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Sample records for combined oral contraception

  1. Choosing a combined oral contraceptive pill

    PubMed Central

    Stewart, Mary; Black, Kirsten

    2015-01-01

    Summary The combined oral contraceptive pill is an effective contraceptive method which can also offer other benefits. However, other contraceptive options should be discussed. If the pill is the chosen method, prescribe a pill with the lowest effective dose of oestrogen and progestogen. Pills containing levonorgestrel or norethisterone in combination with ethinyloestradiol 35 microgram or less are considered first-line. They are effective if taken correctly, have a relatively low risk of venous thromboembolism, and are listed on the Pharmaceutical Benefits Scheme. The pill is usually taken in a monthly cycle. Some women may prefer an extended pill regimen with fewer or no inactive pills. PMID:26648603

  2. Zoely: a new combined oral contraceptive.

    PubMed

    2014-08-01

    ▼Zoely is the second estradiol-containing oral contraceptive formulated as an 'extended regimen' (pill-free interval <7 days) to be licensed in the UK. However, unlike the quadraphasic estradiol-containing contraceptive Qlaira, it is a monophasic preparation.1,2 It is postulated that combined oral contraceptives (COCs) containing synthetic estradiol, which is structurally identical to endogenous oestrogen,3 are potentially safer and better tolerated than those containing ethinylestradiol, the synthetic oestrogen most commonly used in COCs.4 The progestogen in Zoely is nomegestrol acetate, which is structurally related to progesterone,5 in contrast to the majority of progestogens in COCs that are derived from 19-nortestosterone6 and associated with androgenic effects.7 It is suggested that nomegestrol acetate, with its greater specificity for progesterone receptors, may minimise the potential for androgenic, oestrogenic and glucocorticoid effects.7 The company considers Zoely an option for women "who want a contraceptive with hormones similar to her own", and claims that it has a high level of contraceptive efficacy, produces shorter, lighter periods compared with a 21-day regimen of drospirenone 3mg/ethinylestradiol 30µg (Yasmin) and that most women report no negative impact on weight and skin.8 Here we review the effectiveness and place of Zoely. PMID:25104773

  3. Combination oral contraceptives and cancer risk.

    PubMed

    Gast, K; Snyder, T

    1990-07-01

    Substantial evidence exists to suggest that the use of oral contraceptives alters the risk for some types of cancer. Use of oral contraceptives for one year or more will reduce the risk of endometrial cancer and epithelial ovarian cancer by 50%, with the protective effect lasting for at least 10 years. The risk for developing cervical cancer in women who have used oral contraceptives appears to be slightly increased, although two independent studies actually found a protective effect associated with oral contraceptive use. The protective effect was probably related to the increased screening frequency found in oral contraceptive users and not related to a biologically protective effect. Therefore, women should be encouraged to undergo regular Pap tests. Data regarding breast cancer, in general, show no increased risk associated with oral contraceptive use. The latency associated with the development of breast cancer does not allow a definitive conclusion, and further study will be required. Oral contraceptives appear to increase the risk for developing benign hepatocellular adenoma, but not hepatocellular carcinoma. PMID:2202849

  4. Influence of combined oral contraceptives on the periodontal condition

    PubMed Central

    DOMINGUES, Roberta Santos; FERRAZ, Bruna Fidêncio Rahal; GREGHI, Sebastião Luiz Aguiar; de REZENDE, Maria Lúcia Rubo; PASSANEZI, Euloir; SANT'ANA, Adriana Campos Passanezi

    2012-01-01

    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. PMID:22666846

  5. Ziprasidone and the pharmacokinetics of a combined oral contraceptive

    PubMed Central

    Muirhead, G J; Harness, J; Holt, P R; Oliver, S; Anziano, R J

    2000-01-01

    Aims To determine whether multiple doses of ziprasidone alter the steady-state pharmacokinetics of the component steroids, ethinyloestradiol and levonorgestrel, of an oral contraceptive; to evaluate the tolerability of a co-administered combined oral contraceptive and ziprasidone; and to compare plasma concentrations of prolactin in subjects taking a combined oral contraceptive with placebo or ziprasidone. Methods Nineteen women taking a combined oral contraceptive (ethinyloestradiol 30 µg day−1 and levonorgestrel 150 µg day−1) were enrolled into a double-blind, placebo-controlled, two-way crossover study. They received ziprasidone 40 mg day−1 in two divided daily doses or placebo for 8 days (days 8–15) in one of two 21 day treatment periods separated by a 7 day washout period. Venous blood samples were collected immediately before and up to 24 h after the morning dose of oral contraceptive and ziprasidone or placebo on day 15 of each 21 day treatment period. These were assayed for ethinyloestradiol and levonorgestrel and the resulting data used to derive pharmacokinetic data for these steroids. Additional samples were collected immediately before and 4 h after the morning dose of oral contraceptive and ziprasidone or placebo on day 15 of each 21 day treatment period for prolactin assay. All observed and volunteered adverse events were recorded throughout the study. Results The mean AUC(0,24 h), Cmax and tmax for ethinyloestradiol and the mean AUC(0,24 h) and Cmax for levonorgestrel during ziprasidone co-administration were not statistically significantly different from corresponding values occurring during placebo co-administration. The tmax for levonorgestrel was approximately 0.5 h longer. Concomitant therapy with a combined oral contraceptive and ziprasidone did not result in adverse events not previously seen with either preparation alone. Conclusions The findings of this study suggest that, based on pharmacokinetic and tolerability data, ziprasidone

  6. [Zoely, a combined oral contraceptive, monophasic pill containing estradiol and nomegestrol acetate].

    PubMed

    Pintiaux, A; Gaspard, U; Nisolle, M

    2012-03-01

    A new combined oral contraceptive called Zoely has just been marketed in Belgium. It contains nomegestrol acetate, a progestin known for its high contraceptive reliability based on its antigonadotropic power and long half-life. This progestin is associated with estradiol and Zoely is devoid of ethinyl estradiol, which is the usual component of the majority of combined oral contraceptives and is primarily responsible for thrombotic side effects of the pill. The compositon and type of regimen of this new oral contraceptive contribute to its efficacy and excellent clinical tolerance. PMID:22611833

  7. Oral Contraceptives and Cancer Risk

    MedlinePlus

    ... oral contraceptives are available in the United States today? How could oral contraceptives influence cancer risk? How ... oral contraceptives are available in the United States today? Two types of oral contraceptives (birth control pills) ...

  8. Consensus conference on combination oral contraceptives and cardiovascular disease.

    PubMed

    1999-06-01

    At the June 1998 conference of the International Federation of Fertility Societies (IFFS), a consensus was reached that there is no reason to advise selective prescribing of oral contraceptives (OCs) containing different progestins on the basis of their effects on cardiovascular disease. All currently available low-dose OCs, regardless of their progestin component, are more beneficial for a woman's short- or long-term health than the alternative of use of no contraception or use of a less effective method. The usual precautions in selecting appropriate candidates for OC use should be applied. This consensus was reached after several investigators presented the results of their studies on OC use and cardiovascular risk to an IFFS panel. Consolidation of the available research evidence produced annual cardiovascular mortality rates per 100,000 among women 15-24 years old of 1.2 in OC non-users, 2.1 in users of second-generation OCs, and 1.8-2.3 in users of third-generation OCs; among women 35-44 years old, these rates were 9.2, 20.4, and 15.5-17.8, respectively. PMID:10360623

  9. Diabetes and oral contraception.

    PubMed

    Gourdy, Pierre

    2013-02-01

    The prevalence of diabetes mellitus is increasing dramatically worldwide, resulting in more and more women of reproductive age being affected by either type 1 or type 2 diabetes. Management of contraception is a major issue due to the specific risks associated with pregnancy and those potentially induced by hormonal contraceptives in diabetic women. This review emphasizes the urgent need to improve the use of contraception in women with diabetes. There is no consistent evidence that combined oral contraceptives significantly influence the risk of developing diabetes, even in women with a history of gestational diabetes. Furthermore, although data from specific studies remain sparse, no worsening effect has been reported in diabetic women, either in glycemic control or on the course of microvascular complications. Thus, the use of estroprogestive pills is now recognized as a safe and effective option for preconception care of women with uncomplicated diabetes. According to recent guidelines, these contraceptives must be avoided in case of associated cardiovascular risk factors, cardiovascular disease or severe microvascular complications such as nephropathy with proteinuria or active proliferative retinopathy. Prescription of combined hormonal contraception in type 2 diabetic women must also be considered with caution due to a frequent association with obesity and vascular risk factors which increase both thromboembolic and arterial risks. Thanks to their metabolic and vascular safety profile, progestin-only contraceptives, as well as non-hormonal methods, represent alternatives according to patient wishes. PMID:23384747

  10. New contraceptive eligibility checklists for provision of combined oral contraceptives and depot-medroxyprogesterone acetate in community-based programmes.

    PubMed Central

    Stang, A.; Schwingl, P.; Rivera, R.

    2000-01-01

    Community-based services (CBS) have long used checklists to determine eligibility for contraceptive method use, in particular for combined oral contraceptives (COCs) and the 3-month injectable contraceptive depot-medroxyprogesterone acetate (DMPA). As safety information changes, however, checklists can quickly become outdated. Inconsistent checklists and eligibility criteria often cause uneven access to contraceptives. In 1996, WHO produced updated eligibility criteria for the use of all contraceptive methods. Based on these criteria, new checklists for COCs and DMPA were developed. This article describes the new checklists and their development. Several rounds of expert review produced checklists that were correct, comprehensible and consistent with the eligibility requirements. Nevertheless, field-testing of the checklists revealed that approximately half (48%) of the respondents felt that one or more questions still needed greater comprehensibility. These findings indicated the need for a checklist guide. In March 2000, WHO convened a meeting of experts to review the medical eligibility criteria for contraceptive use. The article reflects also the resulting updated checklist. PMID:10994285

  11. Assessment of Incremental Dosage Regimen of Combined Oestrogen-Progestogen Oral Contraceptive

    PubMed Central

    Brosens, I. A.; Robertson, W. B.; Van Assche, F. A.

    1974-01-01

    Eighty-six women of proved fertility used an incremental dosage regimen of a combined oral contraceptive for a total of 570 cycles over one year. A daily tablet containing 50 μg of ethinyloestradiol and 50 μg D-norgestrel was taken for 11 days and a daily tablet containing 50 μg ethinyloestradiol and 125 μg D-norgestrel for the next 10 days. Withdrawal bleeding occurred during the tabletfree interval of seven days. The new preparation proved to be an efficient contraceptive, well tolerated, and with few side effects. Women who had gained weight while taking other oral contraceptives lost weight when they changed to the new preparation. The regimen allowed a significant reduction in the cycle dose of progestogen, and these results suggest that a further reduction in the cycle dose of both oestrogen and progestogen may be possible without losing contraceptive efficiency. PMID:4441832

  12. Estrogen and Progestin (Oral Contraceptives)

    MedlinePlus

    ... syndrome [AIDS]) and other sexually transmitted diseases.Some brands of oral contraceptives are also used to treat ... your doctor.Oral contraceptives come in many different brands. Different brands of oral contraceptives contain slightly different ...

  13. Oral Contraceptive Pill and PCOS

    MedlinePlus

    ... Health Gynecology Medical Conditions Nutrition & Fitness Emotional Health PCOS: The Oral Contraceptive Pill Posted under Health Guides . ... of oral contraceptive pills for young women with PCOS? Regular and Lighter Periods: Oral contraceptive pills can ...

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

    PubMed Central

    Nappi, Rossella E; Serrani, Marco; Jensen, Jeffrey T

    2014-01-01

    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. PMID:25120376

  15. Efficacy and safety of a 24-day regimen of drospirenone-containing combined oral contraceptive in Korean women

    PubMed Central

    Kim, Nayoung; Yoo, Ha-Na; Hyun, Hye Sun; Yoon, Byung-Koo; Choi, Doo-Seok

    2015-01-01

    This study assesses the efficacy and safety of a 24-day regimen of drospirenone-containing combined oral contraceptive, and demonstrates that it is an effective and safe option for contraception, releasing symptom of premenstrual dysphoric disorder and acne in Korean women. PMID:26430665

  16. Comparative study of the effects of combined oral contraceptives in hemostatic variables: an observational preliminary study.

    PubMed

    Stocco, Bianca; Fumagalli, Helen F; Franceschini, Silvio A; Martinez, Edson Z; Marzocchi-Machado, Cleni M; de Sá, Marcos Felipe S; Toloi, Maria Regina T

    2015-01-01

    Thrombotic risk is associated with the estrogen dose and type of progestin in combined oral contraceptives. Studies published since 1990 showed that third-generation progestins have larger risk to contribute to thrombosis development than the second-generation. However, there are conflicts in the literature regarding the thrombotic risk associated to the drospirenone progestin. So, this study aimed to evaluate the effects of 3 formulations of contraceptives containing ethinylestradiol (EE) (20 and 30 μg) combined with drospirenone versus levonorgestrel combined with EE (30 μg) in hemostatic parameters. This cross-sectional study included 70 healthy women between 18 and 30 years, BMI 19 to 30 kg/m², not pregnant, non-smokers, and users or non-users (control) of contraceptives for a minimum period of 6 months. The following parameters were assessed: prothrombin time (PT), Factor VII, activated partial thromboplastin time (aPTT), Factor XII, fibrinogen, Factor 1 + 2, Protein C, Protein S, antithrombin, D-dimers, and plasminogen activator inhibitor-1. Significant alterations were found in PT, aPTT, fibrinogen, D-dimers, and protein S, all favoring a state of hypercoagulation for contraceptive containing DRSP/20EE. Both contraceptives containing DRSP/30EE and LNG/30EE promoted changes that favor the hypercoagulability in the coagulant variable PT and in the anticoagulant variables Protein S and Protein C, respectively. We suggest that the progestin drospirenone can contribute to an inadequate balance among procoagulant, anticoagulant, and fibrinolytic factors, since that the contraceptive containing the lowest dose of estrogen and drospirenone (DRSP/20EE) caused a higher number of hemostatic changes. PMID:25634167

  17. Oral contraceptive drug interactions.

    PubMed

    Baciewicz, A M

    1985-01-01

    Approximately 50 million women use oral contraceptives (OC). Studies and case reports demonstrate that OC failure may be caused by rifampin, anticonvulsant drugs, and possibly some antibiotics. Contraceptive steroids may interfere with the metabolism of the benzodiazepines, theophylline, and the glucocorticoids. Future investigation will document the clinical significance of other OC interactions as well as give rise to new interactions. PMID:2859674

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

    PubMed

    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. PMID:25081657

  19. Antibiotics and oral contraceptives.

    PubMed

    Rubin, D F

    1981-04-01

    Dermatologists often prescribe oral tetracycline for the control of acne, primarily, and to a much lesser extent, for the treatment of cutaneous infections. A number of the patients taking tetracycline are also taking birth control pills. A recent article in the British Medical Journal (1980;1:293) indicates that this combination can lead to a failure of the (OC) oral contraceptive. Such failure had been associated with ampicillin as well. It is believed that the mechanism for this was the disturbance in normal gut flora, with consequent effects on bacterial hydrolysis of steroid conjugates. This would interrupt the enterohepatic circulation of contraceptive steroids, resulting in a less than normal concentration of circulating steroids. It was recommended that women taking low-dose OCs take extra precautions against pregnancy during any cycle in which antibiotics are given. In regard to our care of and responsibilities to our patients, and in an era when malpractice suits for all types of reasons are more common, it certainly behooves dermatologists to recognize and be concerned about this potential consequence of prescribing oral antibiotics. PMID:7212735

  20. History of oral contraception.

    PubMed

    Dhont, Marc

    2010-12-01

    On the 50th birthday of the pill, it is appropriate to recall the milestones which have led to its development and evolution during the last five decades. The main contraceptive effect of the pill being inhibition of ovulation, it may be called a small miracle that this drug was developed long before the complex regulation of ovulation and the menstrual cycle was elucidated. Another stumbling block on its way was the hostile climate with regard to contraception that prevailed at the time. Animal experiments on the effect of sex steroids on ovulation, and the synthesis of sex steroids and orally active analogues were the necessary preliminaries. We owe the development of oral contraceptives to a handful of persons: two determined feminists, Margaret Sanger and Katherine McCormick; a biologist, Gregory Pincus; and a gynaecologist, John Rock. Soon after the introduction of the first pills, some nasty and life-threatening side effects emerged, which were due to the high doses of sex steroids. This led to the development of new preparations with reduced oestrogen content, progestins with more specific action, and alternative administration routes. Almost every decade we have witnessed a breakthrough in oral contraception. Social and moral objections to birth control have gradually disappeared and, notwithstanding some pill scares, oral contraceptives are now one of the most used methods of contraception. Finally, all's well that ends well: recent reports have substantiated the multiple noncontraceptive health benefits paving the way for a bright future for this 50-year-old product. PMID:21091163

  1. Changing convention in combination oral contraceptives: estradiol and nomegestrol acetate in a monophasic 24/4 regimen.

    PubMed

    Shulman, Lee P

    2013-07-01

    Initial oral contraceptive regimens were characterised by high doses of ethinylestradiol (EE) and a progestogen in a 21-day regimen that either included seven additional hormone-free tablets or simply the 21 days of combination hormonal tablets. These regimens were developed to ensure high contraceptive effectiveness, regular and predictable withdrawal bleeding episodes to mimic a menstrual cycle, and minimal unscheduled vaginal bleeding. However, these regimens were associated with adverse tolerability and safety issues resulting from the dose and characteristics of their hormonal components. Attempts to ameliorate these adverse issues included the development of lower-dose EE regimens, the incorporation of new progestogens, multiphasic regimens, and reduced hormone-free interval regimens. However, the EE component has remained a constant until the recent approval of combination oral contraceptives with an estrogen component other than EE. The development and introduction of an estradiol-based oral contraceptive regimen is presented in this review. PMID:23709606

  2. Extended regimen combined oral contraception: A review of evolving concepts and acceptance by women and clinicians

    PubMed Central

    Nappi, Rossella E.; Kaunitz, Andrew M.; Bitzer, Johannes

    2016-01-01

    ABSTRACT Objectives: The clinical utility of extended regimen combined oral contraceptives (COCs) is increasingly being recognised. Our objective was to understand the attitudes of women and clinicians about the use of these regimens. We present the rationale for extended regimen COCs from a historical perspective, and trace their evolution and growing popularity in light of their clinical benefits. We conclude by offering potential strategies for counselling women about extended regimen COC options. Methods: We conducted a MEDLINE search to identify and summarise studies of extended regimen COCs, focusing on attitudes of women and clinicians regarding efficacy, safety/tolerability and fewer scheduled bleeding episodes and other potential benefits. Results: The body of contemporary literature on extended regimen COCs suggests that their contraceptive efficacy is comparable to that of conventional 28-day (i.e., 21/7) regimens. For women seeking contraception that allows infrequent scheduled bleeding episodes, particularly those who suffer from hormone withdrawal symptoms and cyclical symptoms (e.g., headache, mood changes, dysmenorrhoea, heavy menstrual bleeding), extended regimen COCs are an effective and safe option. Although satisfaction with extended regimen COCs in clinical trials is high, misperceptions about continuous hormone use may still limit the widespread acceptance of this approach. Conclusions: Despite the widespread acceptance among clinicians of extended regimen COCs as an effective and safe contraceptive option, these regimens are underused, likely due to a lack of awareness about their availability and utility among women. Improved patient education and counselling regarding the safety and benefits of extended regimen COCs may help women make more informed contraceptive choices. PMID:26572318

  3. Combined oral contraceptives for the treatment of acne: a practical guide.

    PubMed

    Arrington, Elizabeth A; Patel, Nishit S; Gerancher, Karen; Feldman, Steven R

    2012-08-01

    Many therapies exist in the arsenal of drugs available to dermatologists for the treatment of acne vulgaris. Among them, hormonal therapy stands out as a unique and highly efficacious treatment modality. Although some dermatologists may be hesitant to prescribe hormonal therapies, they can be safely and appropriately used in eligible female patients to treat acne vulgaris. Herein, current issues regarding the hormonal treatment of acne in the form of combined oral contraceptives (COCs) are presented, and a practical method for implementing this therapy is proposed. Specifically, drug selection, associated risks, benefits, monitoring, and counseling are discussed, with emphasis on the practicality of use in the clinical setting. PMID:22988652

  4. Progestin-Only Oral Contraceptives

    MedlinePlus

    Progestin-only oral contraceptives are used to prevent pregnancy. Progestin is a female hormone. It works by preventing the ... mucus and the lining of the uterus. Progestin-only oral contraceptives are a very effective method of ...

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

    PubMed Central

    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

    2015-01-01

    Objectives To estimate the proportion and number of cancers occurring in Australia in 2010 attributable to combined oral contraceptive pill (OCP) use. Methods 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. Results 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. Conclusions 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. Implications 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. PMID:26437729

  6. [Medication of the month. A new combined oral contraceptive containing estradiol valerate and dienogest (Qlaira)].

    PubMed

    Gaspard, U; Pintiaux, A; Kridelka, F

    2010-12-01

    In combined oral contraception (OC), a drastic reduction of both ethinylestradiol and androgenic progestins mostly derived from 19 NOR testosterone, allowed to moderately reduce the adverse impact of classical combined pills on metabolism and circulation (both arterial and venous). However, the marked hepatic action of ethinylestradiol, even in small dosages, lessens the expected risk reduction. For the first time, an OC has been developed, which contains estradiol valerate (with reduced hepatic action because of lack of a 17alpha ethinyl group) with dienogest, a 19 NOR testosterone-derived nonandrogenic progestin, which powerfully inhibits endometrial proliferation. Thanks to a dynamic modulation of estrogen and progestin doses (26 active days + 2 placebo days), an adequate contraceptive effectiveness, a good cycle control and drug tolerance are achieved, similar to those obtained with a classical low-dose OC. Recent data indicate that this new combination reduces the usually observed metabolic impact. An adequate cycle control (with 20% amenorrhea) is achieved for the first time with estradiol valerate + progestin,, in opposition with prior catastrophic results with other formulations containing 17beta-estradiol. A second combination containing estradiol + nomegestrol acetate (monophasic, 24 active days + 4 placebo days) is under study and seems also to yield promising results. Of course, in-depth study of metabolic and vascular effects of these new combinations is mandatory - and ongoing. PMID:21287768

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

    PubMed Central

    Bahamondes, Luis; Lira-Plascencia, Josefina; Martin, Ricardo; Marin, Victor; Makuch, Maria Y

    2015-01-01

    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 of COCs. To adequately counsel their patients regarding COC intake, OBGYNs must be updated regarding all aspects of COC use. PMID:25999766

  8. Combined oral contraceptive synergistically activates mineralocorticoid receptor through histone code modifications.

    PubMed

    Igunnu, Adedoyin; Seok, Young-Mi; Olatunji, Lawrence A; Kang, Seol-Hee; Kim, Inkyeom

    2015-12-15

    Clinical studies have shown that the use of combined oral contraceptive in pre-menopausal women is associated with fluid retention. However, the molecular mechanism is still elusive. We hypothesized that combined oral contraceptive (COC) ethinyl estradiol (EE) and norgestrel (N) synergistically activates mineralocorticoid receptor (MR) through histone code modifications. Twelve-week-old female Sprague-Dawley rats were treated with olive oil (control), a combination of 0.1µg EE and 1.0µg N (low COC) or 1.0µg EE and 10.0µg N (high COC) as well as 0.1 or 1.0µg EE and 1.0 or 10.0µg N daily for 6 weeks. Expression of MR target genes in kidney cortex was determined by quantitative real-time polymerase chain reaction. MR was quantified by western blot. Recruitment of MR and RNA polymerase II (Pol II) on promoters of target genes as well as histone code modifications was analyzed by chromatin immunoprecipitation assay. Treatment with COC increased renal cortical expression of MR target genes such as serum and glucocorticoid-regulated kinase 1 (Sgk-1), glucocorticoid-induced leucine zipper (Gilz), epithelial Na(+)channel (Enac) and Na(+)-K(+)-ATPase subunit α1 (Atp1a1). Although COC increased neither serum aldosterone nor MR expression in kidney cortex, it increased recruitment of MR and Pol II in parallel with increased H3Ac and H3K4me3 on the promoter regions of MR target genes. However, treatment with EE or N alone did not affect renal cortical expression of Sgk-1, Gilz, Enac or Atp1a1. These results indicate that COC synergistically activates MR through histone code modifications. PMID:26506558

  9. A combined oral contraceptive affects mucosal SHIV susceptibility factors in a pigtail macaque model

    PubMed Central

    Ostergaard, Sharon Dietz; Butler, Katherine; Ritter, Jana M.; Johnson, Ryan; Sanders, Jeanine; Powell, Nathaniel; Lathrop, George; Zaki, Sherif R.; McNicholl, Janet M.; Kersh, Ellen N.

    2015-01-01

    Background Injectable hormonal contraception may increase women’s risk of HIV acquisition, and can affect biological risk factors in animal models of HIV. We established, for the first time, a model to investigate whether combined oral contraceptives (COC) alter SHIV susceptibility in macaques. Methods Seven pigtail macaques were administered a monophasic levonorgestrel (LNG)/ethinyl estradiol (EE) COC at 33% or 66% of the human dose for 60 days. Menstrual cycling, vaginal epithelial thickness and other SHIV susceptibility factors were monitored for a mean of 18 weeks. Results Mean vaginal epithelial thicknesses was 290.8 μm at baseline and 186.2 μm during COC (p=0.0141, Mann Whitney test). Vaginal pH decreased from 8.5 during to 6.5 post- treatment (0.0176 two-tailed t-test). Measured microflora was unchanged. Conclusions COC caused thinning of the vaginal epithelium and vaginal pH changes, which may increase SHIV susceptibility. 0.033 mg LNG + 0.0066 mg EE appeared effective in suppressing ovulation. PMID:25536296

  10. Serum lipids and proteins during treatment with a new oral contraceptive combination containing desogestrel.

    PubMed

    Penttilä, I M; Bergink, E W; Holma, P; Hulkko, S; Makkonen, M; Pyörälä, T; Castrén, O

    1983-12-01

    The present study was carried out to measure lipid and protein levels in serum of healthy women during treatment with a new oral contraceptive combination containing 0.075 mg desogestrel (Org 2969, 17 alpha-ethinyl-18-methyl-11-methylene-4-estren-17-ol) plus 0.050 mg ethinyloestradiol per tablet. All 30 volunteers took 1 tablet daily for 21 consecutive days, followed by a tablet-free period of 7 days. Treatment lasted 3 months. At the end of treatment serum total cholesterol had increased by 0.26 mmol/l (5.0%), high-density lipoprotein-cholesterol by 0.22 mmol/l (15.2%) and triglycerides by 0.43 mmol/l (50%); the calculated low-density lipoprotein cholesterol had decreased by 0.16 mmol/l (4.9%). All lipid concentrations had returned to initial levels 2 months after treatment stopped. After 3 months treatment serum ceruloplasmin, cortisol-binding globulin capacity, sex-hormone-binding globulin capacity and thyroxine-binding globulin had significantly increased by 85.2, 133, 206 and 101%, respectively. All protein levels returned to normal 2 months after treatment stopped. The relationship between serum lipids and hormone-binding proteins has been discussed, as well as the significance of the high-density lipoprotein level with regard to contraceptive treatment. PMID:6232161

  11. Lack of Pharmacokinetic Interactions Between Macitentan and a Combined Oral Contraceptive in Healthy Female Subjects.

