible birth control method. Failure to adhere to daily pill taking and gaps in use are common and contribute to the risk of unintended pregnancy among OCP users. OCP compliance is influenced by a complex interplay of cognitive, behavioral, logistic, clinical, and social factors. This review outlines the evidence base for strategies that have been studied for their impact on OCP compliance.Keywords: adherence, continuation, unintended pregnancy, reminder system

  7. Combined Oral Contraception and Obesity Are Strong Predictors of Low-Grade Inflammation in Healthy Individuals

    DEFF Research Database (Denmark)

    Sørensen, Cecilie J; Pedersen, Ole B; Petersen, Mikkel S

    2014-01-01

    BACKGROUND: C-reactive protein (CRP) is a well-established marker of inflammation. The level of CRP is affected by several lifestyle factors. A slightly increased CRP level, also known as low-grade inflammation (LGI), is associated with increased risk of several diseases, especially cardiovascular...... and abdominal obesity strongly predicted LGI among healthy individuals. However, the most striking finding was the high prevalence of LGI among premenopausal women who used combined oral contraception. Although the significance of CRP as a marker of inflammation is well known, the role of CRP in pathogenesis...

  8. [Role of oral contraceptives in preventing endometriosis-related pain progression].

    Science.gov (United States)

    Kong, D L; Guo, H Y; Han, X T; Han, J S; Zhang, L F

    2017-10-24

    Objective: To analyze the effect of oral contraceptives on dysmenorrhea in patients with endometriosis. Methods: We designed dysmenorrhea and chronic pelvic pain questionnaire.From February 2014 to February 2016 in the Gynecological Department of Peking University Third Hospital, patients suffered dysmenorrhea with or without endometriosis or adenomyosis were included.According to their own willingness, patients were divided into the research group and the control group.The research group periodically took oral contraceptives (Diane-35 or Yasmin), while the control group received no treatment.They were followed-up about dysmenorrhea every six months, and the total follow-up time was one and a half year. Results: The dysmenorrhea VAS scores of patients in research group after taking oral contraceptives for six or twelve months were significantly lower than that in baseline (VAS 4 vs 5 vs 7). The dysmenorrhea VAS scores increased after quitting medication, but remained still lower than baseline (VAS 6.5 vs 7). However, the dysmenorrhea VAS scores of patients in control group remained unchanged (VAS 6 vs 6). Patients who took pills for more than one year experienced the same severity of dysmenorrhea after six months' or one year's medication (VAS 2 vs 2), and they suffered slowly aggravating recurrent dysmenorrhea, while those who quitted after six months' medication suffered quickly recurrent dysmenorrhea.The relieving rate of dysmenorrhea in research group was significantly higher than that in control group (79.7% vs 8.2%), and the relieving rate in patients with severe pain was significantly higher than that with mild or moderate pain (87.0% vs 66.6 % vs 77.1%). The relieving rate in patients without lesions was significantly higher than patients with adenomyosis (92.6% vs 59.1%). Conclusions: Endometriosis is a progressing disease. Longterm medication of oral contraceptives can relieve the dysmenorrhea pain.The extent of pain relief was not connected with the

  9. Relationship satisfaction and outcome in women who meet their partner while using oral contraception.

    Science.gov (United States)

    Roberts, S Craig; Klapilová, Katerina; Little, Anthony C; Burriss, Robert P; Jones, Benedict C; DeBruine, Lisa M; Petrie, Marion; Havlícek, Jan

    2012-04-07

    Hormonal variation over the menstrual cycle alters women's preferences for phenotypic indicators of men's genetic or parental quality. Hormonal contraceptives suppress these shifts, inducing different mate preference patterns among users and non-users. This raises the possibility that women using oral contraception (OC) choose different partners than they would do otherwise but, to date, we know neither whether these laboratory-measured effects are sufficient to exert real-world consequences, nor what these consequences would be. Here, we test for differences in relationship quality and survival between women who were using or not using OC when they chose the partner who fathered their first child. Women who used OC scored lower on measures of sexual satisfaction and partner attraction, experienced increasing sexual dissatisfaction during the relationship, and were more likely to be the one to initiate an eventual separation if it occurred. However, the same women were more satisfied with their partner's paternal provision, and thus had longer relationships and were less likely to separate. These effects are congruent with evolutionary predictions based on cyclical preference shifts. Our results demonstrate that widespread use of hormonal contraception may contribute to relationship outcome, with implications for human reproductive behaviour, family cohesion and quality of life.

  10. [Angiodysplasia of moya-moya type disclosed by choreic unvoluntary abnormal movements during oral contraception. Apropos of 2 cases].

    Science.gov (United States)

    Pelletier, J; Cabanot, C; Lévrier, O; Thuillier, J N; Chérif, A A

    1997-07-01

    Two seventeen year-old women, developed acute onset left choreic movements following two months and two weeks use of oral contraceptives. Left hemiparesia appeared a few days later, while involuntary movements discontinued. Cranial CT scan and MRI showed bilateral ischemic lesion in the frontal region for the first case and isolated lesion in the right centrum ovale for the second. Angiography showed nearly complete obstruction of the terminal portion of the internal carotid artery with an outline Moya-Moya network. After discontinuing oral contraceptives, there has been no relapse of neurologic dysfunction for more than three years for the first case and twelve months for the second one. The role of perfusion insufficiency in limb-shaking carotid transient ischemic attack is discussed and the possible relations between oral contraceptives, chorea and angiographic features resembling Moya-Moya disease are evaluated.

  11. Parental Gender Equality and Use of Oral Contraceptives Among Young Women: A Longitudinal, Population-based Study in Sweden.

    Science.gov (United States)

    Rashid, Mamunur; Kader, Manzur

    2014-07-01

    Little is known about how parental gender equality early in their children lives can influence daughters' decision to use contraceptive pills. The study aimed at exploring whether maternal working time and paternity leave in Sweden during the first two years of their daughters' lives is associated with the use of oral contraceptives when they are adolescents or young adults. The study population was selected from a cohort of all Swedish fathers and mothers who had their first child together between 1988 and 1989 (n = 57,520 family units). Multivariate logistic regression was used to estimate the association. Mothers' longer working time was mildly associated with daughters' oral contraceptive pill use, though no clear trend was observed. Longer paternity leave periods (>30 days) were not associated with use of oral contraceptives among their daughters, but 1-30 day periods showed a mild positive association. For maternal working time, there seems to be an association, but trends by working hours are not clear. There is no clear association between paternity leave during the first two years of their daughters' life and the use of oral contraceptives when they are adolescents and young adults.

  12. Parental Gender Equality and Use of Oral Contraceptives Among Young Women: A Longitudinal, Population-based Study in Sweden

    Science.gov (United States)

    Rashid, Mamunur; Kader, Manzur

    2014-01-01

    Background: Little is known about how parental gender equality early in their children lives can influence daughters’ decision to use contraceptive pills. Aim: The study aimed at exploring whether maternal working time and paternity leave in Sweden during the first two years of their daughters’ lives is associated with the use of oral contraceptives when they are adolescents or young adults. Materials and Methods: The study population was selected from a cohort of all Swedish fathers and mothers who had their first child together between 1988 and 1989 (n = 57,520 family units). Multivariate logistic regression was used to estimate the association. Results: Mothers’ longer working time was mildly associated with daughters’ oral contraceptive pill use, though no clear trend was observed. Longer paternity leave periods (>30 days) were not associated with use of oral contraceptives among their daughters, but 1-30 day periods showed a mild positive association. Conclusion: For maternal working time, there seems to be an association, but trends by working hours are not clear. There is no clear association between paternity leave during the first two years of their daughters’ life and the use of oral contraceptives when they are adolescents and young adults. PMID:25077078

  13. Association between sex hormone-binding globulin levels and activated protein C resistance in explaining the risk of thrombosis in users of oral contraceptives containing different progestogens

    NARCIS (Netherlands)

    van Vliet, Huib A.A.M.; Frolich, Marijke; Christella, M.; Thomassen, L.G.D.; Doggen, Catharina Jacoba Maria; Rosendaal, Frits R.; Rosing, Jan; Helmerhorst, Frans M.

    2005-01-01

    BACKGROUND: Epidemiological studies have shown that both the estrogen dose and progestogen type of oral contraceptives contribute to the increased risk of thrombosis in oral contraceptive users. Thrombin generation-based activated protein C (APC) sensitivity is a global test for the net

  14. The venous thrombotic risk of oral contraceptives, effects of oestrogen dose and progestogen type: results of the MEGA case-control study

    NARCIS (Netherlands)

    van Hylckama Vlieg, A.; Helmerhorst, F.M.; Vandenbroucke, J.P.; Doggen, Catharina Jacoba Maria; Rosendaal, F.R.

    2009-01-01

    Objective To assess the thrombotic risk associated with oral contraceptive use with a focus on dose of oestrogen and type of progestogen of oral contraceptives available in the Netherlands. Design Population based case-control study. Setting Six participating anticoagulation clinics in the

  15. Risk of venous thromboembolism from use of oral contraceptives containing different progestogens and oestrogen doses: Danish cohort study, 2001-9

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind; Nielsen, Lars Hougaard; Skovlund, Charlotte Wessel

    2011-01-01

    To assess the risk of venous thromboembolism from use of combined oral contraceptives according to progestogen type and oestrogen dose.......To assess the risk of venous thromboembolism from use of combined oral contraceptives according to progestogen type and oestrogen dose....

  16. Clinical comparison of monophasic oral contraceptive preparations of gestodene/ethinyl estradiol and desogestrel/ethinyl estradiol. Latin American Oral Contraceptive Study Group.

    Science.gov (United States)

    1994-09-01

    The efficacy, cycle control, subjective complaints, and safety of monophasic preparations of the oral contraceptives containing gestodene 75 mcg plus ethinyl estradiol 30 mcg versus desogestrel 150 mcg plus ethinyl estradiol 30 mcg were compared in a 6-cycle, open-label, parallel, randomized, multicenter phase IV clinical study in Latin America. Of a total of 176 women in each group, 163 in the gestodene group and 160 in the desogestrel group completed 6 cycles, providing data for 1,015 and 1,006 cycles, respectively. Subject compliance was excellent; pills were missed during only 6.9% of the cycles in each group. No woman became pregnant during the study. Gestodene group exhibited significantly better cycle control as evidenced by the lower incidence of breakthrough bleeding and spotting. Spotting in some cycles was reported by 11.9% of women taking the gestodene-combination compared with 21% of women taking the desogestrel-combination. Based on number of women, 86.4% of the gestodene group reported all cycles were normal (no BTB) compared with 76.7% of the desogestrel group. Also, the women in the gestodene group reported a significantly lower incidence of nuisance side effects during treatment cycles. No amenorrhea was observed for either group. There were no clinically significant differences between groups with respect to body weight, blood pressure, or laboratory evaluations. Seven women withdrew from the gestodene group and 8 women withdrew from the desogestrel group because of adverse reactions. The results of this study indicate that, although both OCs provided effective contraception, in comparison to the desogestrel-combination, the gestodene-containing OC is associated with better cycle control, less bleeding, and fewer subjective complaints.

  17. Venous Thromboembolism Due to Oral Contraceptive Intake and Spending Nights in a Vehicle -A Case from the 2016 Kumamoto Earthquakes.

    Science.gov (United States)

    Sueta, Daisuke; Akahoshi, Rika; Okamura, Yoshinori; Kojima, Sunao; Ikemoto, Tomokazu; Yamamoto, Eiichiro; Izumiya, Yasuhiro; Tsujita, Kenichi; Kaikita, Koichi; Katabuchi, Hidetaka; Hokimoto, Seiji

    2017-01-01

    A 40-year-old woman experiencing sudden dyspnea went to her personal doctor for advice. She was previously diagnosed with endometriosis and prescribed oral contraceptives for treatment. During earthquakes, she spent 7 nights sleeping in a vehicle. The patient had swelling and pain in her left leg and high D-dimer concentration levels. A contrast-enhanced computed tomography scan revealed a contrast deficit in the bilateral pulmonary artery and in the left lower extremity. She was diagnosed with pulmonary thromboembolism (PTE), and anticoagulation therapy was initiated. This present case is the first report of PTE attributed to the use of oral contraceptives after earthquakes.

  18. The effect of pycnogenol on patients with dysmenorrhea using low-dose oral contraceptives

    Directory of Open Access Journals (Sweden)

    Maia Jr H

    2014-12-01

    Full Text Available Hugo Maia Jr, Clarice Haddad, Julio Casoy Centro de Pesquisa e Assistência em Reprodução Humana (CEPARH, Salvador, Bahia, BrazilObjective: Menstrual symptoms such as dysmenorrhea usually occur during the hormone-free interval in oral contraceptive users. Progestin withdrawal activates NF-κB transcription factor, which upregulates both vascular endothelial growth factor (VEGF and Cox-2 expression in the endometrium. The use of natural NF-κB inhibitors such as pycnogenol may block this response, improving dysmenorrhea.Patients and methods: Twenty-four patients with severe dysmenorrhea were allocated to one of two treatment groups. In Group A (n=13, women were treated with an oral contraceptive containing 15 µg of ethinyl estradiol and 60 mg of gestodene (Adoless® in a 24/4 regimen for three consecutive cycles. Women in Group B (n=11 used the same contraceptive regimen together with 100 mg of pycnogenol (Flebon® continuously for 3 months. Pain scores were graded using a visual analog scale (VAS before and during the hormone-free interval at the end of the third treatment cycle.Results: Before treatment, VAS pain scores for dysmenorrhea were 8 and 9 in Groups A and B, respectively. However, by the end of the third treatment cycle, pain scores had decreased significantly (P<0.05 both in groups A and B. The final pain scores were 6 in Group A and 2 in Group B, a difference that was statistically significant (P<0.0001. In Group B, 27% of the patients became pain-free, while in Group A, none of the women reported complete disappearance of this symptom. The number of bleeding days was also lower in Group B.Discussion: Pycnogenol effectively decreased pain scores and the number of bleeding days when administered concomitantly with a low-dose 24/4 oral contraceptive containing gestodene.Keywords: gestodene, hormone-free interval, pain

  19. Risk prediction of developing venous thrombosis in combined oral contraceptive users.

    Directory of Open Access Journals (Sweden)

    Aaron McDaid

    Full Text Available Venous thromboembolism (VTE is a complex multifactorial disease influenced by genetic and environmental risk factors. An example for the latter is the regular use of combined oral contraceptives (CC, which increases the risk to develop VTE by 3 to 7 fold, depending on estrogen dosage and the type of progestin present in the pill. One out of 1'000 women using CC develops thrombosis, often with life-long consequences; a risk assessment is therefore necessary prior to such treatment. Currently known clinical risk factors associated with VTE development in general are routinely checked by medical doctors, however they are far from being sufficient for risk prediction, even when combined with genetic tests for Factor V Leiden and Factor II G20210A variants. Thus, clinical and notably genetic risk factors specific to the development of thrombosis associated with the use of CC in particular should be identified.Step-wise (logistic model selection was applied to a population of 1622 women using CC, half of whom (794 had developed a thromboembolic event while using contraceptives. 46 polymorphisms and clinical parameters were tested in the model selection and a specific combination of 4 clinical risk factors and 9 polymorphisms were identified. Among the 9 polymorphisms, there are two novel genetic polymorphisms (rs1799853 and rs4379368 that had not been previously associated with the development of thromboembolic event. This new prediction model outperforms (AUC 0.71, 95% CI 0.69-0.74 previously published models for general thromboembolic events in a cross-validation setting. Further validation in independent populations should be envisaged.We identified two new genetic variants associated to VTE development, as well as a robust prediction model to assess the risk of thrombosis for women using combined oral contraceptives. This model outperforms current medical practice as well as previously published models and is the first model specific to CC use.

  20. Extended cycle combined oral contraceptives and prophylactic frovatriptan during the hormone-free interval in women with menstrual-related migraines.

    Science.gov (United States)

    Coffee, Andrea L; Sulak, Patricia J; Hill, Alexandria J; Hansen, Darci J; Kuehl, Thomas J; Clark, Jeffrey W

    2014-04-01

    Migraine headaches are a significant problem for American women with many of them suffering from headaches around the time of their menstrual cycle. Women taking oral contraceptives in the standard 21/7 cycle regimen often suffer from headaches around the time of the hormone free intervals (HFIs) as well. Extended oral contraceptive regimens have been shown to decrease the frequency, but not eliminate these headaches. This study is a double-blind, randomized, placebo-controlled pilot study of participants with menstrual-related migraines (MRMs) who were initiated on extended combined oral contraceptives and given frovatriptan prophylactically during HFIs. Participants having spontaneous menstrual cycles or taking daily combined oral contraceptives in a 21/7 regimen with MRMs were placed on a contraceptive containing levonorgestrel and ethinyl estradiol. Analyses compared headache scores during pre-study baseline cycles to those in a 168-day extended regimen with placebo versus frovatriptan treatments during HFIs. Daily headache scores decreased (p=0.034) from 1.29 ± 0.10 during pre-study cycles to 1.10 ± 0.14 during extended combined oral contraceptive use. Frovatriptan blocked the increase in headache score over the placebo during HFIs. However, following the withdrawal of frovatriptan, headache scores increased (p>0.01) despite resuming combined oral contraceptive use. Extended combined oral contraceptive regimen reduces MRM severity. Frovatriptan prevents headaches during HFIs, but is associated with new headache symptoms when withdrawn.

  1. Serum resistin levels in women taking combined oral contraceptives containing desogestrel or gestodene.

    Science.gov (United States)

    Rechberger, Tomasz; Tomaszewski, Jacek; Pieprzowska-Białek, Anna; Kulik-Rechberger, Beata; Skorupski, Paweł

    2004-06-01

    Resistin is a hormone secreted by adipose tissue that could be involved in the development of insulin resistance. Previous studies confirmed that endogenous sex steroids may influence serum resistin concentration in women. The aim of our study was to investigate the influence of combined oral contraceptives containing desogestrel or gestodene on circulating levels of resistin. Fifty-three women were enrolled in the study. Thirteen patients received 20 microg ethinylestradiol/150 microg desogestrel, 15 women were treated with 20 microg ethinylestradiol/75 microg gestodene, 11 with 30 microg ethinylestradiol/150 microg desogestrel and 14 with 30 microg ethinylestradiol/75 microg gestodene. Blood samples for estimation of serum resistin and insulin levels were drawn before administration of oral contraceptive and after 6 cycles of therapy. We found that serum resistin level remained unchanged in women receiving ethinylestradiol/desogestrel and was reduced in women treated with formulations containing gestodene. We conclude that ethinylestradiol combined with desogestrel or gestodene is unlikely to induce insulin resistance through resistin pathway. Copyright 2004 Elsevier Inc.

  2. Early onset vulvar Lichen Sclerosus in premenopausal women and oral contraceptives.

    Science.gov (United States)

    Günthert, Andreas R; Faber, Melanie; Knappe, Gabriele; Hellriegel, Simin; Emons, Günter

    2008-03-01

    For vulvar Lichen sclerosus (LS) immunological factors, genetic predisposition, and decreased 5 alpha-reductase activity have been discussed as aetiological factors. During the last decade an increase of LS in young women has been suspected. Aim of this study was to evaluate data of premenopausal women with early onset LS to find potential risk factors focussing on the use of oral contraceptives. We retrospectively analyzed the data of 40 premenopausal patients with early onset LS regarding use of oral contraceptives (OCPs), and first occurrence of LS. To compare these data in a case-control study we analyzed a matched control group of 110 healthy women. All our LS patients were using OCPs compared to 73 women (66.4%) in the control group. OCPs with anti-androgenic activity (chlormadinone acetate, cyproterone acetate, dienogest, and drospirenone) were used by 28 (70%) of the LS patients and by 35 (47.9%) of the 73 women using OCPs in the control group. Thus, the odds ratio for early onset LS for women using anti-androgenic OCPs was 2.53 (95% CI: 1.12-5.75). Our data suggest that disturbance of the androgen dependent growth of the vulvar skin by OCPs and especially by OCPs with anti-androgenic properties might trigger the early onset of LS in a subgroup of susceptible young women.

  3. Quantitative bias analysis of a reported association between perfluoroalkyl substances (PFAS) and endometriosis: The influence of oral contraceptive use.

    Science.gov (United States)

    Ngueta, Gerard; Longnecker, Matthew P; Yoon, Miyoung; Ruark, Christopher D; Clewell, Harvey J; Andersen, Melvin E; Verner, Marc-André

    2017-07-01

    An association between serum levels of perfluoroalkyl substances (PFAS) and endometriosis has recently been reported in an epidemiologic study. Oral contraceptive use to treat dysmenorrhea (pelvic pain associated with endometriosis) could potentially influence this association by reducing menstrual fluid loss, a route of excretion for PFAS. In this study, we aimed to evaluate the influence of differential oral contraceptive use on the association between PFAS and endometriosis. We used a published life-stage physiologically based pharmacokinetic (PBPK) model to simulate plasma levels of perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) from birth to age at study participation (range 18-44years). In the simulated population, PFAS level distributions matched those for controls in the epidemiologic study. Prevalence and geometric mean duration (standard deviation [SD]) of oral contraceptive use in the simulated women were based on data from the National Health and Nutrition Examination Survey; among the women with endometriosis the values were, respectively, 29% and 6.8 (3.1) years; among those without endometriosis these values were 18% and 5.3 (2.8) years. In simulations, menstrual fluid loss (ml/cycle) in women taking oral contraceptives was assumed to be 56% of loss in non-users. We evaluated the association between simulated plasma PFAS concentration and endometriosis in the simulated population using logistic regression. Based on the simulations, the association between PFAS levels and endometriosis attributable to differential contraceptive use had an odds ratio (95% CI) of 1.05 (1.02, 1.07) for a loge unit increase in PFOA and 1.03 (1.02, 1.05) for PFOS. In comparison, the epidemiologic study reported odds ratios of 1.62 (0.99, 2.66) for PFOA and 1.25 (0.87, 1.80) for PFOS. Our results suggest that the influence of oral contraceptive use on the association between PFAS levels and endometriosis is relatively small. Copyright © 2017 Elsevier

  4. Influence of Body Weight, Ethnicity, Oral Contraceptives, and Pregnancy on the Pharmacokinetics of Azithromycin in Women of Childbearing Age

    Science.gov (United States)

    Habibi, Mitra; Kilpatrick, Sarah J.; Tuomala, Ruth E.; Shier, Janice M.; Wollett, Lori; Fischer, Patricia A.; Khorana, Kinnari S.; Rodvold, Keith A.

    2012-01-01

    Women of childbearing age commonly receive azithromycin for the treatment of community-acquired infections, including during pregnancy. This study determined azithromycin pharmacokinetics in pregnant and nonpregnant women and identified covariates contributing to pharmacokinetic variability. Plasma samples were collected by using a sparse-sampling strategy from pregnant women at a gestational age of 12 to 40 weeks and from nonpregnant women of childbearing age receiving oral azithromycin for the treatment of an infection. Pharmacokinetic data from extensive sampling conducted on 12 healthy women were also included. Plasma samples were assayed for azithromycin by high-performance liquid chromatography. Population data were analyzed by nonlinear mixed-effects modeling. The population analysis included 53 pregnant and 25 nonpregnant women. A three-compartment model with first-order absorption and a lag time provided the best fit of the data. Lean body weight, pregnancy, ethnicity, and the coadministration of oral contraceptives were covariates identified as significantly influencing the oral clearance of azithromycin and, except for oral contraceptive use, intercompartmental clearance between the central and second peripheral compartments. No other covariate relationships were identified. Compared to nonpregnant women not receiving oral contraceptives, a 21% to 42% higher dose-adjusted azithromycin area under the plasma concentration-time curve (AUC) occurred in non-African American women who were pregnant or receiving oral contraceptives. Conversely, azithromycin AUCs were similar between pregnant African American women and nonpregnant women not receiving oral contraceptives. Although higher levels of maternal and fetal azithromycin exposure suggest that lower doses be administered to non-African American women during pregnancy, the consideration of azithromycin pharmacodynamics during pregnancy should guide any dose adjustments. PMID:22106226

  5. Effectiveness and acceptability of progestogens in combined oral contraceptives – a systematic review

    Directory of Open Access Journals (Sweden)

    Kulier Regina

    2004-06-01

    Full Text Available Abstract Background The progestogen component of oral contraceptives (OCs has undergone changes since it was recognized that their chemical structure can influence the spectrum of minor adverse and beneficial effects. Methods The objective of this review was to evaluate currently available low-dose OCs containing ethinylestradiol and different progestogens in terms of contraceptive effectiveness, cycle control, side effects and continuation rates. The Cochrane Controlled Trials Register, MEDLINE and EMBASE databases were searched. Randomized trials reporting clinical outcomes were considered for inclusion and were assessed for methodological quality and validity. Results Twenty–two trials were included in the review. Eighteen were sponsored by pharmaceutical companies and in only 5 there was an attempt for blinding. Most comparisons between different interventions included one to three trials, involving usually less than 500 women. Discontinuation was less with second-generation progestogens compared to first–generation (RR 0.79; 95% CI 0.69–0.91. Cycle control appeared to be better with second-compared to first-generation progestogens for both, mono-and triphasic preparations (RR 0.69; 95% CI 0.52–0.91 and (RR 0.61; 95% CI 0.43–0.85, respectively. Intermenstrual bleeding was less with third- compared to second-generation pills (RR 0.71; 95% CI 0.55–0.91. Contraceptive effectiveness of gestodene (GSD was comparable to that of levonorgestrel (LNG, and had similar pattern of spotting, breakthrough bleeding and absence of withdrawal bleeding. Drospirenone (DRSP was similar compared to desogestrel (DSG regarding contraceptive effectiveness, cycle control and side effects. Conclusion The third- and second-generation progestogens are preferred over first generation in all indices of acceptability. Current evidence suggests that GSD is comparable to LNG in terms of contraceptive effectiveness and for most cycle control indices. GSD is also

  6. Effectiveness and acceptability of progestogens in combined oral contraceptives – a systematic review

    Science.gov (United States)

    Kulier, Regina; Helmerhorst, Frans M; Maitra, Nandita; Gülmezoglu, A Metin

    2004-01-01

    Background The progestogen component of oral contraceptives (OCs) has undergone changes since it was recognized that their chemical structure can influence the spectrum of minor adverse and beneficial effects. Methods The objective of this review was to evaluate currently available low-dose OCs containing ethinylestradiol and different progestogens in terms of contraceptive effectiveness, cycle control, side effects and continuation rates. The Cochrane Controlled Trials Register, MEDLINE and EMBASE databases were searched. Randomized trials reporting clinical outcomes were considered for inclusion and were assessed for methodological quality and validity. Results Twenty–two trials were included in the review. Eighteen were sponsored by pharmaceutical companies and in only 5 there was an attempt for blinding. Most comparisons between different interventions included one to three trials, involving usually less than 500 women. Discontinuation was less with second-generation progestogens compared to first–generation (RR 0.79; 95% CI 0.69–0.91). Cycle control appeared to be better with second-compared to first-generation progestogens for both, mono-and triphasic preparations (RR 0.69; 95% CI 0.52–0.91) and (RR 0.61; 95% CI 0.43–0.85), respectively. Intermenstrual bleeding was less with third- compared to second-generation pills (RR 0.71; 95% CI 0.55–0.91). Contraceptive effectiveness of gestodene (GSD) was comparable to that of levonorgestrel (LNG), and had similar pattern of spotting, breakthrough bleeding and absence of withdrawal bleeding). Drospirenone (DRSP) was similar compared to desogestrel (DSG) regarding contraceptive effectiveness, cycle control and side effects. Conclusion The third- and second-generation progestogens are preferred over first generation in all indices of acceptability. Current evidence suggests that GSD is comparable to LNG in terms of contraceptive effectiveness and for most cycle control indices. GSD is also comparable to DSG

  7. Adolescents' cortisol responses to awakening and social stress; Effects of gender, menstrual phase and oral contraceptives. The TRAILS study

    NARCIS (Netherlands)

    Bouma, Esther M. C.; Riese, Harriette; Ormel, Johan; Verhulst, Frank C.; Oldehinkel, Albertine J.

    Studies on the influence of sex hormones on cortisol responses to awakening and stress have mainly been conducted in adults, while reports on adolescents are scarce. We studied the effects of gender, menstrual cycle phase and oral contraceptive (OC) use on cortisol responses in a large sample of

  8. Plasma factor VII-activating protease is increased by oral contraceptives and induces factor VII activation in-vivo

    DEFF Research Database (Denmark)

    Sidelmann, Johannes J; Skouby, Sven O; Kluft, Cornelis

    2011-01-01

    Oral contraceptive (OC) use influences the hemostatic system significantly and is a risk factor for development of cardiovascular disease. Factor VII-activating protease (FSAP) has potential effects on hemostasis. The 1601GA genotype of the 1601G/A polymorphism in the FSAP gene expresses a FSAP...

  9. Cycle control, safety and acceptability of a new oral contraceptive containing ethinylestradiol 15 micrograms and gestodene 60 micrograms.

    Science.gov (United States)

    Jaithitivit, Ladakan; Jaisamrarn, Unnop; Taneepanichskul, Surasak

    2012-05-01

    To determine cycle control, safety, and acceptability of a 24-day oral contraceptive regimen containing 15 micrograms of ethinylestradiol and 60 micrograms of gestodene. This was an open-label, non-comparative study. Healthy women 18 to 35 years old who attended the Family Planning Clinic of King Chulalongkorn Memorial Hospital were assigned to receive six cycles of the study oral contraceptives, administered daily for 24 days and followed by a 4-day hormone-free interval. Data on bleeding patterns, side effects, body weight, blood pressure, and satisfaction were collected. Descriptive statistics and paired t test were used for the analysis. Ninety-four women completed the present study. There was no pregnancy reported during the present study. Percentages of breakthrough bleeding and spotting were higher in the first cycle (2.1% and 6.4%), then decreased and disappeared after the third cycle. There was no significant change in the body weight and the blood pressure. Only minimal side effects were reported and 93.6% of the women were satisfied or very satisfied. Furthermore, 91.5% would continue using this oral contraceptive. This new oral contraceptive, a combination of 15 micrograms of ethinylestradiol and 60 micrograms of gestodene has acceptable cycle control, minimal side effects, and good acceptability.

  10. Combined oral contraceptives, thrombophilia and the risk of venous thromboembolism : a systematic review and meta-analysis

    NARCIS (Netherlands)

    van Vlijmen, E. F. W.; Wiewel-Verschueren, S.; Monster, T. B. M.; Meijer, K.

    Background Combined oral contraceptives (COCs) are associated with an increased risk of venous thromboembolism (VTE), which is shown to be more pronounced in women with hereditary thrombophilia. Currently, WHO recommendations state that COC-use in women with hereditary thrombophilias (antithrombin

  11. Impact of oral contraceptive use and menstrual phases on patellar tendon morphology, biochemical composition and biomechanical properties in female athletes

    DEFF Research Database (Denmark)

    Hansen, Mette; Couppe, Christian; Hansen, Christina S

    2013-01-01

    Introduction: Gender differences exist with regards to ligament and tendon injuries. Lower collagen synthesis has been observed in exercising females vs. males, and in users of oral contraceptives (OC) vs non-users, but it is unknown if OC will influence tendon biomechanics of females undergoing ...

  12. Changes in blood levels of proteinase inhibitors, pregnancy zone protein, steroid carriers and complement factors induced by oral contraceptives

    DEFF Research Database (Denmark)

    Nielsen, Claus Henrik; Poulsen, Henning Kvist; Teisner, Børge

    1993-01-01

    Three low-dose oral contraceptives Trinordiol, Gynatrol, and Marvelon, containing ethinylestradiol (EE) in combination with triphasic levonorgestrel (LNg), monophasic levonorgestrel, and monophasic desogestrel (DGS), respectively, were given to 65 healthy women, n = 21-22 in each group. Blood lev...

  13. Oral contraceptive pill, progestogen or estrogen pre-treatment for ovarian stimulation protocols for women undergoing assisted reproductive techniques (Review)

    NARCIS (Netherlands)

    Smulders, B.; Oirschot, S.M. van; Farquhar, C.; Rombauts, L.; Kremer, J.A.M.