    PubMed

    Hurst, Noémie; Pellek, Matthias; Dingemanse, Jasper; Sidharta, Patricia N

    2016-06-01

    Macitentan, a dual endothelin receptor antagonist used in pulmonary arterial hypertension, induces cytochrome P450 (CYP) 3A at supratherapeutic concentrations in vitro. Most combined oral hormonal contraceptives (OCs) are CYP3A substrates and their efficacy can be affected by CYP3A inducers. This randomized crossover study assessed possible pharmacokinetic (PK) interactions between macitentan and an OC containing ethinyl estradiol and norethindrone (or norethisterone). Twenty-six healthy women received a single oral dose of OC alone (reference) and concomitantly with 10 mg macitentan at steady state (test). No PK interaction was concluded if the 90% confidence intervals (CIs) of geometric mean ratios (GMRs; test/reference) of the peak plasma concentration (Cmax ) and the exposure from 0 to infinity (AUC0 - ∞ ) to the OC components were within the equivalence limits of 0.8 to 1.25. Cmax and AUC0-∞ of the OC were within the equivalence limits. For ethinyl estradiol, GMRs (90%CIs) of Cmax and AUC0-∞ were 0.92 (0.85-0.99) and 0.95 (0.90-0.99). For norethindrone, these values were 1.02 (0.95-1.09) and 1.04 (0.98-1.09), respectively. Overall, study treatments were well tolerated. No major changes from baseline in safety parameters were reported in either treatment. Macitentan does not affect the PK of OCs. PMID:26381054

  12. Adolescents and oral contraceptives.

    PubMed

    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

  13. Efficacy and safety of combined ethinyl estradiol/drospirenone oral contraceptives in the treatment of acne.

    PubMed

    Tan, Jerry Kl; Ediriweera, Chemanthi

    2010-01-01

    Acne is a common disorder affecting the majority of adolescents and often extends into adulthood. The central pathophysiological feature of acne is increased androgenic stimulation and/or end-organ sensitivity of pilosebaceous units leading to sebum hypersecretion and infundibular hyperkeratinization. These events lead to Propionibacterium acnes proliferation and subsequent inflammation. Hormonal therapy, including combined oral contraceptives (OCs), can attenuate the proximate androgenic trigger of this sequence. For many women, hormonal therapy is a rational option for acne treatment as it may be useful across the spectrum of severity. Drospirenone (DRSP) is a unique progestin structurally related to spironolactone with progestogenic, antimineralocorticoid, and antiandrogenic properties. It is available in 2 combined OC preparations (30 μg EE/3 mg DRSP; Yasmin(®) in a 21/7 regimen; and 20 μg EE/3 mg DRSP; Yaz(®) in a 24/4 regimen). These preparations are bereft of the fluid retentional side effects typical of other progestins and their safety has been demonstrated in large epidemiological studies in which no increased risk of vascular thromboembolic disease or arrhythmias was observed. In acne, the efficacy of DRSP-containing OCs has been shown in placebo-controlled superiority trials and in active-comparator non-inferiority trials. PMID:21072290

  14. Pharmacokinetic interaction study between riociguat and the combined oral contraceptives levonorgestrel and ethinylestradiol in healthy postmenopausal women

    PubMed Central

    Unger, Sigrun; van der Mey, Dorina; Becker, Corina; Saleh, Soundos; Wensing, Georg; Mück, Wolfgang

    2016-01-01

    Abstract Female patients requiring treatment for pulmonary arterial hypertension (PAH) are advised to avoid pregnancy because of the high associated mortality rate. Oral contraception is one of the main methods of preventing pregnancy in this context, mandating pharmacokinetic and safety studies for new agents in this setting. Riociguat is a soluble guanylate cyclase stimulator approved for treatment of PAH and inoperable and persistent or recurrent chronic thromboembolic pulmonary hypertension. This single-center, randomized, nonblinded study involving healthy postmenopausal women investigated the effect of riociguat on plasma concentrations of levonorgestrel (0.15 mg) and ethinylestradiol (0.03 mg) in a combined oral contraceptive. Treatment A was a single oral tablet of levonorgestrel-ethinylestradiol. In treatment B, subjects received 2.5 mg riociguat 3 times daily for 12 days. On the eighth day, they also received a single oral tablet of levonorgestrel-ethinylestradiol. Subjects received both regimens in a crossover design. There was no change in area under the plasma concentration–time curves of levonorgestrel or ethinylestradiol or maximum concentration in plasma (Cmax) of levonorgestrel during combined administration versus levonorgestrel-ethinylestradiol alone. A 20% increase in the Cmax of ethinylestradiol was noted during coadministration; this is not anticipated to adversely impact the contraceptive efficacy or to require any dose adjustment for ethinylestradiol. Plasma concentrations and exposures of riociguat were within the expected range and were not influenced by coadministration with levonorgestrel-ethinylestradiol. Combined treatment was safe and well tolerated. In conclusion, riociguat did not change the exposure to levonorgestrel or ethinylestradiol relative to oral contraceptive administered alone. PMID:27162633

  15. A comparative study of two low-dose combined oral contraceptives: results from a multicenter trial.

    PubMed

    Dunson, T R; McLaurin, V L; Israngkura, B; Leelapattana, B; Mukherjee, R; Perez-Palacios, G; Saleh, A A

    1993-08-01

    A comparative multicenter clinical trial of two low-dose combined oral contraceptives (OCs) was conducted in Malaysia, Egypt, Thailand, and Mexico. Efficacy, safety and acceptability were investigated in women taking either a norgestrel-based (NG) OC or a norethindrone acetate-based (NA) OC. This paper includes analysis of 892 women, all of whom were at least 42 days but within 26 weeks postpartum and randomly allocated to one of the above OCs. Follow-up visits were scheduled at 1, 4, 8 and 12 months after admission. Baseline sociodemographic characteristics were similar for both groups, as well as compliance. There were nine unintended pregnancies reported; eight of these occurring in the NA group. Adverse experiences were minor with headaches and dizziness being the most common complaints; frequency of reports was similar in both groups. The group taking the NG-based OC had significantly (p < .05) fewer menstrual-related complaints. Discontinuations due to menstrual problems were significantly more common among NA users (primarily amenorrhea). Discontinuations in the NG group were primarily for other personal reasons, e.g. unable to return to the clinic. There was also a significant difference between the two groups for the 11-month gross cumulative life table discontinuation rates due to menstrual problems (p < .01); the NA group had the higher rate. PMID:8403908

  16. Seeing things differently: expert and consumer mental models evaluating combined oral contraceptives.

    PubMed

    Vogt, Claudia; Schaefer, Marion

    2012-01-01

    Communication regarding the benefits and risks of combined oral contraceptives (COCs) remains a challenge in view of persistent misconceptions about the 'pill'. The aim of this study was to investigate how women understand the benefits and risks of COCs, comparing their assessments with an expert model created from literature- and guideline-based research and reviewed by a sample of gynaecologists using the mental models approach. Two qualitative studies were conducted in Germany - a questionnaire-based study involving 30 gynaecologists with a mean of 218 COC prescriptions on average per month, and in-depth interviews (plus the use of a questionnaire) with 21 women aged 18-24 years. As expected, women reported only a few concepts of benefits and risks unprompted, but further prompting revealed beliefs of many other associations. The women stated an overall positive valence even if the number of negative concepts predominated indicating a latent cognitive dissonance. The major differences compared with the expert model included: (a) a negative association with weight gain, subfertility and teratogenicity, (b) only a partial association of COC intake with thromboembolic conditions, (c) a confusing, rather negative perception of a COC-related effect on cancer and (d) a partial lack of basic knowledge of the active ingredients, time to excretion and mode of action of COCs. Appropriate COC counselling should cover these discrepancies. PMID:22519728

  17. Non-Contraceptive Benefits of Oral Hormonal Contraceptives

    PubMed Central

    Schindler, Adolf E

    2012-01-01

    Abstract It is becoming evident that oral hormonal contraceptives-besides being well established contraceptives-seem to become important medications for many functional or organic disturbances. So far, clinical effectiveness has been shown for treatment as well as prevention of menstrual bleeding disorders and menstrual-related pain symptoms. Also this is true for premenstrual syndrome (PMS) and premenstrual disphoric disorder (PMDD). Particular oral contraceptives (OCs) containing anti-androgenic progestogens were shown to be effective medications for treatment of androgenisation symptoms (seborrhea, acne, hirsutism, alopecia). Through perfect suppression of the hypothalamic-pituitary-ovarian axis OCs have proven to be effective in elimination of persistent follicular cysts. Endometriosis/adenomyosis related pain symptoms are well handled similar to other drugs like Gonadotropine Releasing Hormone agonists but are less expensive, with less side effects, and possibility to be used for longer periods of time. This is also true for myoma. Pelvic inflammatory disease, rheumatoid arthritis, menstrual migraine, and onset of multiple sclerosis are prevented or delayed. Bone density is preserved and asthma symptoms improved. Endometrial hyperplasia and benign breast disease can be controlled. There is definitely a significant impact on risk reduction regarding endometrial, ovarian, and colon cancers. In conclusion, it needs to be recognized that oral combined hormonal contraceptives (estrogen/ progestogen combination) are - besides being reliable forms of contraception - are cost-effective medications for many medical disorders in women. Therefore, these contraceptives drugs are important for female and global health and should be used in clinical practice. PMID:23853619

  18. [Interactions between oral contraceptives and other drugs].

    PubMed

    Hansen, T H; Jensen, S B

    1991-10-28

    Failures of oral contraceptives are possible when combined with rifampicin or antiepileptics, especially phenobarbitone and phenytoin. The mode of action is shown by clinical trials to be due to induction of hepatic enzymes thus increasing the steroid metabolism. Failure or oral contraceptives has occurred with the concomitant use of antibiotics, i.e. ampicillin and sulfonamides. Clinical trials have focused upon the changes in the intestinal flora induced by antibiotics. This might influence the enterohepatic circulation of estrogen and thereby decrease reabsorption of estrogen, but this has not been definitely proved. The failures may be caused by individual pharmacokinetics of oral contraceptives. Oral contraceptives are able to influence the pharmacodynamics of various other drugs metabolized by oxidation or conjugation but besides an increased pharmacological effect of prednisolone and increased toxicity of imipramine the clinical importance is uncertain. PMID:1949335

  19. Effect of combined low-dose oral contraceptives on blood viscosity and haematocrit.

    PubMed

    Ishak, R; Loh Chooi Khim

    1991-06-01

    Researchers compared the results of hematocrit and blood viscosity tests of 16 women using a combined oral contraceptive (COC) with 30 mcg ethinyl estradiol/150 mcg desogestrel (group 1), 11 women using a COC with 30 mcg ethinyl estradiol/150 mcg levonorgestrel (group 2), and 16 women who did not use any OCs (control group), all who attended the National Population and Family Development Clinic at the General Hospital in Kuala Lumpur, Malaysia. They wanted to examine the effects of COCs on blood viscosity, which is inversely related to blood flow, and hematocrit. The women were matched for age. The hematocrit level of women who took the ethinyl estradiol/desogestrel COC was significantly higher than that of the control group (41.5% vs. 37.4%; p.001). On the other hand, the hematocrit level of women who took the ethinyl estradiol/levonorgestrel COC was close to that of the control group (38.5% vs. 37.4%). Even though the mean whole blood viscosity for group 2 was higher than that of group 1 and the control group (6.6 cps vs. 5.5 cps), the difference was insignificant. Yet whole blood viscosity of group 2 at the higher shear rates (46, 115, and 230 per second) was significantly higher than the control group (p.05). The whole blood viscosities of group 1 and the control group did not differ considerably. This supported the theory that hematocrit contributes to blood viscosity. Further these results agreed with those of another study which also showed increased blood viscosity and hematocrit in healthy women taking OCs. Thus thromboembolic events in women taking OCs could be a result of a drop in rate of blood flow which at the lower shear rates could increase red cell aggregation and clotting. In conclusion, health providers could use these indicators to monitor women who have used OCs over a considerable period for thrombotic risks to determine if OC use should continue. PMID:12317443

  20. Use of Simulated Patients to Evaluate Combined Oral Contraceptive Dispensing Practices of Community Pharmacists

    PubMed Central

    Obreli-Neto, Paulo Roque; Pereira, Leonardo Régis Leira; Guidoni, Camilo Molino; Baldoni, André de Oliveira; Marusic, Srecko; de Lyra-Júnior, Divaldo Pereira; de Almeida, Kelsen Luis; Pazete, Ana Claudia Montolezi; do Nascimento, Janaina Dutra; Kos, Mitja; Girotto, Edmarlon; Cuman, Roberto Kenji Nakamura

    2013-01-01

    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. PMID:24324584

  1. Progestin-Only Oral Contraceptives

    MedlinePlus

    ... oral contraceptives are a very effective method of birth control, but they do not prevent the spread of ... on another day, use a backup method of birth control (such as a condom and/or a spermicide) ...

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

    PubMed Central

    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

  3. Oral contraceptives and exercise.

    PubMed

    Mostardi, R A; Woebkenberg, N R; Jarrett, M T

    1980-01-01

    A laboratory study was undertaken with volunteer females (aged 20-25) to determine the effect of OCs (oral contraceptives) on hematologic and metabolic variables during exercise. 5 of the women studied were naturally cycling and 7 were taking OCs. The women worked at 2 workloads on a bicycle ergometer at 50% and 90% of their maximal aerobic capacity during 3 different phases of their menstrual cycle. There was no better time of the month for doing the 50% or the 90% workload in either group. Heartrate for the OC group was significantly higher at the 50% maximal capacity. Results of the test indicate tha women on OCs have somewhat reduced cardiac efficiency and are ventilating more to carry out a given amount of work when compared to women who are naturally cycling. Possible explanations for the higher heart rate are put forward. The main limitation of the study is that the subject numbers involved are small and the number of cycles studied is also small. PMID:12278397

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

    PubMed

    Maia, Hugo; Haddad, Clarice; Casoy, Julio

    2013-01-01

    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

  5. The Combined Influence of Oral Contraceptives and Human Papillomavirus Virus on Cutaneous Squamous Cell Carcinoma

    PubMed Central

    Efird, Jimmy T.; Toland, Amanda E.; Lea, C. Suzanne; Phillips, Christopher J.

    2011-01-01

    The vast majority of cutaneous squamous cell carcinoma (CSCC) will occur in those with fair complexion, tendency to burn, and high ultraviolet radiation (UVR) exposure. Organ transplant recipients also are an important population at great risk for CSCC. An association has been reported between oral contraceptive (OC) use, human papillomavirus virus (HPV) and cervical cancer, and there could be a similar association for CSCC. The cutaneous HPV β-E6 protein, a close cousin of the transformative E6 protein underlying anogenital cancers, has been shown to inhibit apoptosis in response to UVR damage and stimulate morphologic transformation in rodent fibroblast cell lines. Furthermore, OC use has been shown to enhance HPV transcription and may contribute to CSCC risk through this pathway. PMID:21499554

  6. Oral contraceptives in polycystic ovary syndrome.

    PubMed

    Helvaci, N; Yildiz, B O

    2014-09-01

    Polycystic ovary syndrome (PCOS) is the most common endocrine disorder of women of reproductive age and combined oral contraceptives (OCs) are often the first-line treatment of the syndrome by improving hyperandrogenism and regulating menstrual cycles. Oral contraceptives have some cardiovascular and metabolic effects that varies among different formulations depending upon the dose and type of the both estrogen and progestin components. These cardiometabolic effects of OCs raise some concerns about their long-term use in PCOS, but available data suggest that the benefits outweigh the risks. More studies are needed to clarify the safety of long-term use of OCs in PCOS. PMID:25003228

  7. An overview of the development of combined oral contraceptives containing estradiol: focus on estradiol valerate/dienogest

    PubMed Central

    Fruzzetti, Franca; Trémollieres, Florence; Bitzer, Johannes

    2012-01-01

    Natural estrogens such as estradiol (E2) or its valerate ester (E2V) offer an alternative to ethinyl estradiol (EE). E2-containing combined oral contraceptives (COCs) have demonstrated sufficient ovulation inhibition and acceptable contraceptive efficacy. However, earlier formulations were generally associated with unacceptable bleeding profiles. Two E2V-containing preparations have been approved to date for contraceptive use: E2V/cypro-terone acetate (CPA) (Femilar®; only approved in Finland and only in women >40 years or women aged 35–40 years in whom a COC containing EE is not appropriate) and E2V/dienogest (DNG; Qlaira®/Natazia®). The objective of the current review is to provide an overview of the development of COCs containing natural estrogen, highlighting past issues and challenges faced by earlier formulations, as well as the current status and future directions. The majority of information to date pertains to the development of E2V/DNG. PMID:22468839

  8. [Effect of oral contraceptives on vaginal flora].

    PubMed

    Batashki, I; Markova, D; Milchev, N; Uchikova, E; Gŭrova, A

    2006-01-01

    The contraceptive and non contraceptive advantages of oral chormonal contraceptives as well as the good control on fertility, make it one of the most preffered method of contraception. The normal vaginal flora is a dynamic ecosystem and itsequilibrium and status of eubyosis amongst its inhabitants is an important mechanism against exogenous infections. The use of oral contraceptives is not associated with significant changes in the vaginal microbial flora; the normal concentration of the lactobacillli is preserved. PMID:16889189

  9. [Oral combined hormonal contraception containing nomegestrol acetate and 17beta-oestradiol--the statement of Polish Gynecological Society Experts Group].

    PubMed

    Debski, Romuald; Kotarski, Jan; Paszkowski, Tomasz; Pawelczyk, Leszek; Poreba, Ryszard; Skrzypulec-Plinta, Violetta; Tomaszewski, Jacek

    2012-04-01

    Nomegestrol acetate (NOMAC) combined with E2 (Zoely) is a monophasic oral contraceptive (OC) which safety and efficacy was confirmed in a number of level I evidence clinical trials. Zoely is highly effective OC, especially in overweight and obese patients, with good cycle control, safe and well tolerated. NOMAC/E2 combination causes no or minimal weight gain and is characterized by minimal influence on bone mineral density or blood pressure and presence of acne. Moreover lipids profile, carbohydrates metabolism, haemostasis and endocrine glands functioning were not affected. High tolerance and acceptance of NOMAC/E2 combination by women, low adverse event profile, fast recovery of ovarian activity and ovulation is a reasonable treatment tool in everyday practice. PMID:22712267

  10. Spontaneous hepatic hemorrhage secondary to prolonged use of oral contraceptives.

    PubMed

    Jaffar, Reema; Pechet, Liberto; Whalen, Giles Francis; Banner, Barbara F

    2010-05-15

    Oral contraceptive pills (OCP) are the most commonly used form of contraception throughout the United States of America. The prolonged usage of oral contraceptives leads to a variety of complications, ranging from subclinical modifications of liver function tests to the development of benign and malignant tumors of the liver. Spontaneous hepatic hemorrhage secondary to oral contraceptive use was only reported once in the early 1980s. We report a case of spontaneous hepatic hemorrhage secondary to prolonged ingestion of combined OCPs followed by multiple pulmonary emboli without underlying thrombophilia. PMID:19577854

  11. Benefits and risks of oral contraceptives.

    PubMed

    Sherif, K

    1999-06-01

    The major benefits of modern low-dose oral contraceptives include relative safety and a high degree of efficacy, decreasing the need for abortion or surgical sterilization; reduced risks of bacterial (but not viral) pelvic inflammatory disease and of endometrial and ovarian cancer; improved menstrual regularity, with less dysmenorrhea and blood flow; and, when low-dose combination (not progestogen-only) oral contraceptives are used, reduced acne and hirsutism. Major risks are cardiovascular. Preliminary data from nonrandomized studies suggest that oral contraceptives containing third-generation progestogens are associated with increased risk of venous thromboembolism, particularly in carriers of the coagulation factor V Leiden mutation. The risk of arterial thrombosis, such as myocardial infarction or stroke, may be directly related to estrogen dose, particularly in women who have hypertension, smoke, or are >35 years old. Considering that only users aged >/=30 years who smoke >/=25 cigarettes/d have a higher estimated mortality rate than that of pregnant women, the benefits of oral contraceptives appear to outweigh their risks. PMID:10368519

  12. Evaluation of extended and continuous use oral contraceptives

    PubMed Central

    Wright, Kristen Page; Johnson, Julia V

    2008-01-01

    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. PMID:19209272

  13. Nomegestrol acetate/estradiol: in oral contraception.

    PubMed

    Yang, Lily P H; Plosker, Greg L

    2012-10-01

    Nomegestrol acetate/estradiol is a combined oral contraceptive with approval in many countries. This fixed-dose combination tablet contains nomegestrol acetate, a highly selective progestogen, and estradiol, a natural estrogen. It is the first monophasic combined oral contraceptive to contain estradiol, and is taken in 28-day cycles, consisting of 24 active therapy days with 4 placebo days (i.e. 24/4-day cycles). In two large, 1-year, randomized, open-label, multicentre, phase III trials in healthy adult women (aged 18-50 years), nomegestrol acetate/estradiol was at least as effective as drospirenone/ethinylestradiol as contraceptive therapy, as the pregnancy rates in women aged 18-35 years (primary efficacy population) in terms of the Pearl Index (primary endpoint) were numerically lower with nomegestrol acetate/estradiol, although the between-group difference was not statistically significant. In both trials, nomegestrol acetate/estradiol was given in a 24/4-day cycle, and drospirenone/ethinylestradiol was given in a 21/7-day cycle. The criteria for using condoms in case of forgotten doses were less stringent in the nomegestrol acetate/estradiol group than in the drospirenone/ethinylestradiol group. Nomegestrol acetate/estradiol therapy for up to 1 year was generally well tolerated in healthy adult women, with an acceptable tolerability profile in line with that expected for a combined oral contraceptive. The most commonly reported adverse events were acne and abnormal withdrawal bleeding (most often shorter, lighter or absent periods). Overall, compared with drospirenone/ethinylestradiol, nomegestrol acetate/estradiol appeared to be associated with less favourable acne-related outcomes, and shorter, lighter or absent periods. PMID:22950535

  14. Multinational, multicentre, randomised, open-label study evaluating the impact of a 91-day extended regimen combined oral contraceptive, compared with two 28-day traditional combined oral contraceptives, on haemostatic parameters in healthy women

    PubMed Central

    Paoletti, Anna Maria; Volpe, Annibale; Chiovato, Luca; Howard, Brandon; Weiss, Herman; Ricciotti, Nancy

    2014-01-01

    Objectives To evaluate the impact of a 91-day extended regimen combined oral contraceptive (150 μg levonorgestrel [LNG]/30 μg ethinylestradiol [EE] for 84 days, followed by 10 μg EE for seven days [Treatment 1]) compared with two traditional 21/7 regimens (21 days 150 μg LNG/30 μg EE [Treatment 2] or 150 μg desogestrel [DSG]/30 μg EE [Treatment 3], both with seven days’ hormone free), on several coagulation factors and thrombin formation markers. Methods Randomised, open-label, parallel-group comparative study involving healthy women (18–40 years). The primary endpoint was change from baseline in prothrombin fragment 1 + 2 (F1 + 2) levels over six months. Results A total of 187 subjects were included in the primary analysis. In all groups, mean F1 + 2 values were elevated after six months of treatment. Changes were comparable between Treatments 1 and 2 (least squares mean change: 170 pmol/L and 158 pmol/L, respectively) but noticeably larger after Treatment 3 (least squares mean change: 592 pmol/L). The haemostatic effects of Treatment 1 were comparable to those of Treatment 2 and noninferior to those of Treatment 3 (lower limit of 95% confidence interval [− 18.3 pmol/L] > − 130 pmol/L). Conclusions The LNG/EE regimens had similar effects on F1 + 2. Noninferiority was demonstrated between extended regimen LNG/EE and DSG/EE. PMID:24923685

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

    PubMed Central

    Burke, Anne

    2013-01-01

    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. PMID:23836965

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

    PubMed

    Burke, Anne

    2013-01-01

    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. PMID:23836965

  17. [The acceptability of different oral contraceptive methods].

    PubMed

    Klinger, G; Fritzsche, H; Hempel, E; Carol, W; Böhme, W; Scholz, B; Grass, M; Chemnitius, K H

    1975-05-01

    Results of a survey of contraceptive acceptability are reported. In formation on oral and depot hormonal contraceptives was distributed to 1064 Ovosiston or Nonovlon users, 110 women using depot contraceptives, and 609 women who had never used hormonal contraception. The women's preferences with regard to administration schedule, and their perceptions of effectiveness and safety were noted. Non-users considered daily, weekly, or monthly administration acceptable, while only 2/3 of those taking oral contraceptives thought daily administration convenient. 90.2% of Deposiston patients did not care for daily administration. Deposiston patients also had the greatest confidence in their method. The authors believe on the basis of this survey that weekly administration may be highly acceptable alternative t o conventional oral contraception. PMID:1140078

  18. A randomized comparative trial of a combined oral contraceptive and azelaic acid to assess their effect on sleep quality in adult female acne patients.

    PubMed

    Albuquerque, Rachel Gimenes; da Rocha, Marco Alexandre Dias; Hirotsu, Camila; Hachul, Helena; Bagatin, Edileia; Tufik, Sergio; Andersen, Monica Levy

    2015-12-01

    Several studies have reported an increase in the prevalence of adult female acne. This subtype of acne presents particular characteristics, and can be triggered by several factors such as smoking, stress, the use of oily cosmetics and even by poor sleep. Sleep quality is related to well-being and the maintenance of body homeostasis. In addition, several skin diseases present a bidirectional relationship with sleep, demonstrating an important connection between skin and the central nervous system. With this in mind, we aimed to compare the effect of two types of treatment for adult female acne (azelaic acid or a combined oral contraceptive) on sleep quality and on concentrations of stress hormones. Also, we proposed to assess the correlation of sleep and hormonal parameters with acne severity. In order to do this, 32 women underwent a clinical evaluation, completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire and had their blood collected for hormone assays. These procedures were performed at baseline and after 6 months of treatment. At baseline there were no differences between the groups in terms of body mass index, age, acne severity and hormone concentrations. Results showed that both treatments demonstrated effectiveness but that women treated with azelaic acid presented a better sleep quality after the treatment compared to baseline and to the group treated with the combined oral contraceptive. The combined oral contraceptive group presented an increase in cortisol and a decrease in free testosterone concentration in relation to baseline. These data suggest that both azelaic acid and combined oral contraceptive are effective in the treatment of adult female acne but, azelaic acid seems to be a more suitable option for those women who may benefit from a better subjective sleep quality. PMID:26472098

  19. Use of combined oral contraceptives and risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases

    PubMed Central

    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

  20. Efficacy and tolerability of a monophasic combined oral contraceptive containing nomegestrol acetate and 17β-oestradiol in a 24/4 regimen, in comparison to an oral contraceptive containing ethinylestradiol and drospirenone in a 21/7 regimen

    PubMed Central

    Mansour, Diana; Verhoeven, Carole; Sommer, Werner; Weisberg, Edith; Taneepanichskul, Surasak; Melis, Gian Benedetto; Sundström-Poromaa, Inger; Korver, Tjeerd

    2011-01-01

    Objectives The primary objective was to assess the efficacy, cycle control and tolerability of a monophasic combined oral contraceptive (COC) containing nomegestrol acetate (NOMAC) and 17β-oestradiol (E2). Effects on acne were evaluated as a secondary objective. Results were compared to those of a COC containing drospirenone (DRSP) and ethinylestradiol (EE). Methods Women (aged 18-50 years) were randomised to receive NOMAC/E2 (2.5 mg/1.5 mg) in a 24/4-day regimen (n = 1591) or DRSP/EE (3 mg/30 μg) in a 21/7-day regimen (n = 535) for 13 cycles. Results Estimated Pearl Indices for NOMAC/E2 and DRSP/EE were 0.38 and 0.81 in women aged ≤ 35 years and 0.31 and 0.66 for all women (18–50 years), respectively. Scheduled withdrawal bleedings were shorter and lighter among users of NOMAC/E2 and were sometimes absent altogether. Intracyclic bleeding/spotting was infrequent in both groups, and decreased over time. Type and frequency of adverse events were similar to those typically reported for COCs. Conclusions These data show that NOMAC/E2 provides high contraceptive efficacy with acceptable cycle control as well as an overall adverse event profile similar to that of DRSP/EE. PMID:21995590

  1. Effect of the ethinylestradiol/levonorgestrel combined oral contraceptive on the activity of cytochrome P4503A in obese women

    PubMed Central

    Edelman, Alison; Munar, Myrna; Elman, Miriam R; Koop, Dennis; Cherala, Ganesh

    2012-01-01

    AIM(S) While it is known that CYP3A4/5 activity is decreased with combined oral contraceptive (COC) use and obesity suppresses CYP expression, the combined effects of obesity and COC use on CYP3A4/5 activity are unclear. Therefore, our aim was to examine the effect of COC usage on CYP3A4/5 activity in obese women. METHODS Thirty-four, obese (body mass index, BMI > 30 kg m−2) women of reproductive age (18–35 years old) were placed on a COC pill containing 20 µg ethinylestradiol/100 µg levonorgestrel for 21 days starting at the onset of menses. A midazolam pharmacokinetic study was conducted prior to initiation and after 21 days of COC treatment. Serial blood samples were collected and plasma concentrations of midazolam were measured using liquid chromatography tandem mass spectrometry. Pharmacokinetic parameters were estimated using a non-compartmental method. RESULTS Midazolam clearance, a surrogate measure of CYP3A4/5 activity, was significantly decreased upon COC use (63.3 l h−1vs. 53.9 l h−1, P < 0.05). A median decrease of 5.6 l h−1 (95% CI −4.1, 13.3 l h−1) was observed. However, the magnitude of change was similar to that reported in women with normal BMI. CONCLUSIONS Although we hypothesized that obesity might amplify the impact on CYP3A4/5 activity in COC users, we found that this was not the case. This finding is reassuring regarding potential additional drug−drug interactions in obese COC users as CYP3A4/5 is a major enzyme in the metabolism of many marketed drugs. PMID:22299599

  2. Investigation on the association between breast cancer and consumption patterns of combined oral contraceptive pills in the women of Isfahan in 2011

    PubMed Central

    Ehsanpour, Soheila; Nejad, Fahime Seyed Ahmadi; Rajabi, Fariborz Mokarian; Taleghani, Fariba

    2013-01-01

    Background: Oral contraceptive pills are among the most popular contraceptive methods, but the fear of cancer and cardiovascular disease overshadows its continuous use among women. This study aimed to define the association between consumption patterns of combined oral contraceptives among women with breast cancer. Materials and Methods: This is an analytical case–control study conducted on 175 women with breast cancer, referring to Seyed al Shohada Medical Center and private clinics in Isfahan to be treated and followed up in 2011, as well as 350 healthy women who were identical with the subjects in the study group regarding age and residential location. The data were collected using a researcher-made questionnaire. Content validity and Cronbach's alpha were employed to confirm validity and scientific reliability of the questionnaire, respectively. The data were analyzed by descriptive and analytical statistical methods through SPSS. Results: The findings showed that there was a significant association between history of contraceptive pills’ consumption and incidence of breast cancer (P < 0.001). It was shown that the risk of developing breast cancer is increased by 2.27-fold among those with pills’ consumption compared to those with no history of that. It was also shown that pills’ consumption for 36-72 months increased the risk of breast cancer by 2.18-fold, the age of the first use being less than 20 years increased the risk by 3.28-fold, and time since the last use of less than 25 years increased the risk by 2.63-fold. There was no significant association between duration of use, age of the first and last use, and time since the first and last use in the study and control groups. Conclusion: The results showed that history of pills’ consumption is associated with incidence of breast cancer regardless of the consumption pattern. Use of oral contraceptives pills at any age and for any duration can increase the risk of breast cancer. PMID:23983752

  3. The Effect of Combination Oral Contraceptives on Smoking-Related Symptomatology during Short-Term Smoking Abstinence

    PubMed Central

    Hinderaker, Katie; Tosun, Nicole; al'Absi, Mustafa; Hatsukami, Dorothy; Allen, Sharon S.

    2014-01-01

    Although an estimated 25% of premenopausal smokers report using oral contraceptives (OC), little is known about how OC use may influence smoking cessation. The purpose of this study was to examine the difference in smoking-related symptomatology during acute smoking abstinence between women on a standardized combination OC (Tri-Sprintec ™) compared to women not on OCs (no-OC). Participants were women aged 18-40 who smoked ≥5 cigarettes/day and reported regular menstrual cycles. Using a controlled cross-over design, participants completed two six-day testing weeks: Low Progesterone Week (LPW; Follicular (F) phase in no-OC or 1st week of pills in OC) and High Progesterone Week (HPW; Luteal (L) phase in no-OC or 3rd week of pills in OC). Each testing week included daily assessment of symptomatology and biochemical confirmation of smoking status. During smoking abstinence, the OC group (n=14) reported significantly lower levels of positive affect (21.56±7.12 vs. 24.57±6.46; β=3.63, p=0.0323) than the no-OC group (n=28). Further significant interactions between group and testing week were observed as follows: Smoking satisfaction was higher during LPW in the OC group (LPW: 4.29±1.30 vs. HPW: 4.10±1.37) but higher during HPW in the no-OC group (LPW: 3.91 ± 1.30 vs. HPW: 4.23 ± 1.30; β=-0.5499, p<0.0001). Similar interactions were noted in negative affect and psychological reward of smoking. These results suggest that women on OCs may have different patterns of smoking-related symptomatology during short-term smoking abstinence as compared to women not on OCs. Additional work is needed to examine how this may affect smoking cessation efforts. PMID:25452059

  4. The effect of combination oral contraceptives on smoking-related symptomatology during short-term smoking abstinence.

    PubMed

    Hinderaker, Katie; Allen, Alicia M; Tosun, Nicole; al'Absi, Mustafa; Hatsukami, Dorothy; Allen, Sharon S

    2015-02-01

    Although an estimated 25% of premenopausal smokers report using oral contraceptives (OC), little is known about how OC use may influence smoking cessation. The purpose of this study was to examine the difference in smoking-related symptomatology during acute smoking abstinence between women on a standardized combination OC (Tri-Sprintec(™)) compared to women not on OCs (no-OC). Participants were women aged 18-40 who smoked ≥5 cigarettes/day and reported regular menstrual cycles. Using a controlled cross-over design, participants completed two six-day testing weeks: Low Progesterone Week (LPW; Follicular (F) phase in no-OC or 1st week of pills in OC) and High Progesterone Week (HPW; Luteal (L) phase in no-OC or 3rd week of pills in OC). Each testing week included daily assessment of symptomatology and biochemical confirmation of smoking status. During smoking abstinence, the OC group (n=14) reported significantly lower levels of positive affect (21.56±7.12 vs. 24.57±6.46; β=3.63, p=0.0323) than the no-OC group (n=28). Further significant interactions between group and testing week were observed as follows: Smoking satisfaction was higher during LPW in the OC group (LPW: 4.29±1.30 vs. HPW: 4.10±1.37) but higher during HPW in the no-OC group (LPW: 3.91±1.30 vs. HPW: 4.23±1.30; β=-0.5499, p<0.0001). Similar interactions were noted in negative affect and psychological reward of smoking. These results suggest that women on OCs may have different patterns of smoking-related symptomatology during short-term smoking abstinence as compared to women not on OCs. Additional work is needed to examine how this may affect smoking cessation efforts. PMID:25452059

  5. Risk factors for venous thromboembolism in women under combined oral contraceptive. The PILl Genetic RIsk Monitoring (PILGRIM) Study.

    PubMed

    Suchon, Pierre; Al Frouh, Fadi; Henneuse, Agathe; Ibrahim, Manal; Brunet, Dominique; Barthet, Marie-Christine; Aillaud, Marie-Françoise; Venton, Geoffroy; Alessi, Marie-Christine; Trégouët, David-Alexandre; Morange, Pierre-Emmanuel

    2016-01-01

    Identifying women at risk of venous thromboembolism (VTE) is a major public health issue. The objective of this study was to identify environmental and genetic determinants of VTE risk in a large sample of women under combined oral contraceptives (COC). A total of 968 women who had had one event of VTE during COC use were compared to 874 women under COC but with no personal history of VTE. Clinical data were collected and a systematic thrombophilia screening was performed together with ABO blood group assessment. After adjusting for age, family history, and type and duration of COC use, main environmental determinants of VTE were smoking (odds ratio [OR] =1.65, 95% confidence interval [1.30-2.10]) and a body mass index higher than 35 kg.m⁻² (OR=3.46 [1.81-7.03]). In addition, severe inherited thrombophilia (OR=2.13 [1.32-3.51]) and non-O blood groups (OR=1.98 [1.57-2.49]) were strong genetic risk factors for VTE. Family history poorly predicted thrombophilia as its prevalence was similar in patients with or without first degree family history of VTE (29.3% vs 23.9%, p=0.09). In conclusion, this study confirms the influence of smoking and obesity and shows for the first time the impact of ABO blood group on the risk of VTE in women under COC. It also confirms the inaccuracy of the family history of VTE to detect inherited thrombophilia. PMID:26290123

  6. Pharmacokinetic drug interactions with oral contraceptives.

    PubMed

    Back, D J; Orme, M L

    1990-06-01

    Oral contraceptive steroids are used by an estimated 60 to 70 million women world-wide. Over the past 20 years there have been both case reports and clinical studies on the topic of drug interactions with these agents. Some of the interactions are of definite therapeutic relevance, whereas others can be discounted as being of no clinical significance. Pharmacological interactions between oral contraceptive steroids and other compounds may be of 2 kinds: (a) drugs may impair the efficacy of oral contraceptive steroids, leading to breakthrough bleeding and pregnancy (in a few cases, the activity of the contraceptive is enhanced); (b) oral contraceptive steroids may interfere with the metabolism of other drugs. A number of anticonvulsants (phenobarbital, phenytoin, carbamazepine) are enzyme-inducing agents and thereby increase the clearance of the oral contraceptive steroids. Valproic acid has no enzyme-inducing properties, and thus women on this anticonvulsant can rely on their low dose oral contraceptive steroids for contraceptive protection. Researchers are now beginning to unravel the molecular basis of this interaction, with evidence of specific forms of cytochrome P450 (P450IIC and IIIA gene families) being induced by phenobarbital. Rifampicin, the antituberculous drug, also induces a cytochrome P450 which is a product of the P450IIIA gene subfamily. This isozyme is one of the major forms involved in 2-hydroxylation of ethinylestradiol. Broad spectrum antibiotics have been implicated in causing pill failure; case reports document the interaction, and general practitioners are convinced that it is real. The problem remains that there is still no firm clinical pharmacokinetic evidence which indicates that blood concentrations of oral contraceptive steroids are altered by antibiotics. However, perhaps this should not be a surprise, given that the incidence of the interaction may be very low. It is suggested that an individual at risk will have a low bioavailability

  7. Association of Combined Tobacco Smoking and Oral Contraceptive Use With Cervical Intraepithelial Neoplasia 2 or 3 in Korean Women

    PubMed Central

    Oh, Hea Young; Kim, Mi Kyung; Seo, Sang-Soo; Lee, Jae-Kwan

    2016-01-01

    Background Cigarette smoking and oral contraceptive (OC) use have been associated with cervical neoplasia, and the combination of smoking and OC use could influence cervical carcinogenesis. We aimed to assess the joint effect of smoking and OC use on the risk of cervical intraepithelial neoplasia (CIN). Methods From a cohort of human papillomavirus-positive subjects recruited from 6 hospitals in Korea from March 2006 to November 2012, a total of 678 subjects (411 control, 133 CIN 1, and 134 CIN 2 or 3 cases) were selected for this study (mean age, 43 years). The risk of CIN associated with smoking and OC use on additive and multiplicative scales was estimated via multinomial logistic regression after adjustment for potential confounding factors. The relative excess risk due to interaction (RERI) and the synergy index (S) were used to evaluate the additive interaction. Results OC users (odds ratio [OR] 1.98; 95% confidence interval [CI], 1.07–3.69) and long-term OC use (≥20 months; OR 2.71; 95% CI, 1.11–6.59) had a higher risk of CIN 2/3, but had no association with CIN 1, compared to non-OC users. Smokers and heavy smoking (≥8 cigarettes/day) were not associated with any CIN grade. Combined smoking and OC use (OR 4.91; 95% CI, 1.68–14.4; RERI/S, 3.77/27.4; P for multiplicative interaction = 0.003) and combined heavy smoking and long-term OC use (OR 11.5; 95% CI, 1.88–70.4; RERI/S, 9.93/18.8; P for multiplicative interaction = 0.009) had a higher risk of CIN 2/3 but had no association with CIN 1 compared to combined non-smoking and non-OC use. Conclusions OC use and smoking acted synergistically to increase the risk of CIN 2 or 3 in Korean women. PMID:26441210

  8. Exposure to combined oral contraceptives and risk of venous thromboembolism: a protocol for nested case–control studies using the QResearch and the CPRD databases

    PubMed Central

    Vinogradova, Yana; Coupland, Carol; Hippisley-Cox, Julia

    2014-01-01

    Introduction Many studies have found an increased risk of venous thromboembolism (VTE) associated with the use of combined hormonal contraceptives, but various methodologies have been used in the study design relating to definition of VTE event and the selection of appropriate cases for analysis. This study will focus on common oral hormonal contraceptives, including compositions with cyproterone because of their contraceptive effect and will perform a number of sensitivity analyses to compare findings with previous studies. Methods and analysis 2 nested case–control studies will be based on the general population using records from UK general practices within the QResearch and Clinical Practice Research Datalink databases. Cases will be female patients aged 15–49 with primary VTE diagnosed between 2001 and 2013. Each case will be matched by age, year of birth and practice to five female controls, who are alive and registered with the practice at the time of diagnosis of the case (index date). Exposure to different hormonal contraceptives will be defined as at least one prescription for that contraceptive in the year before the index date. The effects of duration and the length of any gap since last use will also be investigated. Conditional logistic regression will be applied to calculate ORs adjusted for smoking, ethnicity, comorbidities and use of other medications. Possible indications for prescribing hormonal contraceptives, such as menstrual disorders, acne or hirsutism will be included in the analyses as confounding factors. A number of sensitivity analyses will be carried out. Ethics and dissemination The initial protocol has been reviewed and approved by ISAC (Independent Scientific Advisory Committee) for Medicine and Healthcare Products Regulatory Agency Database Research. The project has also been reviewed by QResearch and meets the requirements of the Trent Research Ethics Committee. The results will be published in a peer-reviewed journal. PMID

  9. Combined Oral Contraception and Obesity Are Strong Predictors of Low-Grade Inflammation in Healthy Individuals: Results from the Danish Blood Donor Study (DBDS)

    PubMed Central

    Sørensen, Cecilie J.; Pedersen, Ole B.; Petersen, Mikkel S.; Sørensen, Erik; Kotzé, Sebastian; Thørner, Lise W.; Hjalgrim, Henrik; Rigas, Andreas S.; Møller, Bjarne; Rostgaard, Klaus; Riiskjær, Mads; Ullum, Henrik; Erikstrup, Christian

    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 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. PMID:24516611

  10. Comparison of efficacy of metformin and oral contraceptive combination of ethinyl estradiol and drospirenone in polycystic ovary syndrome

    PubMed Central

    Suvarna, Yashasvi; Maity, Nivedita; Kalra, Pramila; Shivamurthy, MC

    2016-01-01

    Objective The 2013 Endocrine Society guidelines state that hormonal contraceptives should be used for treating both menstrual irregularity and hirsutism in patients with polycystic ovary syndrome (PCOS). Metformin should be reserved for the treatment of women presenting with only menstrual irregularity because it has limited benefits in treating hyperandrogenism associated with PCOS. A high prevalence of insulin resistance is noted among the South Asians, and these guidelines may not hold good for this population. Thus, this study was conducted to investigate and compare the effects of metformin and an oral contraceptive containing drospirenone on menstrual pattern, body mass index, serum testosterone levels, and dehydroepiandrosterone sulfate (DHEAS) levels at baseline to 6 months of therapy in the treatment groups. Material and Methods This was a prospective observational study that was conducted over a year in patients visiting the Endocrinology outpatient department at a tertiary care center in a south Indian city. Forty-six subjects diagnosed with PCOS as per the Rotterdam criteria were included. They received either metformin twice daily or an oral contraceptive containing drospirenone once daily as a monthly regimen for 6 months. Results Metformin regularized menstrual cycles in 72% of patients who were followed up at 6 months. No significant difference was observed between the two treatment groups with respect to decreasing the body mass index, serum testosterone levels, and DHEAS levels (p=0.40, p=0.65, and p=0.22, respectively). Conclusion Metformin is effective in regularizing menstrual cycles, decreasing body mass index, and treating hyperandrogenism in Indian women diagnosed with PCOS. PMID:27026772

  11. Oral contraceptives in the immediate postpartum period.

    PubMed

    Hume, A L; Hijab, J C

    1991-04-01

    Although there is a critical need for effective contraception in the immediate postpartum period for women who are not breastfeeding, this need must be balanced against the inherent risks. The most effective form of contraceptive protection--oral contraceptives (OCs)--can present an increased risk of thromboembolism in the period after delivery. The thrombotic changes associated with pregnancy, and the statistics and vascular damage following a delivery, can combine to create greater potential for thromboembolism after delivery than during pregnancy. Reported here is the case of a 21-year-old woman who, 4 weeks postpartum, developed pain and swelling in the right lower calf and mottled discoloration extending from the proximal thigh to the toes. A diagnosis of deep venous thrombosis was made and heparin was administered. In the hospital, the patient experienced pleuritic chest pain and diaphoresis. A ventilation-perfusion scan indicated a pulmonary embolism. 1 week after delivery, the patient had initiated use of Triphasil. Although this woman had other risk factors (obesity, light cigarette smoking, and a sedentary life-style), OC use in the immediate postpartum period may have been the final factor precipitating the thromboembolic event. It is recommended that OC use should be delayed until at least 2 weeks postpartum in women without other risk factors for thromboembolism and until 4-6 weeks postpartum in those with such factors. PMID:2010744

  12. Pharmacokinetic and pharmacodynamic drug interactions between antiretrovirals and oral contraceptives.

    PubMed

    Tittle, Victoria; Bull, Lauren; Boffito, Marta; Nwokolo, Nneka

    2015-01-01

    More than 50 % of women living with HIV in low- and middle-income countries are of reproductive age, but there are limitations to the administration of oral contraception for HIV-infected women receiving antiretroviral therapy due to drug-drug interactions caused by metabolism via the cytochrome P450 isoenzymes and glucuronidation. However, with the development of newer antiretrovirals that use alternative metabolic pathways, options for contraception in HIV-positive women are increasing. This paper aims to review the literature on the pharmacokinetics and pharmacodynamics of oral hormonal contraceptives when given with antiretroviral agents, including those currently used in developed countries, older ones that might still be used in salvage regimens, or those used in resource-limited settings, as well as newer drugs. Nucleos(t)ide reverse transcriptase inhibitors (NRTIs), the usual backbone to most combined antiretroviral treatments (cARTs) are characterised by a low potential for drug-drug interactions with oral contraceptives. On the other hand non-NRTIs (NNRTIs) and protease inhibitors (PIs) may interact with oral contraceptives. Of the NNRTIs, efavirenz and nevirapine have been demonstrated to cause drug-drug interactions; however, etravirine and rilpivirine appear safe to use without dose adjustment. PIs boosted with ritonavir are not recommended to be used with oral contraceptives, with the exception of boosted atazanavir which should be used with doses of at least 35 µg of estrogen. Maraviroc, an entry inhibitor, is safe for co-administration with oral contraceptives, as are the integrase inhibitors (INIs) raltegravir and dolutegravir. However, the INI elvitegravir, which is given in combination with cobicistat, requires a dose of estrogen of at least 30 µg. Despite the growing evidence in this field, data are still lacking in terms of large cohort studies, randomised trials and correlations to real clinical outcomes, such as pregnancy rates, in women

  13. Semaglutide, a Once-Weekly Human GLP-1 Analog, Does Not Reduce the Bioavailability of the Combined Oral Contraceptive, Ethinylestradiol/Levonorgestrel

    PubMed Central

    Kapitza, Christoph; Nosek, Leszek; Jensen, Lene; Hartvig, Helle; Jensen, Christine B; Flint, Anne

    2015-01-01

    The effect of semaglutide, a once-weekly human glucagon-like peptide-1 (GLP-1) analog in development for type 2 diabetes (T2D), on the bioavailability of a combined oral contraceptive was investigated. Postmenopausal women with T2D (n = 43) on diet/exercise ± metformin received ethinylestradiol (0.03 mg)/levonorgestrel (0.15 mg) once daily for 8 days before (semaglutide-free) and during (steady-state 1.0 mg) semaglutide treatment (subcutaneous once weekly; dose escalation: 0.25 mg 4 weeks; 0.5 mg 4 weeks; 1.0 mg 5 weeks). Bioequivalence of oral contraceptives was established if 90%CI for the ratio of pharmacokinetic parameters during semaglutide steady-state and semaglutide-free periods was within prespecified limits (0.80–1.25). The bioequivalence criterion was met for ethinylestradiol area under the curve (AUC0–24 h) for semaglutide steady-state/semaglutide-free; 1.11 (1.06–1.15). AUC0–24 h was 20% higher for levonorgestrel at semaglutide steady-state vs. semaglutide-free (1.20 [1.15–1.26]). Cmax was within bioequivalence criterion for both contraceptives. Reductions (mean ± SD) in HbA1c (–1.1 ± 0.6%) and weight (–4.3 ± 3.1 kg) were observed. Semaglutide pharmacokinetics were compatible with once-weekly dosing; the semaglutide dose and dose-escalation regimen were well tolerated. Adverse events, mainly gastrointestinal, were mild to moderate in severity. Asymptomatic increases in mean amylase and lipase were observed. Three subjects had elevated alanine aminotransferase levels ≥3x the upper limit of normal during semaglutide/oral contraceptive coadministration, which were reported as adverse events, but resolved during follow-up. Semaglutide did not reduce the bioavailability of ethinylestradiol and levonorgestrel. PMID:25475122

  14. Oral contraceptives and birth defects.

    PubMed

    Smithells, R W

    1981-06-01

    Although OCs (oral contraceptives) are not designed to be taken during pregnancy, in Europe and the U.S. they are taken by 2-5% of women in early pregnancy and by 1/4-1/3 of women 3-4 months prior to conception. The effects of OCs on folic acid and other vitamin metabolism are well known and provide a theoretical basis for possible teratogenicity, even when stopped prior to conception. Both hormone support therapy for threatened abortions and hormonal pregnancy tests have been abandoned in recent years, the first because it proved inefficacious, the second because there are better alternatives available. In neither of these cases were sex hormones shown to be teratogenic. Most cohort (prospective) and many case-control (retrospective) studies have shown no association between OC use and birth defects. Case-control methodology can be criticized because of recall bias and because of the difficulty of choosing entirely matched controls. Several studies have shown OC users to have characteristics slightly different from the general population, e.g., they are younger, more often unmarried, and are more likely to smoke during pregnancy. Any of these characteristics might influence the occurrence of teratogenicity. It is impossible to prove that OCs constitute a low-level teratogen. The author considers them nonteratogenic. PMID:7250546

  15. Oral contraceptives and liver cancer.

    PubMed

    1997-11-01

    To date, nine case-control studies conducted in developed countries have identified an association between oral contraceptives (OCs) and liver cancer. The most recent population-based data from both developed and developing countries failed to confirm such an association, however. A study conducted by the World Health Organization in eight developing countries (Chile, China, Colombia, Israel, Kenya, Nigeria, Philippines, and Thailand), in which 122 women with liver cancer were matched with 802 controls, found no elevated risk for OC users compared with never-users (relative risk, 0.7; 95% confidence interval, 0.4-1.2). This study is particularly significant since it was conducted in countries where hepatitis B virus infection, an important risk factor for primary liver cancer, is widespread. In addition, population mortality data from the US, UK, Japan, and Sweden have failed to document increases in liver cancer cases coincident with increases in OC use. Given that population statistics can detect changes on the magnitude of a 40-50% decrease in the risk of ovarian and endometrial cancer related to OC use, they should be able to detect increases of two to 20 times the risk of liver cancer. The increased risk of liver cancer found in the case-control studies may reflect bias resulting from the small size of these studies. PMID:12348250

  16. Effect of information on the perception of users and prospective users of combined oral contraceptives regarding the risk of venous thromboembolism.

    PubMed

    Machado, Rogério Bonassi; Morimoto, Mariana; Santana, Narayana; Arruda, Lívia Fernandes; Bernardes, Carine Rejane; de Souza, Isadora Matias

    2015-01-01

    This study evaluated patients' knowledge on the risk of venous thromboembolism (VTE) associated with combined oral contraceptives (COCs) and their perception of this risk when it is presented as a relative risk (RR), absolute risk (AbR) or attributable risk (AR). This was a cross-sectional study involving 159 users or potential users of COCs. The participants answered a self-administered questionnaire in which the risk of VTE associated with COCs was presented as RR, AbR and AR. The degree of concern expressed regarding this risk and the women's changes of opinion when the information was communicated through a different risk model were evaluated. Most of the women (67.9%) expressed concern when the risk was presented as an RR. Conversely, they showed no concern when the risk was presented as an AbR (14.5%) or AR (10.7%). A significant number of women changed their opinion regarding their level of concern when the risk was presented as an AbR or AR (p < 0.001). In conclusion, concerns about thrombotic complications from the use of combined hormonal contraception is reduced when incidence rather than relative risk is presented. Presentation of thrombosis complications in terms of incidence rather than RR may improve communication of side effects during counseling for combined hormonal contraception initiation. PMID:25095700

  17. [Cholestatic icterus due to oral contraceptives].

    PubMed

    Pestel, M; Lambert, C; Jeanmougin, M

    1973-03-01

    A case report of cholestatic jaundice in a 25 year old woman, who had had jaundice at age 4 years, and had taken Stediril (a combined oral contraceptive) for 1 month, implicates either the pill or a possibly hereditary hyperlipidemia. The jaundice developed in 2 weeks with vomiting, epigastric pain, anorexia, then discolored urine and feces, and intense pruritus. On hospitalization the patient had moderate bilirubinemia (56 mg/1), low alkaline phosphatase (13 U.K.) and slightly high serum glutamate pyruvate transaminase (270 U.W.). There were elevated serum cholesterol (3 gm/1), triglycerides (2.05 gm/1), total lipids (10.6 gm/1), and a definitely increased pre-beta lipoprotein, suggesting hyperlipidemia type IV (Frederickson classification). Liver biopsy showed fibrosis of the portal spaces lymphocytic infiltration, canalicular and intrahepatocytic thrombi. On laparoscopy the liver had a regular lower border, normal volume color and surface. Albumin, prothrombin and flocculation tests were normal. The patient's jaundice lasted about 1 month, then liver function slowly improved, although pruritus remained intense. Probably this jaundice was due to oral contraceptives, in a patient predisposed either by jaundice in childhood or endogenous hyperlipidemia. PMID:4268576

  18. Pharmacologic considerations for patients taking oral contraceptives.

    PubMed

    Hassan, T

    1987-03-01

    This is a brief review of the theoretical and known drug reactions with oral contraceptives. There are at least 6 possible types of drug reactions that may affect the action of oral contraceptives, not including malabsorption related to changes in intestinal motility or flora. Ampicillin is an example of an antibiotic that may cause diarrhea, thereby reducing absorption of pill steroids. The steroids in orals are subject to enterohepatic circulation, which is in turn affected by the gut flora. Antibiotics known to suppress gut flora include: penicillins, cephalosporins, tetracyclines, sulfas, neomycin and erythromycin. Although controlled clinical trials of antibiotic intake with oral contraception have not shown significant interactions, anecdotal reports of pill failures have been published. The other important drug interaction affecting contraception by orals is enhanced hepatic degradation, as seen with rifampicin. Other drugs such as cimetidine, MAO-inhibitor antidepressants, chloramphenicol, influenza or BCG vaccine, isoniazid, warfarin, metronidazole and disulfiram may delay steroid metabolism and possibly increase side effects. When prescribing drugs it is important to realize that certain drugs decrease oral contraceptive concentrations: antibiotics anticonvulsants, griseofulvin, purgatives and rifampicin. PMID:3155374

  19. Nonspecific side effects of oral contraceptives: nocebo or noise?

    PubMed

    Grimes, David A; Schulz, Kenneth F

    2011-01-01

    Side effects of combined oral contraceptives are the most common reason why women discontinue them. Over the past half century, an elaborate mythology about these ill effects has evolved, fueled by rumor, gossip and poor-quality research. In contrast, placebo-controlled randomized trials document that nonspecific side effects are not significantly more common with combined oral contraceptives than with inert pills. These reported nonspecific side effects may reflect the nocebo phenomenon (the inverse of a placebo): if women are told to expect noxious side effects, these complaints occur because of the power of suggestion. Alternatively, nonspecific complaints may simply reflect their background prevalence in the population. Because Level I evidence documents no important increase in nonspecific side effects with oral contraceptives, counseling about these side effects or including them in package labeling is unwarranted and probably unethical. When in doubt, clinicians should err on the side of optimism. PMID:21134497

  20. [Oral contraceptives: knowledge and compliance].

    PubMed

    Koch, T; Marslew, U; Nielsen, M R

    1993-11-01

    One hundred and twenty (120) women, taking contraceptive pills, underwent a structured interview with a view elucidating their knowledge of the physiology of menstruation, the action and side effects of contraceptive pills and their compliance in the taking of contraceptive pills. The most important sources of information were the medical letters in magazines and the women's own doctors, while the teaching in the Folkeskole (primary and lower secondary school) had not had any major influence on the level of information. Well over one third of the interviewed women knew the most important action mechanism of the contraceptive pill, and half of the women could give a satisfactory explanation of the physiology of menstruation. Twenty-four percent (24%) thought that pregnancy could not occur until 1-2 months after the woman had ceased taking the pill. There was high compliance among the women i.e. that their behavior was correct when they had forgotten to take one or two contraceptive pills, when bleeding was irregular, and when beginning on a new package of pills. Eighty-three percent (83%) had experienced side effects that could be related to contraceptive pills. The investigation shows that there is a need for more efficient information about the effects of the Pill and about the physiology of menstruation. PMID:8236575

  1. The effect of combined oral contraception on testosterone levels in healthy women: a systematic review and meta-analysis

    PubMed Central

    Zimmerman, Y.; Eijkemans, M.J.C.; Coelingh Bennink, H.J.T.; Blankenstein, M.A.; Fauser, B.C.J.M.

    2014-01-01

    BACKGROUND Combined oral contraceptives (COCs) reduce levels of androgen, especially testosterone (T), by inhibiting ovarian and adrenal androgen synthesis and by increasing levels of sex hormone-binding globulin (SHBG). Although this suppressive effect has been investigated by numerous studies over many years, to our knowledge no systematic review concerning this issue had been performed. This systematic review and meta-analysis was performed to evaluate the effect of COCs on concentrations of total T, free T and SHBG in healthy women and to evaluate differences between the various types of COCs (e.g. estrogen dose, type of progestin) and the assays used to assess total T and free T. METHODS A review of the literature was performed using database searches (MEDLINE, EMBASE and the Cochrane Central Register of Clinical Trials) and all publications (from inception date until July 2012) investigating the effect of COCs on androgen levels in healthy women were considered eligible for selection. Three reviewers were involved in study selection, data extraction and critical appraisal. For the meta-analysis, data on total T, free T and SHBG were extracted and combined using random effects analysis. Additional subgroup analyses were performed to evaluate differences between the various types of COCs (e.g. estrogen dose, type of progestin) and the assays used to assess total T or free T. RESULTS A total of 151 records were identified by systematic review and 42 studies with a total of 1495 healthy young women (age range: 18–40 years) were included in the meta-analysis. All included studies were experimental studies and 21 were non-comparative. Pooling of the results derived from all the included papers showed that total T levels significantly decreased during COC use [mean difference (MD) (95% confidence interval, CI) −0.49 nmol/l (−0.55, −0.42); P < 0.001]. Significantly lower levels of free T were also found [relative change (95% CI) 0.39 (0.35, 0.43); P < 0

  2. Cerebral venous and sinus thrombosis associated with subcutaneous immunoglobulin injection and oral contraceptive use.

    PubMed

    Min, Jiangyong; Bhatt, Archit; Aburashed, Rany; Burton, Stephen

    2012-06-01

    Although patients of cerebral sinus thrombosis after intravenous immunoglobulin (IVIG) has been previously reported; reports of cerebral venous thrombosis secondary to subcutaneous injection of immunoglobulin (SIG) in conjunction with oral contraceptives are nonexistent in the current literature. We describe here a patient of cerebral venous and sinus thrombosis occurring after the combination of SIG and oral contraceptive use. Furthermore, we shall explore proper clinical precautions for someone who receives IG therapy, especially in conjunction with the use of oral contraceptives. PMID:21915646

  3. Oral contraceptive marketing in Ibadan, Nigeria.

    PubMed

    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. PMID:1411690

  4. Reassessment of the metabolic effects of oral contraceptives.

    PubMed

    Franklin, M

    1990-01-01

    During the 30 years of experience with oral contraceptives, dramatic changes have occurred in their formulations and in prescribing practices. This article analyzes the latest information on the metabolic effects of oral contraceptives and makes recommendations for practice. PMID:2286849

  5. Clinical investigation of the biological effects of a new combination low-dose oral contraceptive ('Ovostat E').

    PubMed

    Tarkkila, T; Hulkko, S; Alapiessa, U; Kauraniemi, T

    1977-01-01

    A low-dose contraceptive containing 1 mg of lynestrenol and .05 mg of ethinyl estradiol was studied over 12 cycles in 11 healthy fertile women volunteers. The subjects were aged 20-30 years. Measurements were taken of urinary luteinizing hormone (LH), pregnanediol, and estrogen, and serum progesterone and estradiol values; in addition, on a fixed schedule during treatment, the 3rd, 5th, 7th, and 12th months, vaginal smears and endometrial biopsies were taken, along with SGOT and SGPT determinations. According to determinations, ovulation was inhibited during every cycle tested. A clear estrogenic effect was evident in the karyopyknotic index, during cycle 3, at the beginning of the cycle which became a progestational effect around Day 13 (biphasic). In cycle 6, the indexes of cytology decreased, but during Cycle 12, they rose a bit again. Basal body temperature during treatment was monophasic. Cervical mucus assessed by spinnbarket during treatment was low and arborization absent. The SGOT and SGPT liver function tests were within normal values in all cycles in 7 women; 4 showed clearly higher levels in Cycles 3 and 12. None of the cycles showed the high midcycle urinary excretion of LH. No significant side effects were reported. Examination of the endometrial biopsies showed a drug effect in all cases and there was no secretory activity in any of the samples. These findings confirm clinical results that show this low-dose combination to be an effective contraceptive agent. PMID:162661

  6. Oral contraception for women of middle age.

    PubMed

    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. PMID:26163075

  7. An Oral Contraceptive Drug Interaction Study

    ERIC Educational Resources Information Center

    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…

  8. Low dose oestrogen combined oral contraception and risk of pulmonary embolism, stroke, and myocardial infarction in five million French women: cohort study

    PubMed Central

    Dalichampt, Marie; Raguideau, Fanny; Ricordeau, Philippe; Blotière, Pierre-Olivier; Rudant, Jérémie; Alla, François; Zureik, Mahmoud

    2016-01-01

    Objective To assess the risk of pulmonary embolism, ischaemic stroke, and myocardial infarction associated with combined oral contraceptives according to dose of oestrogen (ethinylestradiol) and progestogen. Design Observational cohort study. Setting Data from the French national health insurance database linked with data from the French national hospital discharge database. Participants 4 945 088 women aged 15-49 years, living in France, with at least one reimbursement for oral contraceptives and no previous hospital admission for cancer, pulmonary embolism, ischaemic stroke, or myocardial infarction, between July 2010 and September 2012. Main outcome measures Relative and absolute risks of first pulmonary embolism, ischaemic stroke, and myocardial infarction. Results The cohort generated 5 443 916 women years of oral contraceptive use, and 3253 events were observed: 1800 pulmonary embolisms (33 per 100 000 women years), 1046 ischaemic strokes (19 per 100 000 women years), and 407 myocardial infarctions (7 per 100 000 women years). After adjustment for progestogen and risk factors, the relative risks for women using low dose oestrogen (20 µg v 30-40 µg) were 0.75 (95% confidence interval 0.67 to 0.85) for pulmonary embolism, 0.82 (0.70 to 0.96) for ischaemic stroke, and 0.56 (0.39 to 0.79) for myocardial infarction. After adjustment for oestrogen dose and risk factors, desogestrel and gestodene were associated with statistically significantly higher relative risks for pulmonary embolism (2.16, 1.93 to 2.41 and 1.63, 1.34 to 1.97, respectively) compared with levonorgestrel. Levonorgestrel combined with 20 µg oestrogen was associated with a statistically significantly lower risk than levonorgestrel with 30-40 µg oestrogen for each of the three serious adverse events. Conclusions For the same dose of oestrogen, desogestrel and gestodene were associated with statistically significantly higher risks of pulmonary embolism but not arterial

  9. Comparison of Rates of and Charges from Pregnancy Complications in Users of Extended and Cyclic Combined Oral Contraceptive (COC) Regimens: A Brief Report

    PubMed Central

    Howard, Brandon; Trussell, James; Grubb, ElizaBeth; Lage, Maureen J.