    2010-01-01

    BACKGROUND: For many subfertile women, assisted reproductive techniques (ART) is the only hope for a pregnancy and live birth. The combined oral contraceptive pill (OCP) given prior to the hormone therapy in an IVF cycle may result in better pregnancy outcomes of ART. OBJECTIVES: To assess whether

  14. Contraceptive Methods.

    Science.gov (United States)

    Colquitt, Charlie W; Martin, Tonya S

    2017-02-01

    The prevention of pregnancy remains an important part of the practice of medicine. Contraception can occur at a number of points in the basic reproductive biological process and through a number of contraceptive product options. Pharmacists are health care providers appropriately positioned to assist patients in suitable contraceptive product selection based on their personal situations and lifestyles. This article provides an overview of available products for prevention of pregnancy and associated risks and benefits. Contraceptive products are categorized by their hormonal content and method of action. Hormonal options include oral contraceptive pills, contraceptive patch, implants, injection, intravaginal, and intrauterine devices. Barrier products prevent pregnancy by creating a physical obstacle to the successful fertilization of an egg by sperm. All products and methods are associated with benefits and potential complications that must be considered as patients, and health care providers select the most satisfactory option.

  15. Married Iranian Women's Knowledge, Attitude and Sense of Self-efficacy about Oral Contraceptives: Focus Group Discussion.

    Science.gov (United States)

    Peyman, Nooshin; Oakley, Deborah

    2011-10-01

    Oral contraceptive pills effectiveness is lower in actual use than in clinical trials. The views of a group of married Iranian women were sought as a step toward improving the enhanced use of contraceptive pills. Two focus groups of current pill users (n=13) and two focus groups of women not currently taking the pills (n=14) were held. Leaders trained facilitators; themes were identified from line-by-line analysis of transcripts. The majority of the participants were primary school graduates with a mean age of 34 years. Knowledge about mechanisms of action was low; some women wanted more information. Both users and non-users recognized positive and negative characteristics of contraceptive pills. For non-users, physical and emotional side-effects were the most important; and anecdotal information from their social network was more important. They tended to trust more traditional methods. For users, their own experience and more reality-based understanding of side-effects mitigated concerns about side-effects. They also felt that health clinic staff had a negative attitude toward the pills. A stronger expression of self-efficacy seemed to be associated with more positive attitudes toward oral contraceptive pills. Although Iran has had a government-funded family planning program since 1990, and pills are the single most popular modern contraceptive method, women who take OCPs can provide important information that could increase effective health education about their use.

  16. Importance and knowledge of oral contraceptives in antepartum, low-income, African American adolescents.

    Science.gov (United States)

    Gilliam, Melissa L; Knight, Sara; McCarthy, Martin

    2003-12-01

    To assess motivation, sense of self-efficacy and knowledge of oral contraceptives (OC) in antepartum, African-American Adolescents and young adults following OC counseling. Gravid African-American females, less than 25 years of age, receiving prenatal care at the Prentice Ambulatory Clinic at Northwestern Memorial Hospital were eligible for this study. Participants were enrolled after 34 weeks gestation, received one session of standardized OC counseling and then completed a series of questions regarding importance, confidence and knowledge of OCs. Forty-three adolescents and young adults participated in this study. Almost all participants agreed that it was important to plan their next pregnancy and to avoid unplanned pregnancies. On average, participants were extremely confident they could take a pill each day. Yet, while most were confident that they knew what to do if they missed one pill, only 37% actually knew what to do if they missed one pill. Despite high motivation and confidence in their ability to take OCs following pregnancy, many in this cohort did not fully understand the counseling that they had received. It is important for clinicians to bear in mind that patients may express motivation and confidence about using OCs, but still lack knowledge of the more complex and critical aspects of OC use. Additional education and support are needed in high-risk populations to ensure effective contraceptive knowledge.

  17. Shorter pill-free interval in combined oral contraceptives decreases follicular development.

    Science.gov (United States)

    Spona, J; Elstein, M; Feichtinger, W; Sullivan, H; Lüdicke, F; Müller, U; Düsterberg, B

    1996-08-01

    The objective of the study was to determine the suppressive effect on ovarian activity of 20 micrograms ethinylestradiol plus 75 micrograms gestodene administered for 21 or 23 days. The study was designed as a double-blind, randomized, multicenter trial in 60 women. A pre-treatment cycle, three treatment cycles and a post-treatment period were monitored by ovarian ultrasound and by LH, FSH, 17 beta-estradiol and progesterone measurements every other day. No ovulation and no luteinized, unruptured follicle were observed. Suppression of ovarian activity was more pronounced by the 23-day regimen. 17 beta-Estradiol serum levels during the last six days of a cycle and during the first six days of the next cycle were significantly less (p day regimen. The superiority of the 23-day regimen in comparison to the 21-day regimen with regard to the suppression of ovarian activity was shown in this study. The observed differences in the 17 beta-estradiol levels and follicular development between a 21-day and 23-day preparation combine to suggest that shortening the pill-free interval in combined oral contraceptives may increase the contraceptive safety margin in women on low-dose formulations.

  18. Cancers in Australia in 2010 attributable to and prevented by the use of combined oral contraceptives.

    Science.gov (United States)

    Jordan, Susan J; Wilson, Louise F; Nagle, Christina M; Green, Adele C; Olsen, Catherine M; Bain, Christopher J; Pandeya, Nirmala; Whiteman, David C; Webb, Penelope M

    2015-10-01

    To estimate the proportion and number of cancers occurring in Australia in 2010 attributable to combined oral contraceptive pill (OCP) use. We estimated the population attributable fraction (PAF) for cancers causally associated with combined OCP use (breast, cervix), and the proportion of endometrial and ovarian cancers prevented (prevented fraction [PF]). We used standard formulae incorporating prevalence of combined OCP use in the Australian population, relative risks of cancer associated with this exposure and cancer incidence. An estimated 105 breast and 52 cervical cancers (0.7% and 6.4% of each cancer, respectively) in Australia in 2010 were attributable to current use of combined OCP. Past combined OCP use was estimated to have prevented 1,032 endometrial and 308 ovarian cancers in 2010, reducing the number of cancers that would otherwise have occurred by 31% and 19%, respectively. A small proportion of breast and cervical cancers is attributable to combined OCP use; OCP use is likely to have prevented larger numbers of endometrial and ovarian cancers. Women seeking contraceptive advice should be told of potential adverse effects, but should also be told that - along with reproductive health benefits - combined OCP use can reduce long-term risks of ovarian and endometrial cancers. © 2015 The Authors.

  19. Oral contraceptives, angiotensin-dependent renal vasoconstriction, and risk of diabetic nephropathy

    DEFF Research Database (Denmark)

    Ahmed, Sofia B; Hovind, Peter; Parving, Hans-Henrik

    2005-01-01

    OBJECTIVE: Diabetes, the leading cause of end-stage renal disease in the U.S., is believed to involve activation of the renin angiotensin system (RAS) as a risk factor for nephropathy. RAS activation occurs in healthy women using oral contraceptives (OCs), but the effects of OC use on the diabetic...... kidney are unclear. RESEARCH DESIGN AND METHODS: Renal plasma flow (RPF) response to captopril, as an index of RAS activity, was investigated in 92 women (41 nondiabetic OC nonusers, 10 nondiabetic OC users, 29 diabetic OC nonusers, and 12 diabetic OC users). Based on the hemodynamic findings, we...... examined the impact of OC use on the development of nephropathy as a post hoc analysis in an inception cohort of 114 female patients with newly diagnosed type 1 diabetes followed for a median of 20.7 years (range 1-24). RESULTS: Nondiabetic OC nonusers showed minimal RPF vasodilator response to captopril...

  20. Oral contraceptives, angiotensin-dependent renal vasoconstriction, and risk of diabetic nephropathy

    DEFF Research Database (Denmark)

    Ahmed, Sofia B; Hovind, Peter; Parving, Hans-Henrik

    2005-01-01

    OBJECTIVE: Diabetes, the leading cause of end-stage renal disease in the U.S., is believed to involve activation of the renin angiotensin system (RAS) as a risk factor for nephropathy. RAS activation occurs in healthy women using oral contraceptives (OCs), but the effects of OC use on the diabetic...... examined the impact of OC use on the development of nephropathy as a post hoc analysis in an inception cohort of 114 female patients with newly diagnosed type 1 diabetes followed for a median of 20.7 years (range 1-24). RESULTS: Nondiabetic OC nonusers showed minimal RPF vasodilator response to captopril...... = 0.72, P developed macroalbuminuria compared with 2% (2/81 [0-5.9]) of OC nonusers (P = 0.003, univariate analysis). After adjustment for known risk factors with a Cox regression...

  1. Oral contraceptives vs injectable progestin in their effect on sexual behavior.

    Science.gov (United States)

    Schaffir, Jonathan A; Isley, Michelle M; Woodward, Megan

    2010-12-01

    We sought to compare sexual function and hormone concentrations in combined oral contraceptive (COC) and injectable progestin users. Sexually active COC and depot medroxyprogesterone acetate (DMPA) users completed the Female Sexual Function Index (FSFI) questionnaire, a demographic data form, and had serum testosterone and estradiol levels measured. Multiple linear regression was used to measure associations of interest. Among 50 subjects enrolled, COC users had lower levels of free testosterone compared to DMPA users (0.2 vs 0.6 pg/mL; P education, gravidity, parity, and frequency of intercourse. In multivariate analysis, birth control type was not significantly associated with desire score or total FSFI score. While users of COC and DMPA have significantly different sex hormone levels, they are not different in sexual function as measured by the FSFI. Copyright © 2010 Mosby, Inc. All rights reserved.

  2. Ovarian reserve assessment in users of oral contraception seeking fertility advice on their reproductive lifespan

    DEFF Research Database (Denmark)

    Birch Petersen, K; Hvidman, H W; Forman, J L

    2015-01-01

    STUDY QUESTION: To what extent does oral contraception (OC) impair ovarian reserve parameters in women who seek fertility assessment and counselling to get advice on whether their remaining reproductive lifespan is reduced? SUMMARY ANSWER: Ovarian reserve parameters defined by anti...... in the antral follicles of 5-7 and 8-10 mm with the highest number of AMH secreting granulosa cells. It is essential to be aware of the impact of OC use on ovarian reserve parameters when guiding OC users on their fertility status and reproductive lifespan. STUDY FUNDING/COMPETING INTERESTS: The FAC Clinic...... ageing. In women, AMH declines with age and data suggest a relationship with remaining reproductive lifespan and age at menopause. OC may alter parameters related to ovarian reserve assessment but the extent of the reduction is uncertain. STUDY DESIGN, SIZE, DURATION: A cross-sectional study of 887 women...

  3. Ovarian Reserve Assessment in Users of Oral Contraception Seeking Fertility Advice on their Reproductive Lifespan

    DEFF Research Database (Denmark)

    Petersen, K. Birch; Hvidman, H. W.; Forman, J. L.

    2016-01-01

    STUDY QUESTION: To what extent does oral contraception (OC) impair ovarian reserve parameters in women who seek fertility assessment and counselling to get advice on whether their remaining reproductive lifespan is reduced? SUMMARY ANSWER: Ovarian reserve parameters defined by anti...... in the antral follicles of 5-7 and 8-10 mm with the highest number of AMH secreting granulosa cells. It is essential to be aware of the impact of OC use on ovarian reserve parameters when guiding OC users on their fertility status and reproductive lifespan. STUDY FUNDING/COMPETING INTERESTS: The FAC Clinic...... ageing. In women, AMH declines with age and data suggest a relationship with remaining reproductive lifespan and age at menopause. OC may alter parameters related to ovarian reserve assessment but the extent of the reduction is uncertain. STUDY DESIGN, SIZE, DURATION: A cross-sectional study of 887 women...

  4. Health care provider communicator style and patient comprehension of oral contraceptive use.

    Science.gov (United States)

    Schrader, E L; Schrader, D C

    2001-02-01

    To explore reasons for the incorrect usage of oral contraceptive pills (OCPs) by examining the relationship between patients' abilities to comprehend and/or recall information presented to them by nurse practitioners (NPs) and the communicator style of their NP. A convenience sample of 46 OCP users completed an instrument designed to test their comprehension of OCP use and an instrument designed to measure the communicator style of their NP. A multiple stepwise regression revealed that attentive and friendly communicator styles were positive predictors and the communicator image and dramatic styles were negative predictors of comprehension. Unwanted pregnancies that result from non-compliance with OCP regimens can have significant social and financial effects. A lack of understanding of proper OCP use may depend on the style of communication a NP uses to convey crucial information regarding the regimen.

  5. Oral contraceptive use, caffeine consumption, field-dependence, and the discrimination of colors.

    Science.gov (United States)

    Fine, B J; McCord, L

    1991-12-01

    We attempted to validate laboratory research which indicated that single doses of oral contraceptives (OCs) and caffeine affect the ability to discriminate colors (Böhme & Böhme, 1985). We did this in a nonlaboratory setting by surveying habitual use of OCs and caffeine by 43 female college students and relating that information to their performance on the Farnsworth-Munsell 100-Hue Test. When field-dependence, conceptualized as an indirect measure of sensitivity of the nervous system and previously shown to be strongly related to color discrimination, was included in the analyses, the results supported Böhme and Böhme's findings. For Trays 2 and 3 of the 100-Hue Test (yellow through blue of the color spectrum), higher caffeine consumption among OC users was related to poorer color discrimination, whereas, among nonusers of OCs, it was related to better performance. Study design limitations do not permit attribution of causation to either caffeine or OCs at this time.

  6. Quality of sexual life of women on oral contraceptive continued-regimen: pilot study.

    Science.gov (United States)

    Caruso, Salvatore; Malandrino, Chiara; Cicero, Carla; Ciancio, Fabio; Cariola, Maria; Cianci, Antonio

    2013-02-01

    To date, women may use flexible oral contraceptive (OC) regimens. The aim of this study was to evaluate the quality of sexual life of healthy women on continued-regimen OCs. Fifty women (age range 18-38) were enrolled. The Female Sexual Function Index (FSFI) and the Short Form-36 (SF-36) questionnaires were used to investigate, respectively, sexual behavior and the quality of life (QoL) of women on OC for 72 days with a 4-day hormone-free interval, for two cycles. Both the FSFI and the SF-36 were administered before starting OC intake, at the first (72-82 days) and the second (144-154 days) follow-ups. The main outcomes are the FSFI and the SF-36 questionnaires. The FSFI score obtained at the first follow-up detected a worsening with respect to baseline score (P sexual behavior and the QoL of women. © 2012 International Society for Sexual Medicine.

  7. Growth hormone responses to continuous and intermittent exercise in females under oral contraceptive therapy.

    Science.gov (United States)

    Bernardes, R P; Radomski, M W

    1998-12-01

    In this study we investigated the effect of oral contraceptive (OC) use (OCU) and non-use (OCNU) on growth hormone (GH) responses to exercise in the same females (n = 7, age 22-31 years) during the normal course of OC therapy. Continuous (60% maximum oxygen consumption, VO2max for 20 min) and intermittent exercise (>80% VO2max) protocols of equal total duration, and similar external work were performed during phases of OCNU (days 3-5 of the menstrual cycle) and OCU (days 7-11). Levels of GH, lactate, 17 beta-estradiol, and progesterone were measured. Lactate responses were significantly greater (Pmenstrual cycle to benefit from an increased GH response to exercise during phases of OC use or the luteal phase of women not on OC therapy.

  8. Hypertensive Crisis and Left Ventricular Thrombi after an Upper Respiratory Infection during the Long-term Use of Oral Contraceptives.

    Science.gov (United States)

    Suzuki, Natsuko; Suzuki, Keisuke; Mizuno, Tomofumi; Kato, Yukari; Suga, Norihiro; Yoshino, Masabumi; Miura, Naoto; Banno, Shogo; Imai, Hirokazu

    2016-01-01

    A 34-year-old woman who had been using oral contraceptives for 10 years developed hypertensive crisis with papilloedema after an upper respiratory infection. Laboratory data showed hyperreninemic hyperaldosteronism and elevated levels of fibrinogen, fibrin, and fibrinogen degradation products. Echocardiography demonstrated two masses (18 mm) in the left ventricle. On the fourth hospital day, cerebral infarction, renal infarction, and upper mesenteric artery occlusion suddenly occurred despite the blood pressure being well-controlled using anti-hypertensive drugs. Echocardiography revealed the disappearance of the left ventricular masses, which suggested left ventricular thrombi. Cessation of the contraceptives and administration of heparin, warfarin, and anti-platelets drugs improved her general condition.

  9. A survey regarding acceptability of oral emergency contraception according to the posited mechanism of action.

    Science.gov (United States)

    Willetts, S J; MacDougall, M; Cameron, S T

    2017-08-01

    The objective was to determine the acceptability to women of oral emergency contraception (EC) that works by inhibiting ovulation, preventing implantation or disrupting implantation, and also to determine the characteristics of women associated with the acceptability of each posited mechanism of action. Women completed a self-administered, anonymous questionnaire asking whether they would consider using an EC pill based on each of three hypothetical mechanisms of action: inhibiting ovulation, preventing implantation or disrupting implantation. The questionnaire was distributed among women in Edinburgh, UK, (a) presenting for EC at a community pharmacy, (b) attending a clinic for insertion of intrauterine contraception (IUC) or (c) attending a clinic for an induced abortion. Descriptive analyses stratified women according to healthcare setting and personal characteristics. Univariable and multivariable analyses were used to establish factors which may predict acceptability of each EC pill's mechanism of action. Four hundred and nineteen out of 458 (91%) women responded to the survey. Overall, women reported that EC would be acceptable if it worked by inhibiting ovulation (89%), preventing implantation (83%) or disrupting implantation (75%). Among women seeking abortion, more would accept an EC pill which disrupted implantation compared to women seeking IUC (odds ratio, 2.19; 95% confidence interval, 1.30-3.69; p=.004). Based on multivariable analyses, factors associated with acceptability included previous use of EC, previously holding strong views against abortion and having had a previous abortion. For each of the posited mechanisms of action, a majority of women surveyed would be willing to consider oral EC to prevent unintended pregnancy. The scope of the study was limited, and further work on the views of women in the wider population is needed. This is important as the development of such drugs to prevent pregnancy is likely to raise political and ethical

  10. Lamotrigine kinetics within the menstrual cycle, after menopause, and with oral contraceptives.

    Science.gov (United States)

    Wegner, Ilse; Edelbroek, Peter M; Bulk, Saskia; Lindhout, Dick

    2009-10-27

    We prospectively evaluated the fluctuation of lamotrigine (LTG) clearance during the menstrual cycle. We also assessed the effect of postmenopausal status and investigated in detail the effect of oral contraceptives (OCs) on LTG clearance. Three groups of women with epilepsy using LTG monotherapy were evaluated. Women in the first group (n = 7) had a regular cycle and did not use OCs; the second group used a 1-phase combined OC (n = 7), and the third group (n = 7) was postmenopausal. Two menstrual cycles or at least 2 months (postmenopausal women) were assessed, monitoring LTG levels every other day. The mean apparent LTG clearance in women of reproductive age not using OCs was 49 (SD 22.6, range 20.4-83.5) L/24 hours. No significant effect of endogenous hormones on LTG clearance was found. In women using OCs, the mean LTG clearance was 126 (SD 60.2, range 44.3-205) L/24 hours. There was an increase in LTG levels during the pill-free week, with maximum levels 54% (range 29%-129%) higher than baseline levels. LTG levels decreased to the baseline value within a mean of 8 days of starting OC use (SD 3.7, range 2.5-16.5). In the postmenopausal women, the mean clearance was 82 (SD 38.4, range 35.9-125) L/24 hours. We observed a higher mean lamotrigine (LTG) clearance in postmenopausal women compared with young women not using oral contraceptives (OCs) and confirmed that OC use may have a strong effect on LTG clearance. There was no significant fluctuation of LTG clearance during the menstrual cycle.

  11. Three-step method for menstrual and oral contraceptive cycle verification.

    Science.gov (United States)

    Schaumberg, Mia A; Jenkins, David G; Janse de Jonge, Xanne A K; Emmerton, Lynne M; Skinner, Tina L

    2017-11-01

    Fluctuating endogenous and exogenous ovarian hormones may influence exercise parameters; yet control and verification of ovarian hormone status is rarely reported and limits current exercise science and sports medicine research. The purpose of this study was to determine the effectiveness of an individualised three-step method in identifying the mid-luteal or high hormone phase in endogenous and exogenous hormone cycles in recreationally-active women and determine hormone and demographic characteristics associated with unsuccessful classification. Cross-sectional study design. Fifty-four recreationally-active women who were either long-term oral contraceptive users (n=28) or experiencing regular natural menstrual cycles (n=26) completed step-wise menstrual mapping, urinary ovulation prediction testing and venous blood sampling for serum/plasma hormone analysis on two days, 6-12days after positive ovulation prediction to verify ovarian hormone concentrations. Mid-luteal phase was successfully verified in 100% of oral contraceptive users, and 70% of naturally-menstruating women. Thirty percent of participants were classified as luteal phase deficient; when excluded, the success of the method was 89%. Lower age, body fat and longer menstrual cycles were significantly associated with luteal phase deficiency. A step-wise method including menstrual cycle mapping, urinary ovulation prediction and serum/plasma hormone measurement was effective at verifying ovarian hormone status. Additional consideration of age, body fat and cycle length enhanced identification of luteal phase deficiency in physically-active women. These findings enable the development of stricter exclusion criteria for female participants in research studies and minimise the influence of ovarian hormone variations within sports and exercise science and medicine research. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  12. When is it safe to switch from oral contraceptives to hormonal replacement therapy?

    Science.gov (United States)

    Castracane, V D; Gimpel, T; Goldzieher, J W

    1995-12-01

    Women may continue to use oral contraceptives (OCs) into their 40's and 50's, but to date no method has been evaluated to ascertain their ovarian status, i.e., whether fertility and estrogen production have diminished sufficiently so they could be safely switched to hormonal replacement therapy. A group of 12 postmenopausal women who had been, for long periods of time, on a regimen of 3 back-to-back packages (i.e., 63 days on, 7 days off) of low-dose oral contraceptives have been studied. Secondly, a group of 9 perimenopausal women aged 36 to 47 were examined in the same manner. The third group consisted of early reproductive age women (arbitrarily divided into subsets aged 17-25 and 26-35 using low-dose OCs in the customary regimen) as normal controls. Blood samples were obtained on the last day of a pill cycle and at 7 days off the pill. In some menopausal women, blood samples were obtained at both 7 and 14 days off OCs. Serum was assayed by RIA for estradiol, FSH and LH. As expected in the young reproductive age women, estradiol levels increase at one week off the pill, together with a rebound in FSH and LH to follicular phase levels. In the perimenopausal group, there was a sharp distinction based on age. The women over 40 showed a more marked rise in FSH while those aged 36-40 showed a distinctly lesser response. Estradiol levels were variable, but tended to show some age grouping. Little diagnostic separation was observed for LH. In postmenopausal women, FSH levels were not always elevated at one week post-pill, and even in a second trial with sampling at one and two weeks off the OC, not all postmenopausal women showed a "menopausal" increase in FSH. The more uniform feature was that estradiol levels never increased above basal values. The study found that serum estradiol levels increase after a week off the pill in controls, but are unchanged at one and two weeks in the menopausal group. FSH levels rebound normally in reproductive age women and usually, but

  13. Cycle-Related Changes in Mood, Sexual Desire, and Sexual Activity in Oral Contraception-Using and Nonhormonal-Contraception-Using Couples.

    Science.gov (United States)

    Elaut, Els; Buysse, Ann; De Sutter, Petra; Gerris, Jan; De Cuypere, Griet; T'Sjoen, Guy

    2016-01-01

    Findings on women's sexuality across the menstrual cycle are inconsistent. One relatively consistent finding is a midcycle and premenstrual peak in sexual desire in freely cycling women. Results on the cycle-related effects on sexual behavior are less clear. Large proportions of reproductive-aged women use combined oral contraception (COC), but studies on potential cycle-related shifts in sexual desire and behavior are sparse. A prospective diary study assessed sexual desire, sexual behavior, and mood in 89 heterosexual couples. Women were using one of four contraceptive methods: (1) nonhormonal contraception, (2) low-dose COC containing 20 mcg ethinylestradiol and 75 mcg gestoden or desogestrel, (3) COC containing 35 mcg ethinylestradiol and 2 mg cyproteronacetate, and (4) COC containing 30 mcg ethinylestradiol and 3 mg drospirenone. No cycle effects of sexual desire were established in the COC group, but frequency of sexual intercourse declined in the last days of active pill taking. These results were similar in both female and male partners. Negative affect did not covary with sexual desire.

  14. International Active Surveillance Study of Women Taking Oral Contraceptives (INAS-OC Study

    Directory of Open Access Journals (Sweden)

    Assmann Anita

    2009-11-01

    Full Text Available Abstract Background A 24-day regimen of contraceptive doses of drospirenone and ethinylestradiol (DRSP/EE 24d was recently launched. This regimen has properties which may be beneficial for certain user populations (e.g., women suffering from premenstrual dysphoric disorder or acne. However, it is unknown whether this extended regimen has an impact on the cardiovascular risk associated with the use of oral contraceptives (OCs. The INternational Active Surveillance study of women taking Oral Contraceptives (INAS-OC is designed to investigate the short- and long-term safety of the new regimen in a population which is representative for the typical user of oral contraceptives. Methods/Design A large, prospective, controlled, non-interventional, long-term cohort study with active surveillance of the study participants has been chosen to ensure reliable and valid results. More than 2,000 gynecologists in the US and 5 European countries (Austria, Germany, Italy, Poland, and Sweden will recruit more than 80,000 OC users. The two to five year follow-up of these women will result in at least 220,000 documented women-years. The main clinical outcomes of interest for the follow-up are deep venous thrombosis, pulmonary embolism, acute myocardial infarction and cerebrovascular accidents. Secondary objectives are general safety, effectiveness and drug utilization pattern of DRSP/EE 24d, return to fertility after stop of OC use, as well as the baseline risk for users of individual OC formulations. Because of the non-interference character of this study, potential participants (first-time users or switchers are informed about the study only after the decision regarding prescription of a new OC. There are no specific medical inclusion or exclusion criteria. Study participation is voluntary and a written informed consent is required. After the baseline questionnaire, follow-up questionnaires will be mailed to the participants every 6 months for up to 5 years after

  15. Different combined oral contraceptives and the risk of venous thrombosis: systematic review and network meta-analysis

    Science.gov (United States)

    Stegeman, Bernardine H; de Bastos, Marcos; Rosendaal, Frits R; van Hylckama Vlieg, A; Helmerhorst, Frans M; Stijnen, Theo

    2013-01-01

    Objective To provide a comprehensive overview of the risk of venous thrombosis in women using different combined oral contraceptives. Design Systematic review and network meta-analysis. Data sources PubMed, Embase, Web of Science, Cochrane, Cumulative Index to Nursing and Allied Health Literature, Academic Search Premier, and ScienceDirect up to 22 April 2013. Review methods Observational studies that assessed the effect of combined oral contraceptives on venous thrombosis in healthy women. The primary outcome of interest was a fatal or non-fatal first event of venous thrombosis with the main focus on deep venous thrombosis or pulmonary embolism. Publications with at least 10 events in total were eligible. The network meta-analysis was performed using an extension of frequentist random effects models for mixed multiple treatment comparisons. Unadjusted relative risks with 95% confidence intervals were reported. The requirement for crude numbers did not allow adjustment for potential confounding variables. Results 3110 publications were retrieved through a search strategy; 25 publications reporting on 26 studies were included. Incidence of venous thrombosis in non-users from two included cohorts was 1.9 and 3.7 per 10 000 woman years, in line with previously reported incidences of 1-6 per 10 000 woman years. Use of combined oral contraceptives increased the risk of venous thrombosis compared with non-use (relative risk 3.5, 95% confidence interval 2.9 to 4.3). The relative risk of venous thrombosis for combined oral contraceptives with 30-35 µg ethinylestradiol and gestodene, desogestrel, cyproterone acetate, or drospirenone were similar and about 50-80% higher than for combined oral contraceptives with levonorgestrel. A dose related effect of ethinylestradiol was observed for gestodene, desogestrel, and levonorgestrel, with higher doses being associated with higher thrombosis risk. Conclusion All combined oral contraceptives investigated in this analysis were

  16. Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23,257 women with ovarian cancer and 87,303 controls

    DEFF Research Database (Denmark)

    Cancer, Collaborative Group on Epidemiological Studies of Ovarian; Beral, V.; Doll, R.

    2008-01-01

    BACKGROUND: Oral contraceptives were introduced almost 50 years ago, and over 100 million women currently use them. Oral contraceptives can reduce the risk of ovarian cancer, but the eventual public-health effects of this reduction will depend on how long the protection lasts after use ceases. We...... aimed to assess these effects. METHODS: Individual data for 23,257 women with ovarian cancer (cases) and 87,303 without ovarian cancer (controls) from 45 epidemiological studies in 21 countries were checked and analysed centrally. The relative risk of ovarian cancer in relation to oral contraceptive use...... was estimated, stratifying by study, age, parity, and hysterectomy. FINDINGS: Overall 7308 (31%) cases and 32,717 (37%) controls had ever used oral contraceptives, for average durations among users of 4.4 and 5.0 years, respectively. The median year of cancer diagnosis was 1993, when cases were aged an average...

  17. An overview of four studies of a continuous oral contraceptive (levonorgestrel 90 mcg/ethinyl estradiol 20 mcg) on premenstrual dysphoric disorder and premenstrual syndrome

    DEFF Research Database (Denmark)

    Freeman, Ellen W; Halbreich, Uriel; Grubb, Gary S

    2012-01-01

    This article presents an overview of four studies that evaluated a continuous oral contraceptive (OC) containing levonorgestrel (90 mcg) and ethinyl estradiol (20 mcg; LNG/EE) for managing premenstrual dysphoric disorder (PMDD) and premenstrual syndrome (PMS)....

  18. Adherence to the oral contraceptive pill: a cross-sectional survey of modifiable behavioural determinants

    Directory of Open Access Journals (Sweden)

    Molloy Gerard J

    2012-10-01

    Full Text Available Abstract Background Poor adherence to the oral contraceptive pill (OCP is reported as one of the main causes of unintended pregnancy in women that rely on this form of contraception. This study aims to estimate the associations between a range of well-established modifiable psychological factors and adherence to OCP. Method A cross-sectional survey of 130 female University students currently using OCP (Mean age: 20.46 SD: 3.01, range 17–36 was conducted. An OCP specific Medication Adherence Report Scale was used to assess non-adherence. Psychological predictor measures included necessity and concern beliefs about OCP, intentions, perceived behavioural control (pbc, anticipated regret and action and coping planning. Multiple linear regression was used to analyse the data. Results Fifty-two per cent of participants reported missing their OCP once or more per month and 14% twice or more per month. In bivariate analysis intentions (r = −0.25, perceived behavioural control (r= −0.66, anticipated regret (r=0.20, concerns about OCP (r =0.31, and action (r= −0.25 and coping (r= −0.28 planning were all significantly associated with adherence to OCP in the predicted direction. In a multivariate model almost half (48% of the variation in OCP adherence could be explained. The strongest and only statistically significant predictors in this model were perceived behavioural control (β=−0.62, p Conclusion The present data point to a number of key modifiable psychological determinants of OCP use. Future work will establish whether changing these variables results in better adherence to the OCP.

  19. ESR2 Genetic Variants and Combined Oral Contraceptive Use Associated with the Risk of Stroke.

    Science.gov (United States)

    Xu, Zhenlin; Li, Ying; Huang, Xiaoping; Shen, Wei; Bai, Jianling; Shen, Chong; Zhao, Yang

    2017-02-01

    There is accumulating evidence suggesting an important role of estrogen receptor-β in the development of cardiovascular disease. The present study aims to investigate the relationship of estrogen receptor β gene (ESR2) polymorphisms with stroke risk in Chinese women, and further evaluate the gene-environment interaction of ESR2 and combined oral contraceptive (COC) use on stroke risk. A case-control study was conducted with 446 first-ever stroke patients and 864 control subjects recruited from our prospective female cohort. Four polymorphisms of ESR2 gene were genotyped, and the information of contraceptive use was obtained by a face-to-face interview. Women with rs1256065 CC genotype were at a 1.59 fold increased risk of stroke. Subtype analyses showed that the risk genotype of rs1256065 was associated with ischemic stroke, but not with hemorrhagic stroke. AA genotype of rs4986938 showed a significant correlation with an elevated risk of hemorrhagic stroke. COC users with rs1256065 CC genotype had a 2.36 fold increased risk of stroke, compared with the non-users with the wild-type genotype. Moreover, a significant multiplicative interaction on hemorrhagic stroke was detected between COC use and rs4986938 (pinteraction = 0.023). The risk of hemorrhagic stroke was significantly elevated among carriers of rs4986938 GA or AA genotype combined with COC use. No associations were observed for rs1256049 and rs1271572. ESR2 genetic polymorphisms were associated with the risk of first-ever stroke in Chinese women, and the AA genotype of rs4986938 combined with COC use could significantly increase the risk of hemorrhagic stroke. Copyright © 2017 IMSS. Published by Elsevier Inc. All rights reserved.