    2014-01-01

    Objective Evaluate pregnancy complication rates and related charges in users of 84/7, 21/7, and 24/4 combined oral contraceptives (COCs). Study Design Data were obtained from the i3 InVision Data Mart™ retrospective claims database. Subjects were aged 15–40 years; first prescribed a COC between 1/1/2006 and 4/1/2011; and continuously insured for ≥1 year. 84/7 users were matched 1:1 to 21/7 and 24/4 users. Results Pregnancy-related complication rates and associated charges were significantly lower with 84/7 vs. 21/7 and 24/4 regimens. Conclusion Preliminary data suggest 84/7 regimens may be associated with fewer pregnancy complications and lower related charges. PMID:24457060

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

    PubMed

    Cianci, A; De Leo, V

    2007-08-01

    water retention, weight gain and arterial hypertension often associated with oral contraceptive use. Recent comparative studies recorded weight loss that stabilized after 6 months of treatment with drospirenone/EE. Overweight women may therefore benefit from the formulation with 20 microg EE, whereas the formulation with at least 30 microg EE should be more appropriate for underweight women. Women with slight to moderate acne, the formulation with 30 microg EE has been found to be as effective as 2 mg cyproterone acetate combined with 35 micrig EE (Diane). Menstrual cycle characteristics, however, remain the main factor determining the choice of formulation. Randomised control studies comparing the new formulation with others containing second or third generation progesterones have found similar efficacy in cycle control and incidence of spotting. From this point of view, it is not advisable to prescribe more than 30 microg EE (Yasmin or Yasminelle) for women with normal menstrual cycles, whereas in cases of hypomenorrhea and/or amenorrhea at least this dose of EE plus drospirenone may be used. Women with hypermenorrhea run the risk of spotting if an inappropriate drug is chosen. A solution is to use 30 microg EE/drospirenone from day 5 of the cycle. To control so-called minor side-effects, the dose of EE must be appropriate. In women with premenstrual tension a dose of at least 30 microg EE associated with drospirenone reduces or even prevents symptoms. On the other hand, in cases of chronic headache or headache as a side-effect of oral contraceptive use, a lower dose of estrogen is beneficial, and doses below 20 microg may be used. Although the progesterone component is not considered to affect headache, good results have been obtained with drospirenone, the antimineralcorticoid effects of which reduce blood pressure and improve symptoms. Formulations with 20 microg EE and drospirenone are particularly indicated in women with pre-existing mastodynia, fibrocystic

  11. [Emergency oral contraception policy: the Peruvian experience].

    PubMed

    Pretell-Zárate, Eduardo A

    2013-07-01

    Emergency oral contraception is part of the sexual and reproductive rights of women. In 2001, this health policy was incorporated into the Rules of the National Family Planning Program of the Ministry of Health, primarily to prevent unwanted pregnancy and its serious consequences, induced abortion and the high associated maternal mortality rate, which are major public health problems. Scientific research has confirmed that the main mechanism of action of levonorgestrel, component of emergency oral contraception (EOC) is to inhibit or delay ovulation, preventing fertilization of the egg; additionally, it increases the thickening of the cervical mucus, making the sperm migration more difficult. No study has found endometrial abnormalities that may interfere with the implantation of the fertilized egg or embryo development of an implanted egg. However, despite the support of medical science and legal backing, the EOC is available only to users with economic resources, but its use has not been fully implemented in public sector services, due to obstacles created by groups opposed to contraception under claim of an alleged abortive effect that has already been ruled out scientifically. This article describes the administrative experience and legal confrontations between groups of power that prevent the proper implementation of an emergency contraception policy in Peru. PMID:24100827

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

    PubMed Central

    Divani, Afshin A.; Luo, Xianghua; Datta, Yvonne H.; Flaherty, James D.; Panoskaltsis-Mortari, Angela

    2015-01-01

    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. PMID:25861161

  13. Intracranial venous thrombosis complicating oral contraception

    PubMed Central

    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. Vertebral artery occlusion and oral contraceptives.

    PubMed Central

    Ask-Upmark, E; Bickerstaff, E R

    1976-01-01

    If vertebral artery occlusion occurs in degenerative arterial disease it is almost invariably left-sided, but in vertebral artery deficiency syndromes associated with oral contraceptives a striking preponderance of right-sided involvement has been shown. This observation adds support to the view that causes other than changes in the wall of the vessel at the site of occlusion must be sought as an explanation of the occlusion. PMID:1252812

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

    ERIC Educational Resources Information Center

    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. Efficacy and safety of metformin or oral contraceptives, or both in polycystic ovary syndrome

    PubMed Central

    Yang, Young-Mo; Choi, Eun Joo

    2015-01-01

    Background Polycystic ovary syndrome (PCOS) is an endocrinopathy that affects approximately 10% of reproductive-aged women throughout their lives. Women with PCOS present with heterogeneous symptoms including ovulatory dysfunction, hyperandrogenism, and polycystic ovaries. Therefore, lifelong individualized management should be considered. Pharmacological agents commonly used to manage the symptoms are metformin and oral contraceptive pills. Although these medications have been beneficial in treating PCOS symptoms, their efficacy and safety are still not entirely elucidated. This study aimed to report the efficacy and safety of metformin, oral contraceptives, or their combination in the treatment of PCOS and to define their specific individual roles. Methods A literature search of original studies published in PubMed and Scopus was conducted to identify studies comparing metformin with oral contraceptives or evaluating the combination of both in PCOS. Results Eight clinical trials involving 313 patients were examined in the review. The intervention dosage of metformin ranged from 1,000 to 2,000 mg/d and that of oral contraceptives was ethinylestradiol 35 µg and cyproterone acetate 2 mg. Lower body mass index was observed with regimens including metformin, but increased body mass index was observed in monotherapy with oral contraceptives. Administration of metformin or oral contraceptives, especially as monotherapy, had a negative effect on lipid profiles. In addition, there are still uncertainties surrounding the effects of metformin or oral contraceptives in the management of insulin level, although they improved total testosterone and sex hormone-binding globulin levels. In the included studies, significant side effects due to metformin or oral contraceptives were not reported. Conclusion The clinical trials suggest that metformin or oral contraceptives are at least patient convenient, efficacious, and safe for the treatment of PCOS. However, well

  17. The Current Status of Oral Contraceptives: Progress and Recent Innovations.

    PubMed

    Golobof, Alexandra; Kiley, Jessica

    2016-05-01

    Millions of women in the United States and abroad use oral contraceptive pills. These popular contraceptives are the most common reversible birth control method in the United States, and a wide variety of pills are available for prescription. Oral contraceptives provide safe and effective protection against pregnancy and offer several noncontraceptive benefits. Over the years, advances in the laboratory and knowledge gained through epidemiologic data promoted the development of new contraceptive preparations. Generations of oral contraceptives emerged over time, containing lower doses of estrogens and new and novel progestins. The current review discusses the clinical characteristics of oral contraceptives, with emphasis on basic pharmacology and the evolution of various contraceptive formulations and regimens. PMID:26960906

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

    ClinicalTrials.gov

    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

  19. Factors related to choosing oral contraception at age 15.

    PubMed

    Kosunen, E; Laippala, P

    1996-12-01

    This report aims to identify factors which are related to use of oral contraceptives at an early age. A self-administered questionnaire was completed at schools in 1988 and 1992 in southern and western Finland (N = 1339). Sexually experienced girls (mean age 15.8 years) who had answered the question concerning their oral contraceptive use were included (N = 389). Logistic regression analysis was used to compare oral contraceptive users (N = 121) with the group of non-users. Total number of coital experiences was associated with oral contraceptive use: the odds ratio for those having at least 10 coital experiences was 6.30 compared with those with only one intercourse. The proportion was 73% among oral contraceptive users and 30% among non-users. Girls using oral contraceptives perceived more often (67%) that parents accept their sexual relationship (30% among non-users). Oral contraceptive users were less afraid of getting pregnant (9% compared with 31% among non-users) and felt more often that sex was very important in their life (31 and 13%, respectively). Other factors that entered the model were age at menarche, having a steady partner and frequency of disco visits. When a young girl asks for oral contraceptives, she is probably at true risk of pregnancy, and regular contraception should be considered both in view of effective prevention of pregnancies and sexually transmitted diseases. PMID:10163954

  20. Perceptions of contraceptive effectiveness and health effects of oral contraception.

    PubMed

    Tessler, S L; Peipert, J F

    1997-01-01

    The hypothesis that misperceptions about the effectiveness of contraceptive methods and the risks and benefits of oral contraceptive (OC) use are widespread in the US, even among the most educated population groups, was investigated in 147 women presenting to the Brown University (Providence, Rhode Island) health service and 189 students solicited by female volunteers on the campus. 90% of respondents correctly estimated the effectiveness of OCs in preventing pregnancy, but 32-34% inflated the pregnancy rates associated with subdermal implants and Depo-Provera. 60% overestimated the failure rate of the IUD. On the other hand, a majority underestimated the failure rates of barrier methods and spermicides. 41% believed OCs increase the risk of breast cancer and 33% thought the pill increases cervical cancer risk. 66% knew that OCs reduce dysmenorrhea and 50% were aware the pill decreases menstrual bleeding. However, the majority were unaware OCs reduce the risk of benign breast disease (95%), ectopic pregnancy (91%), pelvic inflammatory disease (90%), and anemia (89%). 81% were unaware of the protective effects of OCs against uterine cancer and 77% did not know they have a protective effect against ovarian cancer. In general, OC users were more aware of the health benefits of OCs than condom users. Finally, respondents were asked to rate their satisfaction with their current birth control method on a scale of 1-12. Mean satisfaction scores were significantly higher among OC users (10.3) than condom users (7.1). These findings indicate that, even among highly educated US women, misperceptions persist about the reliability of birth control, the risks of pregnancy, and the health effects of OCs. PMID:9439201

  1. Fibrinolytic response in women on low-dose oral contraceptive.

    PubMed

    Ishak, R; Ahmad, R; Gudum, H R; Hassan, K; Ang, E S

    1992-06-01

    Long term use of low doses of combination oral contraceptives appears to increase plasminogen level, thereby increasing fibrinolytic activity and reducing the risk of thromboembolism. Blood levels of plasminogen, tissue plasminogen activator (tPA), and plasminogen activator inhibitor (PAI), were measured before and after stress (5 minutes of stair climbing) in a group of 30 women, 23-40 years old, who had taken 30 mcg of ethinyl estradiol with 150 mcg of desogestrel or levonorgestrel for at least 1 year. Similar measurements were taken from a control group of 30 women matched for age, height, and weight. Plasminogen and tPA levels in both groups increased significantly after exercise. The level of PAI did not change significantly with stress in either group. The level of plasminogen was significantly higher in the group taking contraceptives, whether before or after exercise, when compared to the control group. Levels of tPA and PAI, although slightly increased in the oral contraceptive group, were not significantly different between the two groups. The increase in plasminogen may be due to the estrogen component of the contraceptives. Stress seems to increase fibrinolytic response. PMID:12345026

  2. Striae distensae of augmented breasts after oral contraceptive therapy.

    PubMed

    Har-Shai, Y; Barak, A; Taran, A; Weissman, A

    1999-02-01

    A case of striae distensae (SD) of bilateral augmented breasts following oral contraceptive therapy is presented. Striae maturation and the prevention of additional skin marks was achieved with immediate cessation of oral contraceptive pill therapy and long-term daily topical application of tretinoin cream. It is suggested that patients who are candidates for breast augmentation surgery should be informed of the possible risk of developing SD if they are taking or planning to take the contraceptive pill. PMID:10029486

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

    ERIC Educational Resources Information Center

    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…

  4. [Inefficacy of oral contraception during use of minocycline].

    PubMed

    de Groot, A C; Eshuis, H; Stricker, B H

    1990-06-23

    A healthy woman aged 21 years who used the oral contraceptive Trigynon became pregnant while being treated with Minocin (minocycline; 100 mg per day) for acne conglobata. While the risk of use of antibiotics such as this one reducing the efficacy of oral contraceptives is small, patients should nevertheless be informed that the risk exists. PMID:2143563

  5. Effects of a monophasic combined oral contraceptive containing nomegestrol acetate and 17β-oestradiol in comparison to one containing levonorgestrel and ethinylestradiol on markers of endocrine function

    PubMed Central

    Ågren, Ulla M; Anttilat, Marjatta; Mäenpää-Liukko, Kristiina; Rantala, Maija-Liisa; Rautiainen, Hilkka; Sommer, Werner F; Mommers, Ellen

    2011-01-01

    Objectives To compare the effects of two monophasic combined oral contraceptives, containing either nomegestrol acetate/17β-oestradiol (NOMAC/E2) or levonorgestrel/ ethinylestradiol (LNG/EE) on endocrine function, androgens, and sex hormone-binding globulin (SHBG). Methods Randomised, open-label, multi-centre trial involving 121 healthy women, aged 18-50 years old. Participants received NOMAC/E2 (2.5 mg/1.5 mg) in a 24/4-day regimen (n = 60) or LNG/EE (150 μg/30 μg) in a 21/7-day regimen (n = 61) for six cycles. The primary outcome was the change from baseline to cycle 6 in markers of adrenal and thyroid function, androgens, and SHBG. Results Total cortisol, corticosteroid-binding globulin (CBG), and thyroxine-binding globulin (TBG) increased from baseline in both groups, with significantly greater increases in the LNG/EE group. No relevant changes from baseline or differences between the groups were observed for thyroid-stimulating hormone (TSH) and free thyroxine (T4). Androgens and androgen precursors decreased from baseline in both groups, with significantly greater decreases in the LNG/EE group (except for free testosterone). A greater increase in SHBG was observed with NOMAC/E2 than with LNG/EE. Conclusions NOMAC/E2 has significantly less influence on markers of adrenal and thyroid function and androgens than LNG/EE. The clinical relevance of these findings requires further study. PMID:21942708

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

    PubMed

    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. PMID:2801833

  7. Contraceptives.

    PubMed

    1997-01-01

    This chart sets forth brief descriptions of 14 contraceptive methods: male condom, female condom, vaginal diaphragm and cap, spermicides, oral contraceptives, hormonal implants, injectables, IUD, natural family planning, fertility awareness, breast feeding, withdrawal, sterilization, and emergency contraception. After presenting a short description of each method, the chart rates its degree of protection from pregnancy, the protection provided against HIV and other sexually transmitted diseases, its availability, and the method's advantages and disadvantages. PMID:12348240

  8. The effect of a contraceptive vaginal ring and oral contraceptives on the vaginal flora.

    PubMed

    Roy, S; Wilkins, J; Mishell, D R

    1981-10-01

    Premenopausal women seeking a steroid contraceptive method were allowed to choose between a contraceptive vaginal ring (CVR) containing levonorgestrel and estradiol used in a 3-week in, 1-week out regimen (n=20) and an oral contraceptive (OC) containing levonorgestrel and ethinyl estradiol in a 28-day regimen (n = 10). Cultures from the posterior vaginal fornix were obtained before therapy in both groups and monthly for 6 months for the CVR group and after 1, 3, and 6 months for the OC group. These cultures were streaked on specific media to provide quantitative aerobic and anaerobic, lactobacillus, Candida sp., Gardnerella vaginalis and Neisseria gonorrhoeae counts in micro-organisms per milliliter. A comparison of the number and types of organisms isolated from vaginal cultures obtained initially and at 6 months demonstrated no statistically significant differences in colony counts between CVR and OC users. The results of this study suggest that the use of the CVR is not associated with a greater growth of pathogens than is oral administration of a progestin and estrogen combination. PMID:6797788

  9. Do antibiotics decrease effectiveness of oral contraceptives?

    PubMed

    Cottet, C

    1996-09-01

    The number of accidental pregnancies occurring in oral contraceptive (OC) users who are concurrently taking certain antibiotics and antifungal agents exceeds the 1% failure rate associated with OCs, suggesting some form of drug interaction. Two mechanisms of action have been proposed to explain this phenomenon. First, drugs such as rifampin and griseofulvin induce liver enzymes that break down the estrogen and progestin contained in OCs, reducing plasma hormone levels. Second, changes in the intestinal bacterial flora induced by penicillin and tetracycline may reduce the gut's absorption of hormones, also compromising efficacy. Since rifampin and griseofulvin are the medications most frequently implicated in accidental pregnancies in OC users, the induction of liver enzymes is the more probable, potent cause of failure. Although the risk of pregnancy due to OC-antibiotic interactions is extremely small, OC users prescribed antibiotics should be warned to use condoms or spermicides until the antibiotics are discontinued. PMID:9006212

  10. Effects of a monophasic combined oral contraceptive containing nomegestrol acetate and 17β-oestradiol compared with one containing levonorgestrel and ethinylestradiol on haemostasis, lipids and carbohydrate metabolism

    PubMed Central

    Ågren, Ulla M; Anttilat, Marjatta; Mäenpää-Liukko, Kristiina; Rantala, Maija-Liisa; Rautiainen, Hilkka; Sommer, Werner F; Mommers, Ellen

    2011-01-01

    Objectives To compare the effects of a combined oral contraceptive (COC) containing nomegestrol acetate and 17β-oestradiol (NOMAC/E2) on haemostasis, lipids, carbohydrate metabolism, C-reactive protein (CRP) and sex hormone-binding globulin (SHBG) with those of a COC containing levonorgestrel and ethinylestradiol (LNG/EE). Methods In a randomised, open-label study, 121 healthy women, 18-50 years of age, were randomly assigned to receive NOMAC/E2 (2.5 mg/1.5 mg) in a 24/4-day regimen (n = 60) or LNG/EE (150 μg/30 μg) in a 21/7-day regimen (n = 61) for six cycles. The primary outcome was the change from baseline to cycle 6 for all indices. Results All parameters were similar at baseline between the two groups. Over six cycles, NOMAC/E2 had less effect on most haemostatic indices than LNG/EE. Lipids were essentially unchanged with NOMAC/E2, whereas with LNG/EE high-density lipoprotein cholesterol decreased and low-density lipoprotein cholesterol and triglycerides slightly increased. NOMAC/E2 induced negligible changes in glucose and insulin parameters, in contrast to LNG/EE. A much smaller increase in CRP was observed with NOMAC/E2 than with LNG/EE. NOMAC/E2 was associated with a greater increase in SHBG. Conclusions The monophasic COC NOMAC/E2 had less influence on haemostasis, lipids and carbohydrate metabolism than the COC LNG/EE. PMID:22066891

  11. Interaction between brivaracetam (100 mg/day) and a combination oral contraceptive: a randomized, double-blind, placebo-controlled study.

    PubMed

    Stockis, Armel; Watanabe, Shikiko; Fauchoux, Nicolas

    2014-03-01

    This randomized, double-blind, placebo-controlled, two-way crossover study aimed to assess the pharmacokinetic interactions between brivaracetam 100 mg/day and a combination oral contraceptive (OC) containing 30 μg ethinylestradiol and 150 μg levonorgestrel. The study was performed in 28 healthy women over five 28-day menstrual cycles: baseline (OC only), two treatment cycles with brivaracetam (50 mg b.i.d.) or placebo coadministered with OC separated by a wash-out cycle (OC only), and a follow-up cycle (OC only). The OC was administered on days 1-21 of each cycle, and brivaracetam or placebo on days 1-28 of the treatment cycles. Pharmacokinetics of ethinylestradiol and levonorgestrel were determined on day 20; brivaracetam morning trough levels on days 20 (with OC) and 29 (without OC) were compared. Cmax (maximum plasma concentration) and AUC (area under the plasma concentration versus time curve) ratios for brivaracetam versus placebo (90% confidence interval [CI]) were 0.96 (0.88-1.04) and 0.90 (0.86-0.95) for ethinylestradiol, and 0.95 (0.91-0.99) and 0.92 (0.88-0.97) for levonorgestrel, within predefined bioequivalence limits (0.80-1.25). Brivaracetam trough levels were similar on days 20 and 29 (ratio 1.08; 90% CI 0.98-1.18). No differences in breakthrough bleeding were seen across the five cycles. It was concluded that there were no interactions between brivaracetam 100 mg/day and the OC. PMID:24512385

  12. Unique effects on hepatic function, lipid metabolism, bone and growth endocrine parameters of estetrol in combined oral contraceptives

    PubMed Central

    Mawet, Marie; Maillard, Catherine; Klipping, Christine; Zimmerman, Yvette; Foidart, Jean-Michel; Coelingh Bennink, Herjan J.T.

    2015-01-01

    Abstract Objectives Estetrol (E4) is a natural estrogen produced by the human fetal liver. In combination with drospirenone (DRSP) or levonorgestrel (LNG), E4 blocks ovulation and has less effect on haemostatic biomarkers in comparison with ethinylestradiol (EE) combined with DRSP. This study evaluates the impact of several doses of E4/DRSP and E4/LNG on safety parameters such as liver function, lipid metabolism, bone markers and growth endocrine parameters. Methods This was a dose-finding, single-centre, controlled study performed in healthy women aged 18 to 35 years with a documented pretreatment ovulatory cycle. Participants received 5 mg or 10 mg E4/3 mg DRSP; 5 mg, 10 mg or 20 mg E4/150 μg LNG; or 20 μg EE/3 mg DRSP as a comparator for three consecutive cycles in a 24/4-day regimen. Changes from baseline to end of treatment in liver parameters, lipid metabolism, bone markers and growth endocrinology were evaluated. Results A total of 109 women were included in the study. Carrier proteins were minimally affected in the E4/DRSP and E4/LNG groups, in comparison with the EE/DRSP group, where a significant increase in sex hormone-binding globulin was observed. Similarly, minor effects on lipoproteins were observed in the E4 groups, and the effects on triglycerides elicited by the E4 groups were significantly lower than those in the EE/DRSP group. No imbalances in bone markers were observed in any groups. No alterations in insulin-like growth factor were observed in the E4 groups. Conclusions E4-containing combinations have a limited effect on liver function, lipid metabolism, and bone and growth endocrine parameters. Chinese Abstract 摘要 目的 雌四醇(E4)是来源于人胎儿肝脏的天然雌激素。雌四醇与屈螺酮(DRSP)或左炔诺孕酮(LNG)配伍的复方口服避孕药制剂,能够抑制排卵,同时相较于炔雌醇(EE)与屈螺酮配伍制剂,它对凝血功能的各项指标影响较小。本研究的目的是为了评估不同

  13. First time issue of oral hormonal contraception by nurses.

    PubMed

    Presho, M; Leadbetter, C

    1999-10-01

    This study aimed to assess whether introducing the issue of first time oral hormonal contraception by nurses could expand the role of the family planning nurse and improve the service to the client group. Nurse acceptability of, and adherence to, the protocol were examined. Results indicate that with appropriate training the first time issue of oral hormonal contraception is a valuable skill in enhancing the nurses' role, reduces waiting time for clients and is acceptable to clients. PMID:10567062

  14. Does the use of oral contraception depress DZ twinning rates?

    PubMed

    Campbell, D; Thompson, B; Pritchard, C; Samphier, M

    1987-01-01

    Data based on total births from a geographically defined population with zygosity determined from blood samples and placentation and with data on the use of oral contraceptives routinely collected in early pregnancy showed no association between oral contraceptive use prior to pregnancy in either MZ or DZ twinning. Three mutually exclusive control groups of singletons were used to take account of age, parity and secular trends. PMID:3451649

  15. Haemostatic effects of a new combined oral contraceptive, nomegestrol acetate/17β-estradiol, compared with those of levonorgestrel/ethinyl estradiol. A double-blind, randomised study.

    PubMed

    Gaussem, Pascale; Alhenc-Gelas, Martine; Thomas, Jean-Louis; Bachelot-Loza, Christilla; Remones, Veronique; Ali, Fouad Dali; Aiach, Martine; Scarabin, Pierre-Yves

    2011-03-01

    Use of oral contraceptives (OC) that combine a progestogen with synthetic ethinyl estradiol (EE) is associated with increased risk of venous thromboembolism. NOMAC/E2 is a new monophasic OC that combines nomegestrol acetate (NOMAC), a highly selective progestogen, with 17β-estradiol (E2). The study objective was to compare the effects on markers of haemostasis of NOMAC/E2 (2.5 mg/1.5 mg) versus the second-generation OC, levonorgestrel (LNG)/EE (100 μg/20 μg). Healthy women (age 18-38 years) received once-daily treatment for three consecutive 28-day cycles in a double-blind, randomised study: either NOMAC/E2 for 24 days with a four-day placebo interval (n=45) or LNG/EE for 21 days with a seven-day placebo interval (n=45) per cycle. Mean changes from baseline to end-of-treatment in coagulation markers, including prothrombin fragment 1+2 (primary endpoint), fibrinolysis markers and platelet functions were assessed. Mean prothrombin fragment 1+2 levels (primary endpoint) did not increase with NOMAC/E2 compared with LNG/EE ( -0.02 vs. +0.08 nM, p<0.01). Other significant differences between NOMAC/E2 and LNG/EE were mean changes in antithrombin (+0.3% vs. -4.4%, p<0.001), activated protein C resistance - normalised ratio (+0.20 vs. +0.46, p<0.01), D-dimer ( -53 vs. +43 ng/ml, p<0.001), plasminogen (+6% vs. +30%, p<0.0001) and plasminogen activator inhibitor-1 ( -3.1 vs. -8.0 ng/ml, p<0.001). There was no effect of either treatment on platelet aggregation. The NOMAC/E2 pill regimen has fewer adverse effects on blood biological coagulation and fibrinolysis markers than LNG/EE. This suggests that NOMAC/E2 could have a more favourable venous thromboembolism risk profile than LNG/EE; further epidemiological data are required to confirm this. PMID:21225090

  16. 21 CFR 310.501 - Patient package inserts for oral contraceptives.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... comparing the effectiveness of oral contraceptives to other methods of contraception. (4) A boxed warning... indications in addition to contraception that are identified in the professional labeling for the drug...

  17. 21 CFR 310.501 - Patient package inserts for oral contraceptives.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... comparing the effectiveness of oral contraceptives to other methods of contraception. (4) A boxed warning... indications in addition to contraception that are identified in the professional labeling for the drug...

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

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... comparing the effectiveness of oral contraceptives to other methods of contraception. (4) A boxed warning... indications in addition to contraception that are identified in the professional labeling for the drug...

  19. 21 CFR 310.501 - Patient package inserts for oral contraceptives.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... comparing the effectiveness of oral contraceptives to other methods of contraception. (4) A boxed warning... indications in addition to contraception that are identified in the professional labeling for the drug...

  20. 21 CFR 310.501 - Patient package inserts for oral contraceptives.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... comparing the effectiveness of oral contraceptives to other methods of contraception. (4) A boxed warning... indications in addition to contraception that are identified in the professional labeling for the drug...