  20. Effects of Oral, Vaginal, and Transdermal Hormonal Contraception on Serum Levels of Coenzyme Q10, Vitamin E, and Total Antioxidant Activity

    Science.gov (United States)

    Palan, Prabhudas R.; Strube, Felix; Letko, Juraj; Sadikovic, Azra; Mikhail, Magdy S.

    2010-01-01

    The use of the transdermal contraceptive patch is associated with greater bioavailability of ethinyl estradiol (EE) compared with contraceptive vaginal ring or oral contraceptives (OC). We compared the influences of three contraceptive methods (OC, vaginal ring, and transdermal patch) on serum levels of coenzyme Q10, α-tocopherol, γ-tocopherol and total antioxidant capacity in premenopausal women. Blood samples from 30 premenopausal women who used hormonal contraception for at least 4 months were collected. Forty subjects who did not use any contraception were studied as control. Serum levels of coenzyme Q10, α-tocopherol and γ-tocopherol were measured by high-pressure liquid chromatography. Serum samples were also assayed for total antioxidant capacity (TAOC). Serum levels of coenzyme Q10 and α-tocopherol were found to be significantly lower (P < .05) in all three contraceptive users compared with controls. Contraceptive patch users had the lowest levels of coenzyme Q10 levels compared with normal subjects. Serum TAOC levels were significantly lower (P < .05) among the contraceptive user groups. Alterations in coenzyme Q10 and α-tocopherol induced by hormonal contraception and the potential effect(s) of exogenous ovarian hormones should be taken into consideration in future antioxidant research. PMID:20814444

  1. Effects of oral, vaginal, and transdermal hormonal contraception on serum levels of coenzyme q(10), vitamin e, and total antioxidant activity.

    Science.gov (United States)

    Palan, Prabhudas R; Strube, Felix; Letko, Juraj; Sadikovic, Azra; Mikhail, Magdy S

    2010-01-01

    The use of the transdermal contraceptive patch is associated with greater bioavailability of ethinyl estradiol (EE) compared with contraceptive vaginal ring or oral contraceptives (OC). We compared the influences of three contraceptive methods (OC, vaginal ring, and transdermal patch) on serum levels of coenzyme Q(10), alpha-tocopherol, gamma-tocopherol and total antioxidant capacity in premenopausal women. Blood samples from 30 premenopausal women who used hormonal contraception for at least 4 months were collected. Forty subjects who did not use any contraception were studied as control. Serum levels of coenzyme Q(10), alpha-tocopherol and gamma-tocopherol were measured by high-pressure liquid chromatography. Serum samples were also assayed for total antioxidant capacity (TAOC). Serum levels of coenzyme Q(10) and alpha-tocopherol were found to be significantly lower (P < .05) in all three contraceptive users compared with controls. Contraceptive patch users had the lowest levels of coenzyme Q(10) levels compared with normal subjects. Serum TAOC levels were significantly lower (P < .05) among the contraceptive user groups. Alterations in coenzyme Q(10) and alpha-tocopherol induced by hormonal contraception and the potential effect(s) of exogenous ovarian hormones should be taken into consideration in future antioxidant research.

  2. A randomized clinical trial of treatment of clomiphene citrate-resistant anovulation with the use of oral contraceptive pill suppression and repeat clomiphene citrate treatment.

    Science.gov (United States)

    Branigan, Emmett F; Estes, M Antoinette

    2003-06-01

    The purpose of this study was to evaluate the effectiveness and endocrine response of oral contraceptive ovarian suppression followed by clomiphene citrate in patients who previously were clomiphene citrate resistant. Forty-eight patients from a private tertiary infertility clinic were assigned randomly prospectively to either group 1 (oral contraceptive/clomiphene citrate), which received continuous oral contraceptives followed by clomiphene citrate, or to group 2 (control) received no treatment in the cycle before clomiphene citrate treatment. On day 3, 17 beta-estradiol, follicle-stimulating hormone, luteinizing hormone, and androgens were assayed before and after treatment. Follicle growth, ovulation, and pregnancy were evaluated. The Student t test and analysis of variance were used for statistical significance. The oral contraceptive/clomiphene citrate group had a significantly higher percentage of patients who ovulated and of ovulatory cycles and pregnancies. Significantly lower levels of 17 beta-estradiol, luteinizing hormone, and androgen levels were seen in the oral contraceptive/clomiphene citrate group, with no significant changes in group 2. Suppression of the ovary with oral contraceptives results in excellent rates of ovulation and pregnancy in patients who previously were resistant to clomiphene citrate. The decreases in ovarian androgens, luteinizing hormone, and 17 beta-estradiol may be responsible for the improved response.

  3. [Benefit of the Internet as an information tool in case of oral contraceptive miss. Survey of 1964 women visiting the website www.g-oubliemapilule.com].

    Science.gov (United States)

    Lemaître, Sophie; Collier, Francis; Hulin, Vincent

    2009-12-20

    The aim of the study is to evaluate the utility of the website http://www.g-oubliemapilule.com/ that contains the recommendations of the French Haute Autorité de santé in case of oral contraceptive pill missing. This epidemiologic prospective study was conducted using an online questionnaire available at http://www.g-oubliemapilule.com/. The results emphasize the poor quality of information provided by the physicians. 40% of the physicians don't provide information about what to do in case of oral contraceptive pill missing during the first medical visit for oral contraceptive prescription and the physicians don't inquire about oral contraceptive pill missing during the follow-up in 3/4 of the cases. Furthermore, when women find information about what to do in case of oral contraceptive pill missing, a majority of them won't follow the advice provided even if it is fully understood. 60% of the women who should use the condom during the 7 days following the oral contraceptive pill missing don't use it and 86% of the women who should use the emergency contraceptive pill don't use it. The reason mostly invoked (1/3 of the cases) to support that behaviour is the assumption that the risk of pregnancy is too low. The results help to understand the gap between theoretical efficacy (Pearl Index: 0.3%) and real efficacy (8%) of the oral contraceptive pill. Finally, the website http://www.g-oubliemapilule.com/ is a useful well understood additional tool but can't replace the medical follow-up.

  4. Patient understanding of oral contraceptive pill instructions related to missed pills: a systematic review.

    Science.gov (United States)

    Zapata, Lauren B; Steenland, Maria W; Brahmi, Dalia; Marchbanks, Polly A; Curtis, Kathryn M

    2013-05-01

    Instructions on what to do after pills are missed are critical to reducing unintended pregnancies resulting from patient non-adherence to oral contraceptive (OC) regimens. Missed pill instructions have previously been criticized for being too complex, lacking a definition of what is meant by "missed pills," and for being confusing to women who may not know the estrogen content of their formulation. To help inform the development of missed pill guidance to be included in the forthcoming US Selected Practice Recommendations, the objective of this systematic review was to evaluate the evidence on patient understanding of missed pill instructions. We searched the PubMed database for peer-reviewed articles that examined patient understanding of OC pill instructions that were published in any language from inception of the database through March 2012. We included studies that examined women's knowledge and understanding of missed pill instructions after exposure to some written material (e.g., patient package insert, brochure), as well as studies that compared different types of missed pill instructions on women's comprehension. We used standard abstract forms and grading systems to summarize and assess the quality of the evidence. From 1620 articles, nine studies met our inclusion criteria. Evidence from one randomized controlled trial (RCT) and two descriptive studies found that more women knew what to do after missing 1 pill than after missing 2 or 3 pills (Level I, good, to Level II-3, poor), and two descriptive studies found that more women knew what to do after missing 2 pills than after missing 3 pills (Level II-3, fair). Data from two descriptive studies documented the difficulty women have understanding missed pill instructions contained in patient package inserts (Level II-3, poor), and evidence from two RCTs found that providing written brochures with information on missed pill instructions in addition to contraceptive counseling significantly improved

  5. Conformity with current guidelines on oral contraceptive prescribing for breastfeeding women: a New Mexico survey.

    Science.gov (United States)

    Espey, Eve; Ogburn, Tony; Leeman, Larry; Reddy, Shilpa; Lee, Carisa; Qualls, Clifford

    2006-11-01

    National and international contraceptive guidelines reflect expert opinion that recommends against the use of estrogen-containing hormonal contraception in the early postpartum period. This study was undertaken to estimate providers' practices in prescribing hormonal contraception to breastfeeding women. A 19-item survey was mailed to 397 obstetrician gynecologists, midwives and family physicians in the state of New Mexico. The survey included items covering attitudes about the impact of hormonal contraception on breastfeeding and prescribing practices. One hundred ninety-nine (50%) providers completed the survey. The majority (70%) of providers prescribe progestin-only contraceptive methods to breastfeeding women within the first 6 weeks. Despite these recommendations, a sizable minority of providers prescribe combined pills in the early postpartum period: 27% of providers have prescribed combined pills and 13% of providers, mostly those in a university setting, routinely recommend them within the first 6 weeks postpartum. Most providers follow expert recommendations regarding the initiation of hormonal contraception for breastfeeding women.

  6. An assessment of the quality of advice provided by patent medicine vendors to users of oral contraceptive pills in urban Nigeria.

    Science.gov (United States)

    Ujuju, Chinazo; Adebayo, Samson B; Anyanti, Jennifer; Oluigbo, Obi; Muhammad, Fatima; Ankomah, Augustine

    2014-01-01

    In Nigeria about 50% of oral contraceptive pill users obtain their products from proprietary patent medicine vendors (PPMVs). This group of service providers are poorly trained and have very limited knowledge about contraception. This paper investigated the nature of the advice offered to simulated current and potential users of oral contraceptive pills. The main objective was to assess the nature and quality of advice provided by PPMVs to pill users. This study is based on findings from a 'mystery client' approach in which three scenarios related to contraceptive pill use were simulated. Each of the 12 mystery clients simulated one of the following three scenarios: new pill users (new to family planning or switching from condom to pills); user seeking a resupply of pills; and dissatisfied pill users intending to discontinue use. Simple random sampling was used to select 410 PPMVs from a total of 1,826 in four states in Nigeria. Qualitative study using in-depth interviews was also conducted. A majority of the PPMVs had pills in stock on the day of the survey and resupplied pills to the clients. PPMVs also understood the reason and importance of referring clients who were new adopters of oral contraceptive methods to a health facility; 30% of the PPMVs referred new adopters to a health facility. However, demand from clients who do not want to go to health care facilities (for various reasons) necessitated the provision of oral contraceptive pills to 41% of the first time users. Some PPMVs prescribed treatment to mystery clients who presented with perceived complications arising from the use of pills, while 49% were referred to a health facility. The advice given by PPMVs often falls short of safety guidelines related to the use of oral contraceptive pills. There is a need to continuously update knowledge among the PPMVs to ensure that they provide quality oral contraceptive services as PPMVs bridge the gap between medical experts and users in rural communities.

  7. Randomized comparison of bleeding patterns in women using a combined contraceptive vaginal ring or a low-dose combined oral contraceptive on a menstrually signaled regimen.

    Science.gov (United States)

    Weisberg, Edith; Merki-Feld, Gabriele S; McGeechan, Kevin; Fraser, Ian S

    2015-02-01

    To compare bleeding patterns for 12 months continuous use of a contraceptive ring [contraceptive vaginal ring (CVR)] and pill [combined oral contraceptive (COC)] on a menstrually signaled regimen and the effectiveness of 4 days "treatment withdrawal" to stop bleeding. Women, 66 to each group, were randomized to continuous use of a CVR (15 mcg ethinyl estradiol/150 mcg etonogestrel) or a low-dose pill (20 mcg ethinyl estradiol/100 mcg levonorgestrel) for 360 days on a menstrually signaled regimen. Bleeding/spotting days, daily use of ring or pill, was recorded. Endpoint was the total number of bleeding/spotting days for each method over four 90-day reference periods (RP) plus the analysis of bleeding patterns using modified World Health Organization criteria. There was a reduction in the mean (±S.D.) number of bleeding/spotting days from RP1 (CVR 14.2±10; pill 16.6±10.9) to RP4 (CVR 8.8±9.6; pill 8.8±9.1). Fifteen percent of CVR and 4% COC users experienced amenorrhea or infrequent bleeding throughout the study. Amenorrhea increased over time (RP1 vs. RP4: CVR 10% vs. 21% and COC 2% vs. 30%). Compliance with the menstrually signaled regimen was poor. Ceasing hormones for 4 days stopped a bleeding episode within 5 days in the majority of episodes and many stopped spontaneously. Bleeding patterns with continuous use of the CVR and COC are similar and improve over 1 year of use. The unpredictability, but short duration, of bleeding episodes should be stressed during counseling. This information for clinicians and women about breakthrough bleeding patterns with use of a CVR or combined pill over 12 months using a menstrually signaled regimen will give women an indication of what to expect with continuous use. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Toward a new concept of "natural balance" in oral estroprogestin contraception.

    Science.gov (United States)

    Chabbert-Buffet, Nathalie; Gerris, Jan; Jamin, Christian; Lello, Stefano; Lete, Inaki; Lobo, Paloma; Nappi, Rossella E; Pintiaux, Axelle

    2013-10-01

    The Pill has undergone many changes since its first appearance some 50 years ago. Key developments included the reduction of ethinylestradiol doses and the synthesis of new progestins in order to increase safety, compliance and efficiency. Low-dose combined oral contraceptives (COCs) are currently the preferred option for millions of women. Due to this widespread use, it has been argued that the safety of COCs should be even better, raising the threshold for excellence. Yet in spite of major improvements, there is still an associated risk of venous thromboembolism (VTE). The next step in COCs' evolution should take total estrogenicity and hepatic estro-androgenic balance into account. The focus on the estrogen component--which has not changed in 50 years--has yielded a new class of natural estrogen pills. Following the introduction of a first quadriphasic pill, a monophasic estradiol pill based on the concept of "natural balance" was subsequently made available. These recent achievements could represent a step forward in the evolution of COCs and pave the way for better safety.

  9. Continuous versus cyclic use of oral contraceptives after surgery for symptomatic endometriosis: a prospective cohort study.

    Science.gov (United States)

    Vlahos, Nikos; Vlachos, Athanasios; Triantafyllidou, Olga; Vitoratos, Nikolaos; Creatsas, George

    2013-11-01

    To evaluate the efficacy of continuous oral contraceptive (OC) use versus the usual cyclic fashion in the recurrence of endometriosis-related symptoms after surgery. Prospective cohort trial involving patients in two tertiary care units. Academic institution in collaboration with a private hospital. 356 patients underwent surgical treatment by laparoscopy for symptomatic endometriosis. After surgical treatment for endometriosis, patients offered 6-month course of cyclic OC (including a 7-day pill-free period) or continuous OC. Recurrence rate of endometriosis-related symptoms and endometriomas after fertility-sparing surgery. Out of 356 patients, 167 were placed on the usual cyclic OC course and 85 on continuous OC for a minimum of 6 months. The continuous OC group experienced a statistically significant reduction in recurrence rates for endometrioma, dysmenorrhea, and non-menstrual pelvic pain as compared with the cyclic OC group. There was no reduction in the recurrence of dyspareunia between the two groups. After surgical treatment of endometriosis, the use of both cyclic and continuous OC improves pain symptoms when compared with preoperative scores. Continuous OC appears to be associated with a reduced recurrence rate for dysmenorrhea, non-menstrual pelvic pain, and endometrioma but not for dyspareunia as compared with cyclic OC. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  10. Mineralocorticoid receptor haplotype moderates the effects of oral contraceptives and menstrual cycle on emotional information processing.

    Science.gov (United States)

    Hamstra, Danielle A; de Kloet, E Ronald; Tollenaar, Marieke; Verkuil, Bart; Manai, Meriem; Putman, Peter; Van der Does, Willem

    2016-10-01

    The processing of emotional information is affected by menstrual cycle phase and by the use of oral contraceptives (OCs). The stress hormone cortisol is known to affect emotional information processing via the limbic mineralocorticoid receptor (MR). We investigated in an exploratory study whether the MR-genotype moderates the effect of both OC-use and menstrual cycle phase on emotional cognition. Healthy premenopausal volunteers (n=93) of West-European descent completed a battery of emotional cognition tests. Forty-nine participants were OC users and 44 naturally cycling, 21 of whom were tested in the early follicular (EF) and 23 in the mid-luteal (ML) phase of the menstrual cycle. In MR-haplotype 1/3 carriers, ML women gambled more than EF women when their risk to lose was relatively small. In MR-haplotype 2, ML women gambled more than EF women, regardless of their odds of winning. OC-users with MR-haplotype 1/3 recognised fewer facial expressions than ML women with MR-haplotype 1/3. MR-haplotype 1/3 carriers may be more sensitive to the influence of their female hormonal status. MR-haplotype 2 carriers showed more risky decision-making. As this may reflect optimistic expectations, this finding may support previous observations in female carriers of MR-haplotype 2 in a naturalistic cohort study. © The Author(s) 2016.

  11. Impact of oral contraception and neuroticism on cardiovascular stress reactivity across the menstrual cycle.

    Science.gov (United States)

    Schallmayer, Sabine; Hughes, Brian M

    2010-01-01

    In order to avoid interpretation problems relating to the impact of reproductive hormones on cardiovascular variables, research on the psychosomatic etiology of cardiovascular disease frequently excludes women who use oral contraceptives (OCs), and sometimes women as a whole, from study samples. However, such conventions are based on a body of research that suffers from methodological limitations and, in any event, has produced inconclusive findings. Further, the relevant research fails to control for personality differences between users and non-users of OC that may, in turn, lead to differences in stress reactivity. In the present study, using a counterbalanced mixed-factorial design, 24 women (12 OC users and 12 non-users), drawn from a screening sample of 110, were tested across a 4-month timeframe. Cardiovascular reactivity (CVR) was measured during both the follicular and luteal phases of each woman's menstrual cycle. Menstrual phase and OC use were found to exert synergistic effects on CVR. A significant relationship between neuroticism and systolic blood pressure reactivity was observed, which was found to be contingent on menstrual phase. It is concluded that while menstrual phase and OC use are relevant, their contaminating influence on CVR research can be circumvented.

  12. Salivary SIgA responses to acute moderate-vigorous exercise in monophasic oral contraceptive users.

    Science.gov (United States)

    Hayashida, Harumi; Dolan, Nicola J; Hounsome, Charlotte; Alajmi, Nawal; Bishop, Nicolette C

    2015-09-01

    The purpose of this study was to examine the effect of oral contraceptive (OC) use on salivary secretory immunoglobulin A (SIgA) levels at rest and in response to an acute bout of moderate-vigorous exercise during 2 phases of the 4-week OC cycle corresponding to different phases of the synthetic menstrual cycle. Ten healthy active females completed a cycling at 70% peak oxygen uptake for 45 min at 2 time points of an OC cycle: during the equivalent in time to the mid-follicular phase (day 8 ± 2) and the mid-luteal phase (day 20 ± 2). Timed unstimulated saliva samples were obtained before, immediately postexercise, and 1 h postexercise and analyzed for salivary SIgA. Salivary SIgA secretion rate was 26% (95% confidence limits (CI) 6-46) lower at postexercise compared with pre-exercise during the synthetic follicular phase (p = 0.019) but no differences were observed during the synthetic luteal trial. Saliva flow rate was 11% (95% CI, 8-30) lower at postexercise compared with pre-exercise (main effect for time; p = 0.025). In conclusion, the pattern of salivary SIgA secretion rate response to moderate-vigorous exercise varies across the early and late phases of a monophasic OC cycle, with a transient reduction in salivary SIgA responses during the synthetic follicular phase. These findings indicate that monophasic OC use should be considered when assessing mucosal immune responses to acute exercise.

  13. Effect of oral contraceptive use on lipid profile in Korean women aged 35-55 years.

    Science.gov (United States)

    Kim, Kisok; Park, Hyejin

    2012-11-01

    Although oral contraceptives (OCs) are widely used, their effects on lipid profile need monitoring according to current usage in different populations. A cross-sectional study was conducted using data from 1541 participants aged 35-55 years collected by the 2005-2009 Korea National Health and Nutrition Examination Surveys. OC use, demographic characteristics and dietary intake were obtained from the participants by questionnaire, and lipid levels were determined by analysis of blood samples. Longer duration of OC use was positively associated with increasing levels of high-density lipoprotein cholesterol (HDL-C) and decreasing levels of low-density lipoprotein cholesterol (LDL-C). After adjusting for demographic and dietary factors, the odds ratio (OR) of low HDL-C (50 mg/dL) was significantly decreased in the longer-term (>12 months) OC users (OR=0.36, 95% confidence interval 0.24-0.52) compared with those who never used OCs. However, use of OCs was not associated with a risk of high total cholesterol (≥ 240 mg/dL), high LDL-C (≥ 130 mg/dL), high triglycerides (≥ 150 mg/dL) or high ratio of triglycerides to HDL-C (>3.8). These data suggest that the use of OCs may reduce the risk of dyslipidemia, mainly due to the decreased risk of low HDL-C, in Korean women. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Continuous Compared With Cyclic Oral Contraceptives for the Treatment of Primary Dysmenorrhea: A Randomized Controlled Trial

    Science.gov (United States)

    Dmitrovic, Romana; Kunselman, Allen R.; Legro, Richard S.

    2013-01-01

    Objective To estimate whether continuous OCP (oral contraceptive pills) will result in more pain relief in primary dysmenorrhea patients than cyclic OCP, which induces withdrawal bleeding with associated pain and symptoms. Material and Methods We conducted a double-blind, randomized controlled trial comparing continuous to a cyclic 21/7 OCP regimen (gestodene 0.075 mg and ethinyl estradiol 20 mcg) for 6 months in 38 primary dysmenorrhea patients. The primary outcome was the difference in subjective perception of pain as measured by the Visual Analog Scale (VAS) over the period of 6 months. Results Twenty-nine patients completed the study. In both groups, pain reduction measured by VAS declined over time and was significant at 6 months compared to baseline with no difference between groups. Continuous regimen was superior to cyclic regimen after one month (mean difference: -27.3; 95% CI: (-40.5,-14.2); p<0.001) and 3 months (mean difference: -17.8; 95% CI: (-33.4,-2.1); p=0.03) of treatment. Secondary outcomes noted no difference between groups in terms of menstrual distress as measured by the Moos Menstrual Distress Questionnaire. After 6 months, there was an increase in weight and decrease in systolic blood pressure in continuous compared with the cyclic group. Conclusions Both regimens of OCP are effective in the treatment of primary dysmenorrhea. Continuous OCP outperforms cyclic OCP in the short term, but this difference is lost after 6 months. PMID:22617578

  15. Inhibition of ovulation by a triphasic gestodene-containing oral contraceptive.

    Science.gov (United States)

    Spona, J; Lachnit-Fixson, U; Düsterberg, B; Dobianer, K

    1993-09-01

    The minimal effective dose of gestodene for inhibition of ovulation was studied in 30 female volunteers. Daily doses of 10 micrograms to 50 micrograms gestodene were given orally for 21 days. A control cycle prior to treatment and a treatment cycle were monitored for LH, FSH, estradiol, progesterone and cervical score. At a daily dose of 40 micrograms of gestodene, 6/7 volunteers exhibited inhibition of ovulation and 1/7 had a cycle with luteal insufficiency. Ovulation was inhibited in all volunteers on 50 micrograms gestodene, suggesting that the minimum dose required to inhibit ovulation was 40 micrograms gestodene. Cervical score was blunted even at 10 micrograms gestodene. Similarly, 20 volunteers were treated with coated tablets containing ethinylestradiol/gestodene at 30/50 micrograms for 6 days, 40/70 micrograms for 5 days and 30/100 micrograms for 10 days. This triphasic gestodene-containing preparation inhibited ovulation in all 20 females. In one cycle in which follicle development was observed only 43 pg estradiol/ml was secreted. Data from this investigation suggest that this triphasic gestodene-containing OC has a high contraceptive efficacy.

  16. Oral contraceptive pills decrease pulmonary airway resistance in healthy north Indian women.

    Science.gov (United States)

    Kumar, Pradeep; Singh, Shraddha; Singh, Uma; Verma, Pratima

    2011-02-01

    Oral contraceptive pills (OCPs) are hormonal pills used by females to prevent conception; they are a combination of estrogen and progestin. There is, however, compelling evidence that throughout the reproductive life of a woman, her airways are subject to the influence of the cyclical variations in sex hormones which occur in relation to circadian rhythms. The present study has been designed to investigate the effects of OCPs on airway resistance in terms of spirometric parameters in OCP users and nonusers. A total of 100 women (age: 20-40 years) ware selected for the present study. The subjects were provided with a one-month supply of OCPs. The constituents per tablet of MALA-N used were levonorgestrel 0.15 mg and ethinylestradiol 0.03 mg. Peak expiratory flow rate (PEFR), forced expiratory flow in expiring 25-75% air (FEF 25-75), forced expiratory volume percentage in one second (FEV1% or FEV1/FVC), forced vital capacity (FVC), and forced expiratory volume in one second (FEV1) were recorded. In our study, the FEF 25-75and PEFR increased significantly in OCP users, showing that these hormone pills decrease the resistance offered by small bronchioles.

  17. Metabolic and endocrine effects of the desogestrel-containing oral contraceptive Mircette.

    Science.gov (United States)

    Berga, S L

    1998-07-01

    The purpose was to evaluate the metabolic effects of Mircette (brand of desogestrel/ethinyl estradiol and ethinyl estradiol), a low-estrogen, desogestrel-containing oral contraceptive. Women taking Mircette were evaluated to determine its effects on lipid profiles (n = 74), carbohydrate metabolism (n = 25), and endocrine parameters (n = 53). During cycles 3 and 6 of Mircette treatment, changes from baseline included mean increases in serum triglycerides and very low-density lipoprotein cholesterol ranging between 50% and 60%. Smaller mean increases were observed at these time points in high-density lipoprotein cholesterol subfraction 2 (range between 17% and 25%), total cholesterol (hormone, luteinizing hormone, 17beta-estradiol, and progesterone to levels consistent with inhibition of ovulation and increased concentrations of thyroid- and cortisol-binding globulins. Overall, Mircette treatment was associated with expected effects on the pituitary-ovarian axis, triglycerides, and serum binding proteins; a modest decline in glucose tolerance; and a favorable effect on lipid profiles as a result of increases in total high-density lipoprotein cholesterol and high-density lipoprotein cholesterol subfraction 2 in the absence of changes in total cholesterol or low-density lipoprotein cholesterol.

  18. Diminished nap effects on memory consolidation are seen under oral contraceptive use.

    Science.gov (United States)

    Genzel, Lisa; Bäurle, Anna; Potyka, Alina; Wehrle, Renate; Adamczyk, Marek; Friess, Elisabeth; Steiger, Axel; Dresler, Martin

    2014-01-01

    Many young females take exogenous hormones as oral contraceptive (OC), a condition rarely controlled for in studies on sleep and memory consolidation even though sex hormones influence consolidation. This study investigated the effects of OCs on sleep-related consolidation of a motor and declarative task, utilizing a daytime nap protocol. Fifteen healthy, young females taking OCs came to the sleep lab for three different conditions: nap with previous learning, wake with previous learning and nap without learning. They underwent each condition twice, once during the "pill-active" weeks and once during the "pill-free" week, resulting in 6 visits. In all conditions, participants showed a significant off-line consolidation effect, independent of pill week or nap/wake condition. There were no significant differences in sleep stage duration, spindle activity or spectral EEG frequency bands between naps with or without the learning condition. The present data showed a significant off-line enhancement in memory irrespective of potential beneficial effects of a nap. In comparison to previous studies, this may suggest that the use of OCs may enhance off-line memory consolidation in motor and verbal tasks per se. These results stress the importance to control for the use of OCs in studies focusing on memory performance. © 2015 S. Karger AG, Basel

  19. Oral contraceptive use in women is associated with defeminization of otoacoustic emission patterns.

    Science.gov (United States)

    Snihur, A W K; Hampson, E

    2012-05-17

    The production of otoacoustic emissions (OAEs) by the cochlea is a sexually dimorphic trait. Although often hypothesized to be influenced by testosterone in utero, little attention has been devoted to the possibility that levels of circulating sex steroids in adulthood might modulate the sex difference in OAE production. The purpose of the current study was to investigate whether oral contraceptive (OC) use affects OAE production in women, revisiting a question originally posed by McFadden [(2000) Hearing Research 142:23-33]. Forty-five males and 50 females were tested. The women were retrospectively classified based on whether or not they were using OCs at present. Two types of OAEs were quantified: those produced spontaneously (spontaneous otoacoustic emissions or SOAEs) and those produced in response to click stimuli (click-evoked otoacoustic emissions or CEOAEs). Women currently using OCs showed a defeminized pattern of OAE production: they produced fewer SOAEs, SOAEs with significantly less power, and smaller CEOAE response amplitudes compared with naturally cycling women who were tested irrespective of phase of the menstrual cycle. It is proposed that the observed group difference may be mediated by the interaction of circulating estradiol with estrogen receptor alpha (ERα) or estrogen receptor beta (ERβ) receptors in the cochlea. Copyright © 2012 IBRO. Published by Elsevier Ltd. All rights reserved.

  20. Prevalence of smoking and oral contraception in a sample of Danish young women

    DEFF Research Database (Denmark)

    Jeune, B; Wielandt, H

    1991-01-01

    A representative sample of 286 Danish females aged 16-20 years were interviewed during the period April 1984--February 1985. The response rate was 75%. Both use of oral contraception (OC) and smoking were common; 46.6% used OC, 34.2% smoked and 19.6% combined smoking and OC. The prevalence...... of smoking was significantly higher (42.0%) among OC-users than among non-users (27.2%). The combination of smoking and OC was especially prevalent among young women with sexual debut before 16 years (36.8%). The association between smoking and the use of OC was significant both when tested unstratified (p...... less than 0.05) and stratified by age at sexual debut (p less than 0.01). Smoking was also associated with early debut of intercourse (p less than 0.001). It has been reported that the combination of these two factors in adult women increase the risk for cardiovascular mortality. However, the health...

  1. Oral contraceptive use in women changes preferences for male facial masculinity and is associated with partner facial masculinity.

    Science.gov (United States)

    Little, Anthony C; Burriss, Robert P; Petrie, Marion; Jones, Benedict C; Roberts, S Craig

    2013-09-01

    Millions of women use hormonal contraception and it has been suggested that such use may alter mate preferences. To examine the impact of oral contraceptive (pill) use on preferences, we tested for within-subject changes in preferences for masculine faces in women initiating pill use. Between two sessions, initiation of pill use significantly decreased women's preferences for male facial masculinity but did not influence preferences for same-sex faces. To test whether altered preference during pill use influences actual partner choice, we examined facial characteristics in 170 age-matched male partners of women who reported having either been using or not using the pill when the partnership was formed. Both facial measurements and perceptual judgements demonstrated that partners of women who used the pill during mate choice have less masculine faces than partners of women who did not use hormonal contraception at this time. Our data (A) provide the first experimental evidence that initiation of pill use in women causes changes in facial preferences and (B) documents downstream effects of these changes on real-life partner selection. Given that hormonal contraceptive use is widespread, effects of pill use on the processes of partner formation have important implications for relationship stability and may have other biologically relevant consequences. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Does switching contraceptive from oral to a patch or vaginal ring change the likelihood of timely prescription refill?