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

    PubMed

    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. PMID:2631927

  2. Use of Oral Contraceptives for Management of Acne Vulgaris: Practical Considerations in Real World Practice.

    PubMed

    Harper, Julie C

    2016-04-01

    Acne vulgaris may be effectively treated with combination oral contraceptive pills (COCs) in women. COCs may be useful in any woman with acne in the absence of known contraindications. When prescribing a COC to a woman who also desires contraception, the risks of the COC are compared with the risks associated with pregnancy. When prescribing a COC to a woman who does not desire contraception, the risks of the COC must be weighed against the risks associated with acne. COCs may take 3 cycles of use to show an effect in acne lesion count reductions. PMID:27015775

  3. Examining the use of oral contraceptives in the management of acne

    PubMed Central

    Salvaggio, Heather L; Zaenglein, Andrea L

    2010-01-01

    Combined oral contraceptive pills (cOCPs) are often used in the treatment of acne in females. They are effective, safe, and easy to use in appropriate patients in combination with more conventional acne therapies. This article will briefly address the physiologic rationale for the use of cOCPs in the treatment of acne. It will also review efficacy by examining relevant clinical trials. Safety considerations and the adverse event profile for oral contraceptives will be presented. Finally, practical considerations for prescribing cOCPs will be discussed. PMID:21072299

  4. Factors affecting the enterohepatic circulation of oral contraceptive steroids.

    PubMed

    Orme, M L; Back, D J

    1990-12-01

    Oral contraceptive steroids may undergo enterohepatic circulation, but it is relevant for only estrogens, because these compounds can be directly conjugated in the liver. Animal studies show convincing evidence of the importance of the enterohepatic circulation, but studies in humans are much less convincing. The importance of the route and the rate of metabolism of ethinyl estradiol are reviewed. Some antibiotics have been reported anecdotally to reduce the efficacy of oral contraceptive steroids, but controlled studies have not confirmed this observation. Although gut flora are altered by oral antibiotics, the blood levels of ethinyl estradiol are not reduced, and one antibiotic at least (cotrimoxazole) enhances the activity of ethinyl estradiol. PMID:2256523

  5. Chlamydia trachomatis and oral contraceptive use: a quantitative review.

    PubMed Central

    Cottingham, J; Hunter, D

    1992-01-01

    OBJECTIVES--Chlamydia trachomatis is now recognised as a major sexually transmitted disease; oral contraceptive use is rapidly increasing particularly in developing countries. There are thus important public health implications of the many reports that isolation of C trachomatis is more frequent among users of oral contraceptives. The aim of this analysis was to assess the strength and consistency of this association by summarising published studies between 1972 and 1990. DESIGN--Studies identified were grouped according to whether they were prospective or case-control studies. Data were extracted and pooled estimates of the unadjusted odds ratios were made for all studies, as well as for sub-groups defined by an index of study quality, background prevalence of C trachomatis, and the contraceptive comparison being made. LOCATION--Studies in the analysis were mainly conducted in Europe and North America; the meta-analysis was done at the Harvard School of Public Health, Boston, MA, USA. RESULTS--The pooled estimated unadjusted odds ratio for 29 case-control studies examined was 1.93 (95% CI, 1.77-2.11), indicating an almost twofold increased risk of chlamydial infection for oral contraceptive users. Neither study quality nor prevalence of C trachomatis modified this risk. When compared to the use of barrier contraceptives, however, the risk of infection for women using oral contraceptives increased to 2.91 (95% CI, 1.86-4.55). The pooled estimated protective effect of barrier methods in these studies was 0.34 (95% CI, 0.22-0.54). CONCLUSIONS--Cross-study comparisons of the relationship between oral contraceptive use and chlamydial infection are limited by the design and analysis of many component studies which did not control for confounding factors such as sexual behaviour and age. The almost twofold risk of increased chlamydial infection for oral contraceptive users, supported by the findings of two prospective studies, however, points to the importance of

  6. How can we improve oral contraceptive success in obese women?

    PubMed Central

    Cherala, Ganesh; Edelman, Alison

    2015-01-01

    Summary A rapid increase in obesity rates worldwide further underscores the importance of better understanding the pharmacokinetic alterations in this sub-population and the subsequent effects on pharmaco-therapeutics. Pharmacokinetics of contraceptive steroids are altered in obese oral contraceptive users which may in turn impact efficacy. Our work has identified several dosing strategies that offset these pharmacokinetic changes and may improve effectiveness for obese OC users. PMID:25354219

  7. Nomegestrol acetate, a novel progestogen for oral contraception.

    PubMed

    Mueck, Alfred O; Sitruk-Ware, Regine

    2011-05-01

    Nomegestrol acetate (NOMAC) is a potent, highly selective progestogen, which is structurally similar to 19-norprogesterone and characterized as a full agonist at the progesterone receptor, with no or minimal binding to other steroid receptors, including the androgen and glucocorticoid receptors. In animal models, NOMAC demonstrated moderate antiandrogenic activity and strong antiestrogenic activity. In clinical studies, the progestogen was associated with effective suppression of gonadotropic activity and ovulation in premenopausal women, and a neutral impact on hemostasis, lipids, and carbohydrate metabolism. In normal and cancerous human breast tissue, NOMAC has shown favorable effects on estrogen metabolism, and in human breast cancer cell lines in vitro, it does not stimulate cell proliferation. The pharmacologic profile of NOMAC suggested that it would be well suited for combination with a physiologic estrogen in a combined oral contraceptive (COC), with the aim of achieving effective contraception with good cycle control and a favorable safety profile. A monophasic COC containing NOMAC 2.5mg and 17β-estradiol (E2) 1.5mg, administered in a 24/4-day regimen, is currently under clinical investigation. In a phase III study, NOMAC/E2 provided consistent and robust ovulation inhibition, with contraceptive effects that compared favorably with those of drospirenone 3mg/ethinyl estradiol (EE) 30 μg. Investigators for a second phase III study reported less overall impact with NOMAC/E2 on hemostatic, lipid, inflammatory, and carbohydrate metabolism parameters than with levonorgestrel 150 μg/EE 30 μg. These clinical findings are promising; however, full publication of results from the pivotal phase III trials of NOMAC/E2 is pending. PMID:21335021

  8. An Ethinyl Estradiol-Levonorgestrel Containing Oral Contraceptive Does Not Alter Cytochrome P4502C9 In Vivo Activity

    PubMed Central

    Pearson, Jacob; Maslen, Cheryl; Edelman, Alison

    2014-01-01

    Oral contraceptives have been in wide use for more than 50 years. Levonorgestrel, a commonly employed progestin component of combined oral contraceptives, was implicated in drug–drug interactions mediated via CYP2C9. Although in vitro studies refuted this interaction, there are no confirmatory in vivo studies. In the current study, we examined the phenotypic status of CYP2C9 using low-dose (125 mg) tolbutamide before and after oral contraceptive use in reproductive age women. Blood was collected 24 hours after the tolbutamide oral dose was administered, plasma was isolated, and tolbutamide concentration (C24) was measured using liquid chromatography–mass spectrometry. The natural logarithm of tolbutamide C24, a metric for CYP2C9 phenotype, was found to be equivalent (within 80%–125% equivalency boundaries) before and after oral contraceptive use. In conclusion, levonorgestrel-containing oral contraceptives, the most commonly used form of oral contraception, do not affect the status of the CYP2C9 enzyme. This suggests that it is safe to coadminister levonorgestrel-containing oral contraceptives and CYP2C9 substrates, which include a wide array of drugs. PMID:24368832

  9. Physiologic and psychologic symptoms associated with use of injectable contraception and 20 µg oral contraceptive pills

    PubMed Central

    Berenson, Abbey B.; Odom, Susan D.; Radecki Breitkopf, Carmen; Rahman, Mahbubur

    2013-01-01

    Objective To compare menstrual, physiologic, and psychologic symptoms over 2 years among women initiating use of depot medroxyprogesterone acetate or an oral contraceptive pill with a reduced pill-free interval, and those not using hormonal contraception. Methods A total of 608 women reported their experience regarding 17 symptoms prior to initiating contraception and every 6 months thereafter for 24 months. Longitudinal relationships between symptoms and contraceptives were assessed after adjusting for age, visits, and baseline status of symptoms. Results Oral contraceptive pills were protective against mastalgia (OR = 0.7), cramping (OR = 0.5), hair loss (OR = 0.6), acne (OR = 0.4), nervousness (OR = 0.5), and mood swings (OR = 0.7). DMPA was protective against bloating (OR = 0.5) and mood swings (OR = 0.7), but caused weight gain (OR = 2.3), bleeding episodes >20 days (OR = 13.4), and missed periods (OR = 96.9). Both methods caused intermenstrual bleeding. Conclusion Evidence-based data regarding beneficial and adverse symptoms associated with these methods may help clinicians counsel patients appropriately prior to contraceptive initiation. PMID:18599013

  10. Oral contraceptives as anti-androgenic treatment of acne.

    PubMed

    Lemay, André; Poulin, Yves

    2002-07-01

    Although acne is seldom associated with high serum levels of androgens, it has been shown that female acne patients have definite increases in ovarian and adrenal androgen levels when compared to appropriate controls. As shown in several pilot and in multiple open and comparative studies, oral contraceptives (OCs) are effective in causing a significant regression of mild to moderate acne. These results have been confirmed by multicentre randomized trials where low-dose OCs did not cause side effects different from those of the placebo-controlled group. The beneficial effect of OCs is related to a decrease in ovarian and adrenal androgen precursors; to an increase in sex hormone-binding globulin (SHBG), which limits free testosterone; and to a decrease in 3a-androstenediol glucuronide conjugate, the catabolite of dihydrotestosterone (DHT) formed in peripheral tissues. The estrogen-progestin combination containing cyproterone acetate (CPA) is particularly effective in treating acne, since this progestin also has a direct peripheral anti-androgenic action in blocking the androgen receptor. Only two open studies and one randomized study on small numbers of patients have reported some efficacy of spironolactone used alone or in combination with an OC in the treatment of acne. The new non-steroidal anti-androgens flutamide and finasteride are being evaluated for the treatment of hirsutism. Oral antibiotics are prescribed to patients with inflammatory lesions, where they are effective in decreasing the activity of microbes, the activity of microbial enzymes, and leukocyte chemotaxis. Concomitant intake of an OC and an antibiotic usually prescribed for acne does not impair the contraceptive efficacy of the OC. A second effective contraceptive method should be used whenever there would be decreased absorption or efficacy of the OC (digestive problems, breakthrough bleeding), lack of compliance and use of a type or dose of antibiotic different from that usually prescribed

  11. Comparison of recalled and validated oral contraceptive histories.

    PubMed

    Nischan, P; Ebeling, K; Thomas, D B; Hirsch, U

    1993-11-01

    From a case-control study of the relation between oral contraceptives and breast cancer carried out in East Germany during 1982-1986, the authors obtained information on oral contraceptive use through interviews of study subjects and from the records of prescribing gynecologists. The degree of agreement regarding information from these two sources was assessed for 234 breast cancer cases and 524 controls who had ever used oral contraceptives. Agreement between information obtained from medical records and that from interviews on total duration of use, number of episodes of use, and time since first and last use was reasonably good, and levels of agreement did not differ appreciably between cases and controls. Lower levels of agreement were observed for individual brand names and the duration of use of specific brands. Attempts should be made to obtain information on specific brands from medical records when investigating the effects of individual preparations. PMID:8237985

  12. Treating acne with oral contraceptives: use of lower doses.

    PubMed

    Huber, Johannes; Walch, Katharina

    2006-01-01

    Oral contraceptives (OCs) have been shown to effectively treat acne. Clinical trials of various doses of ethinyl estradiol (EE) combined with progestins such as levonorgestrel, desogestrel, norgestimate, gestodene, cyproterone acetate and drospirenone in monophasic, triphasic and combiphasic formulations used to treat acne in women are reviewed here. Open-label and comparative studies beginning in the 1980s were the first to demonstrate objective and subjective reductions in the incidence of acne, severity of existing acne and seborrhea. Placebo-controlled trials have corroborated these findings with a trend toward effective acne treatment with declining doses of EE. Significant reductions in total, inflammatory and noninflammatory lesions compared with placebo have been demonstrated with an OC containing the low dose of 20 microg of EE. Collectively, these findings support the use of low-dose OCs for the treatment of acne. PMID:16371290

  13. Oral Contraceptives and Multiple Sclerosis/Clinically Isolated Syndrome Susceptibility

    PubMed Central

    Hellwig, Kerstin; Chen, Lie H.; Stancyzk, Frank Z.; Langer-Gould, Annette M.

    2016-01-01

    Background The incidence of multiple sclerosis (MS) is rising in women. Objective To determine whether the use of combined oral contraceptives (COCs) are associated with MS risk and whether this varies by progestin content. Methods We conducted a nested case-control study of females ages 14–48 years with incident MS or clinically isolated syndrome (CIS) 2008–2011 from the membership of Kaiser Permanente Southern California. Controls were matched on age, race/ethnicity and membership characteristics. COC use up to ten years prior to symptom onset was obtained from the complete electronic health record. Results We identified 400 women with incident MS/CIS and 3904 matched controls. Forty- percent of cases and 32% of controls had used COCs prior to symptom onset. The use of COCs was associated with a slightly increased risk of MS/CIS (adjusted OR = 1.52, 95%CI = 1.21–1.91; p<0.001). This risk did not vary by duration of COC use. The association varied by progestin content being more pronounced for levenorgestrol (adjusted OR = 1.75, 95%CI = 1.29–2.37; p<0.001) than norethindrone (adjusted OR = 1.57, 95%CI = 1.16–2.12; p = 0.003) and absent for the newest progestin, drospirenone (p = 0.95). Conclusions Our findings should be interpreted cautiously. While the use of some combination oral contraceptives may contribute to the rising incidence of MS in women, an unmeasured confounder associated with the modern woman’s lifestyle is a more likely explanation for this weak association. PMID:26950301

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

    ERIC Educational Resources Information Center

    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…

  15. Oral contraceptives and venous thrombosis: end of the debate?

    PubMed

    Skouby, S O

    1998-06-01

    During the more than 30-year history of oral contraceptives, clinicians have received several official warnings issued by regulating agencies on cardiovascular risks. These have affected not only gynecological practice, but also generated research activities resulting in the refined third-generation products marketed in the 1970s. The alert sent out by the UK Committee on Safety of Medicines (CSM), October 1995, on increased risk of deep venous thrombosis during use of these compounds was, therefore, very much unexpected. The statements were referring to unpublished data and, thus, indicated new and highly alarming findings. However, during the following months, although four epidemiological studies reported a 2-4 fold relative increase compared with the second-generation oral contraceptives. This relative increase means, looking at absolute risks, an excess of 1-2 cases of deep venous thrombosis per 10,000 oral contraceptive users per year. In the academic discussions following the primary publication of the four papers, the possibility of confounding factors and bias was strongly emphasized and follow-up studies together with re-analysis of the original studies have not generated evidence for the suspicion of the increased risk with third-generation oral contraceptives. In contrast, a decreasing tendency was demonstrated for more serious events such myocardial infarction. Also, the biological plausibility for increased risk of deep venous thrombosis with third-generation products is lacking, although one study has pointed to a change in the natural anticoagulatory mechanism. Obviously, the authorities have a right to react on suspicion, but the psychological and social effects of the abrupt stopping of oral contraceptive use should not be ignored, and the public understanding of scientific results is manipulated by the mass media. Following confirmed evidence from both epidemiological and biological studies, with full acknowledgement of the contraceptive and non-contraceptive

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

    ERIC Educational Resources Information Center

    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…

  17. Effect of missed combined hormonal contraceptives on contraceptive effectiveness: a systematic review☆

    PubMed Central

    Zapata, Lauren B.; Steenland, Maria W.; Brahmi, Dalia; Marchbanks, Polly A.; Curtis, Kathryn M.

    2015-01-01

    surrogate measures of pregnancy risk and ranged in quality. For studies providing indirect evidence on the effects of missed CHCs, it is unclear how differences in surrogate measures correspond to pregnancy risk. Fewer studies examined the transdermal patch and vaginal ring than combined oral contraceptives. PMID:23083527

  18. Effects of a triphasic combination oral contraceptive containing norgestimate/ethinyl estradiol on biochemical markers of bone metabolism in young women with osteopenia secondary to hypothalamic amenorrhea.

    PubMed

    Grinspoon, S K; Friedman, A J; Miller, K K; Lippman, J; Olson, W H; Warren, M P

    2003-08-01

    This multicenter, double-blind, placebo-controlled, randomized study of 45 patients evaluated the short-term effects of an oral contraceptive [Ortho Tri-Cyclen, 180-250 micro g of norgestimate (NGM) and 35 microg of ethinyl estradiol (EE)] on biochemical markers of bone resorption, formation, and osteoprotegerin in young women (mean age +/- SD, 26.5 +/- 6.3 yr) with hypothalamic amenorrhea and osteopenia. Body fat, endocrine, and cognitive function were evaluated as secondary endpoints. Biomarkers of bone metabolism were measured at baseline and after three cycles of NGM/EE or placebo. There were significant decreases in mean values of N-telopeptide [mean (SD), -13.4 (13.4) vs. 1.2 (23.8) nmol bone collagen equivalents (BCE)/mmol creatinine (Cr); P = 0.001] and deoxypyridinoline [-1.2 (2.9) vs. -0.5 (1.5) nmol deoxypyridinoline/mmol Cr; P = 0.021] as well as significant decreases in bone specific alkaline phosphatase [-5.1 (3.5) vs. 0.4 (3.1) ng/ml; P < 0.001], osteocalcin [-5.9 (3.6) vs. -2.9 (3.7); P = 0.016], and procollagen of type I propeptide [-35.2 (44.6) vs. -0.2 (30.0) ng/ml; P = 0.025], but not osteoprotegerin [0.39 (1.46) vs. -0.2 (0.49) pmol/liter; P = 0.397] in the NGM/EE vs. placebo group. There were no significant differences between groups with respect to changes in cognitive function, mood, body weight, body mass index, body fat, percentage of body fat, and all endocrine levels except FSH, [-3.7 (3.8) vs. -0.6 (2.1) IU/liter; P < 0.001, NGM/EE vs. placebo]. No serious adverse events were reported in either group. These results suggest that NGM/EE decreases bone turnover in osteopenic premenopausal women with hypothalamic amenorrhea. Further studies are needed to determine whether estrogen will increase bone density in this population. PMID:12915650

  19. Anatomical and Functional Changes Induced by Oral Contraception

    PubMed Central

    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

  20. Birth control pills - combination

    MedlinePlus

    The pill - combination; Oral contraceptives - combination; OCP - combination; Contraception - combination ... Birth control pills help keep you from getting pregnant. When taken daily, they are one of the most ...

  1. Incidence of depressive symptoms in users of the oral contraceptive.

    PubMed

    Fleming, O; Seager, C P

    1978-05-01

    Evidence is presented that the incidence of depression among users of oral contraceptives is no higher than that among matched controls not taking such medication. There is an association between high depression scores and high neuroticism scores, more marked in controls than takers. Intensity of depression is related more to age, personality and occupation than to the use of oral contraceptives. A higher proportion of users than of controls experience sexual satisfaction. Past takers include a large number of individuals with a high neuroticism score. The incidence of depression symptoms in women increases with age. A higher proportion of housewives than of women going out to full-time work show depressive symptoms. PMID:656705

  2. A New and Practical Oral Contraceptive Agent: Norethindrone with Mestranol

    PubMed Central

    Dickinson, J. H.; Smith, G. G.

    1963-01-01

    The usefulness of a new oral contraceptive compound containing norethindrone 5 mg. and mestranol 0.075 mg. (Ortho-Novum) was studied. One hundred and seventeen private patients used this preparation for a total of 998 menstrual cycles. There were no pregnancies. Side effects were minimal and caused few (11 patients) to discontinue use. The most significant of these was weight gain and a premenstrual tension syndrome including nausea, breakthrough bleeding and skin effects. Other symptoms were minor and easily controlled. Instruction in use of the preparation is easy. Patient acceptance is excellent. Possible masculinizing effects, liver damage, or harmful effects on the uterus were checked specifically by laboratory evaluation; no significant abnormal findings were noted. This appears to be an effective oral contraceptive which is well accepted by the patient and which produced no serious side effects as used in this study. PMID:14027723

  3. Letter: Kilopascals. Control of oral contraceptive clinical trails.

    PubMed

    Mitchell, G D

    1975-02-01

    To deal with the confusion surrounding clinical acceptability of specific oral contraceptive preparations, a single set of forms for use in clinical research, together with a set of definitions, was recommended. Senior representatives of major pharmaceutical companies engaging in clinical trials in the United Kingdom were invited to cooperate. The Family Planning Research Unit of the University of Exeter was requested to provide facilities for meetings which began in 1972. An agreed set of forms has been designed and set of definitions has been developed to make the collection and interpretation of data more efficient. Organizations carrying out oral contraceptive clinical trials are invited to contact this unit. Forms, definitions, and further information will be provided on request. PMID:1089453

  4. [A comparative study of the incidence of Gardnerella vaginalis in users of IUD and oral contraceptives].

    PubMed

    Aleixo Neto, A; Peixoto, M L; Cabral, A C

    1987-07-01

    Leukorrhea constitutes one of the most frequent complaints by women visiting out-patient gynecological clinics. The most common etiological agents are Gardnerella vaginalis, Trichomonas vaginalis, Neisseria gonorrhoea and Candida albicans. Some authors have been able to verify an increased presence of certain pathogenic germs in the vaginal flora for users of contraceptive methods, e.g., for users of IUD, Kivijarvi et al. demonstrated a significantly increased presence of Gardnerella vaginalis considered responsible for a large number of inflammatory diseases of the pelvis in woman. In order to establish the frequency of colpo-cervicitis in users of contraceptive methods a study was initiated of women attending the Family Planning Clinic of the Department of Medicine at UFMG during the period January-December 1986. 305 cytological smears obtained from 111 users of oral hormonal contraceptives and from 194 users of IUD were studied by using the Papanicolaou staining method. A microscopic examination enabling the detection of cells that indicate the presence of Gardnerella vaginalis, trichomonas, Candida, papilloma, and dysplastic cells was performed. The results are listed in two tables. In 34.5% of cases a significant association was established between users of IUD and cells indicating the presence of Gardnerella vaginalis. For users of oral contraceptives that figure was lower, 28.8%. This circumstance has been attributed to probable epithelial lesions caused by incorrect insertion of the IUD and more abundant menstrual flux provoked b the IUD in combination with the hemophilic characteristics of Gardnerella vaginalis. A significant prevalence of papilloma and trichomonas was also noted for women using IUD as opposed to those oral contraceptives. The results demonstrate the necessity of frequent clinical attendance and laboratory tests for women using contraceptive methods, particularly the IUD. PMID:12282423

  5. Hypertriglyceridemic Pancreatitis Caused by the Oral Contraceptive Agent Estrostep.

    PubMed

    Abraham, Mary; Mitchell, Jennifer; Simsovits, Debra; Gasperino, James

    2015-07-01

    Norethindrone acetate/ethinyl estradiol (Estrostep; Warner Chilcott, Rockaway, New Jersey) is an "estrophasic" type of oral contraceptive, which combines a continuous low progestin dose with a gradually increasing estrogen dose. In clinical trials, this medication failed to produce clinically significant changes in serum lipid levels. We report a case of severe hypertriglyceridemia-induced acute pancreatitis in a 24-year-old woman caused by Estrostep, occurring nearly 10 years after she began using the drug. The patient was admitted to the medical intensive care unit (ICU) for aggressive volume resuscitation and management of severe electrolyte abnormalities. Laboratory studies obtained on admission indicated severe hypertriglyceridemia (2,200 mg/dL), hyponatremia (120 mEq/L), and hypocalcemia (0.78 mmol/L). Amylase and lipase levels were also elevated (193 and 200 U/L, respectively). Ranson score calculated after 48 hours of admission was 4, and her Acute Physiology and Chronic Health Evaluation (APACHE) IV score was 35. Treatment included an insulin infusion, ω-3 fatty acid esters, and gemfibrozil. The insulin infusion reduced serum triglyceride levels by 50% after 1 day of treatment and to 355 mg/dL by day 7 of her ICU course. We believe that this is the first reported case of severe, acute hypertriglyceridemia-induced pancreatitis caused by this medication. PMID:24671004

  6. A novel male contraceptive pill-patch combination: oral desogestrel and transdermal testosterone in the suppression of spermatogenesis in normal men.

    PubMed

    Hair, W M; Kitteridge, K; O'Connor, D B; Wu, F C

    2001-11-01

    This study investigated the effect of transdermal T and oral desogestrel on the reproductive axis of healthy men. Twenty-three men were randomized to 1 of 3 treatment groups and received a daily transdermal T patch plus oral desogestrel at a dose of 75, 150, or 300 microg/d for 24 wk. Baseline blood and semen samples were obtained and then every 4 wk thereafter for 32 wk. The outcome measures were sperm density and plasma levels of FSH, LH, total and free T. The results show a dose-dependent suppression of spermatogenesis and gonadotropins. Seven of the 17 subjects became azoospermic. Desogestrel (300 microg daily) in combination with 5 mg daily transdermal T was the most effective (57% azoospermic), whereas a dose of 75 microg was ineffective (0% azoospermic). Total and free plasma T were reduced by approximately 30%. High density lipoprotein cholesterol was significantly reduced. No serious side-effects were encountered. We conclude that daily self-administered desogestrel with transdermal T is capable of suppressing the male reproductive axis, although the efficacy was less marked and less consistent than injectable regimens. The lower efficacy is likely to be due to failure of the transdermal T system to maintain circulating T levels consistently in the required range. PMID:11701677

  7. It's all about money: oral contraception alters neural reward processing.

    PubMed

    Bonenberger, Martina; Groschwitz, Rebecca C; Kumpfmueller, Daniela; Groen, Georg; Plener, Paul L; Abler, Birgit

    2013-12-01

    Mating preferences in phases of the natural menstrual cycle with a low probability to conceive have been associated with lower interest in characteristics promising genetic benefits but increased search for safety and future security. We hypothesized that this effect would also be evident under oral contraception and may therefore alter neural processing of monetary rewards as a proxy for potential safety. Our aim was to assess the activation of reward-related brain areas using a monetary incentive task in women with functional MRI (fMRI). We compared fMRI activation of 12 young women taking oral contraceptives with 12 women with a natural hormonal cycle in their follicular phase during the expectation of monetary rewards. Women under hormonal contraception who have already shown decreased anterior insula activation upon erotic stimulation in a previous study of the same sample now showed enhanced activation during monetary reward expectation in the anterior insula/inferior lateral prefrontal cortex (t=2.84; P<0.05) relative to young normal cycling women in the follicular phase. Our finding supports the notion that the switch in mating preferences related to different hormonal states in women is mirrored by a switch in the stimulus-dependent excitability of reward-related brain regions. Beyond highlighting hormonal effects on reward processing, our data underline the importance of monitoring hormonal states in fMRI research in women. PMID:24136199

  8. Jordanian Muslim women's intention to use oral contraceptives.

    PubMed

    Kridli, Suha Al-Oballi; Schott-Baer, Darlene

    2004-01-01

    Oral contraceptives (OCs) are the second most popular method of contraception in Jordan; however, their use remains low compared with the intrauterine device. The purpose of this article is to report the effect of factors identified by The Theory of Planned Behavior (TPB) on Jordanian Muslim women's intention to use OCs. TPB was used to develop an investigator-developed instrument, the Intention to Use Oral Contraceptive Tool (IUOCT). The IUOCT measured attitude (general attitude and attitudinal beliefs), social norms and perceived behavioral control factors in a total of 83 women participants. A stepwise regression analysis was calculated using the IUOCT subscales as predictors of Jordanian Muslim women's intention to use OCs. The findings demonstrated that the attitude, specifically general attitude and positive beliefs, about OC use affect Jordanian Muslim women's intention to use OCs. However, the findings provide limited support for social norms and perceived behavioral control as factors influencing Jordanian Muslim women's intention to use OCs. The findings indicate that more attention should be devoted to health education programs on the benefits of using OCs rather than focusing only on correcting misinformation. Nursing implications and recommendations for future research are discussed. PMID:15776755

  9. Transcortin as an indicator of estrogenic potency in oral contraceptives.

    PubMed

    Carol, W; Börner, A; Klinger, G; Greinke, C

    1980-03-01

    Serum cortisol-binding globulin (CBG) was measured before, during and following a 21-day application period of 5 oral contraceptives used in the GDR. In a second group of patients determinations were carried out at the end of a 24-month treatment period and the end of the first post-treatment cycle. From a third group of volunteers blood samples were taken at the end of the first, second and third treatment cycles. All the drugs tested produced a marked increase of CBG in serum, reaching its maximum at the end of the second treatment cycle. Within four weeks following termination of application the level fell to the control range. There were no significant differences between the various contraceptives. PMID:6156820

  10. In vitro uptake of oral contraceptive steroids by magnesium trisilicate.

    PubMed

    Khalil, S A; Iwuagwu, M

    1978-02-01

    Some steroids used in oral contraceptives were adsorbed significantly by magnesium trisilicate. The adsorption affinity followed the sequence: ethindrone greater than mestranol greater than norethindrone greater than ethinyl estradiol. Adsorption data obtained at relatively low initial concentrations fitted a Langmuir plot; the values for monolayer adsorption ranged between 0.24 and 0.32 mg/g. At higher concentrations of the steroids, multilayer adsorption occurred. The results of desorption experiments made at 37 degrees in water and 0.05 N HCl suggested that desorption was incomplete and depended on the amount of steroid adsorbed. During the dissolution testing of a brand of contraceptive tablets containing norethindrone acetate, the presence of 0.5% (w/v) magnesium trisilicate in the medium resulted in almost complete reduction in the amount of the steroid remaining in solution after 1 hr. PMID:202691

  11. The Emotional Responses of Married Women Receiving Oral Contraceptives

    PubMed Central

    Ringrose, C. A. Douglas

    1965-01-01

    One hundred women taking oral contraceptives were questioned concerning their opinions about personal and sociological effects of this method of conception control. Fifty-three per cent reported improved coital satisfaction while 4% noted the opposite effect. Libido was increased in 22% and decreased in 13%. One woman in five believed that an increase in premarital and extramarital sexual activity would take place in the general population as a result of tablet-induced infertility. The problem of population control is discussed. It is paradoxical that the incidence of unplanned pregnancies continues to increase despite the availability of completely reliable conception control. This reflects present inability to communicate contraceptive knowledge to the appropriate people. PMID:14292887

  12. Seizure facilitating activity of the oral contraceptive ethinyl estradiol.

    PubMed

    Younus, Iyan; Reddy, Doodipala Samba

    2016-03-01

    Contraceptive management is critical in women with epilepsy. Although oral contraceptives (OCs) are widely used by many women with epilepsy, little is known about their impact on epileptic seizures and epileptogenesis. Ethinyl estradiol (EE) is the primary component of OC pills. In this study, we investigated the pharmacological effect of EE on epileptogenesis and kindled seizures in female mice using the hippocampus kindling model. Animals were stimulated daily with or without EE until generalized stage 5 seizures were elicited. EE treatment significantly accelerated the rate of epileptogenesis. In acute studies, EE caused a significant decrease in the afterdischarge threshold and increased the incidence and severity of seizures in fully-kindled mice. In chronic studies, EE treatment caused a greater susceptibility to kindled seizures. Collectively, these results are consistent with moderate proconvulsant-like activity of EE. Such excitatory effects may affect seizure risk in women with epilepsy taking OC pills. PMID:26874323

  13. Estradiol Valerate Pretreatment in Short Protocol GnRH-Agonist Cycles versus Combined Pretreatment with Oral Contraceptive Pills in Long Protocol GnRH-Agonist Cycles: A Randomised Controlled Trial.

    PubMed

    Lukaszuk, Krzysztof; Liss, Joanna; Kunicki, Michal; Kuczynski, Waldemar; Pastuszek, Ewa; Jakiel, Grzegorz; Plociennik, Lukasz; Zielinski, Krzysztof; Zabielska, Judyta

    2015-01-01

    The strategy of in vitro fertilization (IVF) procedures relies on the increasing pregnancy rate and decreasing the risk of premature ovulation and ovarian hyperstimulation syndrome. They are also designed to avoid weekend oocyte retrievals. Combined oral contraceptive (OC) pills are among the medicines used to accomplish these objectives. Alternatively, estradiol can be used instead of OC to obtain similar results. The aim of our study was to compare the differences in pregnancy rates (PRs), implantation rates, and miscarriage rates between a short agonist protocol with estradiol priming and a long protocol with combined OC. Of the 298 women who participated in this study, 134 achieved clinical pregnancies (45.0%). A higher PR (58.4%, n = 80, compared to 40.3%, n = 54) was achieved in the long protocol after OC pretreatment group. The implantation rate was also higher for this group (37.8% versus 28.0%; P = 0.03). The miscarriage rate was 15.0% (n = 12) for the long protocol after OC pretreatment group and 20.4% (n = 11) for the short agonist group (P = 0.81). The short agonist protocol required a 5.7% lower human menopausal gonadotropin (hMG) dosage than the long protocol but surprisingly the number of oocytes retrieved was also smaller. PMID:25922838

  14. Estradiol Valerate Pretreatment in Short Protocol GnRH-Agonist Cycles versus Combined Pretreatment with Oral Contraceptive Pills in Long Protocol GnRH-Agonist Cycles: A Randomised Controlled Trial

    PubMed Central

    Kunicki, Michal; Kuczynski, Waldemar; Pastuszek, Ewa; Jakiel, Grzegorz; Plociennik, Lukasz; Zielinski, Krzysztof; Zabielska, Judyta

    2015-01-01

    The strategy of in vitro fertilization (IVF) procedures relies on the increasing pregnancy rate and decreasing the risk of premature ovulation and ovarian hyperstimulation syndrome. They are also designed to avoid weekend oocyte retrievals. Combined oral contraceptive (OC) pills are among the medicines used to accomplish these objectives. Alternatively, estradiol can be used instead of OC to obtain similar results. The aim of our study was to compare the differences in pregnancy rates (PRs), implantation rates, and miscarriage rates between a short agonist protocol with estradiol priming and a long protocol with combined OC. Of the 298 women who participated in this study, 134 achieved clinical pregnancies (45.0%). A higher PR (58.4%, n = 80, compared to 40.3%, n = 54) was achieved in the long protocol after OC pretreatment group. The implantation rate was also higher for this group (37.8% versus 28.0%; P = 0.03). The miscarriage rate was 15.0% (n = 12) for the long protocol after OC pretreatment group and 20.4% (n = 11) for the short agonist group (P = 0.81). The short agonist protocol required a 5.7% lower human menopausal gonadotropin (hMG) dosage than the long protocol but surprisingly the number of oocytes retrieved was also smaller. PMID:25922838

  15. Oral contraceptive pill use and menstrual cycle phase are associated with altered resting state functional connectivity.

    PubMed

    Petersen, Nicole; Kilpatrick, Lisa A; Goharzad, Azaadeh; Cahill, Larry

    2014-04-15

    At rest, brain activity can be characterized not by an absence of organized activity but instead by spatially and temporally correlated patterns of activity. In this experiment, we investigated whether and to what extent resting state functional connectivity is modulated by sex hormones in women, both across the menstrual cycle and when altered by oral contraceptive pills. Sex hormones have been shown to have important effects on task-related activity, but few studies have investigated the extent to which they can influence the behavior of functional networks at rest. These hormones are dramatically altered by the use of hormonal contraception, which is used by approximately 100 million women worldwide. However, potential cognitive side effects of hormonal contraception have been given little attention. Here, we collected resting state data for naturally-cycling women (n=45) and women using combined oral contraceptive pills (n=46) and evaluated the differences in resting state activity between these two groups using independent component analysis. We found that in the default mode network and in a network associated with executive control, resting state dynamics were altered both by the menstrual cycle and by oral contraceptive use. Specifically, the connectivity of the left angular gyrus, the left middle frontal gyrus, and the anterior cingulate cortex were different between groups. Because the anterior cingulate cortex and left middle frontal gyrus are important for higher-order cognitive and emotional processing, including conflict monitoring, changes in the relationship of these structures to the functional networks with which they interact may have important consequences for attention, affect, and/or emotion regulation. PMID:24365676

  16. Oral contraceptives and the risk of endometrial cancer.

    PubMed

    Levi, F; La Vecchia, C; Gulie, C; Negri, E; Monnier, V; Franceschi, S; Delaloye, J F; De Grandi, P

    1991-03-01

    The relationship between the use of combination oral contraceptives (OCs) and the risk of endometrial cancer was assessed in a case-control study conducted in the Swiss Canton of Vaud between 1 January 1988 and 31 July 1990. Subjects included 122 women aged 75 or less with histologically confirmed endometrial cancer, and 309 control women in hospital for acute conditions unrelated to OC use. Overall, 14 percent of cases and 27 percent of controls had ever used OCs, corresponding to a multivariate relative risk (RR) of 0.5 (95 percent confidence interval [CI]: 0.3, 0.8). The risk of endometrial cancer was found to be related inversely to duration of OC use: RR = 1.0 for less than two years of OC use; 0.5 for two to five years; and 0.3 (95 percent CI: 0.1, 0.7) for more than five years. The protection appeared greater within 20 years since last use, and the RR rose to 0.8 after 20 or more years since last use; numbers are too small, however, for reliable inference from these subanalyses. No significant interaction or modifying effect was observed with other major factors related to endometrial cancer, including parity, body mass index, estrogen replacement therapy, and cigarette smoking. While this study provides further evidence for the protective effect of OCs against risk of endometrial cancer, the relationship requires continued evaluation to assess the long-term implications and public health impact of OC use. PMID:1873443

  17. Mesenteric venous thrombosis associated with oral contraceptives: a case report.

    PubMed

    Milne, P Y; Thomas, R J

    1976-05-01

    Small-bowel infarction resulting from mesenteric venous thrombosis is a rare but life-threatening complication to which young women taking oral contraceptives are liable. The patient characteristically presents with an "acute abdomen" after a variable prodromal period of vague abdominal pain. The correct diagnosis can be made from the macroscopic appearance at laparotomy, provided the surgeon is alert to the condition. An accurate diagnosis is important, as anticoagulation measures must be instituted early to counter the commonly associated thromboembolic phenomena. PMID:1067070

  18. Oral contraceptives and polyp regression in familial adenomatous polyposis.

    PubMed

    Giardiello, Francis M; Hylind, Linda M; Trimbath, Jill D; Hamilton, Stanley R; Romans, Katharine E; Cruz-Correa, Marcia; Corretti, Mary C; Offerhaus, G Johan A; Yang, Vincent W

    2005-04-01

    Epidemiologic and experimental reports suggest that female hormones protect against the development of colorectal cancer, but studies are limited. We describe a patient in the placebo arm of a 4-year primary chemoprevention trial who developed adenomatous polyps and then had eradication of polyps after the administration of oral contraceptives. No change in the prostaglandin levels in the colonic mucosa was noted after polyp elimination, making nonsteroidal anti-inflammatory drug ingestion unlikely as a cause. This report represents the regression of colorectal adenomas with the use of estrogen/progesterone compounds. PMID:15825088

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

    PubMed

    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. PMID:7448666

  20. Combined hormonal contraceptives: prescribing patterns, compliance, and benefits versus risks

    PubMed Central

    2014-01-01

    Combined hormonal contraceptives [combined oral contraceptives (COCs)] have been available for over 50 years and the impact of this invention may not be overestimated. Today over 100 million women are current users and in Western Europe and the United States approximately 80% of women of fertile ages can be considered as ever-users. Over the years several drawbacks have been identified and media alarms on risks are frequently presented, resulting in suboptimal compliance and low compliance and continuation rates. Poor compliance and discontinuation is a big problem and is not generally identified by prescribers. During ideal use COCs offer very good protection against unwanted pregnancies, however there is a big problem with compliance and continuation and thus the ‘real-life’ efficacy is much lower. Reasons for poor compliance include side effects and fear of side effects and it is crucial that the prescriber gives the individual woman thorough and balanced information on the benefits and risks. Most well known is the increased risk of venous thromboembolism, but also an elevated risk of arterial thrombosis and several types of cancer has been reported. The risk estimates are low but according to the large number of users a substantial number of extra cases will occur. However, use of COCs also offers several additional health benefits with significant impact on morbidity and quality of life. COC use is associated with a substantial decrease in the risk of ovarian cancer, endometrial cancer and colorectal cancer. Moreover, COCs are a major option of treatment for women suffering from heavy menstrual bleeding and dysmenorrhea as well as hirsutism and acne vulgaris. The net effect of the additional health effects of COC- use may very well be positive, i.e. a slight increase in life expectancy. PMID:25360241

  1. [ORAL CONTRACEPTIVES AND MOOD/SEXUAL DISORDERS IN WOMEN].

    PubMed

    Sirakov, M; Tomova, E

    2015-01-01

    Oral contraceptives are used since more than 50 years and are very popular due to offering more than 99% confidence in preventing pregnancy. Over 100 million women worldwide use oral contraceptives. In the UK 27% of women between 16 and 49 y. use pills. In the United States they are about 30%, in Germany - 40%, and in The Netherlands - 60%. According to a study by B. Pehlivanov, 2008, in Bulgaria only 4% of women use OC. (1) Despite the convenience and security, in the U.S.A. 29% of women taking OC interrupt prematurely their use (2), while the percentage of adolescents appears to be higher (3) Earlier studies of the reasons for refusal of OC focus on their influence on the menstrual cycle, as well as on some physical side effects such as the appearance of hair growth, weight gain, bloating etc. They paid very little attention to their impact on mood and sexual behavior of women (4). Newer studies suggest that the side effects associated with mood and sexual behavior proved more powerful factor leading to early termination of the use of OC (5). This paper is a review of the literature and evaluation of the facts presented in studies from different countries. They found a high incidence of symptoms such as anxiety, susceptibility to stress, mood changes, incl. depression, anxiety, increased irritability and affection of sexual desire of women. (6) There are many indications that OC-users are at increased risk of suicide and mental illnesses. (9). PMID:26411194

  2. Comparison of a 24-day and a 21-day pill regimen for the novel combined oral contraceptive, nomegestrol acetate and 17β-estradiol (NOMAC/E2): a double-blind, randomized study.

    PubMed

    Christin-Maitre, S; Serfaty, D; Chabbert-Buffet, N; Ochsenbein, E; Chassard, D; Thomas, J-L

    2011-06-01

    BACKGROUND Nomegestrol acetate/17β-estradiol (NOMAC/E(2)) is a new monophasic oral contraceptive combining NOMAC (2.5 mg), a highly selective progesterone-derived progestogen, with E(2) (1.5 mg), which is structurally identical to endogenous estrogen. The objective of this study was to compare the effects on ovarian activity of two different NOMAC/E(2) regimens. METHODS This was a double-blind, randomized study. Healthy, premenopausal women (aged 18-38 years, previous menstrual cycle length 28 ± 7 days) were randomized by computer-generated code to once-daily NOMAC/E(2) for three consecutive 28-day cycles: either 24 days with a 4-day placebo interval (n = 40) or 21 days with a 7-day placebo interval (n = 37) per cycle. Follicular growth (primary outcome measure), plasma hormone profiles and bleeding patterns were assessed. RESULTS There was no evidence of ovulation during treatment with either NOMAC/E(2) regimen. The largest follicle diameter was significantly smaller in the 24-day group than in the 21-day group [mean (SD) mm in cycle 2: 9.0 (3.0) versus 11.3 (5.3) (P = 0.02); in cycle 3: 9.2 (3.0) versus 11.5 (6.0) (P = 0.04)]. Mean FSH plasma levels were significantly lower in the 24-day versus the 21-day group on Day 24 of cycles 1 and 2. Withdrawal bleeding duration was significantly shorter in the 24-day than in the 21-day group [mean (SD) days after cycle 1: 3.5 (1.3) versus 5.0 (2.6) (P = 0.002); after cycle 2: 3.9 (1.6) versus 4.8 (1.7) (P = 0.03)]. CONCLUSIONS The 24-day NOMAC/E(2) regimen was associated with greater inhibition of follicular growth and shorter duration of withdrawal bleeding than the 21-day regimen, suggesting the shorter pill-free interval results in a greater margin of contraceptive efficacy and tolerability, and fewer withdrawal symptoms. PMID:21421664

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

    PubMed

    Amin, Mohamed E K

    2016-04-01

    Background Possessing correct therapeutic information on oral contraceptives is an important prerequisite for the provision of sound advice to women who are using these products. Objectives 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. Setting Community pharmacies throughout Alexandria, Egypt. Methods 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. Main outcome measure Pharmacists' aggregate scores for knowledge questions and pharmacists' interest in developing skills in providing counseling on oral contraceptive pills. Results 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

  4. New contraceptive choices across reproductive life.

    PubMed

    Foran, Therese M

    2003-06-16

    The range of contraceptive options and consumer awareness of new contraceptive methods have both increased significantly over the past 10 years. New methods available in Australia include lower-dose oral contraceptive pills, new oral progestogens, progestogen implants, a progestogen-bearing intrauterine device and polyurethane female condoms. Contraceptive options which may soon be introduced in Australia include novel methods of administering combined (oestrogen-progestogen) contraception, such as dermal patches and vaginal rings. PMID:12797848

  5. Relationship between premenstrual symptoms and oral contraceptive use: a controlled study.

    PubMed

    Walker, A; Bancroft, J

    1990-01-01

    Patterns of menstrual cycle-related change were compared in three groups of women differing in their use of oral contraceptives and being matched for age, occupation, and parity. These groups were: a "monophasic group" (n = 35) established on low dose "combined" pills with stable levels of estrogen and progestagen. a "triphasic group" (n = 30) on low dose pills with escalating progestagen dosage, and a "non-pill control group" (n = 57) using nonsteroidal contraceptives. Each woman kept visual analogue ratings of mood, irritability, energy, tension, breast tenderness, bloating, and sexual interest for two or three cycles. Cyclicity was evident in all variables assessed, but the only variable to show a clear difference between groups was breast tenderness; the "monophasic group" showed less premenstrual breast tenderness than the other two groups. The monophasic group also showed a tendency to menstrual rather than premenstrual symptoms. In view of the similarity of timing of most cyclical symptoms in the three groups, it is difficult to attribute such cyclical phenomena to the effects of either ovulation or variation in corpus luteum function. For most subjects, the cyclical changes were relatively mild, and these findings need to be replicated in women suffering from severe premenstrual syndrome. However, alternative explanations need to account for changes in women both taking and not taking oral contraceptives. PMID:2305025

  6. Oral contraceptives as an over-the-counter medication.

    PubMed

    Halperin, E C

    1994-05-01

    Five physicians debate the pros and cons of changing the prescription requirement for oral contraceptives (OCs) to an over-the-counter (OTC) status. Three of the physicians are in favor of changing the present policy, while the other 2 physicians are in favor of keeping the present policy. Reasons supporting a change to OTC OCs are: the health risks from an unwanted pregnancy are greater than the risks from OC use; the prescription requirement puts an expensive and unnecessary burden on women; and other countries (e.g., India and South Africa) dispense OCs OTC. Reasons for keeping the prescription requirement are: the potential risks of self medication; the possibility of inappropriate use by relatively uninformed patients; and the loss of opportunity for women to obtain a health evaluation, physical examination, and counseling. One family practice physician supports OTC status because this change may reduce the teenage pregnancy rate. She acknowledges, however, that the change will not solve the problem of teenage pregnancy. An advantage of OTC OCs is that women could use them as a postcoital contraceptive. Another physician in favor of OTC status for OCs suggests that the US health department and Planned Parenthood clinics could offer OCs at lower than retail cost to women who undergo an annual health examination. Another physician calls for randomized clinical trials to generate sufficient data to make an informed decision about public and medical policy changes. PMID:8035888

  7. Oral contraceptive use and female genital arousal: methodological considerations.

    PubMed

    Seal, Brooke N; Brotto, Lori A; Gorzalka, Boris B

    2005-08-01

    This study explored effects of oral contraceptive pill (OCP) use on physiological sexual arousal as measured by a vaginal photoplethysmograph. Sixteen women aged 18-29 viewed audiovisual neutral and erotic stimuli before and an average of 6 weeks following the onset of OCP use. Although subjective measures of sexual arousal, including perceptions of genital arousal, significantly increased in response to erotic stimuli both before and after OCP onset, physiological sexual arousal only increased before OCP use. A comparison of individual responses before and after OCP onset reveals a much higher degree of intrasubject variability after OCP onset. We discuss these findings as they relate to OCP use as a confounding methodological variable to consider in future investigations employing vaginal photoplethysmography. PMID:19817038

  8. Hypertension among oral contraceptive users in El Paso, Texas.

    PubMed

    White, Kari; Potter, Joseph E; Hopkins, Kristine; Amastae, Jon; Grossman, Daniel

    2013-11-01

    On the U.S.-Mexico border, residents frequently cross into Mexico to obtain medications or medical care. We previously reported relatively high prevalence of hypertension among Latina oral contraceptive users in El Paso, particularly those obtaining pills over the counter (OTC) in Mexico. Here, we examine factors associated with having hypertension among 411 OTC users and 399 clinic users. We also assess hypertension awareness and interest in using blood pressure kiosks. Women age 35 to 44 and who had BMI ≥ 30 kg/m2 had higher odds of having hypertension. 59% of hypertensive women had unrecognized hypertension, and 77% of all participants would use a blood pressure kiosk; there were no significant differences between clinic and OTC users. Alternative approaches to increase access to health screenings are needed in this setting, where OTC pill use among women with unrecognized hypertension confers unique health risks. PMID:24185148

  9. The return of fertility after discontinuation of oral contraception in Malaysian women.

    PubMed

    Hassan, J; Kulenthran, A; Thum, Y S

    1994-12-01

    The return of fertility after discontinuation of oral contraception was studied in a cross-sectional survey of 61 patients who were desirous of a further pregnancy. For controls, 380 women who did not take any oral contraception were used. Cumulative conception rates in the pill users were reduced but not significantly during the first three (p = 0.15) and six months (p = 0.20). By 12 months this difference was negligible (p = 0.28). We conclude that there is no significant delay in return of fertility following cessation of oral contraception in our group of Malaysian women. PMID:7674970

  10. Evaluation of a unique oral contraceptive in the treatment of premenstrual dysphoric disorder.

    PubMed

    Freeman, E W; Kroll, R; Rapkin, A; Pearlstein, T; Brown, C; Parsey, K; Zhang, P; Patel, H; Foegh, M

    2001-01-01

    Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS). This is the first trial of a unique oral contraceptive containing a combination of drospirenone (DRSP, 3 mg) and ethinyl estradiol (EE, 30 microg) for the treatment of PMDD. DRSP is a spironolactone-like progestin with antiandrogenic and antimineralocorticoid activity. Spironolactone has been shown to be beneficial in PMS, whereas oral contraceptives have shown conflicting results. In this double-blind, placebo-controlled trial, 82 women with PMDD (Diagnostic and Statistical Manual of Mental Disorders, 4th ed. [DSM IV]) were randomized to receive DRSP/EE or placebo for three treatment cycles. The primary end point was change from baseline in luteal phase symptom scores as assessed on the Calendar of Premenstrual Experiences (COPE) scale. Patients treated with DRSP/EE showed a numerically greater change from baseline compared with those treated with placebo on each of the 22 COPE items and each of the 4 symptom factors. Between-group differences in symptom improvement reached statistical significance in factor 3 only (appetite, acne, and food cravings, p = 0.027). The secondary end points, Beck Depression Inventory (BDI) and Profile of Mood States (PMS), were consistent with the primary end point in that patients treated with the oral contraceptive showed a numerically greater improvement from baseline compared with those treated with placebo. The results of this study show a consistent trend in the reduction of symptoms that suggested a beneficial effect of DRSP/EE for the treatment of PMDD, despite limitations of the study design. PMID:11559453

  11. Ovarian Follicular Development During the Use of Oral Contraception: A Review

    PubMed Central

    Baerwald, Angela R.; Pierson, Roger A.

    2010-01-01

    Over the past 40 years, alterations to the composition of oral contraceptives (OCs) have been made in attempts to reduce adverse effects and to improve patient compliance while maintaining contraceptive efficacy. However, there is growing evidence to indicate that reducing the estrogen dose to minimize adverse effects may have compromised the degree of hypothalamo-pituitary-ovarian suppression, particularly during the hormone-free interval (HFI) or following missed doses. Follicle development during OC use appears to occur in association with a loss of endocrine suppression during the HFI. This information provides a rationale for reducing or eliminating the HFI in OC regimens. There is also evidence for an increased risk of follicle development and ovulation in women who use delayed OC initiation schemes, such as the “Sunday Start” method. It is not currently known why some follicles ovulate during OC use while others regress or form anovulatory follicle cysts. Continued research about follicle development during OC use would provide insight into understanding the precise mechanisms of action underlying combined OCs, as well as those of continuous OC formulations and emergency contraceptive regimens. PMID:14715122

  12. Comparison of Drospirenone- with Cyproterone Acetate-Containing Oral Contraceptives, Combined with Metformin and Lifestyle Modifications in Women with Polycystic Ovary Syndrome and Metabolic Disorders: A Prospective Randomized Control Trial

    PubMed Central

    Wang, Qiu-Yi; Song, Yong; Huang, Wei; Xiao, Li; Wang, Qiu-Shi; Feng, Gui-Mei

    2016-01-01

    Background: While combined oral contraceptives (COCs) are commonly used to treat polycystic ovary syndrome (PCOS), comparative data regarding metabolic effects of different progestogens on this patient population are missing. This study aimed to compare the different effects of drospirenone (DRP)-containing COCs with cyproterone acetate (CPA)-containing COCs, combined with metformin and lifestyle modifications in women with PCOS and metabolic disorders. Methods: Ninety-nine women with PCOS and a metabolic disorder between January 2011 and January 2013 were enrolled into this prospective randomized clinical trial. Participants were randomized into two groups such as DRP-containing COCs, and CPA-containing COCs. Participants took COCs cyclically for 6 months, combined with metformin administration (1.5 g/d) and lifestyle modifications (diet and exercise). Clinical measures and biochemical and hormone profiles were compared. Comparisons for continuous variables were evaluated with paired and unpaired Student's t-tests. The Wilcoxon signed rank test was used when the data were not normally distributed. Analysis of covariance was used to control for age, body mass index (BMI), and baseline data of each analyzed parameter when compared between the two groups. Results: A total of 68 patients have completed the study. The combination regimen of COCs, metformin, and lifestyle modifications in these patients resulted in a significant decrease in BMI, acne, and hirsutism scores when compared to baseline levels in both groups (P < 0.05). Blood pressure (BP) was significantly different in the CPA group when compared to baseline (75.14 ± 6.77 mmHg vs. 80.70 ± 5.60 mmHg, P < 0.01), and after 6 months of treatment, only the change in systolic BP was significantly different between the two groups (4.00 [–6.00, 13.00] mmHg vs. –3.50 [–13.00, 9.00] mmHg, P = 0.009). Fasting glucose, fasting insulin, and homeostasis model assessment-insulin resistance decreased significantly

  13. Oral contraception in the former Czech and Slovak Federal Republic: attitudes and use.

    PubMed

    Ketting, E; Visser, A P; Uzel, R; Lehert, P

    1993-06-01

    This paper presents and discusses data on oral contraception from a national representative survey (n = 1072) on knowledge, attitudes and practice with regard to contraceptive use in the Czech and Slovak Federal Republic (CSFR). Only 7% of the women at risk of unplanned pregnancy used the pill. The low rate of use seems to be due to the general negative image of oral contraception, reinforced by the experiences of past users and opinions expressed by relative, friends, doctors, and the media. In particular, perceived psychological disadvantages have an important bearing on the decision not to use the method, whereas perceived advantages have hardly any impact. It is likely that this negative image is closely linked with the types of oral contraceptives that have been available in the country and also with the limited choice. Second- and third-generation oral contraceptives have only very recently become available. It is recommended that balanced information on the advantages and disadvantages of oral contraception be made available to doctors and to the general public on a large scale and through a variety of channels. PMID:8237567

  14. Treatment of recurrent toxic shock syndrome with oral contraceptive agents.

    PubMed

    McIvor, M E; Levin, M L

    1982-09-01

    The case of a 20-year old woman who was hospitalized for toxic shock syndrome (TSS) for 4 consecutive months despite use of conventional therapy for prevention of recurrence is described. Following discharge after the 4th episode she was started on oral contraceptives (OCs), and her next 8 menstrual cycles were uneventful despite continued use of tampons. She since discontinued use of tampons and remains asymptomatic. TSS recurrences occur in 30-64% of patients and can follow the initial episode by up to 41 months. The experience of this patient demonstrates the limitations of using antistaphyloccal antibiotics at the end of each menstrual cycle but suggests that hormonal manipulation may be an effective alternative therapy for TSS recurrences. Epidemiological studies show TSS patients use OCs less frequently than controls. Whether OCs suppress the vaginal flora, as some evidence suggests, or make conditions less favorable for the development of TSS in some other way is unknown. OC therapy for recurrences of TSS should receive further study. PMID:7144265

  15. Affective responsiveness is influenced by intake of oral contraceptives.

    PubMed

    Radke, Sina; Derntl, Birgit

    2016-06-01

    Despite the widespread use of oral contraceptive pills (OCs), little is known about their impact on psychological processes and emotional competencies. Recent data indicate impaired emotion recognition in OC users compared to naturally cycling females. Building upon these findings, the current study investigated the influence of OC use on three components of empathy, i.e., emotion recognition, perspective-taking, and affective responsiveness. We compared naturally cycling women to two groups of OC users, one being tested in their pill-free week and one in the phase of active intake. Whereas groups did not differ in emotion recognition and perspective-taking, an effect of pill phase was evident for affective responsiveness: Females currently taking the pill showed better performance than those in their pill-free week. These processing advantages complement previous findings on menstrual cycle effects and thereby suggest an association with changes in endogenous and exogenous reproductive hormones. The current study highlights the need for future research to shed more light on the neuroendocrine alterations accompanying OC intake. PMID:27039036

  16. Using Changes in Binding Globulins to Assess Oral Contraceptive Compliance

    PubMed Central

    Westhoff, Carolyn; Petrie, K.A.; Cremers, S.

    2012-01-01

    Background Validity of oral contraceptive pill (OCP) clinical trial results depends on participant compliance. Ethinyl estradiol (EE2) induces increases in hepatic binding globulin (BG) levels. Measuring these BG increases may provide an effective and convenient approach to distinguishing non-compliant from compliant OCP users in research settings. This analysis evaluated the usefulness of measuring increases in corticosteroid, sex hormone and thyroxine binding globulins (CBG, SHBG, TBG) as measures of OCP compliance. Methods We used frozen serum from a trial that compared ovarian suppression between normal weight and obese women randomized to one of two OCPs containing EE2 and levonorgestrel (LNG). Based on serial LNG measurements during the trial, 17% of participants were non-compliant. We matched non-compliant participants with compliant participants by age, BMI, ethnicity and OCP formulation. We measured CBG, SHBG and TBG levels, and compared change from baseline to 3-month follow-up between the non-compliant and compliant participants. Construction of receiver operator characteristic (ROC) curves allowed comparison of various BG measures. Results Changes in CBG and TBG distinguished OCP non-compliant users from compliant users (area under the ROC curve (AUROC), 0.86 and 0.89, p < 0.01). Changes in SHBG were less discriminating (AUROC 0.69) Conclusions EE2 induced increases in CBG and TBG provide a sensitive integrated marker of compliance with an LNG-containing OCP. PMID:22795088

  17. Clinical utility of folate-containing oral contraceptives

    PubMed Central

    Lassi, Zohra S; Bhutta, Zulfiqar A

    2012-01-01

    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. PMID:22570577

  18. The effect of elevated ovarian hormones on periodontal health: oral contraceptives and pregnancy.

    PubMed

    Zachariasen, R D

    1993-01-01

    The most common oral manifestation of elevated levels of ovarian hormones, as seen in pregnancy or oral contraceptive usage, is an increase in gingival inflammation with an accompanying increase in gingival exudate. This gingivitis can be avoided or at least minimized by establishing low plaque levels at the beginning of pregnancy or the beginning of oral contraceptive therapy. It would appear that bacteria are not solely responsible for the gingivitis seen during these times, nor are the ovarian hormones solely responsible for the condition. Data from numerous studies suggest that the ovarian hormones alter the microenvironment of the oral bacteria so as to promote their growth and shifts in their populations. The present article reviews the current state of knowledge concerning the relationship of gingivitis to elevated levels of ovarian hormones, and describes the role that these hormones may play in the gingivitis associated with pregnancy or oral contraceptive usage. PMID:8372477

  19. The effect of combined hormonal contraceptives use on brain reactivity during response inhibition.

    PubMed

    Gingnell, Malin; Bannbers, Elin; Engman, Jonas; Frick, Andreas; Moby, Lena; Wikström, Johan; Sundström-Poromaa, Inger

    2016-04-01

    Objectives Cognitive control, which can be described as the ability to moderate impulses, has not previously been investigated in users of combined hormonal contraception (CHC). Given the suggested modulatory role of ovarian steroids in prefrontal dopaminergic function, which in turn taps into cognitive control, this randomised, double-blinded, placebo-controlled oral contraceptive trial set out to investigate the brain activity pattern during response inhibition in CHC users. Methods Thirty-four women were randomised to one treatment cycle with a levonorgestrel-containing CHC or placebo. The women performed a Go/NoGo task to measure brain activity during response inhibition by use of event-related functional magnetic resonance imaging (fMRI) prior to and during the CHC/placebo treatment cycle. Results No differences between CHC and placebo users in number of correct inhibitions were found during treatment, but only women on CHC significantly improved their performance between the baseline and treatment assessments. During the treatment cycle CHC users displayed decreased activity in the right middle frontal gyrus in comparison with placebo users. No other significant activations were evident between treatment groups or within groups. Conclusion Overall, CHC use had marginal effects on brain activity during response inhibition. If anything, the findings of the study may suggest reduced effort or increased efficiency in maintaining orbitofrontal cortex inhibitory cognitive control when using a combined oral contraceptive. PMID:26291330

  20. Bioprostethic mitral valve thrombosis due to oral contraceptive drug use and management with ultra-slow thrombolytic therapy.