    Science.gov (United States)

    Law, Amy; Lee, Yi-Chien; Gorritz, Magdaliz; Plouffe, Leo

    2014-08-01

    This study evaluated contraceptive refill patterns of women insured commercially in the US who switched from oral contraceptives (OCs) to the patch or vaginal ring and assessed if switching contraceptive methods changes refill patterns. Women aged 15-44 with ≥2 patch or ring prescriptions and ≥2 OC prescriptions before the first patch/ring prescription were identified from the MarketScan® Commercial database (1/1/2002-6/30/2011). Refill patterns 1-year pre- and postindex date (first patch/ring prescription) were evaluated, and women were categorized as timely or delayed refillers on OCs and patch/ring. Regression modeling was used to investigate the association between refill patterns and contraceptive methods and switching effects on refill patterns. Of 17,814 women identified, 7901 switched to the patch, and 9913 switched to the ring. Among timely OC refillers, the percentage of timely refills decreased (patch: 95.6% to 79.4%, pcontraceptive efficacy by simply switching to the patch or ring. The impact on timely refills of switching from OCs to either the patch or ring is complex and varies depending on the pattern of timely refills on OCs. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Dose finding in a low-dose 21-day combined oral contraceptive containing gestodene.

    Science.gov (United States)

    Lüdicke, F; Sullivan, H; Spona, J; Elstein, M

    2001-10-01

    An open label, non-comparative study was carried out in 22 women over a total of five cycles. After an untreated cycle, oral administration of 20 microg ethinyl estradiol (EE) with 50 microg gestodene (GST) (tablets taken daily for 21 days with a break of 7 days) was commenced, and three treatment cycles were followed by an untreated follow-up control cycle. The ability of this formulation to inhibit ovulation and suppress ovarian activity was assessed by using hormonal parameters and ultrasound. One ovulation occurred during treatment. Luteinized unruptured follicles were observed in three cases in the second treatment cycle and in one case during the third treatment cycle. Follicle-like structures larger than 13 mm associated with a serum estradiol level of more than 30 pg/mL were noted in 19% of the women in the first treatment cycle. The rate of active follicle-like structures was 43% in the second treatment cycle and 28% in the third treatment cycle. The results were compared with previously reported findings of a preparation containing 20 microg EE and 75 microg GST. With regard to ovarian grading and endogenous hormone secretion, considerably more residual ovarian activity, with all parameters examined, was found in the 20 microg EE and 50 microg GST preparation compared to the 20 microg EE and 75 microg GST preparation. It was concluded that the 20 microg EE and 50 microg GST preparation administered for 21 days does not meet the requirements of a combined oral contraceptive with respect to ovulation inhibition.

  4. Early History of Oral Contraceptive Pill in Finland: The Diffusion of the New Contraceptive and Fertility Patterns

    Directory of Open Access Journals (Sweden)

    Aura Pasila

    2011-01-01

    Full Text Available The 1960s is often characterized as a decade of outstanding social and demographic changes in Western societies. The introduction of the contraceptive pill is assumed to have contributed to these changes. Yet the social as well as the demographic significance of the pill is ambiguous. This article has two aims: 1 to describe the early history of the pill in Finland in the 1960s and in the early 1970s and 2 to explore relationships between fertility and the pill. Surveys, pharmaceutical market data, and estimations are used to depict the diffusion of the pill. Based on calculated user percentages, the pill was adopted neither instantly nor extremely widely in Finland during the period under study. The results show that the diffusion coincided with fertility decline and other changes in fertility patterns. However, a causal connection of any kind cannot be established due to a lack of sufficient data.

  5. Biotransformation of oral contraceptive ethynodiol diacetate with microbial and plant cell cultures

    Directory of Open Access Journals (Sweden)

    Zafar Salman

    2012-09-01

    Full Text Available Abstract Background Biotransformation by using microbial and plant cell cultures has been applied effectively for the production of fine chemicals on large scale. Inspired by the wealth of literature available on the biotransformation of steroids, we decided to investigate the biotransformation of ethynodiol diacetate (1 by using plant and microbial cultures. Results The biotransformation of ethynodiol diacetate (1 with Cunninghamella elegans and plant cell suspension cultures of Ocimum basilicum and Azadirachta indica is being reported here for the first time. Biotransformation of 1 with Cunninghamella elegans yielded three new hydroxylated compounds, characterized as 17α-ethynylestr-4-en-3β,17β-diacetoxy-6α-ol (2, 17α-ethynylestr-4-en-3β,17β-diacetoxy-6β-ol (3, and 17α-ethynylestr-4-en-3β,17β-diacetoxy-10β-ol (4 and a known metabolite, 17α-ethynyl-17β-acetoxyestr-4-en-3-one (5. The biotransformation of 1 with Ocimum basilicum included hydrolysis of the ester group, oxidation of alcohol into ketone, and rearrangement of the hydroxyl group. Thus four major known metabolites were characterized as 17α-ethynyl-17β-acetoxyestr-4-en-3-one (5, 17α-ethynyl-17β-hydroxyestr-4-en-3-one (6, 17α-ethynyl-3 β-hydroxy-17β-acetoxyestr-4-ene (7 and 17α-ethynyl-5α,17β-dihydroxyestr-3-ene (8. Biotransformation of 1 with Azadirachta indica culture yielded compounds 5 and 6. Spectroscopic data of compound 8 is being reported for the first time. Structure of compound 6 was unambiguously deduced through single-crystal x-ray diffraction studies. Conclusion Biotransformation of an oral contraceptive, ethynodiol diacetate (1, by using microbial and plant cell cultures provides an efficient route to the synthesis of a library of new steroids with potential contraceptive properties. These methods can be employed in the production of such compounds with high stereoselectivity.

  6. Ovarian reserve assessment in users of oral contraception seeking fertility advice on their reproductive lifespan.

    Science.gov (United States)

    Birch Petersen, K; Hvidman, H W; Forman, J L; Pinborg, A; Larsen, E C; Macklon, K T; Sylvest, R; Andersen, A Nyboe

    2015-10-01

    To what extent does oral contraception (OC) impair ovarian reserve parameters in women who seek fertility assessment and counselling to get advice on whether their remaining reproductive lifespan is reduced? Ovarian reserve parameters defined by anti-Müllerian hormone (AMH), antral follicle count (AFC) and ovarian volume were found to be significantly decreased by 19% (95% CI 9.1-29.3%), 18% (95% CI 11.2-24.8%) and 50% (95% CI 45.1-53.7%) among OC users compared with non-users. AMH and AFC have proved to be reliable predictors of ovarian ageing. In women, AMH declines with age and data suggest a relationship with remaining reproductive lifespan and age at menopause. OC may alter parameters related to ovarian reserve assessment but the extent of the reduction is uncertain. A cross-sectional study of 887 women aged 19-46 attending the Fertility Assessment and Counselling Clinic (FACC) from 2011 to 2014 comparing ovarian reserve parameters in OC users with non-OC users. The FAC Clinic was initiated to provide individual fertility assessment and counselling. All women were examined on a random cycle day by a fertility specialist. Consultation included; transvaginal ultrasound (AFC, ovarian volume, pathology), a full reproductive history and AMH measurement. Women were grouped into non-users and users of OC (all combinations of estrogen-progestin products and the contraceptive vaginal ring). Non-users included women with an intrauterine device (IUD) or no hormonal contraception. Of the 887 women, 244 (27.5%) used OC. In a linear regression analyses adjusted for age, ovarian volume was 50% lower (95% CI 45.1-53.7%), AMH was 19% lower (95% CI 9.1-29.3%), and AFC was 18% lower (95% CI 11.2-24.8%) in OC users compared with non-users. Comparison of AMH at values of <10 pmol/l OC was found to have a significant negative influence on AMH (OR 1.6, 95% CI 1.1; 2.4, P = 0.03). Furthermore, we found a significant decrease in antral follicles sized 5-7 mm (P < 0.001) and antral

  7. Oral contraceptives modify DNA methylation and monocyte-derived macrophage function

    Directory of Open Access Journals (Sweden)

    Campesi Ilaria

    2012-01-01

    Full Text Available Abstract Background Fertile women may be encouraged to use contraception during clinical trials to avoid potential drug effects on fetuses. However, hormonal contraception interferes with pharmacokinetics and pharmacodynamics and modifies internal milieus. Macrophages depend on the milieu to which they are exposed. Therefore, we assessed whether macrophage function would be affected by the use of combined oral contraceptives (OCs and if this influence depended on the androgenic or non-androgenic properties of progestin. Methods Healthy adult women were enrolled and stratified into two groups: women who did not use OCs (Fs and women treated with OCs (FOCs. FOCs were further stratified as a function of androgenic (FOCA+ and non-androgenic (FOCA- properties of progestins. Routine hematological, biochemical, inflammatory and endothelial dysfunction parameters were measured. Monocyte-derived macrophages (MDMs were evaluated for the expression and activity of estrogen receptors and androgen receptors, and release of tumor necrosis factor α (TNFα was measured from unstimulated and lipopolysaccharide-stimulated cells. Results As is already known, the use of OCs changed numerous parameters: the number of lymphocytes, iron levels, total iron-binding capacity of transferrin, triglycerides, high-density lipoprotein, total cholesterol, and C-reactive protein increased, while prothrombin time and alkaline phosphatase decreased. Hormonal levels also varied: cortisol was higher in FOCs, while luteinizing hormone, follicle-stimulating hormone, and testosterone were lower in FOCs. Asymmetric dimethylarginine, an index of endothelial function, was lower in FOC than in Fs, as were cysteine and bilirubin. The androgenic properties of progestins affected the activity of OCs: in particular, white blood cell count, hemoglobin, high-density lipoprotein and calcium were higher in FOCA- than in FOCA+, whereas percentage oxygen saturation and γ-glutamyl transpeptidase

  8. Initiation of oral contraceptives using a quick start compared with a conventional start: a randomized controlled trial.

    Science.gov (United States)

    Westhoff, Carolyn; Heartwell, Stephen; Edwards, Sharon; Zieman, Mimi; Cushman, Linda; Robilotto, Christina; Stuart, Gretchen; Morroni, Chelsea; Kalmuss, Debra

    2007-06-01

    To estimate whether young women taking the first pill on the day of prescription had higher continuation rates and lower pregnancy rates than women who waited until menses to start the oral contraceptive pill (OCP). We recruited 1,716 women aged younger than 25 years seeking to initiate the oral contraceptive at three publicly funded family planning clinics, and randomly assigned them to conventional initiation of the pill (conventional start) or immediate, directly observed ingestion of the first pill (quick start) during the clinic visit. Women underwent follow-up interviews at 3 and 6 months. Sixty percent of participants discontinued the pill, and 8% became pregnant during follow-up. Women who took the first pill in the clinic were more likely to continue to the second OCP pack (odds ratio 1.5, 95% confidence interval 1.0-2.1.); however, the Quick Start approach did not improve OCP continuation rates at 3 and 6 months. Those assigned to Quick Start were slightly less likely to become pregnant within 6 months from the time they started the pill (hazard ratio 0.90, 95% confidence interval 0.64-1.25). Eighty-one percent of women rated the Quick Start approach as acceptable or preferable to waiting. Rates of serious adverse events were low and similar in the two groups. Protocols that require a woman to wait until the next menses to start hormonal contraceptives are an obstacle to contraceptive initiation. Directly observed, immediate initiation of the pill improves short-term continuation. ClinicalTrials.gov, www.clinicaltrials.gov, NCT00068848

  9. Postabortal contraception.

    Science.gov (United States)

    Lähteenmäki, P

    1993-04-01

    The return of fertility is rapid after first trimester abortion. The first ovulation may take place as soon as 2 weeks after abortion, and half of the women have ovulated by 3 weeks. Hence, commencement of effective contraception is necessary even before the first postabortal menstrual period. Women are highly motivated as regards contraception at this time. Several studies, both in developed and developing countries, have shown that the insertion of a modern copper intrauterine device (IUD) at the end of the abortion procedure is a safe and well-accepted way to start the method. Hormonal methods, such as NORPLANT, levonorgestrel-releasing IUD, injectables and oral combination pills do not affect the recovery of the pituitary-ovarian system, even though introduced immediately after abortion. The combination of preceding pregnancy, abortion procedure and immediate start of low dose oral contraceptives containing 30 micrograms of ethinyloestradiol results in a slight tendency towards hypercoagulability. This may be clinically insignificant, but it can be avoided by postponing oral contraceptives until 1 week after abortion, without losing the contraceptive efficacy of the method.

  10. An assessment of the quality of advice provided by patent medicine vendors to users of oral contraceptive pills in urban Nigeria

    Directory of Open Access Journals (Sweden)

    Ujuju C

    2014-04-01

    Full Text Available Chinazo Ujuju,1 Samson B Adebayo,2 Jennifer Anyanti,3 Obi Oluigbo,3 Fatima Muhammad,4 Augustine Ankomah5 1Research and Evaluation Division, Society for Family Health, Abuja, Nigeria; 2Planning, Research and Statistics Directorate, National Agency for Food and Drug Administration and Control, Abuja, Nigeria; 3Technical Services Directorate, Society for Family Health, Abuja, Nigeria; 4Family Planning Directorate, Society for Family Health, Abuja, Nigeria; 5Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana Introduction: In Nigeria about 50% of oral contraceptive pill users obtain their products from proprietary patent medicine vendors (PPMVs. This group of service providers are poorly trained and have very limited knowledge about contraception. This paper investigated the nature of the advice offered to simulated current and potential users of oral contraceptive pills. The main objective was to assess the nature and quality of advice provided by PPMVs to pill users. Method: This study is based on findings from a 'mystery client' approach in which three scenarios related to contraceptive pill use were simulated. Each of the 12 mystery clients simulated one of the following three scenarios: new pill users (new to family planning or switching from condom to pills; user seeking a resupply of pills; and dissatisfied pill users intending to discontinue use. Simple random sampling was used to select 410 PPMVs from a total of 1,826 in four states in Nigeria. Qualitative study using in-depth interviews was also conducted. Results: A majority of the PPMVs had pills in stock on the day of the survey and resupplied pills to the clients. PPMVs also understood the reason and importance of referring clients who were new adopters of oral contraceptive methods to a health facility; 30% of the PPMVs referred new adopters to a health facility. However, demand from clients who do not want to go

  11. Injectable and oral contraceptive use and cancers of the breast, cervix, ovary, and endometrium in black South African women: case-control study.

    Directory of Open Access Journals (Sweden)

    Margaret Urban

    Full Text Available Oral contraceptives are known to influence the risk of cancers of the female reproductive system. Evidence regarding the relationship between injectable contraceptives and these cancers is limited, especially in black South Africans, among whom injectable contraceptives are used more commonly than oral contraceptives.We analysed data from a South African hospital-based case-control study of black females aged 18-79 y, comparing self-reported contraceptive use in patients with breast (n = 1,664, cervical (n = 2,182, ovarian (n = 182, and endometrial (n = 182 cancer, with self-reported contraceptive use in 1,492 control patients diagnosed with cancers with no known relationship to hormonal contraceptive use. We adjusted for potential confounding factors, including age, calendar year of diagnosis, education, smoking, alcohol, parity/age at first birth, and number of sexual partners. Among controls, 26% had used injectable and 20% had used oral contraceptives. For current and more recent users versus never users of oral or injectable contraceptives, the odds ratios (ORs for breast cancer were significantly increased in users of oral and/or injectable contraceptives (OR 1.66, 95% CI 1.28-2.16, p<0.001 and separately among those exclusively using oral (1.57, 1.03-2.40, p = 0.04 and exclusively using injectable (OR 1.83, 1.31-2.55, p<0.001 contraceptives; corresponding ORs for cervical cancer were 1.38 (1.08-1.77, p = 0.01, 1.01 (0.66-1.56, p = 0.96, and 1.58 (1.16-2.15, p = 0.004. There was no significant increase in breast or cervical cancer risk among women ceasing hormonal contraceptive use ≥10 y previously (p = 0.3 and p = 0.9, respectively. For durations of use ≥5 y versus never use, the ORs of ovarian cancer were 0.60 (0.36-0.99, p = 0.04 for oral and/or injectable contraceptive use and 0.07 (0.01-0.49, p = 0.008 for injectable use exclusively; corresponding ORs for endometrial cancer were 0

  12. The venous thrombotic risk of oral contraceptives, effects of oestrogen dose and progestogen type: results of the MEGA case-control study

    Science.gov (United States)

    van Hylckama Vlieg, A; Helmerhorst, F M; Vandenbroucke, J P; Doggen, C J M

    2009-01-01

    Objective To assess the thrombotic risk associated with oral contraceptive use with a focus on dose of oestrogen and type of progestogen of oral contraceptives available in the Netherlands. Design Population based case-control study. Setting Six participating anticoagulation clinics in the Netherlands (Amersfoort, Amsterdam, The Hague, Leiden, Rotterdam, and Utrecht). Participants Premenopausal women gestodene (5.6, 3.7 to 8.4), 7.3-fold for desogestrel (7.3, 5.3 to 10.0), 6.8-fold for cyproterone acetate (6.8, 4.7 to 10.0), and 6.3-fold for drospirenone (6.3, 2.9 to 13.7). The risk of venous thrombosis was positively associated with oestrogen dose. We confirmed a high risk of venous thrombosis during the first months of oral contraceptive use irrespective of the type of oral contraceptives. Conclusions Currently available oral contraceptives still have a major impact on thrombosis occurrence and many women do not use the safest brands with regard to risk of venous thrombosis. PMID:19679614

  13. Cycle and gender-specific cerebral activation during a verb generation task using fMRI: comparison of women in different cycle phases, under oral contraception, and men.

    Science.gov (United States)

    Rumberg, Bastian; Baars, Anneke; Fiebach, Jochen; Ladd, Mark E; Forsting, Michael; Senf, Wolfgang; Gizewski, Elke R

    2010-04-01

    Recent observations have revealed some evidence of the influence of sex and menstrual cycle on cognitive functions. In order to examine further differences depending on different phases of menstrual cycle, the use of oral contraception, and gender, fMRI during verb generation tests was performed in 12 female volunteers at menstrual phase and at luteal phase, 12 female volunteers under oral contraception, and in 12 men. Females under oral contraception compared to females in the menstrual or luteal phase revealed superior activation during verb generation in the right hemisphere; compared to menstrual phase in the superior temporal and in the luteal phase in the inferior frontal cortex. Two further significant activations were revealed comparing females in the luteal phase with males; for the females in the left inferior frontal and for the males in the left superior temporal cortex. Our results indicate that cerebral activity during a verb generation task differs between women during different phases of the menstrual cycle and men, between women under oral contraception and men, as well as between women with and without oral contraception. Copyright 2009 Elsevier Ireland Ltd and the Japan Neuroscience Society. All rights reserved.

  14. Effect of long-term combined oral contraceptive pill use on endometrial thickness.

    Science.gov (United States)

    Talukdar, Nayana; Bentov, Yaakov; Chang, Paul T; Esfandiari, Navid; Nazemian, Zohreh; Casper, Robert F

    2012-08-01

    To estimate whether there is any association of long-term use of combined oral contraceptive pills (OCP) with adverse endometrial growth. We reviewed the charts of 137 patients with history of OCP use undergoing endometrial preparation with estrogen for frozen embryo transfer. Endometrial thickness was measured by transvaginal ultrasonography on day 10 after menses and patients were divided into two groups (less than 7 mm and 7 mm or more). Thirty patients had endometrial thickness less than 7 mm and 107 had thickness of 7 mm or more. Mean years of combined OCP use in each group were 9.8±4.54 and 5.8±4.52, respectively (Pday 10 in patients using combined OCP for less than 10 years and 10 years or more were 9.54±1.88 mm and 8.48±2.33 mm, respectively, with P=.007. The mean endometrial thickness was 9.72±1.69 mm in less than 5 years and 8.81±2.23 mm in 5 or more years of use, respectively (P=.008). Cycle cancellation rates in the less than 7 mm group and 7 mm or greater endometrial thickness group were 23% and 4%, respectively (P=.002), but there was no difference in the clinical pregnancy rates between the two groups (13% compared with 27%, respectively; P=.15). Long-term combined OCP use (5 years or more) can potentially affect optimal endometrial growth, leading to a higher cancellation rate and longer stimulation in frozen embryo transfer cycles. These findings suggest a previously unidentified adverse effect of long-term combined OCP use in women who are anticipating future fertility. II.

  15. Oral contraceptive therapy reduces serum relaxin-2 in elite female athletes.

    Science.gov (United States)

    Nose-Ogura, Sayaka; Yoshino, Osamu; Yamada-Nomoto, Kaori; Nakamura, Mariko; Harada, Miyuki; Dohi, Michiko; Okuwaki, Toru; Osuga, Yutaka; Kawahara, Takashi; Saito, Shigeru

    2017-03-01

    Recent investigations have demonstrated that athletes with high relaxin-2 levels have a high risk of anterior cruciate ligament injuries, while athletes taking oral contraceptives (OC) have low relaxin-2 levels. It has not yet been clarified whether taking OC reduces relaxin-2 levels. The purpose of this study was to investigate changes in relaxin-2 levels in athletes taking OC. Levels of relaxin-2, estradiol, progesterone, luteinizing hormone and follicle-stimulating hormone were measured in serum samples (n = 183) from 106 elite female athletes. Five athletes with serum relaxin-2 concentrations > 6 pg/mL during the luteal phase were recruited to assess the effect of OC therapy. Serum relaxin-2 concentrations were significantly higher during the luteal phase (n = 57) than in the follicular phase (n = 72), or in athletes on OC therapy (n = 10) (P athletes had relaxin levels > 6 pg/mL. In 23 athletes, serum relaxin-2 concentrations were measured during both the follicular and luteal phases, revealing that relaxin-2 levels were significantly higher in the luteal phase compared with the follicular phase. In 5 out of 23 athletes, serum relaxin-2 concentrations were > 6 pg/mL in the luteal phase and during the second cycle of OC therapy, relaxin-2 concentrations decreased dramatically to below the detection limit (0.26 pg/mL). High serum relaxin-2 concentrations were only detected during the luteal phase. In athletes with high relaxin-2 concentrations during the luteal phase, OC therapy decreased serum relaxin-2 levels. © 2016 Japan Society of Obstetrics and Gynecology.

  16. [Oral contraceptives and cerebral thromboembolism. A Danish case-control study].

    Science.gov (United States)

    Lidegaard, O

    1993-11-01

    A retrospective case control study was carried out in order to assess the risk of developing cerebral thromboembolism by use of low dose oral contraceptives (OC). The subjects were all the 794 women in Denmark aged 15-44 who had suffered a cerebral thromboembolic attack (CTA) during the period 1985-1989, and an age-matched randomly selected control population of 1588 women. CTA included occlusion of precerebral arteria (ICD 432), cerebral thrombosis (ICD 433), cerebral embolism (ICD 434), transitory cerebral ischaemia (TCI; ICD 435) and the unspecified group apoplexia cerebri (ICD 436). Of 692/1584 case/control questionnaires sent out, 590/1396 (85.1/88.1%) were returned. Among the cases, 15 refused to participate, 69 had a revised or unreliable diagnosis, 40 had previously had thromboembolic disease, 13 were pregnant, and 152 had a disease predisposing them for CTA, leaving 323 without known predisposition, of whom 320 reported use/non-use of OC. Among 1396 controls, eight either refused to participate, were mentally retarded or resident in foreign countries; 18 returned an uncompleted questionnaire, 17 had previously had thromboembolic disease, 31 were pregnant, and 130 had a disease predisposing them to CTA. Thus, 1198 non-predisposed controls were provided, among whom 1197 reported use/non-use of OC. Among 320 cases, 116 (36.3%) were OC users at the time of the CTA, vs. 191 users (16.0%) among 1197 controls, corresponding to a crude odds ratio (OR) of 3.00.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Venous thromboembolism and desogestrel- or gestodene-containing combination oral contraceptives: what are the facts?

    Science.gov (United States)

    1996-04-01

    The UK's prescription drug regulatory agency warned the public and health care providers about the possible increased risk of venous thromboembolism (VTE) among users of the combined oral contraceptives (OCs) containing desogestrel or gestodene. Data from three large not-yet-published studies served as the basis for the warning. The studies found about a 2-fold increased risk of VTE for these OC users when compared to users of OCs with other progestins. Yet the observational studies are subject to inherent biases (e.g., hospitalized cases and selection bias), which may explain the increased risk. Assuming the increased risk to be true, the risk of VTE is still lower than that linked to pregnancy (30 vs. 60 VTE cases per 100,000). The risk of VTE for users of OCs containing older progestins is about 15 VTE cases and that among healthy, nonpregnant, nonusers is about 4 VTE cases. The mortality risk associated with VTE among users of OCs containing desogestrel or gestodene is 1-1.5 deaths/1 million woman-years. The US Food and Drug Administration has examined the data and has concluded that the risk is not high enough to justify switching to other OCs or stopping use of OCs containing desogestrel or gestodene. It recommends that users of the OCs in question discuss the OCs with their providers and make an informed choice based on the benefits and risks and individual preferences. It might consider changes in labeling, but not pulling the OCs off the market. In Germany, women aged less than 30 were temporarily advised not to begin use of desogestrel- or gestodene-containing OCs. Women using them were advised to continue their use, however. The European Union announced that bias or chance could account for the findings and thus did not recommend changes in prescribing desogestrel- or gestodene-containing OCs.

  18. Menstrual cycle phase and oral contraceptive effects on triglyceride mobilization during exercise.

    Science.gov (United States)

    Casazza, Gretchen A; Jacobs, Kevin A; Suh, Sang-Hoon; Miller, Benjamin F; Horning, Michael A; Brooks, George A

    2004-07-01

    We examined the effects of menstrual cycle phase and oral contraceptive (OC) use on triglyceride mobilization during 90 min of rest and 60 min of leg ergometry exercise at 45 and 65% peak O(2) uptake (Vo(2 peak)) in eight moderately physically active, eumenorrheic women (24.8 +/- 1.2 yr). Subjects were tested during the follicular phase (FP) and the luteal phase (LP) before OC use and during the inactive phase (IP) and high-dose phase (HP) after 4 complete mo of OC use. Glycerol rate of appearance (R(a)), a measure of triglyceride mobilization, was determined in a 3-h postabsorptive state using a primed constant infusion of [1,1,2,3,3-(2)H]glycerol. Before OC use (BOC), there were no significant differences between FP and LP in any of the variables studied. Dietary composition, exercise patterns, plasma glycerol concentrations, growth hormone concentrations, and exercise respiratory exchange ratio did not change with OC use. However, 4 mo of OC use significantly (P Vo(2 peak) (6.2 +/- 0.2, 6.5 +/- 0.4, and 7.7 +/- 1.1 micromol.kg(-1).min(-1) for BOC, IP, and HP, respectively) and in IP and HP at 65% Vo(2 peak) (6.6 +/- 0.1, 8.2 +/- 0.6, and 8.1 +/- 0.7 micromol.kg(-1).min(-1) for BOC, IP, and HP, respectively). Plasma cortisol concentrations were significantly higher with OC use at rest and during exercise at 45 and 65% Vo(2 peak). In summary, although fluctuations of endogenous ovarian steroids have little effect on triglyceride mobilization, the synthetic ovarian steroids found in OCs increase triglyceride mobilization and plasma cortisol concentrations in exercising women. We conclude that the hierarchy of effects of ovarian steroids and their analogs on triglyceride mobilization in exercising women is as follows: energy flux > OC use > recent carbohydrate nutrition, menstrual cycle effects.

  19. Menstrual cycle and oral contraceptive use do not modify postexercise heat loss responses.

    Science.gov (United States)

    Kenny, Glen P; Leclair, Emily; Sigal, Ronald J; Journeay, W Shane; Kilby, Donald; Nettlefold, Lindsay; Reardon, Francis D; Jay, Ollie

    2008-10-01

    It is unknown whether menstrual cycle or oral contraceptive (OC) use influences nonthermal control of postexercise heat loss responses. We evaluated the effect of menstrual cycle and OC use on the activation of heat loss responses during a passive heating protocol performed pre- and postexercise. Women without OC (n = 8) underwent pre- and postexercise passive heating during the early follicular phase (FP) and midluteal phase (LP). Women with OC (n = 8) underwent testing during the active pill consumption (high exogenous hormone phase, HH) and placebo (low exogenous hormone phase, LH) weeks. After a 60-min habituation at 26 degrees C, subjects donned a liquid conditioned suit. Mean skin temperature was clamped at approximately 32.5 degrees C for approximately 15 min and then gradually increased, and the absolute esophageal temperature at which the onset of forearm vasodilation (Th(vd)) and upper back sweating (Th(sw)) were noted. Subjects then cycled for 30 min at 75% Vo(2 peak) followed by a 15-min seated recovery. A second passive heating was then performed to establish postexercise values for Th(vd) and Th(sw). Between 2 and 15 min postexercise, mean arterial pressure (MAP) remained significantly below baseline (P cycle phases. During LP/HH, Th(vd) was 0.16 +/- 0.24 degrees C greater than FP/LH preexercise (P = 0.020) and 0.15 +/- 0.23 degrees C greater than FP/LH postexercise (P = 0.017). During LP/HH, Th(sw) was 0.17 +/- 0.23 degrees C greater than FP/LH preexercise (P = 0.016) and 0.18 +/- 0.16 degrees C greater than FP/LH postexercise (P = 0.001). Postexercise thresholds were significantly greater (P menstrual cycle nor OC use modifies the magnitude of the postexercise elevation in Th(vd) and Th(sw).

  20. Restoring testosterone levels by adding dehydroepiandrosterone to a drospirenone containing combined oral contraceptive: I. Endocrine effects.

    Science.gov (United States)

    Zimmerman, Y; Foidart, J-M; Pintiaux, A; Minon, J-M; Fauser, B C J M; Cobey, K; Coelingh Bennink, H J T

    2015-02-01

    Combined oral contraceptives (COCs) decrease testosterone (T) levels. This study investigated restoration of T and other androgen concentrations during COC use by 'co-administration' of dehydroepiandrosterone (DHEA). In this randomized, double-blind, placebo-controlled study in 99 new COC starters (18-35 years old with body mass index range 18-34 kg/m²), a COC containing 30mcg ethinylestradiol (EE) and 3 mg drospirenone (DRSP) was used for 3cycles, followed by 6cycles of the same COC combined with either 50 mg/day DHEA or placebo. Total T, albumin, sex hormone-binding globulin (SHBG), DHEA-sulfate (DHEA-S), Δ4-androstenedione (AD), 3α-androstanediol glucuronide (ADG) and estradiol (E₂) were measured, whereas free T and the free T index (FTI) were calculated. Assessments took place at baseline (no COC use), after the run-in period (COC use alone) and during the treatment period (DHEA or placebo). During COC use alone, androgen levels decreased, especially total T by 62% and free T by 86%, and SHBG increased by 243%. Total T increased with DHEA compared to placebo (change from end of run-in period to end of treatment period -- 1.3±1.2 nmol/L vs. 0.0±0.4 nmol/L; pFree T and the FTI increased significantly (pfree T level was still 53% below baseline levels. DHEA-S, AD and ADG increased significantly to levels above baseline (pfree T levels were restored by only 47% as most of the T remains bound to SHBG. When using a COC that increases SHBG considerably, a daily dose of 50 mg DHEA is insufficient to normalize free T levels completely. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Oral contraceptives positively affect mood in healthy PMS-free women: A longitudinal study.

    Science.gov (United States)

    Hamstra, Danielle A; de Kloet, E Ronald; de Rover, Mischa; Van der Does, Willem

    2017-12-01

    Menstrual cycle phase and oral contraceptives (OC) use influence mood and cognition and these effects may be moderated by the mineralocorticoid receptor (MR) genotype. The effect of menstrual cycle phase on mood may be increased if participants know that this is the focus of study. We assessed aspects associated with reproductive depression such as mood, interpersonal sensitivity, affect lability and depressive cognitions in MR-genotyped OC-users and naturally cycling (NC) women in a carefully masked design. A homogenous sample of healthy, PMS-free, pre-menopausal MR-genotyped women (n=92) completed online questionnaires eight times during two consecutive cycles. The masking of the research question was successful. OC-users did not differ significantly from NC women in positive and negative affect at the time of assessment, personality characteristics (e.g. neuroticism) or mental and physical health. Both groups reported more shifts in anger in the first cycle week (p<0.001; ηp2=0.08). Compared to NC women, OC-users reported fewer mood-shifts between depression and elation in the mid-luteal phase of the menstrual cycle (p=0.002; ηp2=0.10) and had fewer ruminating thoughts at all phases (p=0.003; ηp2=0.11). Effects of MR-genotype were not significant after correction for multiple comparisons. OC users scored more favorably on measures associated with reproductive depression. OC users also showed a decreased affect variability possibly indicating an emotional blunting effect, which is in line with previous reports on affect-stabilizing effects of OC. Limitations were loss of cases due to irregularities in the menstrual cycle length and possible confounding by the 'survivor effect', since almost all OC-users took OC for more than a year. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Evidence about extending the duration of oral contraceptive use to suppress menstruation.

    Science.gov (United States)

    Hitchcock, Christine L; Prior, Jerilynn C

    2004-01-01

    For many years, individual women and doctors have experimented with extending the duration of active oral contraceptive (OC) pills between pill-free intervals (long OC) to control menstruation. The U.S. approval of an OC with 84 active days and 7 pill-free days in 2003 has attracted considerable media attention. In this review we consider the published evidence on the effectiveness, side effects, and risks of menstrual suppression with long OC. We performed a systematic review of published literature on long OC, up to April 2003. Ten papers were located; two were randomized trials comparing long OC to standard OC; the remaining studies were single-group observational studies. Women on long OC schedules had fewer days of scheduled bleeding during days without pills but more days of unscheduled bleeding and spotting than those on standard OC. These problems were worse for women new to OC and diminished over time. Women on long OC were more likely to discontinue due to poor control of bleeding; women on standard OC were more likely to stop because of problems with headaches. Women on long OC and standard OC both showed increases in physiological factors related to clotting, with a nonsignificant tendency for those on long OC to be more affected. No studies considered the effects of long OC on breast tissue, breast density, endometrial safety, or adolescent maturation and reproductive development. No systematic data were available on the return to reproductive function and fertility after taking long OC. There were no placebo-controlled trials and no information on how long OC compares to normal, unmedicated menstrual cycles. Therefore we believe scientific evidence for safety of long OC use is presently lacking.

  3. Use of simulated patients to evaluate combined oral contraceptive dispensing practices of community pharmacists.

    Directory of Open Access Journals (Sweden)

    Paulo Roque Obreli-Neto

    Full Text Available BACKGROUND: Combined oral contraceptive (COC use is the most commonly used reversible method of birth control. The incorrect use of COCs is frequent and one of the most common causes of unintended pregnancies. Community pharmacists (CPs are in a strategic position to improve COC use because they are the last health professional to interact with patients before drug use. OBJECTIVE: To evaluate the COC dispensing practices of CPs in a developing country. METHOD: A cross-sectional study was conducted in community pharmacies of Assis and Ourinhos microregions, Brazil, between June 1, 2012, and October 30, 2012. Four simulated patients (SPs (with counseled audio recording visited community pharmacies with a prescription for Ciclo 21(® (a COC containing ethinyl estradiol 30 mcg + levonorgestrel 15 mcg. The audio recording of every SP visit was listened to independently by 3 researchers to evaluate the COC dispensing practice. The percentage of CPs who performed a screening for safe use of COCs (i.e., taking of patients' medical and family history, and measuring of blood pressure and provided counseling, as well as the quality of the screening and counseling, were evaluated. RESULTS: Of the 185 CPs contacted, 41 (22.2% agreed to participate in the study and finished the study protocol. Only 3 CPs asked the SP a question (1 question asked by each professional, and all of the questions were closed-ended, viz., "do you smoke?" (n = 2 and "what is your age?" (n = 1. None of the CPs measured the patient's blood pressure. Six CPs provided counseling when dispensing COCs (drug dosing, 5 CPs; possible adverse effects, 2 CPs, and one CP provided counseling regarding both aspects. CONCLUSION: The CPs evaluated did not dispense COC appropriately and could influence in the occurrence of negatives therapeutic outcomes such as adverse effects and treatment failure.

  4. Oral contraception does not alter single dose saquinavir pharmacokinetics in women

    Science.gov (United States)

    Fröhlich, Margit; Burhenne, Jürgen; Martin-Facklam, Meret; Weiss, Johanna; von Wolff, Michael; Strowitzki, Thomas; Walter-Sack, Ingeborg; Haefeli, Walter E

    2004-01-01

    Aims Women experience more adverse drug reactions (ADR) to antiretroviral therapy than men. This may be attributed to higher plasma concentrations of protease inhibitors due to pharmacokinetic interactions with hormonal preparations. Thus, in the present study we aimed to investigate the influence of oral contraceptives (OC) on the pharmacokinetics of the protease inhibitor saquinavir. Methods Saquinavir was administered in a hard gelatin capsule formulation (Invirase®) to rule out confounding by pharmaceutical aids of the more frequently used soft gelatin capsule. After an overnight fast, eight healthy female participants ingested a single oral dose of 600 mg saquinavir immediately before and after the 19th dose of a combined, low dose OC (0.03 mg ethinylestradiol, 0.075 mg gestodene) in a prospective, fixed sequence study design. The first saquinavir application was scheduled on day 1, 2, or 3 of the individual menstrual cycle. Plasma concentrations of saquinavir and relative concentrations of its M2&M3-hydroxy metabolites were determined by LC/MS/MS for 48 h. Results Intake of OC resulted in a significant decrease in morning serum concentrations (before intake of OC, compared to day 19 of OC therapy) of 17β-estradiol by −23.4 pg ml−1 (57%, 95%CI: −76% to −37.4%); progesterone by −0.25 ng ml−1 (33%, 95%CI: −45.3% to −21.5%); follicle-stimulating hormone by −4.06 U l−1 (82%, 95%CI: −96.5% to −67.7%); and luteinizing hormone by −3.49 U l−1 (74%, 95%CI: −93 to −54.6%). Conversely, sexual hormone binding globulin serum concentrations increased by 83.6 nmol l−1 (205%, 95%CI: 32.2% to 377%). Pharmacokinetic parameters of saquinavir (AUC, Cmax, tmax, t1/2, CLR) were not affected by OC, nor was the relative metabolic ratio of saquinavir/M2&M3-hydroxy saquinavir. Furthermore, there was no association of serum hormone concentrations or MDR1-polymorphisms (C3435T and G2677T) with pharmacokinetic parameters of saquinavir. Conclusions There

  5. Causes d'échec de la contraception orale et connaissance des femmes quant au maniement de leur pilule contraceptive : enquête menée au CPEF du CHU Antoine Béclère à Clamart dans les Hauts-de-Seine

    OpenAIRE

    Arciniega, Stéphanie

    2014-01-01

    BACKGROUND. The prescription of oral contraception is too often trivialized in France, neglecting the complexity of its handling. This results in a high number of unwanted pregnancies leading to abortions that could be prevented if women used correctly their contraceptive pills. METHOD. We conducted a study for six months at the planning family center of the Antoine Béclère Hospital among women requesting an abortion after a pill failure and among women consulting for their oral contraceptive...

  6. Comparison of postprandial lipemia between women who are on oral contraceptive methods and those who are not.

    Science.gov (United States)

    Petto, Jefferson; Vasques, Leila Monique Reis; Pinheiro, Renata Leão; Giesta, Beatriz de Almeida; Santos, Alan Carlos Nery dos; Gomes Neto, Mansueto; Ladeia, Ana Marice Teixeira

    2014-09-01

    Postprandial Lipemia (PPL) is a physiological process that reflects the ability of the body to metabolize lipids. Even though the influence of oral contraceptives (OC) on PPL is not known, it is a known fact that their use increases fasting lipid values. To compare the PPL between women who are on OC and those who are not. A prospective analytical study which assessed eutrophic women, aged between 18 and 28 years old, who were irregularly active and with fasting triglycerides ≤ 150 mg/dL. They were divided into two groups: oral contraceptive group (COG) and non-oral contraceptive group (NCOG). Volunteers were submitted to the PPL test, in which blood samples were collected in time 0 (12-hour fasting) and after the intake of lipids in times 180 and 240 minutes. In order to compare the triglyceride deltas, which reflect PPL, the two-tailed Mann-Whitney test was used for independent samples between fasting collections and 180 minutes (Δ1) and between fasting and 240 minutes (Δ2). Forty women were assessed and equally divided between groups. In the fasting lipid profile, it was observed that HDL did not present significant differences and that triglycerides in COG were twice as high in comparison to NCOG. Medians of Δ1 and Δ2 presented significant differences in both comparisons (p ≤ 0.05). The results point out that women who are irregularly active and use OC present more PPL in relation to those who do not use OC, which suggests that in this population, its chronic use increases the risk of heart conditions.

  7. Comparison of Postprandial Lipemia between Women who are on Oral Contraceptive Methods and Those who are not

    Directory of Open Access Journals (Sweden)

    Jefferson Petto

    2014-09-01

    Full Text Available Background: Postprandial Lipemia (PPL is a physiological process that reflects the ability of the body to metabolize lipids. Even though the influence of oral contraceptives (OC on PPL is not known, it is a known fact that their use increases fasting lipid values. Objective: To compare the PPL between women who are on OC and those who are not. Methods: A prospective analytical study which assessed eutrophic women, aged between 18 and 28 years old, who were irregularly active and with fasting triglycerides ≤150 mg/dL. They were divided into two groups: oral contraceptive group (COG and non-oral contraceptive group (NCOG. Volunteers were submitted to the PPL test, in which blood samples were collected in time 0 (12-hour fasting and after the intake of lipids in times 180 and 240 minutes. In order to compare the triglyceride deltas, which reflect PPL, the two-tailed Mann-Whitney test was used for independent samples between fasting collections and 180 minutes (Δ1 and between fasting and 240 minutes (Δ2. Results: Forty women were assessed and equally divided between groups. In the fasting lipid profile, it was observed that HDL did not present significant differences and that triglycerides in COG were twice as high in comparison to NCOG. Medians of Δ1 and Δ2 presented significant differences in both comparisons (p ≤0.05. Conclusion: The results point out that women who are irregularly active and use OC present more PPL in relation to those who do not use OC, which suggests that in this population, its chronic use increases the risk of heart conditions.

  8. Effect of administration of oral contraceptives in vivo on collagen synthesis in tendon and muscle connective tissue in young women

    DEFF Research Database (Denmark)

    Hansen, M; Miller, B F; Holm, Lars

    2009-01-01

    , body composition, and exercise-training status were included. The two groups were either habitual users of oral contraceptives exposed to a high concentration of synthetic estradiol and progestogens (OC, n = 11), or non-OC-users tested in the follicular phase of the menstrual cycle characterized by low...... concentrations of estradiol and progesterone (control, n = 12). Subjects performed 1 h of one-legged kicking exercise. The next day collagen fractional synthesis rates (FSR) in tendon and muscle connective tissue were measured after a flooding dose of [(13)C]proline followed by biopsies from the patellar tendon...

  9. The influence of medical education level on the Jagiellonian University Collegium Medicum medical students' knowledge concerning oral hormonal contraceptive pills.

    Science.gov (United States)

    Polak, Karina; Pityński, Kazimierz; Banaś, Tomasz; Bubel, Magdalena; Kałwa, Maria; Jamroga, Joanna; Knysak, Magdalena; Kusior, Magdalena; Truszkiewicz, Katarzyna; Oleksy, Piotr

    In December 2014 the authors carried out a research among Jagiellonian University Collegium Medicum medical students in a form of a questionnaire which consisted of two parts: personal information and multiple choice test concerning student's knowledge on OCPs. It showed that the level of medical education, defined as the year of study, increases student's knowledge about oral hormonal contraceptive pills. New program of study introduced from academic year 2012/2013 gives students wider knowledge on OCPs at earlier stage of education. Factors as female sex, usage of OCPs by student or his partner, positive attitude towards recommending OCPs to future patients show positive correlation with student's knowledge.

  10. Are hormonal components of oral contraceptives associated with impaired female sexual function? A questionnaire-based online survey of medical students in Germany, Austria, and Switzerland.

    Science.gov (United States)

    Wallwiener, Christian W; Wallwiener, Lisa-Maria; Seeger, Harald; Schönfisch, Birgitt; Mueck, Alfred O; Bitzer, Johannes; Zipfel, Stephan; Brucker, Sara Y; Taran, Florin-Andrei; Wallwiener, Markus

    2015-10-01

    To investigate in a large cohort of young university women whether different progestins and different ethinyl estradiol (EE) dosages in oral hormonal contraceptives (OHCs) adversely affect sexual function. Female medical students from German, Austrian, and Swiss universities (14/1/1) completed an anonymous online questionnaire comprising the 19 Female Sexual Function Index (FSFI) questions and 17 additional questions concerning demographics, lifestyle, sexual activity, and contraceptive use. OHCs were categorized by EE dose (≤20, 30 µg) and partially androgenic or antiandrogenic progestins. FSFI scores were analyzed by contraceptive method using descriptive statistics and standard nonparametric tests. We analyzed 2612 questionnaires submitted by respondents aged ≤30 years [mean age (SD) 23.5 (2.5) years]. Of 2126 contraceptive users, 1535 (72.2 %) used OHCs. Median FSFI total scores (ranges) were 28.2 (2.0-36.0) for all respondents. Median FSFI was significantly lower in non-users (24.4) versus users (28.7) of contraception (p < 0.001). Stratified analysis showed that 279/486 (57.4 %) respondents using no contraceptives, 563/1535 (36.7 %) using OHCs, 71/227 (31.3 %) using non-oral hormonal contraceptives, and 96/351 (27.4 %) using non-hormonal contraceptives were at risk for female sexual dysfunction (FSFI total score <26.55). FSFI scores for the three EE dosage categories and progestin components did not differ significantly. For OHCs, the FSFI score was lower than for other contraceptives but there was no significant association with EE dose or progestins, possibly due to small sample sizes. Further research needs to clarify the role of OHCs in female sexual function.

  11. Psychometric Properties of a Measure Assessing Attitudes and Norms as Determinants of Intention to Use Oral Contraceptives.

    Science.gov (United States)

    Lee, Jongwon; Carvallo, Mauricio; Lee, Taehun

    2015-06-01

    Asian immigrant and Asian American women are less likely to use oral contraceptives (OCs) and tend to rely on low-efficacy methods of contraception. This contraceptive pattern remains poorly understood, in part, because no theory-driven measurement exists to assess psychosocial determinants essential in explaining behaviors related to OC use in this population. The current study aimed to evaluate the psychometric properties of a measure of attitudes and subjective norms toward OC use among Korean American women as a first step to determine whether the measure can be used in this population and, potentially, in other Asian ethnic groups. The sample consisted of 329 Korean immigrant women living in New York City. The theory of reasoned action guided the development of the measure assessing attitudes and norms. Psychometric evaluation included item analysis, internal consistency estimates of reliability, and construct validity (i.e., factorial, discriminant, and predictive). All item-total correlations were above the recommendation of .30. The Cronbach's alpha for the attitudes and subjective norms measure was .88 and .86, respectively. Exploratory factor analyses revealed four interpretable factors, and confirmatory factor analyses confirmed that the factor structures derived from the exploratory factor analyses fit the data well. Discriminant and predictive validity of the measure were also established. The study provides support for the validity and reliability of the measure and its use for determining the degree to which Korean immigrant women intend to use OCs. Copyright © 2015. Published by Elsevier B.V.

  12. CONTRACEPTIVE CHOICES AMONG WOMEN IN ZARIA, NIGERIA

    African Journals Online (AJOL)

    about contraceptives. Results: Four hundred and eighteen clients were interviewed. Three hundred and severity two (89%) knew at least one method of contraception; 50.7% used injectable contraceptives, 22.5% intrauterine contraceptive devices, 13.9% Norplant and 10.3% oral contraceptive pills. One hundred and forty ...

  13. Injectable and Oral Contraceptive Use and Cancers of the Breast, Cervix, Ovary, and Endometrium in Black South African Women: Case–Control Study

    Science.gov (United States)

    Urban, Margaret; Banks, Emily; Egger, Sam; Canfell, Karen; O'Connell, Dianne; Beral, Valerie; Sitas, Freddy

    2012-01-01

    Background Oral contraceptives are known to influence the risk of cancers of the female reproductive system. Evidence regarding the relationship between injectable contraceptives and these cancers is limited, especially in black South Africans, among whom injectable contraceptives are used more commonly than oral contraceptives. Methods and Findings We analysed data from a South African hospital-based case–control study of black females aged 18–79 y, comparing self-reported contraceptive use in patients with breast (n = 1,664), cervical (n = 2,182), ovarian (n = 182), and endometrial (n = 182) cancer, with self-reported contraceptive use in 1,492 control patients diagnosed with cancers with no known relationship to hormonal contraceptive use. We adjusted for potential confounding factors, including age, calendar year of diagnosis, education, smoking, alcohol, parity/age at first birth, and number of sexual partners. Among controls, 26% had used injectable and 20% had used oral contraceptives. For current and more recent users versus never users of oral or injectable contraceptives, the odds ratios (ORs) for breast cancer were significantly increased in users of oral and/or injectable contraceptives (OR 1.66, 95% CI 1.28–2.16, pcontraceptives; corresponding ORs for cervical cancer were 1.38 (1.08–1.77, p = 0.01), 1.01 (0.66–1.56, p = 0.96), and 1.58 (1.16–2.15, p = 0.004). There was no significant increase in breast or cervical cancer risk among women ceasing hormonal contraceptive use ≥10 y previously (p = 0.3 and p = 0.9, respectively). For durations of use ≥5 y versus never use, the ORs of ovarian cancer were 0.60 (0.36–0.99, p = 0.04) for oral and/or injectable contraceptive use and 0.07 (0.01–0.49, p = 0.008) for injectable use exclusively; corresponding ORs for endometrial cancer were 0.44 (0.22–0.86, p = 0.02) and 0.36 (0.11–1.26, p = 0.1). Conclusions In this study, use of oral and

  14. A 1-year study to compare the hemostatic effects of oral contraceptive containing 20 microg of ethinylestradiol and 100 microg of levonorgestrel with 30 microg of ethinylestradiol and 100 microg of levonorgestrel

    DEFF Research Database (Denmark)

    Jespersen, Jørgen; Endrikat, Jan; Düsterberg, Bernd

    2005-01-01

    OBJECTIVES: To comparatively evaluate the impact of a balanced one-third dose-reduced oral contraceptive on hemostatic variables. METHODS: In an open-label, randomized study, a dose-reduced oral contraceptive containing 20 microg of ethinylestradiol (EE) and 100 microg of levonorgestrel (LNG) was...

  15. Contraception after medical abortion.

    Science.gov (United States)

    Mittal, Suneeta

    2006-07-01

    This study's objectives were to examine current evidence on contraception after abortion and to formulate guidelines for the use of different contraceptives after medical abortion based on current evidence. This study was based on review of published literature and guidelines on postabortion use of contraception. Contraception needs to be initiated early following a first-trimester abortion. Postabortion family planning is an integral part of comprehensive abortion care. Concurrent contraception with surgical abortion has been found to be practical and effective, with high contraception usage following abortion. Most methods can be safely used following medical abortion and can be initiated either on the day of misoprostol administration (oral pills, condoms and injectable contraceptives) or after the next menstrual cycle (intrauterine device and sterilization). With proper precautions, almost all contraceptive methods can be effectively used following medical abortion.

  16. Blood pressure stability in a normotensive population during intake of a monophasic oral contraceptive containing 20 microg ethinylestradiol and 75 g gestodene.

    Science.gov (United States)

    Endrikat, J; Gerlinger, C; Cronin, M; Ruebig, A; Schmidt, W; Düsterberg, B

    2001-09-01

    Evaluation of the impact of a monophasic gestodene-based oral contraceptive on blood pressure in a population that was normotensive at baseline. Data on blood pressure were retrospectively analyzed from four large prospective clinical phase III trials with an oral contraceptive containing 20 microg ethinylestradiol and 75 microg gestodene. A total of 1342 young fertile women were evaluated after 12 treatment cycles. The mean systolic and diastolic blood pressure did not change during treatment. Approximately 89% of women were normotensive at baseline and 93% at the end of the treatment period. Only a few women (gestodene has a negligible effect on blood pressure in users who were normotensive before treatment began.

  17. A study of the interactive effects of oral contraceptive use and dietary fat intake on blood pressure, cardiovascular reactivity and glucose tolerance in normotensive women.

    Science.gov (United States)

    Straznicky, N E; Barrington, V E; Branley, P; Louis, W J

    1998-03-01

    To investigate the interactive effects of oral contraceptive pill use and dietary fat intake on cardiovascular haemodynamics and metabolic parameters in young normotensive women. Thirty-two women participated, of whom 16 were taking oral contraceptive pills (ethinyl-oestradiol plus levonorgestrel) and 16 were age-matched and weight-matched controls not taking such pills. Subjects consumed either a high-fat or a low-fat diet for 2 weeks in an open, randomized, crossover study lasting 6 weeks. Investigations were performed at the end of each diet during the luteal phase of the menstrual cycle. Blood pressure was measured by 24 h ambulatory recording; cardiovascular reactivity was determined by examining blood pressure responses to systemic infusions of noradrenaline and angiotensin II and to the cold pressor test; and carbohydrate metabolism was investigated by an intravenous glucose-tolerance test. Plasma triglyceride levels were significantly higher in women taking oral contraceptive pills compared with non-users on both diets; however, responses of lipoprotein levels to the two diets did not differ between study groups (total and low-density lipoprotein cholesterol levels decreased by 15 and 17% in oral contraceptive pill users and by 14% each in non-users, on the low-fat compared with the high-fat diet). Fasting plasma insulin levels, the insulin-production response to administration of glucose (insulin area under the curve) and resting clinic and night-time systolic blood pressures were all significantly reduced on the low-fat diet, but only in non-users. Blood pressure responses to noradrenaline and maximal heart rate response to cold were significantly attenuated during the low-fat diet in oral contraceptive pill users. During the low-fat diet, resting systolic, 24 h systolic and diastolic blood pressures and insulin area under the curve were all significantly higher for women taking the oral contraceptive pills. Users of these pills also exhibited a greater

  18. Pharmacokinetic Interactions Between Mirabegron and Metformin, Warfarin, Digoxin or Combined Oral Contraceptives.

    Science.gov (United States)

    Groen-Wijnberg, Monique; van Dijk, Jan; Krauwinkel, Walter; Kerbusch, Virginie; Meijer, John; Tretter, Reiner; Zhang, Wenhui; van Gelderen, Marcel

    2017-06-01

    Mirabeg ron is a selective β3-adrenoceptor agonist approved for the treatment of overactive bladder (OAB). Four phase 1 studies were conducted in healthy subjects to evaluate the potential for pharmacokinetic interactions between mirabegron and metformin, warfarin, digoxin, or a combination oral contraceptive (COC). Thirty-two male subjects received metformin (500 mg twice daily) or mirabegron (160 mg once daily) alone, in combination or with placebo. Twenty-four male and female subjects received single doses of warfarin (25 mg) alone and in combination with mirabegron (100 mg once daily). Twenty-five male and female subjects were administered digoxin (0.25 mg) alone and in combination with mirabegron (100 mg once daily). Thirty female subjects received low-dose COC containing ethinylestradiol (EE)/levonorgestrel (LNG) (30/150 µg once daily) in combination with mirabegron (100 mg once daily) or placebo. Pharmacokinetic parameters were determined by non-compartmental methods. Absence of a Pharmacokinetic interaction was concluded if the 90 % confidence intervals (CI) of geometric least-squares means ratio of area under the curve (AUC) and maximum concentration (C max) were contained within the standard 80-125 % no-effect boundaries. The effect of mirabegron on warfarin International Normalized Ratio (INR) was also assessed. Mirabegron increased digoxin AUC and Cmax by 27 and 29 %, respectively, indicating that mirabegron is a weak inhibitor of P-glycoprotein (P-gp) in vivo. Co-administration of mirabegron did not affect the pharmacokinetics of metformin, warfarin, EE and LNG, or warfarin INR, except for a slight extension of the 90 % CI for the C max ratio for metformin (lower limit 79 %). Metformin decreased mirabegron AUC and C max by 21 %. Most treatment-emergent adverse events were mild, and all resolved by study end. No dose adjustment of either drug is required when mirabegron is administered concomitantly with metformin, warfarin or COC

  19. Metabolic profile of six oral contraceptives containing norgestimate, gestodene, and desogestrel.

    Science.gov (United States)

    Teichmann, A

    1995-01-01

    The alterations in lipid metabolism that occur with the use of oral contraceptives (OCs) have aroused considerable concern that OCs might increase the risk of premature atherosclerosis. However, most studies examining the role of OCs in atherogenesis were performed using earlier-generation preparations employing larger doses of sex hormones than present formulation. Therefore, we undertook a comparative and standardized determination of the effects on lipid metabolism of six modern, low-dose OCs. This open, randomized, comparative study included patients recruited at 21 study centers throughout Europe. Four hundred sixty-six women, aged 18-38 years, participated. They were randomly assigned to the following OC formulations:(1) norgestimate 250 micrograms + ethinyl estradiol (EE) 35 micrograms (Cilest); (2) norgestimate 180/215/250 micrograms + EE 35 micrograms (Tricilest); (3) desogestrel 150 micrograms + EE 20 micrograms = (Marvelon); (4) desogestrel 150 micrograms + EE 30 micrograms (Mercilon); (5) gestodene 75 micrograms + EE 30 micrograms (Femovan); and (6) gestodene 50/70/100 micrograms + EE 30/40/30 micrograms (Trifemovan). There were three parallel studies with six parallel patient groups. Fasting blood samples were drawn at baseline (between days 24 and 28) and on days 18-22 of cycle 6, and cycle 12. Sample were analyzed for total cholesterol,high-density lipoprotein (HDL) cholesterol, HDL2 cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, apolipoprotein (apo)A1, and apoB at one central laboratory. Two hundred eighty-two women completed all 12 cycles and were included in the final evaluation. As expected, triglyceride and total cholesterol concentrations increased in all study groups but to lesser levels with the formulations containing gestodene. All OCs, except the monophasic gestodene preparation, slightly but significantly increased HDL. The HDL2 subfraction did ot change significantly except in the group using the monophasic

  20. Effect of oral contraceptives and/or metformin on GLP-1 secretion and reactive hypoglycemia in PCOS

    DEFF Research Database (Denmark)

    Glintborg, Dorte; Mumm, Hanne; Holst, Jens Juul

    2017-01-01

    CONTEXT: Insulin resistance in polycystic ovary syndrome (PCOS) may increase the risk of reactive hypoglycaemia (RH) and decrease glucagon-like peptide-1 (GLP-1) secretion. The possible effects of treatment with oral contraceptives (OCP) and/or metformin on GLP-1 secretion and risk of RH in PCOS...... is undetermined. SETTING: Outpatient clinic. PATIENTS AND INTERVENTIONS: Randomized, controlled clinical trial. Ninety women with PCOS were randomized to 12 month treatment with OCP (150 mg desogestrel+30 microgram ethinylestradiol), metformin (2 g/day), or metformin +OCP. Five-hour oral glucose tolerance tests...... common after treatment with metformin +OCP (increase from 3/23 to 6/23, p=0.01). Reactive hypoglycemia was associated with higher insulin and C-peptide levels during 5h OGTT, but was unassociated with BMI and AUC GLP-1. GLP-1 levels were comparable in PCOS vs. CONTROLS: AUC GLP-1 levels were...

  1. Folates for reduction of risk of neural tube defects: using oral contraceptives as a source of folate

    Directory of Open Access Journals (Sweden)

    Nelson AL

    2011-11-01

    Full Text Available Anita L Nelson Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Harbor UCLA Medical Center, Torrance, CA, USA Abstract: The evidence that folates reduce the risk of neural tube defects (NTDs is so compelling that supplementation has been recommended by every relevant authority. The Cochrane Database of Systematic Reviews has determined that folate supplementation should be rated as a Grade 1 recommendation. United States Preventive Health Services Task Force, the US Food and Drug Administration (FDA, and the Centers for Disease Control and Prevention (CDC have all produced clear guidelines for such supplementation. Unfortunately, despite food fortification and targeted public health campaigns promoting folic acid supplementation, periconceptional utilization of folic acid supplements has decreased in the US in recent years. Worldwide, over 300,000 newborns are affected with NTDs every year. NTDs account for 10% of all neonatal mortality. This article will review the risk factors for NTDs and the evidence supporting folate supplementation. It will also describe the remaining problems and outline current ideas to solve them. Finally, new evidence of the effectiveness of adding metafolin to drospirenone-containing oral contraceptives in raising serum and red blood cell folate levels, the rationale for making such an addition, and an estimate of the magnitude of the contribution use of such pills might have on reducing NTDs will be discussed. Keywords: neural tube defects, folate, metafolin, oral contraceptives

  2. Oral Contraceptive Use and Prevalence of Self-Reported Glaucoma or Ocular Hypertension in the United States.

    Science.gov (United States)

    Wang, Ye Elaine; Kakigi, Caitlin; Barbosa, Diego; Porco, Travis; Chen, Rebecca; Wang, Sophia; Li, Yingjie; Singh, Kuldev; Pasquale, Louis R; Lin, Shan C

    2016-04-01

    To investigate the association between oral contraceptive (OC) use and glaucoma prevalence in the United States. Cross-sectional study. A total of 3406 female participants, aged 40 years or older, from the 2005 to 2008 National Health and Nutrition Examination Survey, who reported a presence or absence of glaucoma or ocular hypertension completed both the vision and the reproductive health questionnaires and underwent eye examinations. Multivariate regression analysis was used to assess the correlation between OC use and self-reported glaucoma or ocular hypertension (n = 231 cases), controlling for potential confounders, including age, ethnicity, systemic comorbidities such as hypertension and stroke, ocular diseases such as cataract and diabetic retinopathy, and reproductive health factors, including age at menopause, age at menarche, history of hormone replacement therapy, and gynecological surgical history. The outcome variable was self-reported glaucoma or ocular hypertension. After adjusting for confounders, those with ≥3 years of OC use had greater odds (odds ratio, 1.94; 95% confidence interval, 1.22-3.07) of self-reported glaucoma or ocular hypertension. Other factors associated with higher glaucoma or ocular hypertension prevalence included older age, African American race, and later age at menarche. Oral contraceptive use may be associated with increased risk of self-reported glaucoma or ocular hypertension. Copyright © 2016 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  3. New once-a-month injectable contraceptives, with particular reference to Cyclofem/Cyclo-Provera.

    Science.gov (United States)

    Hall, P E

    1998-08-01

    Once-a-month injectable contraceptives containing a progestogen and an estrogen have been developed that disrupt vaginal bleeding patterns less than the widely used progestogen-only preparations. Pharmacokinetic studies were undertaken of dosages and ratios of the progestogens and the respective estrogens. In Phase III clinical trials, annual pregnancy rates were below 0.4% for Mesigyna (norethisterone enanthate/estradiol valerate, Schering AG, Berlin, Germany) and below 0.2% for Cyclofem (MPA/E2C) (medroxyprogesterone acetate/estradiol cypionate, Aplicaciones Farmaceuticas, SA, Mexico and PT Tunggal, Indonesia). More than two-thirds of women had predictable, regular cycles, and discontinuation due to bleeding-related problems occurred less than half as often as with progestogen-only injectables. With MPA/E2C, return to fertility is similar to that observed with other hormonal or intrauterine methods, and both products have little effect on lipids or hemostasis. Introductory trials of MPA/E2C in 12000 women with 100000 woman-months of experience confirmed the high efficacy of the product in routine use. The use of MPA/E2C in a non-reusable injection device, Uniject (Becton Dickinson, Franklin Lakes, NJ) is discussed. Once-a-month hormonal contraceptives have been shown to provide a safe contraceptive option for all women and an alternative for women who wish to use injectable formulations that cause less disruption in vaginal bleeding and minimal side effects.