    PubMed

    Yesin, Mahmut; Kalçik, Macit; Gündüz, Sabahattin; Astarcioğlu, Mehmet Ali; Gürsoy, Mustafa Ozan; Karakoyun, Süleyman; Özkan, Mehmet

    2016-03-01

    Prosthetic valve thrombosis is a severe complication, which usually occurs in inadequately anticoagulated patients. Mechanical valve thrombosis is more common than bioprosthetic valve thrombosis (BVT). Oral contraceptive drugs are associated with increased risk of thromboembolism in women. The possible association between oral contraceptive drug use and BVT has never been reported before. We present a case of obstructive BVT occurring after the use of an oral contraceptive drug and successful management with ultra-slow thrombolytic therapy. PMID:26378817

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

    PubMed Central

    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

  2. Greater Beta-Adrenergic Receptor Mediated Vasodilation in Women Using Oral Contraceptives

    PubMed Central

    Limberg, Jacqueline K.; Peltonen, Garrett L.; Johansson, Rebecca E.; Harrell, John W.; Kellawan, Jeremy M.; Eldridge, Marlowe W.; Sebranek, Joshua J.; Walker, Benjamin J.; Schrage, William G.

    2016-01-01

    Background: β-adrenergic receptors play an important role in mitigating the pressor effects of sympathetic nervous system activity in young women. Based on recent data showing oral contraceptive use in women abolishes the relationship between muscle sympathetic nervous system activity and blood pressure, we hypothesized forearm blood flow responses to a β-adrenergic receptor agonist would be greater in young women currently using oral contraceptives (OC+, n = 13) when compared to those not using oral contraceptives (OC–, n = 10). Methods: Women (18–35 years) were studied during the early follicular phase of the menstrual cycle (days 1–5) or placebo phase of oral contraceptive use. Forearm blood flow (FBF, Doppler ultrasound) and mean arterial blood pressure (MAP, brachial arterial catheter) were measured at baseline and during graded brachial artery infusion of the β-adrenergic receptor agonist, Isoproterenol (ISO), as well as Acetylcholine (ACH, endothelium-dependent vasodilation) and Nitroprusside (NTP, endothelium-independent vasodilation). Forearm vascular conductance was calculated (FVC = FBF/MAP, ml/min/100 mmHg) and the rise in FVC from baseline during infusion quantified vasodilation (ΔFVC = FVCinfusion − FVCbaseline). Results: ISO increased FVC in both groups (p < 0.01) and ISO-mediated ΔFVC was greater in OC+ compared to OC– (Main effect of group, p = 0.02). Expressing data as FVC and FBF resulted in similar conclusions. FVC responses to both ACH and NTP were also greater in OC+ compared to OC–. Conclusions: These data are the first to demonstrate greater β-adrenergic receptor-mediated vasodilation in the forearm of women currently using oral contraceptives (placebo phase) when compared to those not using oral contraceptives (early follicular phase), and suggest oral contraceptive use influences neurovascular control. PMID:27375493

  3. The effects of oral contraceptives on well-being and sexuality.

    PubMed

    Bancroft, J; Sartorius, N

    1990-01-01

    The extent to which the high discontinuation rate for oral contraceptives is due to adverse effects of mood, well-being and sexuality is explored, taking into account early studies on high dose combined and sequential pills, recent studies on low-dose combined and triphasics, experimental design factors, effects of OCs on free androgen levels, psychosocial factors and reasons for choosing or stopping pills, effects on depressive illness, premenstrual syndrome, sexuality, and possible mechanisms for direct effects of steroids on mood and sexuality. Study design is complicated by selection of early or late oral contraceptive users, types of controls, and unknown confounding factors such as reason for choice of pills, effect of a reliable contraceptive on the sexual relationship, prior history of depression and premenstrual tension. Furthermore virtually all topics reviewed here resulted in inconsistent or contradictory findings, making a case for individual variation and subgroups of women with different responses regarding the end point being examined. Examples include whether progestogen alter female sexual desire or male attraction; and whether rising or falling free testosterone levels affect sexual response. Factors affecting experimental design include culture, language, life-cycle, type of relationship, personal qualities affecting contraceptive choice, manner of eliciting reports of side effects, steroid dose, whether ovulation was blocked, initial or established pill-use, possibility of missed pills, and type of controls. Current pill users seem to discontinue for depression and low libido less frequently than did users of higher dose pills, and severity scores of adverse effects are lower. Premenstrual and other cyclic events may be altered in timing, and premenstrual symptoms are relieved in most women, but worsened in some who take pills. It is likely that women with depressive and premenstrual complaints tend to discontinue pills, leaving the remaining

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

    NASA Astrophysics Data System (ADS)

    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.

  5. The in vitro effect of aspirin on increased whole blood platelet aggregation in oral contraceptive users.

    PubMed

    Norris, L A; Bonnar, J

    1994-05-01

    The effects of triphasic oral contraceptives on whole blood platelet aggregation in 36 Italian women are reported here. Aspirin's effects on platelet aggregation were also studied. 18 women took a triphasic oral contraceptive; 10 women took Trinordiol, while 8 took Trinovum for at least 90 days. The remaining 18 women took nothing and served as controls. The study was aligned with each woman's birth control pill cycle. Blood was taken daily on days 15-21 of their cycle. Either saline solution or acetylsalicylic acid was added to the blood samples and compared. All data was statistically analyzed using unpaired student's t-test. Effects of 3 aggregating agents, ADP, PAF, and EDTA, on platelet aggregation were studied. Arachidonic acid and adrenalin bitartrate were also studied in this manner. An increase in platelet aggregation was observed in women taking oral contraceptives. No difference was found between patients taking Trinordiol and those taking Trinovum. The results of this study indicate an increase in whole blood platelet sensitivity to collagen, adrenalin, and arachidonic acid when using oral contraceptives. Aspirin, at low doses, may have a role in preventing early thrombus formation in women taking oral contraceptives. PMID:8042198

  6. [The choice of oral contraception in 1984: general indications and specific cases].

    PubMed

    Gaspard, U

    1984-04-01

    Oral contrceptives (OCs), usd by over 30% of reproductive aged women in Belgium, are by far the most widely used contraceptive in that country. The various types of OCs include monophasic, biphasic, and triphasic combinations of an estrogen and a progestin, sequentials containing estrogen only for 7-14 days followed by a progestin through the 21st day; macrodose or microdose progestin only formulations, 3-month injectable progestins, and the morning after pill. Side effects of OCs are mainly due to metabolic effects on coagulation factors, the renin-angiotensin system, glucose tolerance, or the lipid profile. Users of OCs face increased risks of cholelithiases, thrombophlebitis, thromboembolism, cerebrovascular accidents, myocardial infarcts (among smokers over 35 years of age), and hepatic adenomas. The most troubling secondary effect is the excess cardiovascular morbidity and mortality show by contraceptive users, not just those who are obese, hypertensive, or who have histories of vascular pathology, but also those over 40 years of age and smokers. Lenght of use of OCs does not increase vascular risks. Epidemiologic studies demonstrate that vascular risks are reduced in lower dose formulations. Absolute contraindications to OC use include serious cardiovascular problems, severe hepatic pathology, estrogen-dependent tumors, pregnancy and undiagnosed gynecologic problems, and significant hyperlipidemia. Relative contraindications include severe headaches, cholelithiase, previous cholestasis of pregnancy, severe renal disease, fibromyomas, benign breast disease, age over 40 years, smoking, surgery anticipated within 4 weeks, infectious mononucleosis, falciform anemia, and immediate postpartum and lactation. Epilepsy, diabetes, depression, and varicose veins are not strictly speaking contraindications but require additonal surveillance. Lower dose formulations should be prescribed if possible. OC users should be followed up every 6-12 months. Among other steroidal

  7. Review of the safety, efficacy and patient acceptability of the combined dienogest/estradiol valerate contraceptive pill.

    PubMed

    Guida, Maurizio; Bifulco, Giuseppe; Di Spiezio Sardo, Attilio; Scala, Mariamaddalena; Fernandez, Loredana Maria Sosa; Nappi, Carmine

    2010-01-01

    The aim of this review is to define the role of the combined dienogest (DNG)/estradiol valerate (E2V) contraceptive pill, in terms of biochemistry, metabolic and pharmacological effects and clinical application as well. E2V is the esterified form of 17β-estradiol (E2), while dienogest is a fourth-generation progestin with a partial antiandrogenic effect. The cycle stability is achieved with 2 to 3 mg DNG, supporting contraceptive efficacy. In this new oral contraceptive, E2V is combined with DNG in a four-phasic dose regimen (the first two tablets contain 3 mg E2V; the next five tablets include 2 mg E2V + 2 mg DNG, followed by 17 tablets with 2 mg E2V + 3 mg DNG; followed by two tablets with 1 mg E2V only, and finally two placebo tablets). Duration and intensity of scheduled withdrawal bleeding are lower with this contraceptive pill, whereas the incidence and the intensity of intra-cyclic bleeding are similar to the other oral contraceptive. With this new pill the levels of high density lipoprotein increased, while the levels of prothrombin fragment 1 + 2 and D-dimer remained relatively unchanged; the levels of sex hormone binding globulin, cortisol binding globulin, thyroxine binding globulin increased. The most frequently reported adverse events are: breast pain, headache, acne, alopecia, migraine, increase of bodyweight. The satisfaction rate is about 79.4%. PMID:21151673

  8. Bleeding patterns of women using Lunelle monthly contraceptive injections (medroxyprogesterone acetate and estradiol cypionate injectable suspension) compared with those of women using Ortho-Novum 7/7/7 (norethindrone/ethinyl estradiol triphasic) or other oral contraceptives.

    PubMed

    Garceau, R J; Wajszczuk, C J; Kaunitz, A M

    2000-12-01

    Persistent and/or unpredictable bleeding is a common reason for discontinuation of hormonal contraceptive methods. An open-label, nonrandomized, parallel, controlled study compared the efficacy, safety, and cycle control of the new, highly efficacious monthly injectable contraceptive containing 25 mg medroxyprogesterone acetate (MPA) and 5 mg estradiol cypionate (E(2)C) (MPA/E(2)C) (Lunelle Monthly Contraceptive Injection) with that of the frequently used norethindrone 0.5, 0.75, 1.0 mg/0.035 mg ethinyl estradiol (NET/EE) triphasic oral contraceptive (Ortho-Novum 7/7/7). This report directly compares the bleeding patterns of women on MPA/E(2)C to those of women on NET/EE and untreated women. Overall, breakthrough bleeding occurred less frequently in women using MPA/E(2)C than in women using NET/EE (p < or =0.01). However, more women using MPA/E(2)C experienced amenorrhea/missed periods than those on NET/EE (p < or =0.01). In addition, the percentage of women experiencing breakthrough bleeding or amenorrhea while using other oral contraceptives is compared to that of women using MPA/E(2)C. A rapidly reversible method, MPA/E(2)C, combines the high contraceptive efficacy of surgical sterilization with the convenience of monthly administration. These data suggest that, for a large proportion of women, MPA/E(2)C offers predictability in bleeding patterns comparable to or greater than that experienced by ovulatory untreated women or those using combination oral contraceptives. PMID:11239615

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

    PubMed

    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. PMID:25420716

  10. Early Impact Of The Affordable Care Act On Oral Contraceptive Cost Sharing, Discontinuation, And Nonadherence.

    PubMed

    Pace, Lydia E; Dusetzina, Stacie B; Keating, Nancy L

    2016-09-01

    The oral contraceptive pill is the contraceptive method most commonly used by US women, but inconsistent use of the pill is a contributor to high rates of unintended pregnancy. The relationship between consumer cost sharing and consistent use of the pill is not well understood, and the impact of the elimination of cost sharing for oral contraceptive pills in a mandate in the Affordable Care Act (ACA) is not yet known. We analyzed insurance claims for 635,075 women with employer-sponsored insurance who were initiating use of the pill, to examine rates of discontinuation and nonadherence, their relationship with cost sharing, and trends before and during the first year after implementation of the ACA mandate. We found that cost sharing for oral contraceptives decreased markedly following implementation, more significantly for generic than for brand-name versions. Higher copays were associated with greater discontinuation of and nonadherence to generic pills than was the case with zero copayments. Discontinuation of the use of generic or brand-name pills decreased slightly but significantly following ACA implementation, as did nonadherence to brand-name pills. Our findings suggest a modest early impact of the ACA on improving consistent use of oral contraceptives among women initiating their use. PMID:27605641

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

    PubMed

    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. PMID:24818612

  12. Oral contraception, parity, breast feeding, and severity of rheumatoid arthritis.

    PubMed Central

    Jorgensen, C; Picot, M C; Bologna, C; Sany, J

    1996-01-01

    OBJECTIVE: To investigate the influence of breast feeding, use of the oral contraceptive pill (OCP), and parity on rheumatoid arthritis (RA). METHODS: One hundred and seventy six women with RA were compared with 145 control subjects; all had at least one child. RA patients were classified as having severe (n = 82) or mild disease (n = 89) according to clinical joint evaluation, radiological score, biological inflammation, and the presence of HLA-DR1 or -DR4 alleles. RESULTS: The mean age of RA patients was 58 years, and the mean age at the time of diagnosis of RA was 46 years. The mean time between onset of RA and the first birth was 23.6 (SD 3.8) years. The OCP user rates were 33% in the RA group and 47.6% in the control group (p < 0.02). OCP use was related to the mother's year of birth. The relative risk for developing RA was 0.598 (95% confidence interval (CI) 0.33 to 1.1) in women who had used OCP for more than five years compared with those who had never used OCPs. In contrast, the age at which the first pregnancy occurred, the number of children breast fed, and the duration of breast feeding were comparable in RA patients and healthy subjects. Among the RA patients, parity, duration of breast feeding, and the number of breast fed children were significantly increased in those with severe disease. Having more than three children increased the risk of developing severe disease 4.8-fold when adjusted for age and OCP use. Forty six percent of women with severe RA had a history of breast feeding duration greater than six months before disease onset, compared with 26% of patients with mild disease (p < 0.008). Having more than three breast fed children increased the risk of poor disease prognosis 3.7-fold. In contrast, OCP use had a protective role in the course of RA (44% of RA patients with mild disease were OCP users, compared with 21.7% of those with severe RA; p < 0.001). Among those using OCP for more than five years, the relative risk of developing severe

  13. Cerebral venous sinus thrombosis with ophthalmic manifestations in 18-year-olds on oral contraceptives.

    PubMed

    Tan, Jeffrey J; Hassoun, Ameer; Elmalem, Valerie I

    2014-08-01

    Cerebral venous sinus thrombosis (CVST) is a rare and potentially life-threatening cause of stroke. In the past few decades, the incidence and patient demographics have changed because of many factors, including the widespread use of oral contraceptives, improved detection of prothrombotic conditions, and advancement of imaging technology. The presentation of CVST is varied and can include ocular signs and symptoms. We present 2 cases of oral contraceptive-induced CVST in 18-year-old women, whose main presenting findings were ophthalmologic. PMID:24803635

  14. Timing of oral contraceptive use and the risk of breast cancer in BRCA1 mutation carriers.

    PubMed

    Kotsopoulos, Joanne; Lubinski, Jan; Moller, Pal; Lynch, Henry T; Singer, Christian F; Eng, Charis; Neuhausen, Susan L; Karlan, Beth; Kim-Sing, Charmaine; Huzarski, Tomasz; Gronwald, Jacek; McCuaig, Jeanna; Senter, Leigha; Tung, Nadine; Ghadirian, Parviz; Eisen, Andrea; Gilchrist, Dawna; Blum, Joanne L; Zakalik, Dana; Pal, Tuya; Sun, Ping; Narod, Steven A

    2014-02-01

    It is not clear if early oral contraceptive use increases the risk of breast cancer among young women with a breast cancer susceptibility gene 1 (BRCA1) mutation. Given the benefit of oral contraceptives for the prevention of ovarian cancer, estimating age-specific risk ratios for oral contraceptive use and breast cancer is important. We conducted a case-control study of 2,492 matched pairs of women with a deleterious BRCA1 mutation. Breast cancer cases and unaffected controls were matched on year of birth and country of residence. Detailed information about oral contraceptive use was collected from a routinely administered questionnaire. Conditional logistic regression was used to estimate the odds ratios (OR) and 95 % confidence intervals (CI) for the association between oral contraceptive and breast cancer, by age at first use and by age at diagnosis. Among BRCA1 mutation carriers, oral contraceptive use was significantly associated with an increased risk of breast cancer for women who started the pill prior to age 20 (OR 1.45; 95 % CI 1.20-1.75; P = 0.0001) and possibly between ages 20 and 25 as well (OR 1.19; 95 % CI 0.99-1.42; P = 0.06). The effect was limited to breast cancers diagnosed before age 40 (OR 1.40; 95 % CI 1.14-1.70; P = 0.001); the risk of early-onset breast cancer increased by 11 % with each additional year of pill use when initiated prior to age 20 (OR 1.11; 95 % CI 1.03-1.20; P = 0.008). There was no observed increase for women diagnosed at or after the age of 40 (OR 0.97; 95 % CI 0.79-1.20; P = 0.81). Oral contraceptive use before age 25 increases the risk of early-onset breast cancer among women with a BRCA1 mutation and the risk increases with duration of use. Caution should be taken when advising women with a BRCA1 mutation to take an oral contraceptive prior to age 25. PMID:24458845

  15. A consumer intercept study of oral contraceptive users in the Dominican Republic.

    PubMed

    Green, E C

    1988-01-01

    Purchasers of a low-cost oral contraceptive were intercepted and interviewed in a sample of Santo Domingo pharmacies that represented the highest sales of the product, yet also reflected the socioeconomic profile of the city's entire population. Users of the contraceptive were later interviewed in greater depth in their homes. The survey of users showed that the Dominican Republic's social marketing program, implemented by PROFAMILIA, was reaching an appropriate target market--that is, younger, lower-middle-class women of low parity. The program was, in addition, successful in attracting first-time adopters, and it was also expanding the overall commercial market for all contraceptives. The marketing campaign was successful in part because a mass audience was reached, through brief television spots. Program impact on contraceptive prevalence can be assessed from sales data. PMID:3381225

  16. [Pregnancy under oral contraceptives after treatment with tetracycline].

    PubMed

    Lequeux, A

    1980-01-01

    A 35 year old woman on hormonal contraception became pregnant during prolonged tetracycline treatment to cure acne. There is only 1 similar case published in the literature. Tetracycline may have been responsible for alterations in the intestinal flora, thus impairing the enterohepatic cycle of mestranol. An enzymatic microsomal induction is also possible, with acceleration of estrogen metabolization at the hepatic level. PMID:12336602

  17. Mortality among oral contraceptive users: 20 year follow up of women in a cohort study.

    PubMed Central

    Vessey, M. P.; Villard-Mackintosh, L.; McPherson, K.; Yeates, D.

    1989-01-01

    OBJECTIVE--To see whether the use of oral contraceptives influences mortality. DESIGN--Non-randomised cohort study of 17,032 women followed up on an annual basis for an average of nearly 16 years. SETTING--17 Family planning clinics in England and Scotland. SUBJECTS--Women recruited during 1968-74. At the time of recruitment each woman was aged 25-39, married, a white British subject, willing to participate, and either a current user of oral contraceptives or a current user of a diaphragm or intrauterine device (without previous exposure to the pill). MAIN OUTCOME MEASURES--Overall mortality and cause specific mortality. RESULTS--238 Deaths occurred during the follow up period. The main analyses concerned women entering the study while using either oral contraceptives or a diaphragm or intrauterine device. The overall relative risk of death in the oral contraceptive users was 0.9 (95% confidence interval 0.7 to 1.2). Though the numbers of deaths were small in most individual disease categories, the trends observed were generally consistent with findings in other reports. Thus the relative risk of death in the oral contraceptive users was 4.9 (95% confidence interval 0.7 to 230) for cancer of the cervix, 3.3 (95% confidence interval 0.9 to 17.9) for ischaemic heart disease, and 0.4 (95% confidence interval 0.1 to 1.2) for ovarian cancer. There was a linear trend in the death rates from cervical cancer and ovarian cancer (in opposite directions) with total duration of oral contraceptive use. Death rates from breast cancer (relative risk 0.9; 95% confidence interval 0.5 to 1.4) and suicide and probable suicide (relative risk 1.1; 95% confidence interval 0.3 to 3.6) were much the same in the two contraceptive groups. In 1981 the relative risk of death in oral contraceptive users from circulatory diseases as a group was reported to be 4.2 (95% confidence interval 2.3 to 7.7) in the Royal College of General Practitioners oral contraception study. The corresponding

  18. Cerebral arterial occlusion and intracranial venous thrombosis in a woman taking oral contraceptives.

    PubMed Central

    Montón, F.; Rebollo, M.; Quintana, F.; Berciano, J.

    1984-01-01

    Occlusion of the middle cerebral artery and thrombosis of the superior sagittal sinus are reported in a 30-year-old woman taking oral contraceptives (OC). The coexistence of arterial and venous cerebral pathology as a complication of OC use has only been previously reported in one case. The pathogenesis of this rare association is briefly discussed. Images Fig. 1 Fig. 2 PMID:6462985

  19. Menstrual and oral contraceptive use patterns among deployed military women by race and ethnicity.

    PubMed

    Deuster, Patricia A; Powell-Dunford, Nicole; Crago, Mark S; Cuda, Amanda S

    2011-01-01

    Menstrual cycle patterns and concerns and oral contraceptive use in the combat environment were examined in Caucasian, Asian, Hispanic, and African American women to guide the development of educational resources for women soldiers. An anonymous, questionnaire was completed by 455 U.S. Army women-Caucasian (CA: n = 141); Asian (AS: n = 67); Hispanic (HIS: n = 67); and African American (AA: n = 184) to compare menstrual patterns and concerns, dysmenorrhea, and oral contraceptive patterns. Total menstrual concerns were significantly lower among African Americans relative to Caucasians, Asians, or Hispanics; Asians and Hispanics reported the greatest concern. Overall, secondary amenorrhea was noted by 14.9% of women. Severe dysmenorrhea rates were significantly lower in African American (6.1%) compared to Caucasian (11.6%), Asian (20.9%) and Hispanic (19.7%) women. Asian women reported missing less work-only 9.3% with moderate to severe dysmenorrhea missed work compared to 25.1% of all other women. Only 9.2% of women with mild, compared to 25.8% with moderate to severe (OR = 3.44; p ≤ 0.0001) dysmenorrhea sought health care. Less than 50% of women took oral contraceptive, and less than half of those women took oral contraceptive continuously. African Americans seemed to experience menstruation as less bothersome than others, despite no difference in the proportion with menstrual irregularities, mean duration of menses, and/or mean time between cycles. PMID:21391160

  20. Factor V Leiden: should we screen oral contraceptive users and pregnant women?

    PubMed Central

    Vandenbroucke, J. P.; van der Meer, F. J.; Helmerhorst, F. M.; Rosendaal, F. R.

    1996-01-01

    The factor V Leiden mutation is the most common genetic risk factor for deep vein thrombosis: it is present in about 5% of the white population. The risk of deep vein thrombosis among women who use oral contraceptives is greatly increased by the presence of the mutation. The same seems to be true of the risk of postpartum thrombosis. Several authors have called for all women to be screened before prescription of oral contraceptives and during pregnancy. Such a policy might deny effective contraception to a substantial number of women while preventing only a small number of deaths due to pulmonary emboli. Moreover, in pregnancy the ensuing use of oral anticoagulation prophylaxis might carry a penalty of fatal bleeding that is equal to or exceeds the risk of death due to postpartum thrombosis. It might pay, however, to take a personal and family history of deep vein thrombosis when prescribing oral contraceptives or at a first antenatal visit to detect women from families with a tendency to multiple thrombosis. Images p1129-a PMID:8916702

  1. [Objective and perceived knowledge of oral contraceptive methods among adolescent mothers].

    PubMed

    Sousa, Michelle Chintia Rodrigues de; Gomes, Keila Rejane Oliveira

    2009-03-01

    The high rate of early pregnancy in Brazil and particularly in Teresina (21.5%), Piauí State, motivated the current study, the aim of which was to identify levels of objective and perceived knowledge on oral contraceptives, as well as predictive reproductive and socio-demographic variables for high knowledge. A cross-sectional study was performed including 278 teenage mothers (15-19 years), with their childbearing history, admitted to four maternity hospitals in Teresina in 2006. Logistic regression provided the basis for the statistical analysis. Nearly 98% of the adolescent mothers showed low objective and perceived knowledge of oral contraceptives. High parity was the only predictor of increased objective knowledge on oral contraceptives. The adolescents' low level of objective and perceived knowledge on use of oral contraceptives emphasized their susceptibility to risky sexual behavior. The findings emphasize the need for a more interactive approach with adolescents concerning their level of objective and perceived knowledge, to reduce the occurrence and repetition of unwanted teenage pregnancy and its negative consequences for the lives of these young mothers and their children. PMID:19300853

  2. [Hormonal contraception using the oral depot preparation, Deposiston].

    PubMed

    Vasilev, D

    1978-01-01

    The efficacy of a new contraceptive delayed-action preparation, Deposiston is reviewed. Deposiston is the estrogen-progestin preparation with predominant estrogen activity. The estrogen and progestin eomponents of the preparation are ehtinyl estradiol and norethindrone acetate, respectively. Contraceptive effect is associated with gonadotropic stimulation by estrogen component, while progestin component provides the thermogenic effect. Mutagenicity, carcinogenicity, and toxicity tests show safety of Deposiston. Clinical trials of Deposiston in 815 women over the period of 16,207 cycles (18.1 cycles/woman) confirm contraceptive efficacy of the preparation: pregnancy occurred in only 12 women. Side effects of Deposiston include nausea (16.06%), vomiting (3.7%), headache (5.08%), and vaginal discharge (11.86%). Each Deposiston package contains 3 white estrogen tablets and 2 red progestin tablets. A woman starts to take Deposiston on day 4 of the cycle: white tablets are taken on days 4, 11, and 18 and 2 red tablets are taken on day 25. On day 2-7 after the red progestin tablets, the woman experiences hemorrhage. Average duration of and the amount of blood loss during the hemorrhage do not differ from those during the normal menstruation. Deposiston is indicated for women with recurrent uterine hemorrhages, gastrointestinal disorders, and decreased libido. The preparation is contraindicated for adolescents younger than 16 years of age, for women with hormonal active tumors, thromboembolism, chronic liver diseases, and idiopathic jaundice. PMID:350070

  3. The link between oral contraceptive use and prevalence in autism spectrum disorder.

    PubMed

    Strifert, Kim

    2014-12-01

    Autism spectrum disorder (ASD) is a group of developmental disabilities that include full syndrome autism, Asperger's syndrome, and other pervasive developmental disorders. The identified prevalence of ASD has increased in a short time period across multiple studies causing some to conclude that it has reached epidemic proportions in the U.S. Many possible explanations for the rise in numbers of individuals diagnosed with ASD have been offered and yet, causes and contributing factors for ASD are inadequately understood. Current evidence suggests that both genetics and environment play a part in causing ASD. One possible risk factor for the increase in prevalence has been profoundly overlooked in the existing biomedical and epidemiologic literature. As the prevalence of ASD has risen in the last sixty years, so has the prevalence of the usage of the oral contraceptives and other modern hormonal delivery methods. In 1960 about one million American women were using oral contraceptives, today close to 11 million women in the U.S. use oral contraceptives. Eighty-two percent of sexually active women in the U.S. have used oral contraceptives at some point during their reproductive years. Thus, the growth in use of progesterone/estrogen-based contraceptives in the United State has reached near-ubiquitous levels among women in the child-bearing age range. The suppression of ovulation produced by estrogen-progesterone is an indisputable abnormality. It is logical to consider the outcome of the ovum that would have been normally released from the ovary during ovulation. To date there is no comprehensive research into the potential neurodevelopmental effects of oral contraceptive use on progeny. The issue has been only sparsely considered in the biomedical literature. This article hypothesizes that the compounds, estrogen and progesterone, used in oral contraceptives modify the condition of the oocyte and give rise to a potent risk factor that helps explain the recent increase

  4. Oral contraceptive use and mortality after 36 years of follow-up in the Nurses’ Health Study: prospective cohort study

    PubMed Central

    Charlton, Brittany M; Rich-Edwards, Janet W; Colditz, Graham A; Missmer, Stacey A; Rosner, Bernard A; Hankinson, Susan E; Speizer, Frank E

    2014-01-01

    Objective To determine whether use of oral contraceptives is associated with all cause and cause specific mortality. Design Prospective cohort study. Setting Nurses’ Health Study, data collected between 1976 and 2012. Population 121 701 participants were prospectively followed for 36 years; lifetime oral contraceptive use was recorded biennially from 1976 to 1982. Main outcome measures Overall and cause specific mortality, assessed throughout follow-up until 2012. Cox proportional hazards models were used to calculate the relative risks of all cause and cause specific mortality associated with use of oral contraceptives. Results In our population of 121 577 women with information on oral contraceptive use, 63 626 were never users (52%) and 57 951 were ever users (48%). After 3.6 million person years, we recorded 31 286 deaths. No association was observed between ever use of oral contraceptives and all cause mortality. However, violent or accidental deaths were more common among ever users (hazard ratio 1.20, 95% confidence interval 1.04 to 1.37). Longer duration of use was more strongly associated with certain causes of death, including premature mortality due to breast cancer (test for trend P<0.0001) and decreased mortality rates of ovarian cancer (P=0.002). Longer time since last use was also associated with certain outcomes, including a positive association with violent or accidental deaths (P=0.005). Conclusions All cause mortality did not differ significantly between women who had ever used oral contraceptives and never users. Oral contraceptive use was associated with certain causes of death, including increased rates of violent or accidental death and deaths due to breast cancer, whereas deaths due to ovarian cancer were less common among women who used oral contraceptives. These results pertain to earlier oral contraceptive formulations with higher hormone doses rather than the now more commonly used third and fourth generation formulations

  5. [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].