  4. Efficacy and safety of a 21/7-active combined oral contraceptive with continuous low-dose ethinyl estradiol.

    Science.gov (United States)

    Kroll, Robin; Ackerman, Ronald; Feldman, Robert; Howard, Brandon; Weiss, Herman; Hsieh, Jennifer; Ricciotti, Nancy

    2016-03-01

    Substituting low-dose ethinyl estradiol (EE) for the hormone-free interval in combined oral contraceptives (COCs) may enhance ovarian suppression and improve tolerability. This noncomparative phase 3 study evaluated the efficacy and safety of a 21/7-active COC regimen including 21days of desogestrel (DSG)/EE followed by 7days of EE. This multicenter, open-label, phase 3, single-arm study enrolled sexually active women aged 18-40years at risk for pregnancy. Women received up to 1year, or 13 consecutive 28-day cycles, of DSG 150mcg/EE 20mcg for 21days and EE 10mcg alone for 7days. Participants kept diaries to record compliance, bleeding/spotting and other contraceptive use. Efficacy was measured using the Pearl Index (PI) and life-table approach. Safety and tolerability were assessed primarily through reported adverse events (AEs). A total of 2858 women enrolled and 1680 completed the study. Forty-six pregnancies in 2401 women aged 18-35years occurred after COC initiation and up to 7days after last DSG/EE or EE-only tablet was taken. When cycles in which another contraceptive method was used were excluded, the PI was 2.68 [95% confidence interval (CI), 1.96-3.57]. The cumulative pregnancy rate after 1year of treatment was 2.47% (95% CI, 1.85-3.29) for all users aged 18-35years. When only cycles during which women considered compliant were included, the PI was 2.00 (95% CI, 1.39-2.80). AEs were similar to those seen with other oral contraceptives. This 21/7-active DSG/EE COC with 7days of low-dose EE was efficacious and well tolerated for pregnancy prevention. This phase 3 open-label study demonstrated that a 21/7-active COC regimen including 21days of DSG 150mcg/EE 20mcg and 7days of EE 10mcg was efficacious and well tolerated for pregnancy prevention. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Comparison of the single dose pharmacokinetics, pharmacodynamics, and safety of two novel oral formulations of dimethandrolone undecanoate (DMAU): a potential oral, male contraceptive.

    Science.gov (United States)

    Ayoub, R; Page, S T; Swerdloff, R S; Liu, P Y; Amory, J K; Leung, A; Hull, L; Blithe, D; Christy, A; Chao, J H; Bremner, W J; Wang, C

    2017-03-01

    Dimethandrolone (DMA, 7α,11β-dimethyl-19-nortestosterone) has both androgenic and progestational activities, ideal properties for a male hormonal contraceptive. In vivo, dimethandrolone undecanoate (DMAU) is hydrolyzed to DMA. We showed previously that single oral doses of DMAU powder in capsule taken with food are well tolerated and effective at suppressing both LH and testosterone (T), but absorption was low. We compared the pharmacokinetics and pharmacodynamics of two new formulations of DMAU, in castor oil and in self-emulsifying drug delivery systems (SEDDS), with the previously tested powder formulation. DMAU was dosed orally in healthy adult male volunteers at two academic medical centers. For each formulation tested in this double-blind, placebo-controlled study, 10 men received single, escalating, oral doses of DMAU (100, 200, and 400 mg) and two subjects received placebo. All doses were evaluated for both fasting and with a high fat meal. All three formulations were well tolerated without clinically significant changes in vital signs, blood counts, or serum chemistries. For all formulations, DMA and DMAU showed higher maximum (p food, but only the SEDDS formulation was effectively suppressed serum T when given fasting. We conclude that while all three formulations of oral DMAU are effective and well tolerated when administered with food, DMAU in oil and SEDDS increased conversion to DMA, and SEDDS may have some effectiveness when given fasting. These properties might be advantageous for the application of DMAU as a male contraceptive. © 2016 American Society of Andrology and European Academy of Andrology.

  6. Emergency contraception with a Copper IUD or oral levonorgestrel: an observational study of 1-year pregnancy rates

    Science.gov (United States)

    Turok, David K.; Jacobson, Janet C.; Dermish, Amna I.; Simonsen, Sara E.; Gurtcheff, Shawn; McFadden, Molly; Murphy, Patricia A.

    2014-01-01

    Objective We investigated the one-year pregnancy rates for emergency contraception (EC) users who selected the copper T380 IUD or oral levonorgestrel (LNG) for EC. Study Design This prospective study followed women for 1 year after choosing either the copper T380 IUD or oral LNG for EC. The study was powered to detect a 6% difference in pregnancy rates within the year after presenting for EC. Results Of the 542 women who presented for EC, agreed to participate in the trial, and meet inclusion criteria, 215 (40%) chose the copper IUD and 327 (60%) chose oral LNG. In the IUD group, 127 (59%) were nulligravid. IUD insertion failed in 42 women (19%). The 1-year follow-up rate was 443/542 (82%); 64% of IUD users contacted at 1 year still had their IUDs in place. The 1-year cumulative pregnancy rate in women choosing the IUD was 6.5% vs. 12.2% in those choosing oral LNG (HR= 0.53, 95% CI: 0.29–0.97, p=0.041). By type of EC method actually received, corresponding values were 5.2% for copper IUD users vs. 12.3% for oral LNG users, HR 0.42 (95% CI: 0.20–0.85, p= 0.017). A multivariable logistic regression model controlling for demographic variables demonstrates that women who chose the IUD for EC had fewer pregnancies in the following year than those who chose oral LNG (HR 0.50, 95% CI: 0.26–0.96, p=0.037). Conclusion One year after presenting for EC women choosing the copper IUD for EC were half as likely to have a pregnancy compared to those choosing oral LNG. PMID:24332433

  7. Oral contraception and menstrual bleeding during treatment of venous thromboembolism: Expert opinion versus current practice Combined results of a systematic review, expert panel opinion and an international survey

    NARCIS (Netherlands)

    Klok, F. A.; Schreiber, K.; Stach, K.; Ageno, W.; Middeldorp, S.; Eichinger, S.; Delluc, A.; Blondon, M.; Ay, C.

    2017-01-01

    Introduction: The optimal management of oral contraception and menstrual bleeding during treatment of venous thromboembolism (VTE) is largely unknown. We aimed to elicit expert opinion and compare that to current practice as assessed by a world-wide international web-based survey among physicians.

  8. Enhancement by factor V Leiden mutation of risk of deep-vein thrombosis associated with oral contraceptives containing a third-generation progestagen

    NARCIS (Netherlands)

    Bloemenkamp, K. W.; Rosendaal, F. R.; Helmerhorst, F. M.; Büller, H. R.; Vandenbroucke, J. P.

    1995-01-01

    Recent concern about the safety of combined oral contraceptives (OCs) with third-generation progestagens prompted an examination of data from a population-based case-control study (Leiden Thrombophilia Study). We compared the risk of deep-vein thrombosis (DVT) during use of the newest OCs,

  9. A pooled analysis of case-control studies of thyroid cancer - III. Oral contraceptives, menopausal replacement therapy and other female hormones

    NARCIS (Netherlands)

    La Vecchia, C; Ron, E; Franceschi, S; Dal Maso, L; Mark, SD; Chatenoud, L; Braga, C; Preston-Martin, S; McTiernan, A; Kolonel, L; Mabuchi, K; Jin, F; Wingren, G; Galanti, MR; Hallquist, A; Lund, E; Levi, F; Linos, D; Negri, E

    Objective: The relations between oral contraceptives (OC), hormone replacement therapy (HRT) for menopause, and other female hormone use and thyroid cancer risk was analyzed using the original data from 13 studies from North America, Asia and Europe. Methods: Based on 2,132 cases and 3,301 controls,

  10. Oral contraceptives and the absolute risk of venous thromboembolism in women with single or multiple thrombophilic defects - Results from a retrospective family cohort study

    NARCIS (Netherlands)

    van Vlijmen, Elizabeth F. W.; Brouwer, Jan-Leendert P.; Veeger, Nic J. G. M.; Eskes, Tom K. A. B.; de Graeff, Pieter A.; van der Meer, Jan

    2007-01-01

    Background: The risk of venous thromboembolism (VTE) in women taking combined oral contraceptives (COCs) is attributed to changes in coagulation and fibrinolysis. Their impact may be greater in women with preexistent thrombophilic defects. Methods: We assessed the effects of COCs on absolute VTE

  11. Uso de contraceptivos orais induzindo trombose mesentérica Use of oral contraceptives causing mesenteric thrombosis

    Directory of Open Access Journals (Sweden)

    Josiane L. Simão

    2008-02-01

    Full Text Available A trombose mesentérica é causa rara de dor abdominal em jovens, sendo responsável por cerca de 5% a 10% de todos os eventos de isquemia mesentérica. Contraceptivos hormonais orais têm sido associados a dezenas de casos de trombose mesentérica. Os autores relatam o caso de paciente com diagnóstico de trombose mesentérica após uso de contraceptivos e descrevem a relação entre ambos. M.R.F.S., sexo feminino, 19 anos, branca, deu entrada no Pronto Socorro do Hospital das Clínicas de Marília com quadro de dor abdominal há três dias associada ao uso de cinco comprimidos de anticoncepcional hormonal oral um dia antes de iniciar o quadro. Apresentava-se em regular estado geral, com abdome tenso, enrijecido, com ruídos hidroaéreos hipoativos, doloroso difusamente à palpação, sinal de Jobert e Blumberg positivos. A maioria das causas de trombose mesentérica são devidas a estados pró-trombóticos derivados de desordens da coagulação herdadas ou adquiridas. Portanto, uma vez confirmado este diagnóstico, os pacientes devem ser investigados para trombofilias hereditárias ou adquiridas com testes para deficiência de proteínas C e S, fator V de Leiden, hiperhomocisteinemia e hemoglobinúria paroxística noturna.Mesenteric thrombosis is a rare cause of abdominal pain in the young and is responsible for about 5-10% of all mesenteric ischemic events. Oral contraceptives are associated to many cases of mesenteric thrombosis. The case of a woman with mesenteric thrombosis after taking a high dose of contraceptives is reported. M.R.F.S., a 19-year-old caucasian woman, arrived in the Emergency Service of the Hospital das Clínicas in Marília reporting abdominal pain over 3 days associated with the use of 5 tablets of oral contraceptives one day earlier. An examination identified the abdominal wall was hardened and tense, with hypoactive bowel sounds, generalized pain on palpation , and Jobert and Blumberg signs. Most causes of mesenteric

  12. Sexual behavior of women taking low-dose oral contraceptive containing 15 microg ethinylestradiol/60 microg gestodene.

    Science.gov (United States)

    Caruso, Salvatore; Agnello, Carmela; Intelisano, Giorgia; Farina, Marco; Di Mari, Lucia; Cianci, Antonio

    2004-03-01

    The objective of this prospective study was to assess the effects of a low-dose oral contraceptive (OC) containing 15 microg ethinylestradiol and 60 microg gestodene on sexuality. Forty-eight healthy volunteers (age range, 18-35 years), having regular menstrual cycles with ovulation, participated in the study. Sexual behavior was assessed using the self-administered Personal Experience Questionnaire, at baseline, and at 3, 6 and 9 months of pill use. Women reported decreased sexual desire (p < 0.005) and sexual activity (p < 0.05) at the 9th month of pill use, and diminished sexual arousal at the 3rd month of pill intake (p < 0.05), with respect to baseline. The frequency of orgasm did not change during OC use (p = NS). Moreover, sexual enjoyment was worse at the 3rd, 6th and 9th month with respect to baseline (p < 0.001). The low dose of ethinylestradiol could cause decreased vaginal lubrication, and diminished sexual arousal could be due to hypoandrogenism. Women may expect increased sexual performance when they take the pill, as compared to before starting contraception. Consequently, they could have an unexpected effect with pill use, though sexuality may remain the same.

  13. The effect of ethinyl estradiol and drospirenone-containing oral contraceptives upon mucoprotein content of cervical mucus.

    Science.gov (United States)

    Aksoy, Murat; Guven, Suleyman; Tosun, Ilknur; Aydın, Faruk; Kart, Cavit

    2012-09-01

    To report the effect of oral contraceptives (OC) on cervical mucoprotein content by evaluating quantitatively mucoprotein 1 (MUC1), mucoprotein 2 (MUC2), mucoprotein 5AC (MUC5AC) and mucoprotein 5B (MUC5B) levels. This prospective controlled study included 20 women of reproductive age who had requested OC. Cervical mucus samples were obtained from the women before use of the OC and after 2 months of OC use. The mucus samples were then evaluated quantitatively for MUC1, MUC2, MUC5AC and MUC5B by ELISA by using specific antibodies. MUC5AC mucoprotein predominated quantitatively both before and after OC use. After OC use, compared to before OC use, variable increases in the levels of all studied mucoproteins were recorded, but the increases in MUC1, MUC2 and MUC5B were statistically significant. The difference in the level of MUC2 was remarkable (+54.36 ± 31.88 ng/mL). OC use may change the mucoprotein content (especially for MUC2) of cervical mucus and thus, may cause a highly viscous pattern of cervical mucus which may enhance the contraceptive efficacy of OC pills. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  14. Influence of gender, anxiety and depression symptoms, and use of oral contraceptive in color perception.

    Science.gov (United States)

    Silva, Maria Aparecida da; Anfe, Taciana Emília de Almeida; Matos, Adriana Bona; Vieira, Glauco Fioranelli

    2015-01-01

    The color is a psychophysical phenomenon, and much has been studied about its physical components. However, the psychological part is poorly investigated, except for the difference between genders in the literature shows that more men are color deficient than women. Dental students are trained to better understand the differences in color, so we became interested in studying whether psychological variables such as anxiety and depression and use of hormonal contraceptives may interfere with this ability. The aim of this in vitro study was to investigate if factors, such as, hormonal contraceptive use, depressive symptoms, anxiety and quality of life, influence on the ability of color discrimination of dental school students. Sixty-one subjects participated and the following instruments apply: (1) test that consists in the observation of a set of 25 labels (Pantones) with values of known colors, (2) scales of depression, anxiety, and quality of life assessments, and (3) Ishihara test. No difference was observed between genders as color perception (p = 0.868). Symptoms of anxiety and depression were significantly more frequent in the female population that showed worse quality of life (p color perception. Women using hormonal contraceptives had lower color perception than men (p = 0.04). No difference between the genders in the perception of colors was observed, contrary to common sense that women discriminate more colors than men, but women using hormonal contraceptives showed more difficulty in color perception. The ability to understand and distinguish color differences is extremely important in clinical dentistry. There could be differences in color perception between men and women that would influence clinical performance. © 2014 Wiley Periodicals, Inc.

  15. A single-arm study to evaluate the efficacy, safety and acceptability of pericoital oral contraception with levonorgestrel.

    Science.gov (United States)

    Taylor, Douglas J; Lendvay, Anja; Halpern, Vera; Bahamondes, Luis G; Fine, Paul M; Ginde, Savita Y; Wheeless, Angie; Raymond, Elizabeth G

    2014-03-01

    An oral dose of 0.75 mg levonorgestrel (LNG) taken shortly after sex was marketed as a routine, nonemergency contraceptive method until the 1990s. Because a hormonal method used only at the time of intercourse may be desirable for women who have infrequent sex, we conducted a study to reevaluate the potential of pericoital LNG as a primary means of contraception. We enrolled women aged 18-45 years in Brazil and the USA who expected to have sex 1-4 days per month for 6.5 months. Participants were instructed to take one tablet 0.75 mg LNG within 24 h before or after sex, with no more than one dose in any 24-h period. The primary efficacy measure was the Pearl Index among women aged 18-35 years. The study was stopped after 72 of the planned 300 participants were enrolled due to slow recruitment and related feasibility considerations. In the primary analysis, three pregnancies occurred during 13.4 woman-years of follow-up, resulting in a Pearl Index of 22.4 (95% confidence interval, 4.6-65.4). No serious adverse events were reported, and vaginal bleeding patterns were generally acceptable. Our estimated Pearl Index was noticeably higher than expected from previous research of LNG for pericoital contraception. Although the regimen was safe and generally acceptable, the study was challenged by slow enrollment and curtailed person-years of follow-up, resulting in poor precision for the estimated treatment effect. Future research may inform whether our results are symptomatic of the regimen, study design or characteristics of the populations from which we recruited. Our study failed to confirm prior data suggesting that 0.75 mg LNG for pericoital contraception could be more effective than typical use of barrier methods among women having infrequent sex. Characterizing populations most likely to adhere to, and benefit from, pericoital regimens is essential to future research on these methods. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. The Coraliance study: non-compliant behavior. Results after a 6-month follow-up of patients on oral contraceptives.

    Science.gov (United States)

    Aubeny, E; Buhler, M; Colau, J C; Vicaut, E; Zadikian, M; Childs, M

    2004-12-01

    This follow-up study was planned to establish the frequency with which women miss their contraceptive pill, and to observe their behavior when they forget it. In those women who changed from a continuous cycle to an interrupted type of cycle, or vice versa, the study also aimed to evaluate the impact of this change on the pattern of omission of pills. The longitudinal, prospective cohort study included healthy women of child-bearing age for whom a change of pill was being prescribed by their gynecologist. Data were recorded during the 6 months preceding inclusion in the study, and for the 6 months of follow-up; the women were asked to complete a diary in which they recorded the number and exact times of pill omission, and their behavior at each omission. A total of 617 gynecologists included 3316 women into the study; of these, a group of 2418 (73%) revisited the same gynecologist at follow-up. The groups who either visited the same or a different gynecologist were similar with respect to age, oral contraception type, omission type and frequency. A large non-compliance rate and women's difficulties in maintaining safe contraception after missing a pill were observed in the group with follow-up. Women were never risk-free when they missed a pill; they turned to numerous sources for discordant or conflicting information; 15% of 'not-forgetting' women at the pre-inclusion cycle recorded at least one omission at the last cycle of the 6-month follow-up period. Omission fluctuations during the observational period make it difficult to designate 'forgetful' or 'non-forgetful' classes of women. Administration of the pill in a continuous cycle, and probably 'study' and 'auto-questionnaire' effects, contributed to an improvement in compliance. In the group taking the continuous cycle pill, the omission number slightly decreased, particularly on the first day and week of the cycle, irrespective of the initial cycle type. The importance of the phenomenon of non-compliance rate

  17. Oral contraceptives, pregnancy and the risk of cerebral thromboembolism: the influence of diabetes, hypertension, migraine and previous thrombotic disease

    DEFF Research Database (Denmark)

    Lidegaard, O

    1995-01-01

    -matched, randomly selected controls. RESPONSE: Of the 692 case and 1584 control questionnaires sent out, 590 (85.1%) and 1396 (88.1%), respectively, were returned. Of the 590 cases, nine had had cerebral thrombosis before 1980, 15 refused to participate, 44 had a revised diagnosis (primarily multiple sclerosis......) and 25 had an unreliable diagnosis, leaving 497 with a reliable cerebral thromboembolic diagnosis. Among the 1396 controls, 26 either refused to participate, were mentally handicapped, lived abroad or returned an uncompleted questionnaire, leaving 1370 controls included in the study. RESULTS: After...... thromboembolism whereas diabetes, hypertension, migraine and past thromboembolic events increased the risk of cerebral thromboembolism significantly. Women with these increased thrombotic risks should use oestrogen-containing oral contraceptives only after careful considerations of the risks, if at all....

  18. Risk of venous thromboembolism in women taking the combined oral contraceptive: A systematic review and meta-analysis.

    Science.gov (United States)

    Bateson, Deborah; Butcher, Belinda E; Donovan, Catherine; Farrell, Louise; Kovacs, Gab; Mezzini, Tonia; Raynes-Greenow, Camille; Pecoraro, Gino; Read, Christine; Baber, Rod

    2016-01-01

    Much scientific, media and patient interest surrounds the risk of venous thromboembolism (VTE) in women taking combined oral contraceptives (COCs). We conducted a systematic review and meta-analysis to assess VTE risk in women taking COCs, focusing on drospirenone. Literature searches of clinical studies on COCs in which VTE was reported were undertaken in May 2015. No overall estimate of VTE risk between drospirenone-containing COCs and other COCs was produced because of heterogeneity of the study designs. The final review and meta-analysis included 15 studies. No increased risk of VTE with drospirenone was seen in prospective or case control studies, but the risk of VTE was increased in retrospective cohort and nested case control studies. The difference in risk of VTE based on the choice of progestin in COCs is, at worst, very small in absolute terms and should not be the sole factor considered when choosing the 'right' COC for each woman.

  19. Overdose of oral contraceptive pills as a means of intentional self-poisoning amongst young women in Sri Lanka

    DEFF Research Database (Denmark)

    Weerasinghe, Manjula; Konradsen, Flemming; Eddleston, Michael

    2017-01-01

    OBJECTIVE: Oral contraceptive pills (OCPs) are one of the most popular family planning methods in Sri Lanka. As part of two hospital-based studies on self-harm, the use of OCPs was identified, from yet unpublished results, as a means of intentional self-poisoning. To inform future guidelines...... for better OCP promotion, this article aims to describe the extent, patient characteristics and outcomes of OCP self-poisoning in the North Central Province of Sri Lanka. METHODS: A secondary analysis was carried out on two hospital-based self-harm case series, from January 2011 to June 2014. RESULTS: Fifty...... year of marriage. CONCLUSIONS: More research is required to understand why young women in rural Sri Lanka overdose with OCPs as a means of intentional self-poisoning. Although the toxicity of OCPs is low and the public health significance of OCP poisoning remains minor, reproductive health service...

  20. Effect of eslicarbazepine acetate on the pharmacokinetics of a combined ethinylestradiol/levonorgestrel oral contraceptive in healthy women.

    Science.gov (United States)

    Falcão, Amilcar; Vaz-da-Silva, Manuel; Gama, Helena; Nunes, Teresa; Almeida, Luís; Soares-da-Silva, Patrício

    2013-08-01

    To investigate the effect of once-daily (QD) eslicarbazepine acetate (ESL) 800 mg and 1,200 mg administration on pharmacokinetics of a combined ethinylestradiol/levonorgestrel oral contraceptive (OC) in women of childbearing potential. Two two-way, crossover, two-period, randomized, open-label studies were performed in 20 healthy female subjects, each. In one period (ESL+OC period), subjects received ESL 800 mg QD in one study and ESL 1200 mg QD in the other study, for 15 days; concomitantly with the Day 14 ESL dose, an oral single dose of 30 μg ethinylestradiol and 150 μg levonorgestrel was administered. In the other period (OC alone), a single dose of 30 μg ethinylestradiol and 150 μg levonorgestrel was administered. Three weeks or more separated the periods. An analysis of variance (ANOVA) was used to test for differences between pharmacokinetic parameters of 30 μg ethinylestradiol and 150 μg levonorgestrel following ESL+OC and OC alone, and 90% confidence intervals (90%CI) for the ESL+OC/OC alone geometric mean ratio (GMR) were calculated. ESL significantly decreased the systemic exposure to both ethinylestradiol and levonorgestrel. GMR (90%CI) for AUC0-24 of ethinylestradiol were 68% (64%; 71%) following 1,200 mg ESL and 75% (71%; 79%) following 800 mg ESL. GMR (90%CI) for AUC0-24 of levonorgestrel were 76% (68%; 86%) following 1,200 mg ESL and 89% (82%; 97%) following 800 mg ESL. A clinically relevant dose-dependent effect of ESL administration on the pharmacokinetics of ethinylestradiol and levonorgestrel was observed. Therefore, to avoid inadvertent pregnancy, women of childbearing potential should use other adequate methods of contraception during treatment with ESL, and, in case ESL treatment is discontinued, until CYP3A4 activity returns to normal. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. The Risk of Venous Thromboembolism with Different Generation of Oral Contraceptives; a Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Alireza Baratloo

    2014-03-01

    Full Text Available Introduction: Oral contraceptives (OCs are considered as one of the most common risk factor of venous thromboembolism (VTE in child bearing age. Some of the recent researches indicate that the odds of VTE may be even higher with newer generations of OCs. The present meta-analysis was designed to evaluate the effect of different generation of OCs on the occurrence of VTE. Methods: Two researchers independently ran a thorough search in Pubmed, ISI Web of Science, EMBASE, CINAHL and Scopus databases regarding study keywords including thromboembolic event, thromboembolism, embolism, thromboembolic, thrombotic and thrombosis, combined with oral contraceptive. The outcomes were the incidence of diagnosed thromboembolism, such as deep vein thrombosis, pulmonary embolism and cerebral venous thrombosis. Based on the heterogeneity of the studies, random effect model was used and pooled odds ratio was reported. Results: Three cohort and 17 case-control studies with 13,265,228 subjects were entered into meta-analysis. Analysis showed that the odds of VTE in women taking OCs are more than three-fold (OR=3.13; 95% CI: 2.61-3.65. The risk of VTE in women taking first-, second- and third-generation OCs are 3.5 fold (OR=3.48; 95% CI: 2.01-4.94, 3 fold (OR=3.08; 95% CI: 2.43-3.74 and 4.3 fold (OR=4.35; CI: 3.69‒5.01, respectively. Conclusion: It seems that the risk of VTE is not same between different generations of OCs, so that third-generation has highest risk. Taking second and third-generation OCs increases the risk of VTE up to 3 and 4.3 fold, respectively. The researchers of the present study suggest that more clinical trials be designed in relation to the effect of newer generations of OCs in different communities. 

  2. Effect of two oral contraceptives containing ethinyl estradiol and gestodene or norgestimate on different lipid and lipoprotein parameters.

    Science.gov (United States)

    Wiegratz, I; Jung-Hoffmann, C; Gross, W; Kuhl, H

    1998-08-01

    The effect of a triphasic oral contraceptive containing ethinyl estradiol and gestodene (EE/GSD) on various lipid and lipoprotein parameters was compared with that of a monophasic formulation containing 35 micrograms ethinyl estradiol and 250 micrograms norgestimate (EE/NGM). Blood samples were collected from 46 women on days 2, 11, and 21 of the preceding control cycle and of the third, sixth, and twelfth treatment cycles. There was no significant difference between formulations with regard to the influence on any measured parameter. As compared with controls, a significant increase was observed in the plasma levels of total triglycerides (24-78%), total phospholipids (7-20%), very low density lipoprotein (VLDL) triglycerides (61-76%), VLDL-phospholipids (14-60%), low density lipoprotein (LDL) triglycerides (8-35%), LDL-phospholipids (28-30%), high density lipoprotein (HDL) cholesterol (8-16%), HDL 3-cholesterol (11-20%), HDL-triglycerides (17-66%), HDL-phospholipids, HDL 3-phospholipids (7-11%), apolipoprotein (apo) A-I (5-20%) and apo A-II (10-40%) during treatment with both formulations. In contrast, the LDL-cholesterol levels were significantly decreased. These changes in lipid metabolism appear to reflect a predominance of the effect of the estrogen component. The results indicate that both low dose oral contraceptives containing different progestins and different amounts of EE do not exert a deleterious effect on lipoprotein metabolism, as high HDL-cholesterol and low LDL-cholesterol levels are known as low risk factors of cardiovascular disease. In contrast to endogenous hypertriglyceridemia, an EE-induced rise in triglyceride levels does not appear to increase cardiovascular risk if LDL is not increased.

  3. The influence of lifestyle, menstrual function and oral contraceptive use on bone mass and size in female military cadets

    Directory of Open Access Journals (Sweden)

    Tendy Susan

    2007-08-01

    Full Text Available Abstract Purpose To determine the influence of menstrual irregularity, oral contraceptive use and other factors on bone mineral density (BMD and bone size at different skeletal sites in 135 college-aged fit women. Methods Menstrual history, oral contraceptive use, exercise history, and nutritional factors including calcium, caffeine, and alcohol intake as well as tobacco use were determined by written survey. Height, weight and fitness levels were measured. Spine and hip BMD were measured by dual x-ray absorptiometry (DXA, calcaneus BMD by peripheral DXA, and tibial bone mineral content (BMC and size by peripheral Quantitative Computed Tomography (pQCT. Results The mean age was 18.4 ± 0.8 years. Weight and prior exercise were positively related to BMD at most skeletal sites and to tibial bone size. Milk intake was positively related to calcaneal BMD, tibial BMC and cortical thickness. Fracture history was an important predictor of spine, hip and heel BMD. Women who had ≥ 10 menstrual cycles in the year prior to BMD measurement had higher BMD at all sites as well as a greater tibial mineral content and cortical thickness than women who had oligomenorrhea/amenorrhea (≤ 9 cycles in the prior year; all p p p = 0.04, smaller tibial periosteal circumference and lower tibial mineral content (p Conclusion In a population of fit, college-aged women, OC use and oligomenorrhea were associated with reduced BMD and bone size. Weight, as well as prior exercise and milk intake was positively related to bone density and size at some skeletal sites. Understanding these relationships would help improve skeletal health in young women.

  4. Lack of a clinically important pharmacokinetic interaction between sofosbuvir or ledipasvir and hormonal oral contraceptives norgestimate/ethinyl estradiol in HCV-uninfected female subjects.

    Science.gov (United States)

    German, P; Moorehead, L; Pang, Phillip; Vimal, M; Mathias, A

    2014-11-01

    This study evaluated the potential for a drug-drug interaction between HCV direct-acting antivirals sofosbuvir or ledipasvir and oral hormonal contraceptive (OC) norgestimate/ethinyl estradiol (norgestimate 0.18/0.215/0.25 mg with ethinyl estradiol 25 μg). This was a 112-day, open-label, fixed-sequence pharmacokinetic (PK) study in healthy female subjects that included a lead-in cycle (OC only; N = 21), cycle 1 (OC only; N = 15), cycle 2 (OC + sofosbuvir; N = 15), and cycle 3 (OC + ledipasvir; N = 15). Administration of sofosbuvir with OC did not alter PK of norelgestromin (primary norgestimate metabolite) or ethinyl estradiol. Small increases in norgestrel (secondary norgestimate metabolite) AUC(tau) (19%) and C(tau) (23%) with sofosbuvir were noted. Ledipasvir did not impact PK of norelgestromin or norgestrel but modestly increased ethinyl estradiol C(max) (40%). Sofosbuvir, GS- 331007 (predominant circulating metabolite of SOF), and ledipasvir PK were similar to historical data. Pharmacodynamic markers luteinizing hormone, follicle-stimulating hormone, and progesterone values were generally comparable in all cycles. No loss in contraceptive efficacy is expected upon administration of sofosbuvir or ledipasvir/sofosbuvir with oral contraceptives containing norgestimate and ethinyl estradiol. The use of sofosbuvir or ledipasvir/sofosbuvir FDC with oral contraceptives is permitted. © 2014, The American College of Clinical Pharmacology.

  5. Hormonal contraceptives and venous thrombosis

    NARCIS (Netherlands)

    Stegeman, Berendina Hendrika (Bernardine)

    2013-01-01

    Oral contraceptive use is associated with venous thrombosis. However, the mechanism behind this remains unclear. The aim of this thesis was to evaluate genetic variation in the first-pass metabolism of contraceptives, to identify the clinical implications of hormonal contraceptive use after a

  6. New hormonal methods of contraception.

    Science.gov (United States)

    Newton, J R

    1996-04-01

    Three types of new contraceptive delivery system have been discussed in this chapter. Each have novel methods of delivery and may be acceptable to certain groups of women. It is clear that subdermal contraceptive implants are extremely useful as a long-term method of contraception, and provided insertion occurs correctly, removal will then be easy. The second-generation implants using a single rod, compared with the first-generation ones using six capsules, would appear to offer advantages both to the patient and in relation to the training of medical and paramedical personnel who have to fit the subdermal implant. The main disadvantage is the incidence of irregular bleeding, which, by and large, can be overcome by pre-insertion counselling and by time. The second method of delivery, vaginal rings, offers high patient acceptability, but a usable ring for contraception has as yet to be developed. Two approaches appear to be the use of a continuous progestogen-only ring, or a combined ring releasing oestrogen and progestogen with a 21-day-in, 7-day-out cycle of use. Ongoing studies will indicate whether vaginal lesions are significant or related to the flexibility of the ring. If these studies prove satisfactory, further development of the vaginal rings, both as an alternative method for interval use or as a specific postpartum form of contraception using progesterone-releasing rings, will be developed. Significant developments in the use of a combined monthly injectable have led to the release of two preparations, Cyclofem and Mesigyna, which are now available in many countries. This combined approach offers a significant reduction in amenorrhoea rates and unacceptable bleeding, the majority of women having acceptable menstrual patterns even during the first 3 months of use. All three methods have low and acceptable rates of pregnancy, the lowest being seen with the subdermal implants and with combined monthly injectables. Due to the length of action of subdermal

  7. Gestodene and desogestrel do not have a different influence on concentration profiles of ethinylestradiol in women taking oral contraceptives--results of isotope dilution mass spectrometry measurements.

    Science.gov (United States)

    Siekmann, L; Siekmann, A; Bidlingmaier, F; Brill, K; Albring, M

    1998-08-01

    A new method for the quantitative determination of 17alpha-ethinylestradiol-17beta (EE2) in serum is presented here based on the principle of isotope dilution mass spectrometry (IDMS) with [13C]EE2 as internal standard. The technique was used to determine the concentration profiles of EE2 in the serum of female subjects who had taken oral contraceptives with different progestin components. The method has proved to be very reliable with respect to trueness, specificity, precision and detection sensitivity and offers considerable advantages compared with the immunological methods of measurement used to date. Forty-seven female volunteers took two different oral contraceptives containing EE2 combined with different progestins in accordance with a cross-over design. After the administration of 30 microg EE2 combined with 75 microg gestodene (EE2/GSD) or 150 microg desogestrel (EE2/DES), blood samples were taken from the subjects on certain days and in certain previously specified cycles in the course of 12 h after medication. The biometric analysis of the results showed that the concentration profiles of EE2 were in their statistics, significantly equivalent after the administration of either of the two oral contraceptives. The sometimes contradictory results found in former studies after the administration of the different contraceptives were presumably due to the methodological shortcomings of the radioimmunological measurement technique. With the use of the highly accurate and specific technique of IDMS it can now be unequivocally established that the different progestins in the tested oral contraceptives have no influence on the bioavailability of EE2 (area under EE2 serum concentration curves, as usually defined in pharmacokinetics).

  8. Contraceptive Sponge

    Science.gov (United States)

    Contraceptive sponge Overview By Mayo Clinic Staff The contraceptive sponge is a type of birth control (contraceptive) that prevents ... shaped, and made of polyurethane foam. The contraceptive sponge contains spermicide, which blocks or kills sperm. Before ...

  9. Medical eligibility, contraceptive choice, and intrauterine device acceptance among HIV-infected women receiving antiretroviral therapy in Lilongwe, Malawi.

    Science.gov (United States)

    Haddad, Lisa B; Feldacker, Caryl; Jamieson, Denise J; Tweya, Hannock; Cwiak, Carrie; Bryant, Amy G; Hosseinipour, Mina C; Chaweza, Thomas; Mlundira, Linly; Kachale, Fanny; Stuart, Gretchen S; Hoffman, Irving; Phiri, Sam

    2014-09-01

    To determine medical eligibility for contraceptive use, contraceptive preference, and acceptance of a copper intrauterine device (IUD) among a cohort of HIV-infected women receiving antiretroviral therapy (ART). All HIV-infected women who received ART and sought contraceptive services at the Lighthouse clinic, an integrated HIV/ART clinic in Lilongwe, Malawi, between August and December 2010 were invited to participate in a structured interview. Eligibility and preference for the following contraceptive methods were assessed: combined hormonal contraceptives, progestogen-only pills, copper IUD, injectable depot medroxyprogesterone acetate (DMPA), and contraceptive implants. The final sample included 281 women; five were pregnant. The remaining 276 women were eligible for at least three contraceptive methods, with 242 (87.7%) eligible for all five methods evaluated. After counseling, 163 (58.0%) selected DMPA and 98 (34.9%) selected an IUD as their preferred contraceptive method. Regardless of their method of choice, 222 (79.0%) women agreed to have an IUD placed on the same day. Most methods of contraception are safe for use by HIV-infected women. Approximately 80% of the women were willing to receive an IUD. Efforts must be made to increase education about, and access to, long-acting reversible methods that may be acceptable and appropriate contraceptive options for HIV-infected women. Copyright © 2014 International Federation of Gynecology and Obstetrics. All rights reserved.

  10. Emergency contraception with a copper IUD or oral levonorgestrel: an observational study of 1-year pregnancy rates.

    Science.gov (United States)

    Turok, David K; Jacobson, Janet C; Dermish, Amna I; Simonsen, Sara E; Gurtcheff, Shawn; McFadden, Molly; Murphy, Patricia A

    2014-03-01

    We investigated the 1-year pregnancy rates for emergency contraception (EC) users who selected the copper T380 intrauterine device (IUD) or oral levonorgestrel (LNG) for EC. This prospective study followed women for 1 year after choosing either the copper T380 IUD or oral LNG for EC. The study was powered to detect a 6% difference in pregnancy rates within the year after presenting for EC. Of the 542 women who presented for EC, agreed to participate in the trial and met the inclusion criteria, 215 (40%) chose the copper IUD and 327 (60%) chose oral LNG. In the IUD group, 127 (59%) were nulligravid. IUD insertion failed in 42 women (19%). The 1-year follow-up rate was 443/542 (82%); 64% of IUD users contacted at 1 year still had their IUDs in place. The 1-year cumulative pregnancy rate in women choosing the IUD was 6.5% vs. 12.2% in those choosing oral LNG [hazard ratio (HR) 0.53, 95% confidence interval (CI): 0.29-0.97, p=.041]. By type of EC method actually received, corresponding values were 5.2% for copper IUD users vs. 12.3% for oral LNG users (HR 0.42, 95% CI: 0.20-0.85, p=.017). A multivariable logistic regression model controlling for demographic variables demonstrates that women who chose the IUD for EC had fewer pregnancies in the following year than those who chose oral LNG (HR 0.50, 95% CI: 0.26-0.96, p=.037). One year after presenting for EC, women choosing the copper IUD for EC were half as likely to have a pregnancy compared to those choosing oral LNG. Compared to EC users who choose oral levonorgestrel, those who select the copper IUD have lower rates of pregnancy in the next year. Greater use of the copper IUD for EC may lower rates of unintended pregnancy in high-risk women. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. [Electronmicroscopical aspects of endometrial distrophy induced by oral contraceptives (author's transl)].

    Science.gov (United States)

    Gonzalez-Gómez, F; Merchan, J; Caballero-Peregrin, P; Aldama Magnet, J

    1975-01-01

    An electron-optical study on the endometrium of 5 controls and 25 patients subjected during 3-12 months to 0.25 mg norgestrel + 0.05 mg etinil-estradiol association treatment is performed. The most prominent electronmicroscopical features of endometrial changes are described, such as the asynchronical maturation of the epithelium and the stroma, the shorthening of the proliferative and secretory phases and the epithelial involution towards the last days of the cycle. Special emphasis is placed on the zonal distribution of these changes. An increase of the nostocitosis phenomena is reported and its significance as a complementary contraceptive mechanism is discussed.

  12. Use of Oral Contraceptives, Intrauterine Devices and Tubal Sterilization and Cancer Risk in a Large Prospective Study, from 1996 to 2006

    Science.gov (United States)

    DORJGOCHOO, Tsogzolmaa; SHU, Xiao-Ou; LI, Hong-Lan; QIAN, Han-Zhu; YANG, Gong; CAI, Hui; GAO, Yu-Tang; ZHENG, Wei

    2009-01-01

    The association of contraceptive methods, including oral contraceptives (OC), intrauterine devices (IUD) and tubal sterilization (TS), with overall and site-specific cancer were prospectively investigated in a cohort of 66,661 Chinese women in Shanghai; 76.7% of whom used contraception. During a median follow up time of 7.5 years, 2,250 women were diagnosed with cancer. Ever-use of any contraceptive method was not associated with overall cancer risk [adjusted hazard ratio (HRadj)=1.02, 95% CI 0.92–1.12]. Use of any contraceptive method was associated with increased risk of rectal cancer (HRadj=1.68, 95% CI 1.08–2.62) and reduced risk of thyroid cancer (HRadj=0.63, 95% CI 0.38–1.04). Risk of gallbladder cancer increased with ever use of OC (HRadj=2.38, 95% CI 1.26–4.49). IUD use was associated with a possible reduced risk of thyroid cancer (HRadj=0.64, 95% CI 0.38–1.07). Longer duration of IUD use decreased risk for breast, thyroid, and lung cancers. Ever having a TS was associated with increased uterine body cancer (HRadj=2.50, 95% CI 1.47–4.25) and decreased risk of stomach cancer (HRadj =0.59, 95% CI 0.39–0.91). We did not find any contraceptive method to be related to the risk of ovarian cancer but the analyses were based on few events. Although chance findings are a likely explanation for some of the associations found in our study, these findings may suggest that various contraceptive methods or reproductive patterns may play a role in the etiology of cancer. PMID:19170208

  13. Androgen Restored Contraception

    NARCIS (Netherlands)

    Zimmerman, X.Y.

    2014-01-01

    Combined oral contraceptives (COCs) reduce androgen levels, especially testosterone (T), by inhibiting ovarian and adrenal androgen synthesis and by increasing levels of sex hormone-binding globulin (SHBG). Possible consequences of this androgen loss are diminished sexual function and mood

  14. Metabolic effects of low-dose fluconazole in healthy female users and non-users of oral contraceptives.

    Science.gov (United States)

    Devenport, M H; Crook, D; Wynn, V; Lees, L J

    1989-06-01

    1. Azole antifungal agents such as ketoconazole act by inhibiting cytochrome P-450 mediated sterol synthesis in the fungal cell membrane and thus have the potential to interfere with mammalian steroidogenesis. Fluconazole is a novel orally-effective antifungal triazole which has been reported to have more specific effects on the cytochrome P-450 enzymes involved in fungal sterol synthesis. 2. Due to the potential value of systemic antifungal agents in the treatment of infections commonly occurring in women, we assessed the effect of oral fluconazole on the metabolic profile of 18 healthy premenopausal women, 10 of whom were taking combined oral contraceptives (OC). Each woman acted as her own control, being studied both before and 21-28 days after fluconazole therapy (50 mg daily), in the luteal phase of consecutive menstrual cycles. 3. The endocrinological profile included measurement of serum oestradiol, progesterone, testosterone and sex hormone binding globulin (SHBG) concentrations, short tetracosactrin adrenal stimulation test and thyroid function tests. Carbohydrate metabolism was investigated by means of an oral glucose tolerance test with measurement of plasma glucose, insulin and C-peptide concentrations. Serum lipids, lipoproteins and apolipoproteins were analysed on samples taken after an overnight fast. 4. Minor biochemical changes associated with fluconazole treatment included increases in serum thyroxine and testosterone concentrations (but not in women taking OC as well as fluconazole) and in insulin and apolipoprotein B levels (but only in women taking OC as well as fluconazole). In general, these changes were small and of no clinical significance with the values remaining within the laboratory normal range. There were no adverse side-effects.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Preference for and efficacy of oral levonorgestrel for emergency contraception with concomitant placement of a levonorgestrel IUD: a prospective cohort study.

    Science.gov (United States)

    Turok, David K; Sanders, Jessica N; Thompson, Ivana S; Royer, Pamela A; Eggebroten, Jennifer; Gawron, Lori M

    2016-06-01

    We assessed intrauterine device (IUD) preference among women presenting for emergency contraception (EC) and the probability of pregnancy among concurrent oral levonorgestrel (LNG) plus LNG 52 mg IUD EC users. We offered women presenting for EC at a single family planning clinic the CuT380A IUD (copper IUD) or oral LNG 1.5 mg plus the LNG 52 mg IUD. Two weeks after IUD insertion, participants reported the results of a self-administered home urine pregnancy test. The primary outcome, EC failure, was defined as pregnancies resulting from intercourse occurring within five days prior to IUD insertion. One hundred eighty-eight women enrolled and provided information regarding their current menstrual cycle and recent unprotected intercourse. Sixty-seven (36%) chose the copper IUD and 121 (64%) chose oral LNG plus the LNG IUD. The probability of pregnancy two weeks after oral LNG plus LNG IUD EC use was 0.9% (95% CI 0.0-5.1%). The only positive pregnancy test after treatment occurred in a woman who received oral LNG plus the LNG IUD and who had reported multiple episodes of unprotected intercourse including an episode more than 5 days prior to treatment. Study participants seeking EC who desired an IUD preferentially chose oral LNG 1.5 mg with the LNG 52 mg IUD over the copper IUD. Neither group had EC treatment failures. Including the option of oral LNG 1.5 mg with concomitant insertion of the LNG 52 mg IUD in EC counseling may increase the number of EC users who opt to initiate highly effective reversible contraception. Consideration should be given to LNG IUD insertion with concomitant use of oral LNG 1.5 mg for EC. Use of this combination may increase the number of women initiating highly effective contraception at the time of their EC visit. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Safety evaluation of long term oral treatment of methanol sub-fraction of the seeds of Carica papaya as a male contraceptive in albino rats.

    Science.gov (United States)

    Goyal, S; Manivannan, B; Ansari, A S; Jain, S C; Lohiya, N K

    2010-02-03

    The manuscript is one of the series of attempts in authenticating scientific documentation of the seeds of Carica papaya being traditionally used for contraception. To establish safety of the methanol sub-fraction (MSF) of the seeds of Carica papaya as a male contraceptive following long term oral treatment. MSF was administered orally to albino rats at multiples of contraceptive dose (CD) at 50 (1x), 100 (2x), 250 (5x) and 500 (10x)mg/kg body weight daily for 52 weeks. Body weight, organs weight, morbidity, mortality, clinical chemistry, sperm analysis, histopathology and serum testosterone were evaluated to assess the safety and contraceptive efficacy. MSF treatment at various dose regimens, daily for 52 weeks did not show significant changes in body weight, organs weight, food and water intake and pre-terminal deaths compared to those of control animals. Sperm count and viability in 50mg/kg body weight treated animals and the weight of epididymis, seminal vesicle and prostate of all the treated animals showed significant reduction compared to control. Cauda epididymal spermatozoa of 50mg/kg body weight treated animals were immotile. Azoospermia was observed in 100, 250 and 500 mg/kg body weight treated animals. Serum clinical parameters, serum testosterone and histopathology of vital organs were comparable to those of control animals. Histology of testis revealed adverse effects on the process of spermatogenesis, while the histology of epididymis, seminal vesicles and ventral prostate showed no changes compared to control. The long term daily oral administration of MSF affects sperm parameters without adverse side effects and is clinically safe as a male contraceptive. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  17. The possible role of enterohepatic cycling on bioavailability of norethisterone and gestodene in women using combined oral contraceptives.

    Science.gov (United States)

    Elomaa, K; Ranta, S; Tuominen, J; Lähteenmäki, P

    2001-01-01

    Using steady-state conditions we aimed to test if administration of oral activated charcoal affects the bioavailability of norethisterone acetate (NET Ac) and gestodene (GEST) by inhibiting their enterohepatic recirculation. Thirteen volunteers received, in a randomized order, Minulet (75 microg GEST and 30 microg ethinylestradiol [EE(2)]) and Econ/30 (1 mg NET Ac and 30 microg EE(2)), each for 4 months. Serum GEST and norethisterone (NET) levels were evaluated with respect to C(max,) t(max) and 24-h area under the curve (AUC(0-24h)) in the middle of the control (3rd) cycle and the charcoal treatment (4th) cycle during both pill treatments. No statistically significant difference was seen in any of the aforementioned variables between the control and charcoal treatment cycles of either pill. Neither was a difference seen in the bioavailability of GEST and NET as evaluated by the ratios of two 24-h AUCs calculated in the control and charcoal cycles of each pill treatment (p = 0.29). The results suggest that enterohepatic circulation of GEST and NET is not of clinical importance. We conclude that women on oral contraceptives can take activated charcoal for the treatment of diarrhea when administered 3 h after and at least 12 h before pill intake.

  18. Contraception during perimenopause.

    Science.gov (United States)

    Kailas, N A; Sifakis, S; Koumantakis, E

    2005-03-01

    Perimenopause marks the transition from normal ovulation to anovulation and ultimately to permanent loss of ovarian function. Fecundity, the average monthly probability of conception, declines by half as early as the mid-forties, however women during the perimenopause still need effective contraception. Issues arising at this period such as menstrual cycle abnormalities, vasomotor instability, the need for osteoporosis and cardiovascular disease prevention, as well as the increased risk of gynecological cancer, should be taken into consideration before the initiation of a specific method of contraception. Various contraceptive options may be offered to perimenopausal women, including oral contraceptives, tubal ligation, intrauterine devices, barrier methods, hormonal injectables and implants. Recently, new methods of contraception have been introduced presenting high efficacy rates and minor side-effects, such as the monthly injectable system, the contraceptive vaginal ring and the transdermal contraceptive system. However, these new methods have to be further tested in perimenopausal women, and more definite data are required to confirm their advantages as effective contraceptive alternatives in this specific age group. The use of the various contraceptive methods during perimenopause holds special benefits and risks that should be carefully balanced, after a thorough consultation and according to each woman's contraceptive needs.

  19. Association of oral contraceptive and metformin did not improve insulin resistance in women with polycystic ovary syndrome

    Directory of Open Access Journals (Sweden)

    Margareth Chiharu Iwata

    2015-06-01

    Full Text Available Summary Objective: Objective: to compare clinical and laboratory parameters in women with polycystic ovary syndrome (PCOS using metformin or combined oral contraceptive (COC after 6 months. Methods: retrospective study analyzing records of patients with PCOS using the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS Society criteria. The groups were: I-COC (21 tablets, pause of 7 days; n=16; II-metformin (850mg 12/12h, n=16; III-COC plus metformin (n=9. Body mass index (BMI, acne (% of improvement, modified Ferriman-Gallway index and menstrual cycle index (MCI, luteinizing hormone (LH, follicle-stimulating hormone (FSH, total testosterone (TT, androstenedione (A and homeostasis model assessment: insulin resistance (HOMA-IR index were assessed Results: isolated use of COC compared to metformin was better regarding to acne, Ferriman index, MCI, LH, TT and A levels. On the other hand, metformin was better in the HOMA-IR index (4.44 and 1.67 respectively, p=0.0007. The association COC plus metformin, compared to metformin alone shows the maintenance of improvement of acne, Ferriman index, MCI, and testosterone levels. The HOMA-IR index remained lower in the metformin alone group (4.19 and 1.67, respectively; p=0,046. The comparison between COC plus metformin and COC alone, in turn, shows no difference in the improvement of acne, Ferriman index, MCI, LH, TT and A levels, indicating that the inclusion of metformin did not lead to additional benefits in these parameters. Still, the HOMA-IR index was similar in both groups (4.19 and 4.44 respectively; p=0.75, showing that the use of metformin associated with COC may not improve insulin resistance as much as it does if used alone. Conclusion: our data suggest that the combination of metformin and contraceptive does not improve insulin resistance as observed with metformin alone.

  20. Menstrual irregularity and use of oral contraceptives in female adolescent athletes in Swedish National Sports High Schools.

    Science.gov (United States)

    von Rosen, Philip; Heijne, Annette; Frohm, Anna; Fridén, Cecilia

    2017-11-23

    Objective Female adolescent athletes seem to use oral contraceptives (OCs) in the same proportion as the general population. In athletes not using OCs, menstrual irregularity (MI) is reported to be common but there are few studies of MI in adolescent athletes. The aim of the study was to survey menarche, menstrual irregularity and use of OCs in adolescent athletes in the National Sports High Schools in Sweden. A further aim was to study the associations between current sport injury and menstrual irregularity as well as use of OCs. Subjects Two hundred and ninety-eight female adolescent athletes at Swedish National Sports High Schools. Methods A web-based questionnaire containing questions related to menstrual status, contraception and current injury. Results One third (32.6%) of the athletes used OCs and of the remaining athletes 31.8% had MI. The group of athletes with MI had a significantly (p = 0.038; Cohen's d, 0.32) lower BMI and consisted of a significantly (p = 0.043) higher proportion of endurance athletes. OC users were less likely to participate in endurance sports compared to non-OC users (p = 0.024). Current injury was equally distributed in the OC and the non-OC group but athletes with MI had fewer sports injuries compared to eumenorrheic women. Conclusion OCs are frequently used among athletes at Swedish National Sports High Schools. OC users were less likely to participate in endurance sports compared to non-OC users. MI was common and athletes with MI had lower BMI compared to eumenorrheic athletes. Sports injuries were not associated with use of OC and eumenorrheic athletes had a higher proportion of current injury.

  1. [Contraception and adolescence].

    Science.gov (United States)

    Amate, P; Luton, D; Davitian, C

    2013-06-01

    The mean age of first sexual intercourse is still around 17 in France, but a lot of teenagers are concerned by contraception before, with approximately 25% of sexually active 15-year-old girls. The contraceptive method must take into consideration some typical features of this population, as sporadic and non-planned sexual activity, with several sexual partners in a short period of time. In 2004, the "Haute Autorité de santé" has recommended, as first-line method, combined oral contraceptive (COC) pills, in association with male condoms. Copper-containing intrauterine contraceptive devices (IUCD) and etonogestrel-containing subcutaneous implant have been suggested but not recommended. However, oral contraceptive pill, as a user-based method, carries an important typical-use failure rate, because remembering taking a daily pill, and dealing with stop periods, may be challenging. Some easier-to-use method should be kept in mind, as 28-day COC packs, transdermal contraceptive patches, and vaginal contraceptive rings. Moreover, American studies have shown that long-acting reversible contraceptives (LARC), i.e. IUCD and implant, have many advantages for teenagers: very effective, safe, invisible. They seem well-fitted for this population, with high satisfaction and continuation rates, as long as side effects are well explained. Thus, LARC methods should be proposed more widely to teenagers. Anyway, before prescribing a contraceptive method, it is important to determine the specific situation of every teenager, to let them choose the method that they consider as appropriate in their own case, and to think about the availability of the chosen method. It is necessary to explain how to handle mistakes or misses with user-based contraceptive methods, and emergency contraception can be anticipated and prescribed in advanced provision. The use of male condoms should be encouraged for adolescents, with another effective contraceptive method, in order to reduce the high risk

  2. The effect on blood pressure of a monophasic oral contraceptive containing ethinylestradiol and gestodene.

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    Fuchs, N; Düsterberg, B; Weber-Diehl, F; Mühe, B

    1995-06-01

    To obtain an overview of the effect of monophasic gestodene on blood pressure and to determine the frequency of "OC elevated BP/hypertension," the results of blood pressure monitoring from four clinical studies of contraceptive efficacy and safety have been retrospectively analyzed. A total of 1930 women took part in the studies, which recorded BP for up to 24 cycles. Analysis of results revealed that 97 women (5.0%) showed an increase in blood pressure from previously normal to elevated values while taking monophasic gestodene, with only 26 (1.35%) fulfilling the criteria of "OC elevated BP/hypertension." Only four women dropped out of the trials due to hypertensive blood pressure values, while 67 women (3.5%) experienced a normalization of previously elevated blood pressure measurements. In conclusion, this analysis has confirmed that gestodene has a negligible effect on blood pressure, with increased BP a relatively rare event.

  3. Adolescent contraception.

    Science.gov (United States)

    Bolton, G C

    1981-09-01

    , attention is directed to all available contraceptive methods (abstinence, sex without intercourse, natural family planning, withdrawal, condoms and vaginal spermicidal agents, diaphragm, IUDs, and abortion), but emphasis is on oral contraceptives (OCs). The popularity of OCs among adolescents is due primarily to 2 factors: the agents are highly effective and their use is not associated directly with the act of coitus. For the physician, there are 2 concerns associated with the use of these exogenous steroids in the not fully mature patient: administration might cause premature closure of the epiphyses and inhibition of full stature development; and the steroids might cause permanent hypothalamic-pituitary dysfunction. Both concerns are relatively unwarranted. The OC might be an excellent choice for the adolescent without medical contraindication, who has established regular menses, and who has intercourse on a regular or fairly frequent basis.

  4. Evaluation of Distributive Frequency of Oral Contraceptive Pills Consumption in Women with Cerebrovascular Events Admitted in Farshchian Hospital of Hamadan between 1997-2007

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    Mehrdokht Mazdeh

    2011-06-01

    Full Text Available Background & Objectives: Although there is no prolonged time elapsed from propagation of oral contraceptive pills (OCP, case reports demonstrated occurrence of pulmonary embolism and cerebral infarction in women using these pills. Present study was done to specify distributive frequency of oral contraceptive pills consumption in women with cerebrovascular events admitted in Farshchian hospital of Hamadan between 1997 to 2007. Materials & Methods: Every woman with cerebrovascular events during years 1997-2007 who was admitted in Farshchian hospital of Hamadan and her dossier was present in archive of hospital, were carefully checked and those who hadn’t exclusion criteria, were include in this study, a total of 1587 of them with respect to their Characteristics such as type of cerebrovascular event, age, type of oral contraceptive pill and duration of pill use were extracted from patient dossier and registered in respective checklist. Results: 24.1% of patient used oral contraceptive pill and 76.9% of patients were non users. Mean age of OCP users and non users were 45 years. Mean duration of pill use among these patients was 33 months. In assessing type of vascular events, in the group OCP users 73.1% and non users 66.4% had ischemic stroke.Which was statistically significant. In the group OCP users 24.6% and non users 29.1% were hemorrhagic stroke.. Also in the group OCP users 2.3% and non users 4.5% were affected sagital sinuses thrombosis that showed no significant difference. Among OCP users 85% of the patients used OCP, LD and 15% of the patients OCP, HD. Conclusion: The present study showed, the ischemic stroke rate of the patients with OCP consumption were significantly more than those of non users.

  5. A cross-sectional study of different patterns of oral contraceptive use among premenopausal women and circulating IGF-1: implications for disease risk

    OpenAIRE

    Blackmore, Kristina M; Wong, Jody; Knight, Julia A

    2011-01-01

    Abstract Background Insulin-like growth factor-1 (IGF-1) is important in normal growth, development, and homeostasis. Current use of oral contraceptives (OC) decreases IGF-1 concentrations; however, the effect of past use, age/timing of use, and type of OC used on IGF-1 levels is unknown. OC are the most commonly used form of birth control worldwide. Both IGF-1 and OC use have been linked to premenopausal breast and colorectal cancers, osteoporosis and cardiovascular disease (CVD). Understand...

  6. The Drop That Spilled the Cup: Acute Myocardial Infarction in a Young Woman with Underlying Thrombophilic Polymorphisms and Oral Contraceptive Use

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    Nunzio Russo

    2014-01-01

    Full Text Available We present the case of a 28-year-old woman who was admitted to our cardiology unit for acute coronary syndrome. Her history was notable for cardiovascular disease familiarity, active smoking, and oral contraceptive use. On further analysis, she was noted to have thrombophilic polymorphisms involving the plasminogen activator inhibitor (PAI, angiotensin-converting enzyme (ACE, and methylenetetrahydrofolate reductase (MTHFR genes. We discuss the implications that these cofactors may have had in the genesis of the disease.

  7. Contraceptive methods and risk of HIV acquisition or female-to-male transmission.

    Science.gov (United States)

    Haddad, Lisa B; Polis, Chelsea B; Sheth, Anandi N; Brown, Jennifer; Kourtis, Athena P; King, Caroline; Chakraborty, Rana; Ofotokun, Igho

    2014-12-01

    Effective family planning with modern contraception is an important intervention to prevent unintended pregnancies which also provides personal, familial, and societal benefits. Contraception is also the most cost-effective strategy to reduce the burden of mother-to-child HIV transmission for women living with HIV who wish to prevent pregnancy. There are concerns, however, that certain contraceptive methods, in particular the injectable contraceptive depot medroxyprogesterone acetate (DMPA), may increase a woman's risk of acquiring HIV or transmitting it to uninfected males. These concerns, if confirmed, could potentially have large public health implications. This paper briefly reviews the literature on use of contraception among women living with HIV or at high risk of HIV infection. The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) recommendations place no restrictions on the use of hormonal contraceptive methods by women with or at high risk of HIV infection, although a clarification recommends that, given uncertainty in the current literature, women at high risk of HIV who choose progestogen-only injectable contraceptives should be informed that it may or may not increase their risk of HIV acquisition and should also be informed about and have access to HIV preventive measures, including male or female condoms.

  8. Effect on quality of life of switching to combined oral contraception based on natural estrogen: an observational, multicentre, prospective phase IV study (ZOCAL Study).

    Science.gov (United States)

    Lete, Iñaki; de la Viuda, Esther; Pérez-Campos, Ezequiel; Martínez, María Ángeles Gómez; Sanchez-de la Rosa, Rainel; Novalbos, Jesús; Sánchez-Borrego, Rafael

    2016-08-01

    This observational, multicentre, prospective phase IV study examined change in health-related quality of life (QOL) from baseline to 6 months in women initiating combined oral contraception (COC) based on natural estrogen. Eligible women attending a baseline and 6-month gynaecology appointment belonged to one of three groups: group 1 used barrier contraception (condoms) and elected to continue this method; group 2 used condoms and elected to switch to COC based on natural estrogen; group 3 used COC based on ethinylestradiol and elected to switch to COC based on natural estrogen. The Spanish Society of Contraception (SEC)-QOL scale assessed health-related QOL. Secondary outcomes included symptoms of premenstrual syndrome, intermenstrual bleeding, duration and intensity of menstrual bleeding, contraception continuation rate, and tolerability. A total of 857 women were enrolled and 785 completed the study. Group 2 (n = 224 completed) had significantly lower SEC-QOL global and dimension scores at baseline and significantly greater increases in SEC-QOL from baseline to 6 months compared with groups 1 (n = 72) and 3 (n = 489). Group 3 reported a similar SEC-QOL score to that of group 1 at baseline but showed significantly greater improvement in SEC-QOL global and psychological scores from baseline to 6 months. Among women receiving COC based on natural estrogen, the contraception continuation rate was 713/780 (91.4%); treatment-related adverse events were reported by 13/780 (1.7%). Improved SEC-QOL after 6 months was found in women who were dissatisfied with their current contraception at baseline and chose to switch to COC based on natural estrogen.

  9. Use of combined oral contraceptives and risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases

    Science.gov (United States)

    Coupland, Carol; Hippisley-Cox, Julia

    2015-01-01

    Objective To investigate the association between use of combined oral contraceptives and risk of venous thromboembolism, taking the type of progestogen into account. Design Two nested case-control studies. Setting General practices in the United Kingdom contributing to the Clinical Practice Research Datalink (CPRD; 618 practices) and QResearch primary care database (722 practices). Participants Women aged 15-49 years with a first diagnosis of venous thromboembolism in 2001-13, each matched with up to five controls by age, practice, and calendar year. Main outcome measures Odds ratios for incident venous thromboembolism and use of combined oral contraceptives in the previous year, adjusted for smoking status, alcohol consumption, ethnic group, body mass index, comorbidities, and other contraceptive drugs. Results were combined across the two datasets. Results 5062 cases of venous thromboembolism from CPRD and 5500 from QResearch were analysed. Current exposure to any combined oral contraceptive was associated with an increased risk of venous thromboembolism (adjusted odds ratio 2.97, 95% confidence interval 2.78 to 3.17) compared with no exposure in the previous year. Corresponding risks associated with current exposure to desogestrel (4.28, 3.66 to 5.01), gestodene (3.64, 3.00 to 4.43), drospirenone (4.12, 3.43 to 4.96), and cyproterone (4.27, 3.57 to 5.11) were significantly higher than those for second generation contraceptives levonorgestrel (2.38, 2.18 to 2.59) and norethisterone (2.56, 2.15 to 3.06), and for norgestimate (2.53, 2.17 to 2.96). The number of extra cases of venous thromboembolism per year per 10 000 treated women was lowest for levonorgestrel (6, 95% confidence interval 5 to 7) and norgestimate (6, 5 to 8), and highest for desogestrel (14, 11 to 17) and cyproterone (14, 11 to 17). Conclusions In these population based, case-control studies using two large primary care databases, risks of venous thromboembolism associated with combined oral

  10. Impact of Contraceptive Type on Sexual Desire of Women and of Men Partnered to Contraceptive Users.

    Science.gov (United States)

    Mark, Kristen P; Leistner, Christine E; Garcia, Justin R

    2016-09-01

    Research investigating the impact of contraceptive use on sexual desire has produced mixed results. This scholarship also has had inconsistent methodology, with some studies not separating contraceptive types and others lacking non-hormonal comparison groups. Relationship context of contraceptive use and sexual behavior also have not been well represented. To investigate the impact of contraceptive type on sexual desire in women and in men who are partnered to contraceptive-using women. In two separate studies we examined the impact of contraceptives on the sexual desire of women currently using contraceptives and men partnered to women using contraceptives. The first study examined the impact of contraceptive type on sexual desire in women and in men partnered to contraceptive users in relationships of different lengths. The second study examined this impact in heterosexual couples in long-term relationships. Solitary and dyadic sexual desire as measured by the Sexual Desire Inventory and contraceptive type as categorized into three types: oral hormonal contraceptive, other hormonal contraceptive, and non-hormonal contraceptive. Contraceptive type significantly affected solitary and dyadic desire. Women on non-hormonal contraceptives reported higher solitary sexual desire than women on other hormonal contraceptives. Women on oral hormonal contraceptives reported significantly higher dyadic sexual desire than women on non-hormonal contraceptives. In male partners of female contraceptive users, solitary and dyadic sexual desires were not affected by partner contraceptive type. In the multivariate model, relationship length and age were stronger predictors of contraceptive type than was solitary or dyadic sexual desire. At the couple level, contraceptive type also was not related to solitary or dyadic sexual desire in men and women. Contraceptive type can affect solitary and dyadic sexual desire in women; however, contextual factors seem to be stronger predictors of

  11. Effect of the coadministration of daclatasvir on the pharmacokinetics of a combined oral contraceptive containing ethinyl estradiol and norgestimate.

    Science.gov (United States)

    Bifano, Marc; Sevinsky, Heather; Hwang, Carey; Kandoussi, Hamza; Jiang, Hao; Grasela, Dennis; Bertz, Richard

    2014-01-01

    Daclatasvir is a highly selective NS5A replication complex inhibitor currently in development for the treatment of chronic hepatitis C infection. Daclatasvir is active at picomolar concentrations and demonstrates in vitro activity against a broad range of HCV genotypes. The primary objective of this study was to assess the effect of daclatasvir on the pharmacokinetics of a combined oral contraceptive containing ethinyl estradiol and norgestimate (Ortho Tri-Cyclen(®)). In this open-label single-sequence study, 20 healthy female subjects received ethinyl estradiol and norgestimate for three cycles, with coadministration of daclatasvir in cycle 3. Pharmacokinetics of ethinyl estradiol and the active metabolites of norgestimate (norelgestromin and norgestrel) were assessed in cycles 2 and 3. Adjusted ratios of geometric means and 90% CIs were estimated for the maximum observed plasma concentration (ethinyl estradiol 1.11 [1.02, 1.20], norelgestromin 1.06 [0.99, 1.14] and norgestrel 1.07 [0.99, 1.16]) and area under the plasma concentration-time curve in one dosing interval (ethinyl estradiol 1.01 [0.95, 1.07], norelgestromin 1.12 [1.06, 1.17] and norgestrel 1.12 [1.02, 1.23]). Coadministration of daclatasvir resulted in no clinically relevant effects on exposure to ethinyl estradiol, norelgestromin or norgestrel.

  12. Comparison of the effects of metformin, flutamide plus oral contraceptives, and simvastatin on the metabolic consequences of polycystic ovary syndrome

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    Ferdous Mehrabian

    2016-01-01

    Full Text Available Background: Polycystic ovary syndrome (PCOS is one of the common endocrine disorders in women of reproductive ages. It is associated with a range of disorders, such as dyslipidemia, hypertension, insulin resistance (IR, compensatory hyperinsulinemia, gestational, and type 2 diabetes, and increased risk of cardiovascular morbidity. There are different treatments available for PCOS. The purpose of this study was to determine and compare the effects of metformin, flutamide plus oral contraceptives (OCs, and simvastatin on the metabolic consequences of PCOS. Materials and Methods: This study was a single-blind clinical trial. The subjects were selected from a group of patient with PCOS and metabolic syndrome, who were referred to the midwifery clinic of Al-Zahra Hospital and Beheshti Hospital, Isfahan, Iran. A total of 111 subjects were randomly assigned to three groups: metformin, flutamide plus OCs, and simvastatin groups. The measurements were performed at baseline and after 6 months of therapy. Paired t-test, analysis of variance (ANOVA, and chi-square test were applied in this study. Results: A total of 102 subjects were analyzed in this study, 34 subjects were allotted in each group. The prevalence of IR was statistically different between three groups (P-value = 0.001. After a 6-month course, metformin showed larger reduction in fasting blood sugar (FBS level (P-value 0.05. Conclusion: Metformin performed better in FBS reduction. Simvastatin had better performance in terms of reducing TG level and waist circumference.

  13. Effect of a combined oral contraceptive containing 20 microg ethinyl estradiol and 75 microg gestodene on hemostatic parameters.

    Science.gov (United States)

    Aldrighi, José Mendes; De Campos, Luis Salvoni Carneiro; Eluf Gebara, Otávio Celso; Petta, Carlos Alberto; Bahamondes, Luis

    2006-01-01

    The effects of a combined oral contraceptive (COC) containing 20 microg ethinyl estradiol (EE) and 75 microg gestodene (GSD) on prothrombin activity (PA), activated partial thromboplastin time (APTT), thrombin time (TT), platelet number, fibrinogen, antithrombin III (ATIII), protein C, protein S and D-dimer were evaluated over 6 months in 23 young, healthy women. Laboratory assessments were performed prior to initiation of COC use (pretreatment) and after 3 and 6 months of use. Results showed no significant changes in fibrinogen, protein C, ATIII or D-dimer during COC use, compared with pretreatment values. The increase in platelet count, decreases in protein S level, PA and APTT, and the prolongation of TT were significant. In conclusion, the use of a COC containing 20 microg EE and 75 microg GSD did not cause any significant changes in the hemostatic parameters studied that could be suggestive of a higher prothrombotic risk. Further studies with a larger sample size are necessary in order to obtain conclusive data.

  14. Thrombosis of the internal jugular vein after tympanoplasty caused by interaction of oral contraceptives and hereditary hypofibrinolysis

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    Dubravka Ivić

    2011-08-01

    Full Text Available This case report describes a case of venous thrombosis in a young woman who had undergonetympanoplasty due to chronic otitis media.Other than that she was healthy. According to the anamnesis she stopped taking oral contraceptive pills (OCP a month before the surgery. She did not receive thromboprophylaxis before the surgerybecause it was estimated that there was a low risk for a thromboembolic incident. Several hours after the surgery she was still not responding properly to external stimulus and there was noverbal contact. An urgent computed tomography (CT scan of head and neck revealed thrombosis of the left internal jugular vein. She was admitted to the Intensive Care Unit (ICU and heparin therapy started. After a few days she was fully recovered. Later it was confirmed that the patient had an inherited fibrinolysis disorder caused by plasminogen activator inhibitor 1 (PAI-1 gene polymorphism. Our opinion is that the unexpected thrombotic incident was a result of interaction of multiple factors, including the venous stasis at the surgery site, decreased fibrinolysis ability, and the prothrombotic effect of OCP.

  15. Early pregnancy loss in women stimulated with gonadotropin-releasing hormone antagonist protocols according to oral contraceptive pill pretreatment.

    Science.gov (United States)

    Bellver, José; Albert, Carmen; Labarta, Elena; Pellicer, Antonio

    2007-05-01

    To evaluate and compare the risk of early pregnancy loss in patients stimulated with GnRH antagonist protocols according to oral contraceptive pill (OCP) pretreatment. Retrospective case-control study. Instituto Valenciano de Infertilidad. University of Valencia. Spain. One thousand five hundred thirty-nine patients, aged <36, stimulated with GnRH antagonists for IVF between January 1, 2000 and November 1, 2005. Reproductive outcome was compared based on the application (or not) of OCP pretreatment: 944 women were included in the OCP group and 595 in the non-OCP group. The Student's t test was used for statistics. Pregnancy, biochemical pregnancy, ectopic pregnancy, early clinical pregnancy loss, early pregnancy loss, and ongoing pregnancy rates. No significant differences were observed in any of the outcome parameters. Early pregnancy loss rates were similar: 23% in the OCP pretreatment group versus 19.2% in the non-OCP pretreatment group. However, longer periods of ovarian stimulation and higher doses of gonadotropins needed to be employed in the OCP group. There is not sufficient evidence to confirm OCP pretreatment as a risk factor for miscarriage in patients stimulated with GnRH antagonist protocols.

  16. Combined oral contraception and obesity are strong predictors of low-grade inflammation in healthy individuals: results from the Danish Blood Donor Study (DBDS.

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    Cecilie J Sørensen

    Full Text Available BACKGROUND: C-reactive protein (CRP is a well-established marker of inflammation. The level of CRP is affected by several lifestyle factors. A slightly increased CRP level, also known as low-grade inflammation (LGI, is associated with increased risk of several diseases, especially cardiovascular disease. The aim of this study was to identify predictors of increased CRP levels in healthy individuals. We therefore assessed CRP in a large cohort of blood donors. METHODS: We measured plasma CRP levels in 15,684 participants from the Danish Blood Donor Study. CRP was measured by a commercial assay. Furthermore, all participants completed a standard questionnaire on smoking status, alcohol consumption, physical activity, diet, and various body measurements. Female participants also reported the use of contraception, childbirth, and menopausal status. The relationship between LGI (defined here as a plasma CRP level between 3 mg/L and 10 mg/L and predictors was explored by multivariable logistic regression analysis. Results were presented as odds ratios (OR with 95% confidence intervals (CI. RESULTS: We found LGI in a total of 1,561 (10.0% participants. LGI was more frequent in women using combined oral contraception (OC (29.9% than in men (6.1% and women not using OC (7.9%. Among premenopausal women, OC was the strongest predictor of LGI (odds ratio = 8.98, p<0.001. Additionally, body mass index (BMI and waist circumference were positively associated with LGI. CONCLUSION: High BMI and abdominal obesity strongly predicted LGI among healthy individuals. However, the most striking finding was the high prevalence of LGI among premenopausal women who used combined oral contraception. Although the significance of CRP as a marker of inflammation is well known, the role of CRP in pathogenesis is still uncertain. The impact of oral contraception on CRP levels should nevertheless be considered when CRP is used in risk assessment.

  17. Preliminary study on the effect of four-phasic estradiol valerate and dienogest (E2V/DNG) oral contraceptive on the quality of sexual life.

    Science.gov (United States)

    Caruso, Salvatore; Agnello, Carmela; Romano, Mattea; Cianci, Stefano; Lo Presti, Lucia; Malandrino, Chiara; Cianci, Antonio

    2011-10-01

    A new oral contraceptive containing the natural estrogen estradiol and a 19-nortestosterone derivate dienogest (DNG) in a four-phasic 28-day regimen may be used by women. To investigate the quality of sexual life of healthy women on estradiol valerate and DNG (E2V/DNG) oral contraceptive. Fifty-seven women (age range 18-48 years) were enrolled. The Short Form-36 (SF-36) questionnaire to assess quality of life (QoL) was administered at baseline and at the 26th day of both the 3rd and 6th cycles of oral contraceptive (OC) intake. The Short Personal Experience Questionnaire (SPEQ) to measure the change of sexual behavior was used at the 2nd, 7th, 14th, 21st, 26th, and 28th days of the baseline cycle, as well as at the same days of both the 3rd and 6th cycle of contraceptive intake. The SF-36 and the SPEQ questionnaires. Women reported QoL improvement at the 3rd (P sexuality during the 3rd and the 6th cycle with respect to baseline experience was observed (P sexual activity remained basically unchanged (P = NS). Enjoyment and desire improved at the 6th cycle with respect to the 3rd cycle (P sexual activity improved, reaching a peak around the 14th day of the menstrual cycle (P sexually cyclic, but the peak improvement of desire, arousal, orgasm, enjoyment, and sexual activity appeared around the 7th day of OC intake (P sexuality of users. © 2011 International Society for Sexual Medicine.

  18. Effect of oral contraceptives and/or metformin on GLP-1 secretion and reactive hypoglycaemia in polycystic ovary syndrome

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    Dorte Glintborg

    2017-06-01

    Full Text Available Context: Insulin resistance in polycystic ovary syndrome (PCOS may increase the risk of reactive hypoglycaemia (RH and decrease glucagon-like peptide-1 (GLP-1 secretion. The possible effects of treatment with oral contraceptives (OCP and/or metformin on GLP-1 secretion and risk of RH in PCOS is undetermined. Setting: Outpatient clinic. Patients and interventions: Randomized, controlled clinical trial. Ninety women with PCOS were randomized to 12-month treatment with OCP (150 mg desogestrel + 30 mg ethinylestradiol, metformin (2 g/day or metformin + OCP. Five-hour oral glucose tolerance tests (5-h OGTT measuring fasting and area under the curve (AUC for GLP-1, glucose, insulin and C-peptide were performed before and after the intervention period. Sixty-five women completed the study and 34 weight-matched healthy women were included as controls. Main outcome measures: Changes in GLP-1, glucose, insulin and C-peptide during 5-h OGTT. Results: Fasting GLP-1 levels increased during metformin + OCP vs OCP treatment, whereas AUC GLP-1 levels were unchanged during medical treatment. The prevalence of reactive hypoglycemia increased from 9/65 to 14/65 after intervention (P < 0.01 and was more common after treatment with metformin + OCP (increase from 3/23 to 6/23, P = 0.01. Reactive hypoglycaemia was associated with higher insulin and C-peptide levels during 5-h OGTT, but was unassociated with BMI and AUC GLP-1. GLP-1 levels were comparable in PCOS vs controls. AUC GLP-1 levels were significantly lower in obese vs lean patients and were inversely associated with BMI. Conclusions: AUC GLP-1 levels were unchanged during treatment. Increased risk of hypoglycemia during metformin + OCP could be associated with increased insulin secretion.

  19. [Postcoital contraception].

    Science.gov (United States)

    Hoffmann, K O

    1984-02-01

    Since 1979, Pro Familia, the German Association for Family Planning and Sexual Counselling, has offered a postcoital contraceptive program utilizing either the ethinyl estradiol (EE)-norgestrel combined oral contraceptive (OC) described by Yuzpe in Canada or a levonorgestrel-only regime. In the Yuzpe method, 4 pills each containing .05 mg EE and .5 mg norgestrel are taken, 2 in the 48 hours following the unprotected coitus and the other two 12 hours later. The other method requires that .6 mg of levonorgestrel be taken in the 12 hours following coitus. In 737 cases of administration of postcoital contraceptives in 26 Pro Familia clinics over the past 3 years, 85% of women were under 28 years old and almost 30% were 14-18 years old. The reasons for utilizing a postcoital method varied but were mostly related to the user, such as nonuse of contraception or forgetting of pills. 25% initiated treatment 1-12 hours after the unprotected intercourse, 44% 13-24 hours later, 27% 25-48 hours later, and 4% 49 or more hours later. In 1% of cases the timing was unknown. 54 patients were treated on cycle days 1-9, 435 on days 10-18, 178 on days 19-27, 37 on day 28 or later, and for 22 the cycle day was unknown. 16 intrauterine pregnancies and no tubal pregnancies occurred. The 522 patients receiving the combined OC treatment had 10 pregnancies for a failure rate of 1.9% and the 205 receiving the progestin-only treatment had 6 pregnancies, for a failure rate of 2.9%.

  20. Emergency contraception

    Science.gov (United States)

    Morning-after pill; Postcoital contraception; Birth control - emergency; Plan B; Family planning - emergency contraception ... Emergency contraception most likely prevents pregnancy in the same way as regular birth control pills: By preventing ...

  1. ORAL HORMONAL CONTRACEPTION - THE INFLUENCE ON HUMAN GENOME AND LIPID STATUS

    Directory of Open Access Journals (Sweden)

    Dragan Loncar

    2007-01-01

    Full Text Available Micronucleus test is the method which is used in discovering the chromosome aberrations in the cells which are exposed to the effects of chemical mutagens. The cell which suffered the DNA damage cytologically fits to extranuclear bodies in cytoplasm, which represent the chromosomal fragments, the whole chromosomes or the groups of chromosomes. These cytoplasmic masses look like small cores, micronucleuses, and their size varies depending on the size of chromosome frag-ments or the number of chromosomes which are in the cytoplasm.The aim of the paper was to examine the influence of monophased, combined, low-dosed contraceptive pills which contain ethinyl- estradiol and gestoden on the micronucleus frequency in human lymphocytes of peripheral blood and their influence on the lipid status of the users.We examined 30 patients older than 18 years. All the patients took part in the research in order to prevent unwanted pregnancy.The existence of cardiovascular, endocrinological, neurological and malignant diseases was excluded by using clinical examinations, biochemical, hematological and additional researches.After the therapy of 20 µg of ethynil- estradiol and 75 µg of gestoden in the period of six consequtive menstrual cycles in order to prevent unwanted pregnancy, there was not statistically significant change of micronucleus frequency in lympho-cytes of peripheral blood in the cases of patients which took part in the research; (p> 0,05.The therapy significantly increases the value of cholesterol, low- density lipo-proteins (LDL and triglycerides in the blood of the patients (p< 0,05.The therapy can be applied along with the regular control of the gynecologist in order to prevent unwanted pregnancy.

  2. Views and attitudes of oral contraceptive users towards the their availability without a prescription in the Republic of Ireland

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    Barlassina L

    2015-06-01

    Full Text Available Background: Previous studies show that provision of oral contraceptive pill (OCs without a prescription is safe, feasible and effective and that users are interested in obtaining contraception in this way, especially if a pharmacist screening is involved. A recent national survey conducted in the Republic of Ireland has highlighted that unintended pregnancy resulting from the failure of OCs could be linked to poor compliance due to costs and difficulty of access. Objective: To evaluate views and attitudes of OC users towards the availability of OCs without a prescription in the Republic of Ireland. Methods: A cross sectional survey was conducted using an opportunistic sample of OC users aged 18 to 50 years. Sixty community pharmacists were recruited nationwide. Data were collected using self-completed questionnaires. The questionnaires comprised information on: demographic data, need of the service, views on the availability of OCs without prescription, advantages and concerns around the service, role of pharmacists and cost implications for private and public patients. Results: A total of 488 eligible OC users completed the survey. The majority of the respondents (71.7%;n = 350/488 reported to have missed a pill for reasons connected to the OCs prescription status and 55.5% (n = 268/488 of the respondents reported to have felt distressed on at least one occasion because they could not renew their OC prescription. A total of 87.9% (n = 429/488 of the respondents said they were in favour of OCs being available without prescription and 92% (n = 448/488 said they were likely to obtain OCs without prescription if available. Convenience and ease of access were indicated as the main advantages of availing of OCs without prescription, while safety was the biggest concern reported. Over 88% (n = 430/488 of the respondents indicated that pharmacists would be able to safely supply OCs without prescription. Private patients expected to save an average of

  3. Cardiovascular risk in Egyptian healthy consumers of different types of combined oral contraceptives pills: A comparative study.

    Science.gov (United States)

    El-Haggar, Sahar M; Mostafa, Tarek M

    2015-08-01

    This study aimed to evaluate the associated cardiovascular risk in Egyptian healthy consumers of different types of combined oral contraceptives pills (COCPs) via determination of lipids profiles, Castelli index I, leptin, adiponectin, and resistin concentrations as cardiovascular risk factors. In this cross-sectional study, the study groups consisted of control group that represented by 30 healthy married women who were not on any contraceptive mean or any hormonal therapy and had normal menstrual cycles, group two consisted of 30 women who were users of Levonorgesterl 0.15 mg plus Ethinylestradiol 0.03 mg as 21 days cycle, group three consisted of 30 women who were users of Gestodene 0.075 mg plus Ethinylestradiol 0.03 mg as 21 days cycle, and group four consisted of 30 women who were users of Drospirenone 3 mg plus Ethinylestradiol 0.03 mg as 21 days cycle. One-way analysis of variance followed by LSD post hoc test was used for comparison of variables. P value <0.05 was considered to be significant. The comparison of the studied groups revealed that COCPs containing levonorgestrel plus ethinylestradiol resulted in significantly lower adiponectin level, and significantly higher leptin and resistin levels with more atherogenic lipid profile presented by significantly higher LDL-C, significantly lower HDL-C concentrations, and significantly higher atherogenic index. Formulation containing ethinylestradiol combined with gestodene neither altered adipose tissue function nor showed deleterious effect on lipid panel. Formulation containing ethinylestradiol combined with drospirenone resulted in significantly higher HDL-C and adiponectin concentrations. In conclusion, the uptake of COCPs containing levonorgestrel plus ethinylestradiol is associated with high cardiovascular risk since this formulation showed significantly lower adiponectin concentration, significantly higher leptin, resistin, and atherogenic index as compared to other studied groups. By contrast, the

  4. Male contraception

    Directory of Open Access Journals (Sweden)

    Vivek Mathew

    2012-01-01

    Full Text Available Contraception is an accepted route for the control of population explosion in the world. Traditionally hormonal contraceptive methods have focused on women. Male contraception by means of hormonal and non hormonal methods is an attractive alternative. Hormonal methods of contraception using testosterone have shown good results. Non hormonal reversible methods of male contraception like reversible inhibition of sperm under guidanceare very promising. In this article we have reviewed the current available options for male contraception.

  5. Latin american experience with two low-dose oral contraceptives containing 30 microg ethinylestradiol/75 microg gestodene and 20 microg ethinylestradiol/150 microg desogestrel.

    Science.gov (United States)

    Bassol, S; Alvarado, A; Celis, C; Cravioto, M C; Peralta, O; Montaño, R; Novelli, J; Albornoz, H; Kesseru, E; Soares, A; Petracco, A; Isaia, B; Mendes, J; Bahamondes, L; de Melo, N R; Reyes-Marquez, R; Albrecht, G

    2000-09-01

    The objective of this study was to compare cycle control, efficacy and tolerance of an oral contraceptive containing 20 microg ethinylestradiol and 150 microg desogestrel with a preparation containing 30 microg ethinylestradiol combined with 75 microg gestodene. This study involved 342 women and 4104 cycles use in Argentina, Brazil, Chile, and Mexico. Contraceptive efficacy was good with both formulations. Two pregnancies occurred in the desogestrel group but were not due to method failure. With respect to cycle control, the incidence of intermenstrual bleeding was higher during the first 3 cycles in the desogestrel group; it was significant (p gestodene group (8.5%). Adverse events were similar in all the countries with headache, breast tension, and nausea, the most frequently reported symptoms. The range of mean increase in body weight varied from 0.2 kg in the Argentine group to 2.6 kg in the Chilean group (95% confidence limit, +/- 2.51) in the gestodene group, and 0.2 kg in the Argentine group to 2.5 kg in Brazilian group (95% confidence limit, +/- 2.36) in the desogestrel group. Fifteen women discontinued because of headache, but there were no significant differences between the groups regarding discontinuation for this and other medical or non-medical reasons. Both oral contraceptive preparations are reliable and well tolerated, and both have favorable effects on control cycle.

  6. ANGIOPLASTIA DE RESCATE EN MUJER DE 33 AÑOS CON ANTICONCEPCIÓN ORAL Y CORONARIOPATÍA DILATADA / Rescue angioplasty in a 33-year old woman with oral contraception and dilated coronariopathy

    Directory of Open Access Journals (Sweden)

    Francisco L Moreno-Martínez

    2009-09-01

    Full Text Available Coronary angioplasty is recognized nowadays as the first-choice therapeutic strategy for acute coronary syndrome with ST-segment elevation. Atherosclerotic disease is still the main cause ofthis sickness; however, other disturbances, such is dilated coronariopathy, may favor this coronary event. Although some authors raise that atherosclerosis is the main cause of coronary dilation, it is uncommon that this lipid disorder promotes consequences early in life. We present the case of a 33-year-old female (oral contraceptive user - etinor who had not any apparent coronary risk factor but suffered from inferior acute myocardial infarction. The thrombolysis failed, and fortunately we could perform the angioplasty. Intracoronary thrombosis with distal embolism occurred, that waswhy we administered streptokinase. Possible mechanisms that involve oral contraceptives and dilated coronariopathy are discussed, and angiographic images are shown.

  7. Users of withdrawal method in the Islamic Republic of Iran: are they intending to use oral contraceptives? Applying the theory of planned behaviour.

    Science.gov (United States)

    Rahnama, P; Hidarnia, A; Shokravi, F A; Kazemnejad, A; Montazeri, A; Najorkolaei, F R; Saburi, A

    2013-09-01

    Many couples in the Islamic Republic of Iran rely on coital withdrawal for contraception. The purpose of this cross-sectional study was to use the theory of planned behaviour to explore factors that influence withdrawal users' intent to switch to oral contraception (OC). Participants were 336 sexually active, married women, who were current users of withdrawal and were recruited from 5 public family planning clinics in Tehran. A questionnair included measures of the theory of planned behaviour: attitude (behavioural beliefs, outcome evaluations), subjective norms (normative beliefs, motivation to comply), perceived behaviour control, past behaviour and behavioural intention. Linear regression analyses showed that past behaviour, perceived behaviour control, attitude and subjective norms accounted for the highest percentage of total variance observed for intention to use OC (36%). Beliefs-based family planning education and counsellingshould to be designed for users of the withdrawal method.

  8. Efeitos dos contraceptivos hormonais orais de baixa dosagem estrogênica nas taxas de folato intra-eritrocitário Effects of low-dose oral hormonal contraceptive on intraerythrocytic folate levels

    Directory of Open Access Journals (Sweden)

    Túlio Bráulio Cantalice de Paula

    2003-08-01

    Full Text Available OBJETIVO: identificar os efeitos do uso dos contraceptivos hormonais orais (ACHO de baixa dosagem estrogênica (PURPOSE: to study the effects of low-dose oral hormonal contraceptives (OHC (<30 mg of ethynylestradiol on the intraerythrocytic folate levels. METHODS: this was a prospective transversal study with 95 patients treated in the Family Planning Clinic of UNIFESP (Federal University of São Paulo. The control group (Condom group consisted of patients using condom as their exclusive contraceptive method during the last 12 months, and the study groups consisted of patients using low-dose oral hormonal contraceptives, in the following way: OHC 3 group (three to six months of use, OHC 6 group (six to twelve months of use and OHC 12 group (more than twelve months of use. Intraerythrocytic folate was determined by the ionic capture method. Analysis of variance and c² test were used for statistical analysis. RESULTS: the Condom group showed a rate of 44% of patients with folate lower than 186.0 ng/mL and the users of low-dose oral contraceptives showed a rate of 32% (OHC 3 group, 16% (OHC 6 group and 31% (OHC 12 group. We did not find in the group using low-dose oral contraceptives a significant reduction in the average level of intraerythrocytic folate compared to the control group and there was no statistically significant difference (p=0.28 regarding time of use. CONCLUSION: we observed reduced levels of intraerythrocytic folate in a significant number (44% of patients not using low-dose oral hormonal contraceptives. Their rates were similar to the lower limit considered to be normal by most authors, which points to a basal folate deficiency in the studied group. We did not observe any alteration in the level of intraerythrocytic folate in patients using low-dose oral hormonal contraceptives.

  9. [Contraception and obesity].

    Science.gov (United States)

    Lobert, M; Pigeyre, M; Gronier, H; Catteau-Jonard, S; Robin, G

    2015-11-01

    The prevalence of obesity is increasing massively over several decades in industrialized countries. Obese women are sexually active but they use fewer contraceptive methods and are at high risk of unintended pregnancy. In addition, obesity is an important risk factor for venous thromboembolism events and arterial thrombosis (myocardial infarction and ischemic stroke). All of these data are to be considered in choosing a contraceptive method for obese women. Except depot medroxyprogesterone acetate injection, the progestin-only contraceptives (progestin only pills and etonogestrel subdermal implant) and the intra-uterine devices are the preferred contraceptive methods in obese women. The combined estrogen-progestin contraceptives (pill, patch and vaginal ring) may be proposed in very strict conditions (no other associated vascular risk factor). Obesity does not increase the risk of failure of most contraceptive methods. Bariatric surgery is a complex situation. It requires to program a possible pregnancy and contraception is needed for several months. Some bariatric surgical techniques such as by-pass can induce gastrointestinal malabsorption. In this situation, all oral contraceptives are not recommended because of a higher risk of failure. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  10. A systematic review of effectiveness and safety of different regimens of levonorgestrel oral tablets for emergency contraception.

    Science.gov (United States)

    Shohel, Mohammad; Rahman, Mohammad Mahfuzur; Zaman, Asif; Uddin, Mir Muhammad Nasir; Al-Amin, Md Mamun; Reza, Hasan Mahmud

    2014-04-04

    Unintended pregnancy is a complex phenomenon which raise to take an emergency decision. Low contraceptive prevalence and high user failure rates are the leading causes of this unexpected situation. High user failure rates suggest the vital role of emergency contraception to prevent unplanned pregnancy. Levonorgestrel - a commonly used progestin for emergency contraception. However, little is known about its pharmacokinetics and optimal dose for use. Hence, there is a need to conduct a systematic review of the available evidences. Randomized, double-blind trials were sought, evaluating healthy women with regular menstrual cycles, who requested emergency contraception within 72 h of unprotected coitus, to one of three regimens: 1.5 mg single dose levonorgestrel, two doses of 0.75 mg levonorgestrel given 12 h apart or two doses of 0.75 mg levonorgestrel given 24 h apart. The primary outcome was unintended pregnancy; other outcomes were side-effects and timing of next menstruation. Every trial under consideration successfully established the contraceptive effectiveness of levonorgestrel for preventing unintended pregnancy. Moreover, a single dose of levonorgestrel 1.5 mg for emergency contraception supports its safety and efficacy profile. If two doses of levonorgestrel 0.75 mg are intended for administration, the second dose can positively be taken 12-24 h after the first dose without compromising its contraceptive efficacy. The main side effect was frequent menstrual irregularities. No serious adverse events were reported. The review shows that, emergency contraceptive regimen of single-dose levonorgestrel is not inferior in efficacy to the two-dose regimen. All the regimens studied were very efficacious for emergency contraception and prevented a high proportion of pregnancies if taken within 72 h of unprotected coitus. Single levonorgestrel dose (1.5 mg) can substitute two 0.75 mg doses 12 or 24 h apart. With either regimen, the earlier the treatment is given

  11. Impact and mechanistic role of oral contraceptive pills on the number and epithelial type of ovarian cortical inclusion cysts; a clinicopathology and immunohistochemical study.

    Science.gov (United States)

    DastranjTabrizi, Ali; MostafaGharabaghi, Parvin; SheikhzadehHesari, Farzam; Sadeghi, Liela; Zamanvandi, Sharareh; Sarbakhsh, Parvin; Ghojazadeh, Morteza

    2016-03-22

    Ovarian epithelial cancers are among the most lethal women's cancers. There is no doubt about the preventive role of oral contraceptive pills (OCPs) in development of ovarian cancers. But, there are limited numbers of studies to address the effect of these agents on the number of cortical inclusion cysts (CICs), their epithelial type and suppression of the metaplastic phenomenon by these pills. The aim of this study was to clarify the role of these agents in the prevention of these cyst formation and tubal metaplasia and also examine the mesenchymal-epithelial transition theory in this context by immunohistochemical methods. The representative section(s) of ovarian cortex from a total number of 201 consecutive total abdominal hysterectomy with bilateral or unilateral salpingo-oophorectomy specimens were examined for mean number of CICs and their epithelial type between two groups of the patients. Group A included the patients who were on oral contraceptive pills for more than 5 years. All of the subjects with other contraceptive methods or a history of less than 5 years contraceptive pills usage were stratified in group B. Sections from 20 cases in which more than five inclusion cysts were found, were selected for IHC staining with calretinine and PAX8 as markers for mesothelium and mullerian epithelium respectively. The mean age of the patients was 51.67 years with no significant differences between two groups. The mean number of cysts were 1.27 and 3.23 in group A and B respectively (P =0.0001). Similarly the mean number of CICs, lined by tubal epithelium, was significantly different between two groups (0.65 vs 2.65, P =0.0001). In IHC staining 123 out of 150 CICs (82 %) were PAX+ while only 7 CICs (4.8 %) showed positive reaction for calretinin irrespective of type of epithelium. Our findings showed that the use of OCP for more than five years in women, significantly prevents development of cortical inclusion cysts in the ovaries which lined by tubal

  12. Obesity and hormonal contraceptive efficacy.

    Science.gov (United States)

    Robinson, Jennifer A; Burke, Anne E

    2013-09-01

    Obesity is a major public health concern affecting an increasing proportion of reproductive-aged women. Avoiding unintended pregnancy is of major importance, given the increased risks associated with pregnancy, but obesity may affect the efficacy of hormonal contraceptives by altering how these drugs are absorbed, distributed, metabolized or eliminated. Limited data suggest that long-acting, reversible contraceptives maintain excellent efficacy in obese women. Some studies demonstrating altered pharmacokinetic parameters and increased failure rates with combined oral contraceptives, the contraceptive patch and emergency contraceptive pills suggest decreased efficacy of these methods. It is unclear whether bariatric surgery affects hormonal contraceptive efficacy. Obese women should be offered the full range of contraceptive options, with counseling that balances the risks and benefits of each method, including the risk of unintended pregnancy.

  13. Norethindrone acetate 1.0 milligram and ethinyl estradiol 10 micrograms as an ultra low-dose oral contraceptive.

    Science.gov (United States)

    Archer, David F; Nakajima, Steven T; Sawyer, Allan T; W