    PubMed

    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. PMID:19323063

  6. [Contraceptive pill amenorrhea--does it exist?].

    PubMed

    Fries, H; Nillius, S J

    1975-11-01

    The possibility of amenorrhea as a direct result of discontinuing oral contraceptives is discussed and its etiology is explored. In a study of 1860 women in Uppsala county in Sweden, 16% of the amenorrhea cases among these women could be temporally related to the discontinuation of oral contraceptive use. Earlier irregularities of menstruation and psychological stress are discussed as indications that "contraceptive pill amenorrhea" could occur. Loss of weight, often combined with symptoms of anorexia nervosa, is also a frequent indication of susceptibility to "contraceptive pill amenorrhea." The possibility of "contraceptive pill amenorrhea" as an iatrogenic syndrome is discussed. PMID:1186384

  7. Oral Contraceptive Use, Muscle Sympathetic Nerve Activity, and Systemic Hemodynamics in Young Women.

    PubMed

    Harvey, Ronee E; Hart, Emma C; Charkoudian, Nisha; Curry, Timothy B; Carter, Jason R; Fu, Qi; Minson, Christopher T; Joyner, Michael J; Barnes, Jill N

    2015-09-01

    Endogenous female sex hormones influence muscle sympathetic nerve activity (MSNA), a regulator of arterial blood pressure and important factor in hypertension development. Although ≈80% of American women report using hormonal contraceptives sometime during their life, the influence of combined oral contraceptives (OCs) on MSNA and systemic hemodynamics remains equivocal. The goal of this study was to determine whether women taking OCs have altered MSNA and hemodynamics (cardiac output and total peripheral resistance) at rest during the placebo phase of OC use compared with women with natural menstrual cycles during the early follicular phase. We retrospectively analyzed data from studies in which healthy, premenopausal women (aged 18-35 years) participated. We collected MSNA values at rest and hemodynamic measurements in women taking OCs (n=53; 25±4 years) and women with natural menstrual cycles (n=74; 25±4 years). Blood pressure was higher in women taking OCs versus those with natural menstrual cycles (mean arterial pressure, 89±1 versus 85±1 mm Hg, respectively; P=0.01), although MSNA was similar in both groups (MSNA burst incidence, 16±1 versus 18±1 bursts/100 heartbeats, respectively; P=0.19). In a subset of women in which detailed hemodynamic data were available, those taking OCs (n=33) had similar cardiac output (4.9±0.2 versus 4.7±0.2 L/min, respectively; P=0.47) and total peripheral resistance (19.2±0.8 versus 20.0±0.9 U, respectively; P=0.51) as women with natural menstrual cycles (n=22). In conclusion, women taking OCs have higher resting blood pressure and similar MSNA and hemodynamics during the placebo phase of OC use when compared with naturally menstruating women in the early follicular phase. PMID:26101348

  8. Oral contraceptive use, muscle sympathetic nerve activity, and systemic hemodynamics in young women

    PubMed Central

    Harvey, Ronee E.; Hart, Emma C.; Charkoudian, Nisha; Curry, Timothy B.; Carter, Jason R.; Fu, Qi; Minson, Christopher T.; Joyner, Michael J.; Barnes, Jill N.

    2015-01-01

    Endogenous female sex hormones influence muscle sympathetic nerve activity (MSNA), a regulator of arterial blood pressure and important factor in hypertension development. While nearly 80% of American women report using hormonal contraceptives sometime during their life, the influence of combined oral contraceptives (OCs) on MSNA and systemic hemodynamics remains equivocal. The goal of this study was to determine if women taking OCs have altered MSNA and hemodynamics (cardiac output and total peripheral resistance) at rest during the placebo phase of OC use compared to women with natural menstrual cycles during the early follicular phase. We retrospectively analyzed data from studies in which healthy, premenopausal women (ages 18–35 years old) participated. We collected MSNA values at rest and hemodynamic measurements in women taking OCs (n=53, 25±4 yr) and women with natural menstrual cycles (n=74, 25±4 yr). Blood pressure was higher in women taking OCs versus those with natural menstrual cycles (mean arterial pressure: 89±1 vs. 85±1 mmHg, respectively; p=0.01), although MSNA was similar in both groups (MSNA burst incidence: 16±1 vs. 18±1 bursts/100 heartbeats, respectively, p=0.19). In a subset of women in which detailed hemodynamic data were available, those taking OCs (n=33) had similar cardiac output (4.9±0.2 vs. 4.7±0.2 L/min, respectively; p=0.47) and total peripheral resistance (19.2±0.8 vs. 20.0±0.9 units, respectively; p=0.51) as women with natural menstrual cycles (n=22). In conclusion, women taking OCs have higher resting blood pressure and similar MSNA and hemodynamics during the placebo phase of OC use compared to naturally menstruating women in the early follicular phase. PMID:26101348

  9. Comparative safety, efficacy, and cycle control of Lunelle monthly contraceptive injection (medroxyprogesterone acetate and estradiol cypionate injectable suspension) and Ortho-Novum 7/7/7 oral contraceptive (norethindrone/ethinyl estradiol triphasic). Lunelle Study Group.

    PubMed

    Kaunitz, A M; Garceau, R J; Cromie, M A

    1999-10-01

    An open-label, nonrandomized, parallel, controlled study compared the efficacy, safety, and cycle control of a new monthly injectable contraceptive containing 25 mg of medroxyprogesterone acetate (MPA) and 5 mg of estradiol cypionate (E2C) (MPA/E2C) (Lunelle Monthly Contraceptive Injection) with that of a norethindrone 0.5, 0.75, 1.0 mg/0.035 mg ethinyl estradiol (NET/EE) triphasic oral contraceptive (Ortho-Novum 7/7/7). At study enrollment, women chose either the injections or the oral contraceptive. A higher proportion of women in the NET/EE group (65.1%) than in the MPA/E2C group (48.7%) had used hormonal contraception during the month before the study (p < 0.01). Overall, 55.5% (434/782) of MPA/E2C users and 67.6% (217/321) of NET/EE users completed the 60-week trial. One-year contraceptive efficacy (13 cycles of 28 days) for MPA/E2C and NET/EE was based on 8008 and 3434 woman-cycles of use, respectively. During the first year, one pregnancy occurred in an NET/EE user for a life table rate of 0.3; no pregnancies occurred in users of MPA/E2C. One additional pregnancy in the NET/EE group occurred during the 15th treatment cycle. After the first treatment cycle, women in both groups experienced regular menses, with an average cycle length of 28 days in MPA/E2C users and 27 days in NET/EE users. Although MPA/E2C users were more likely to experience bleeding irregularities, only 2.5% (19/775) cited metrorrhagia as a reason for discontinuing treatment. The adverse events reported in both treatment groups are consistent with those expected with the use of combined hormonal contraceptives. Overall, the results of this first Phase III US clinical trial of MPA/E2C confirm this method's high contraceptive efficacy and safety, as shown in previous studies by the World Health Organization. These results suggest that a monthly combination injectable would represent a welcome new contraceptive option for women in the US. PMID:10640164

  10. Contraceptive knowledge and attitudes of Austrian adolescents after mass media reports linking third-generation oral contraceptives with an increased risk of venous thromboembolism.

    PubMed

    Egarter, C; Strohmer, H; Lehner, R; Földy, M; Leitich, H; Berghammer, P

    1997-09-01

    We performed a representative survey to determine the level of knowledge of 1,010 Austrian adolescents aged 14 to 24 years about selected facts relating to the recent massive news coverage of the increase in the risk of venous thromboembolism in users of third-generation oral contraceptives and to assess the contraceptive behavior of this population. The overall use rate of oral contraceptives and condoms had increased significantly between 1991 and 1996. Sixty-six percent of the adolescents surveyed stated not having heard or read any media reports on oral contraceptives. Only 8% of those who had knew that most reports focused on the pill as a possible cause of venous thromboembolism, whereas the majority of respondents indicated that the media conveyed doubts regarding the health safety of oral contraceptives in general. Nearly half of adolescents were unable to define what a thrombosis was. Thus, although the mass media play an important role in transmitting medical information, the dissemination of practical, accurate advice on the risks of a drug and competent patient counseling is reserved for the health care professionals. PMID:9347204

  11. Contraceptive Development.

    ERIC Educational Resources Information Center

    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…

  12. MHC-correlated odour preferences in humans and the use of oral contraceptives

    PubMed Central

    Roberts, S. Craig; Gosling, L. Morris; Carter, Vaughan; Petrie, Marion

    2008-01-01

    Previous studies in animals and humans show that genes in the major histocompatibility complex (MHC) influence individual odours and that females often prefer odour of MHC-dissimilar males, perhaps to increase offspring heterozygosity or reduce inbreeding. Women using oral hormonal contraceptives have been reported to have the opposite preference, raising the possibility that oral contraceptives alter female preference towards MHC similarity, with possible fertility costs. Here we test directly whether contraceptive pill use alters odour preferences using a longitudinal design in which women were tested before and after initiating pill use; a control group of non-users were tested with a comparable interval between test sessions. In contrast to some previous studies, there was no significant difference in ratings between odours of MHC-dissimilar and MHC-similar men among women during the follicular cycle phase. However, single women preferred odours of MHC-similar men, while women in relationships preferred odours of MHC-dissimilar men, a result consistent with studies in other species, suggesting that paired females may seek to improve offspring quality through extra-pair partnerships. Across tests, we found a significant preference shift towards MHC similarity associated with pill use, which was not evident in the control group. If odour plays a role in human mate choice, our results suggest that contraceptive pill use could disrupt disassortative mate preferences. PMID:18700206

  13. Obesity and hormonal contraceptive efficacy

    PubMed Central

    Robinson, Jennifer A; Burke, Anne E

    2014-01-01

    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. PMID:24007251

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

    PubMed

    Díaz, Soledad; Hardy, Ellen; Alvarado, Gloria; Ezcurra, Enrique

    2003-01-01

    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. PMID:14666232

  15. [Monoclonal human immunoglobulin (IgG lambda) with antiethinylestradiol activity, oral contraceptives, and arterial pulmonary thrombosis].

    PubMed

    Beaumont, J L; Lemort, N

    1975-06-23

    In a 36-year-old woman taking an oral contraceptive containing 50 mug of ethinyloestradiol each day, a pulmonary arterial thrombosis and a monoclonal gammapathia were associated. The monoclonal IgI lambda Mai... was prepared. When purified, this IgG lambda binds ethinyloestradiol with strong affinity (Ka= 2.7 times 10(7)M-1) and also 17-beta-oestradiol with a little less affinity (Ka = 0.4 times 10(7)M-1. For those ligands each IgG lambda Mai... molecule has two sites of same affinity and specificity so that a Scatchard plot of the experimental values gives a straight line. It is likely that the antibody sites of the IgG lambda Mai... are the binding sites. These facts support the hypothesis of an immunological mechanism of the thromboembolic disease which may be induced by oral contraceptives. PMID:808320

  16. A case-series study of cerebral venous thrombosis in women using short course oral contraceptive

    PubMed Central

    Khomand, Payam; Hassanzadeh, Kambiz

    2016-01-01

    Background: We report a case series of cerebral vein thrombosis (CVT) in women who used oral contraceptive pill (OCP) in the Muslims Ramadan and fasting month. Methods: This study was a retrospective case series of 9 patients with diagnosis of CVT, who admitted in the neurology ward of Tohid Hospital of Sanandaj, Iran, in July-August 2014-2015. Results: Patients had no history of thrombosis before. They were treated with oral contraceptive more than 1 month to be able to fast during Ramadan. They did not have other possible risk factors for CVT. A headache was the most common in 9/9 patients (100%) followed by vomiting and vertigo. Conclusion: We found that high rate of CVT in female population during Ramadan indicates that it needs be considered as a specific risk factor and should be considered by healthcare system. PMID:27326364

  17. Resting state alpha frequency is associated with menstrual cycle phase, estradiol and use of oral contraceptives.

    PubMed

    Brötzner, Christina P; Klimesch, Wolfgang; Doppelmayr, Michael; Zauner, Andrea; Kerschbaum, Hubert H

    2014-08-19

    Ongoing intrinsic brain activity in resting, but awake humans is dominated by alpha oscillations. In human, individual alpha frequency (IAF) is associated with cognitive performance. Noticeable, performance in cognitive and emotional tasks in women is associated with menstrual cycle phase and sex hormone levels, respectively. In the present study, we correlated frequency of alpha oscillation in resting women with menstrual cycle phase, sex hormone level, or use of oral contraceptives. Electroencephalogram (EEG) was recorded from 57 women (aged 24.07 ± 3.67 years) having a natural menstrual cycle as well as from 57 women (aged 22.37 ± 2.20 years) using oral contraceptives while they sat in an armchair with eyes closed. Alpha frequency was related to the menstrual cycle phase. Luteal women showed highest and late follicular women showed lowest IAF or center frequency. Furthermore, IAF as well as center frequency correlated negatively with endogenous estradiol level, but did not reveal an association with endogenous progesterone. Women using oral contraceptives showed an alpha frequency similar to women in the early follicular phase. We suggest that endogenous estradiol modulate resting alpha frequency. PMID:25010817

  18. Sexual and reproductive life events in relation to duration of oral contraceptive use.

    PubMed

    Lidegaard, O; Helm, P

    1988-07-01

    In order to disclose differences between users and non-users of oral contraceptives (OC), 620 women aged 15-54 were invited to participate in an in depth interview about sexual, contraceptive, and reproductive life events. Of the 585 women who participated, 459 were consecutive gynecological in- or outpatients, and 126 were selected from visitors in general practice. Data was analysed by multivariate test statistics. After correction for present age and social class, the duration of use of OC (DOC) among women 15-34 years of age correlated negatively to age at menarche and coital debut and positively to number of sexual partners, oral-genital sexual practice, and number of pelvic inflammatory diseases. Among women over 35, DOC was positively associated only to cigarette smoking. No correlation was found to coital frequency (whether earlier, present or during pregnancy or menstruation), number of births and abortions, or to social classification. In epidemiological research on benefits and risks of oral contraceptives, confounding influence of one or more variables is of crucial importance. The present findings point at sexual and life-style habits as potential confounders in the study of OC and associated diseases. PMID:3168446

  19. Relative impact of smoking and oral contraceptive use on women in the US

    SciTech Connect

    Goldbaum, G.M.; Kendrick, J.S.; Hogelin, G.C.; Gentry, E.M.

    1987-09-11

    Women who smoke and use oral contraceptives (OCs) are at increased risk for cardiovascular and cerebrovascular disease. To study the prevalence of smoking and OC use and of other behaviors affecting health, 28 states and the District of Columbia conducted telephone surveys during 1981 through 1983. More than 22,000 US adults were interviewed, of whom 5779 women aged 18 to 44 years were studied. Data were weighted to represent the US population. Overall, 7.4% of US women aged 18 to 44 years reported smoking and using OCs' 1.1% reported smoking 25 or more cigarettes per day while using OCs. Although women aged 18 to 24 years were most likely to smoke and use OCs, combined smoking and OC use contributed substantially to the number of excess cases of myocardial infarctions occurring among US women aged 35 to 44 years. However, regardless of OC use, smoking accounted for most of the excess cases. Therefore, health care providers need to intensity their efforts to reduce smoking among their patients.

  20. Design Features of Drug-Drug Interaction Trials Between Antivirals and Oral Contraceptives.

    PubMed

    Ayala, Ruben C; Arya, Vikram; Younis, Islam R

    2016-05-01

    The aim of this work was to explore the major design features of drug-drug interaction trials between antiviral medications (AVs) and oral contraceptives (OCs). Information on these trials (n = 27) was collected from approved drug labels and clinical pharmacology reviews conducted by the U.S. Food and Drug Administration. The primary objective of all trials was to evaluate changes in OC exposure following the coadministration of AVs. In addition, an evaluation of potential pharmacodynamic interaction was performed in 10 of these trials. Twenty-two trials were open label with a fixed-sequence design, and 5 trials used a double-blind crossover design. The trials were conducted using one, two, or three 28-day ovulatory cycles in 10, 8, and 9 trials, respectively. Only 1 trial enrolled HIV-infected women. The median number of women in a trial was 20 (range, 12 to 52). Norethindrone/ethinyl estradiol (EE) combination was the most commonly used OC (n = 16, 59%) followed by norgestimate/EE (n = 9, 33%). Labeling recommendations were based on exposure changes in 25 cases and on safety observations in the trial in 2 cases. In conclusion, a wide variety of trial designs was used, and there is no preferred design. The answer to the exposure question can be achieved using multiple designs. PMID:26384089

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

    PubMed Central

    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 (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. PMID:25525393

  2. Does the Progestogen Used in Combined Hormonal Contraception Affect Venous Thrombosis Risk?

    PubMed

    Han, Leo; Jensen, Jeffrey T

    2015-12-01

    Combined hormonal contraceptives (CHCs) use a combination of estrogen and progestogen to provide contraception. The most important risk of using CHCs is venous thromboembolism (VTE). It is unclear whether the type of progestogen used in a method augments that risk. Although the evidence supporting an increase in thrombosis risk is not conclusive, neither is the evidence supporting the benefit of newer progestogens in terms of tolerability or continuation. The benefits of CHCs outweigh the risks and the absolute risk of VTE remains small. A balanced discussion of potential risks and benefits of particular CHC formulations is warranted during contraception counseling. PMID:26598309

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

    PubMed

    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. PMID:27382200

  4. A chewable low-dose oral contraceptive: a new birth control option?

    PubMed Central

    Weisberg, Edith

    2012-01-01

    A new chewable combined oral contraceptive pill containing ethinyl estradiol (EE) 0.025 mg and norethindrone (NE) 0.8 mg in a 24/4 regimen was approved for marketing in December 2010. Each of the four inactive tablets contains 75 mg ferrous fumarate, which has no therapeutic benefit. The tablet can be taken with food but not water as this affects the absorption of EE. The Pearl index based on intention to treat women aged 18–35 years has been reported at 2.01 (confidence interval [CI] 1.21, 3.14) and for the whole population 1.65 (CI 1.01, 2.55). The effect of a body mass index of >35 was not studied. Regular withdrawal bleeding occurred for 78.6% of women in Cycle 1, but by Cycle 13 almost half the women failed to have a withdrawal bleed. This new formulation provides an intermediate dose of an EE/NE combination that will be useful for women experiencing breakthrough bleeding on the lower-dose EE/NE pill. The convenience of a low-dose pill, which can be chewed without the need for water, will be useful to enable women who have forgotten a pill to take one whenever they remember, provided they carry it with them. The advantage of a 24/4 regimen is better suppression of follicular development in the pill-free interval and may be beneficial for women who experience menstrual cycle-related problems, such as heavy bleeding or dysmenorrhea. PMID:22573934

  5. [Contraception and obesity].

    PubMed

    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. PMID:26527416

  6. How does Intimate Partner Violence Affect Condom and Oral Contraceptive Use in the United States? A Systematic Review of the Literature

    PubMed Central

    Bergmann, Julie N.; Stockman, Jamila K.

    2015-01-01

    INTRODUCTION Intimate partner violence (IPV) is estimated to affect 25% of adult women in the US alone. IPV directly impacts women’s ability to use contraception, resulting in many of unintended pregnancies and STIs. This review examines the relationship between IPV and condom and oral contraceptive use within the United States at two levels: the female victim’s perspective on barriers to condom and oral contraceptive use, in conjunction with experiencing IPV (Aim 1) and the male perpetrator’s perspective regarding condom and oral contraceptive use (Aim 2). STUDY DESIGN We systematically reviewed and synthesized all publications meeting the study criteria published since 1997. We aimed to categorize the results by emerging themes related to each study aim. RESULTS We identified 42 studies that met our inclusion criteria. We found 37 studies that addressed Aim 1. Within this we identified three themes: violence resulting in reduced condom or oral contraceptive use (n=15); condom or oral contraceptive use negotiation (n=15); which we further categorized as IPV due to condom or oral contraceptive request, perceived violence (or fear) of IPV resulting in decreased condom or oral contraceptive use, and sexual relationship power imbalances decreasing the ability to use condoms or oral contraceptives; and reproductive coercion (n=7). We found 5 studies that addressed Aim 2. Most studies were cross-sectional, limiting the ability to determine causality between IPV and condom or oral contraceptive use; however, most studies did find a positive relationship between IPV and decreased condom or oral contraceptive use. CONCLUSIONS Quantitative, qualitative, and mixed methods research has demonstrated the linkages between female IPV victimization/male IPV perpetration and condom or oral contraceptive use. However, additional qualitative and longitudinal research is needed to improve the understanding of dynamics in relationships with IPV and determine causality between IPV

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

    NASA Technical Reports Server (NTRS)

    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.

  8. Practice Bulletin Summary No. 152: Emergency Contraception.

    PubMed

    2015-09-01

    Emergency contraception, also known as postcoital contraception, is therapy used to prevent pregnancy after an unprotected or inadequately protected act of sexual intercourse. Common indications for emergency contraception include contraceptive failure (eg, condom breakage or missed doses of oral contraceptives) and failure to use any form of contraception (1-3). Although oral emergency contraception was first described in the medical literature in the 1960s, the U.S. Food and Drug Administration (FDA) approved the first dedicated product for emergency contraception in 1998. Since then, several new products have been introduced. Methods of emergency contraception include oral administration of combined estrogen-progestin, progestin only, or selective progesterone receptor modulators and insertion of a copper intrauterine device (IUD). Many women are unaware of the existence of emergency contraception, misunderstand its use and safety, or do not use it when a need arises (4-6). The purpose of this Practice Bulletin is to review the evidence for the efficacy and safety of available methods of emergency contraception and to increase awareness of these methods among obstetrician-gynecologists and other gynecologic providers. PMID:26287780

  9. Practice Bulletin No. 152: Emergency Contraception.

    PubMed

    2015-09-01

    Emergency contraception, also known as postcoital contraception, is therapy used to prevent pregnancy after an unprotected or inadequately protected act of sexual intercourse. Common indications for emergency contraception include contraceptive failure (eg, condom breakage or missed doses of oral contraceptives) and failure to use any form of contraception (). Although oral emergency contraception was first described in the medical literature in the 1960s, the U.S. Food and Drug Administration (FDA) approved the first dedicated product for emergency contraception in 1998. Since then, several new products have been introduced. Methods of emergency contraception include oral administration of combined estrogen-progestin, progestin only, or selective progesterone receptor modulators and insertion of a copper intrauterine device (IUD). Many women are unaware of the existence of emergency contraception, misunderstand its use and safety, or do not use it when a need arises (). The purpose of this Practice Bulletin is to review the evidence for the efficacy and safety of available methods of emergency contraception and to increase awareness of these methods among obstetrician-gynecologists and other gynecologic providers. PMID:26287787

  10. The dynamics of oral contraceptive use in The Netherlands 1990-1993.

    PubMed

    Oddens, B J; Arnolds, H T; Van Maris, M G; Van Lunsen, H W

    1994-09-01

    Data from an ongoing series of surveys on contraceptive use in the Netherlands were analyzed with respect to the percentages of oral contraceptive (OC) users who annually started use, discontinued use or switched to another OC type. The surveys had been conducted between 1990 and 1993 among samples of women aged 15-49 who belonged to a survey panel. Response rates of the surveys were 89-90% and the sample sizes ranged from 4560 to 4621 women. The assessed OC use rates reflected those of the Dutch population reasonably well. Of all respondents who had used OCs during the 12 months prior to the surveys, 12-15% discontinued use within this period, mainly in order to get pregnant, 12-16% were starters and 9-14% switchers. Of all starters 37% switched to another OC type within the first 12 months after starting. Switching was mainly related to the experience of perceived side-effects and wishes for better cycle control. The results highlighted the relevance of closely monitoring the individual woman's satisfaction with her OC. Since OC use appeared in many cases to be characterized by an active seeking for the most acceptable OC type, a wide range of OC types available and the development and introduction of new types is highly relevant for tailoring contraceptive use to individual needs. PMID:7863842

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

    PubMed Central

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

    2012-01-01

    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. PMID:21993500

  12. Effects of manufacturing oral contraceptives on blood clotting.

    PubMed

    Poller, L; Thomson, J M; Otridge, B W; Yee, K F; Logan, S H

    1979-06-30

    In monitoring the effects of industrial exposure resulting from the pharmaceutical manufacture of oestrogen-progestogen combinations by coagulation studies acceleration of some clotting tests was found. The most pronounced changes were in workers most closely associated with the industrial process. Less pronounced changes were found in women employees not closely concerned with the processing and may have been secondary to the postmenopausal bleeding to which they were prone. A safer work procedure elaborated by the Employment Medical Advisory Service was monitored by clotting studies for over a year but the three most highly exposed subjects showed no substantial improvement. PMID:466212

  13. The underrated benefits of oral contraception: consequences of pregnancy and induced abortion in teenagers.

    PubMed

    Dreyfus, R

    1992-01-01

    If complications occur within a pregnancy planned and brought to term, they often can be dealt with and accepted. They are even more traumatic when they occur in an unwanted pregnancy that could have been prevented through contraception. Teenagers, because of their physical and psychological immaturity and also because of their social environment, seem to suffer with undue frequency from the complications of induced abortion. Its result, for the teenager, is a handicapped future in comparison to other women. Hence, access to contraception is important for all women, and especially for teenagers, in order to avoid such prejudicial situations. It is important, then, to prescribe oral contraception for its efficacy and its short- and long-term innocuousness. Because of her immaturity, the pregnant teenager is at risk: of spontaneous abortion, pre-eclampsia, anemia, hemorrhage, and prematurity. She is also at risk because of the social difficulties she will be facing. This is particularly true in families from developing countries. From birth, the child is also at risk: of low birth weight for the term, mortality in the first year of life, and all risks linked to abandonment, or education by a third party. In a proportion of 13 to 30% in western countries and in a proportion of 3% in East Asia or in Northwest Africa (Maghreb), induced abortions are a reflection of the following: early sexual activity without contraception even if fertility is still low in very young teenagers, absence of social protection or social independence, refusal of forced marriage, and presence or absence of liberal legislation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1362187

  14. A double-blind, placebo-controlled evaluation of the effect of oral doses of rizatriptan 10 mg on oral contraceptive pharmacokinetics in healthy female volunteers.

    PubMed

    Shadle, C R; Liu, G; Goldberg, M R

    2000-03-01

    Rizatriptan (MAXALT), a potent, oral 5-HT1B/1D agonist with a rapid onset of action, is available now for the acute treatment of migraine. This study examined the pharmacokinetic and clinical interaction between rizatriptan 10 mg and the components (ethinyl estradiol [EE] 35 micrograms and norethindrone [NET] 1.0 mg) of a well-established oral contraceptive combination product, ORTHO-NOVUM 1/35. Levels of sex hormone binding globulin (SHBG), a protein increased by EE to which NET binds, were also examined. In this two-period crossover study, 20 healthy young female subjects received a coadministration of 8 days of rizatriptan treatment (6 days of single-dose 10 mg rizatriptan and 2 days of multiple-dose rizatriptan, 10 mg q 4 hours for three doses, giving a total daily dose of 30 mg on Days 7 and 8) or matching placebo along with their daily dose (one tablet) of ORTHO-NOVUM 1/35 within their oral contraceptive cycle. Plasma was sampled for EE, NET, and SHBG concentrations. Safety evaluations included routine laboratory safety studies, physical examinations, and monitoring for ECG, vital signs, and adverse events. There were no statistically significant differences in any of the pharmacokinetic parameters of EE or NET between the rizatriptan and placebo treatment periods, thus indicating that rizatriptan had no meaningful effect on the disposition of either the EE or the NET component of ORTHO-NOVUM 1/35. The SHBG concentration did not change throughout the entire study. Clinically, coadministration of rizatriptan with ORTHO-NOVUM 1/35 was well tolerated. Blood pressure, heart rate, and temperature showed no consistent trend or clinically important changes. Adverse events following coadministration of rizatriptan with ORTHO-NOVUM 1/35 were similar to those reported when placebo was given with ORTHO-NOVUM 1/35. The findings of this study indicate that there is little potential for dosages as high as 30 mg/day, the maximum recommended dosing schedule, of rizatriptan

  15. Oral contraception does not alter single dose saquinavir pharmacokinetics in women

    PubMed Central

    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

  16. Acute effects of bright light and caffeine on nighttime melatonin and temperature levels in women taking and not taking oral contraceptives

    NASA Technical Reports Server (NTRS)

    Wright, K. P. Jr; Myers, B. L.; Plenzler, S. C.; Drake, C. L.; Badia, P.; Czeisler, C. A. (Principal Investigator)

    2000-01-01

    Caffeine and bright light effects on nighttime melatonin and temperature levels in women were tested during the luteal phase of the menstrual cycle (n=30) or the pseudo luteal phase for oral contraceptive users (n=32). Participants were randomly assigned to receive either bright (5000 lux) or dim room light (<88 lux) between 20:00 and 08:00 h under a modified constant routine protocol. Half the subjects in each lighting condition were administered either caffeine (100 mg) or placebo in a double-blind manner at 20:00, 23:00, 02:00 and 05:00 h. Results showed that the combination of bright light and caffeine enhanced nighttime temperature levels to a greater extent than did either caffeine or bright light alone. Both of the latter groups had higher temperature levels relative to the dim light placebo condition and the two groups did not differ. Temperature levels in the bright light caffeine condition were maintained at near peak circadian levels the entire night in the luteal and pseudo luteal phase. Melatonin levels were reduced throughout the duration of bright light exposure for all women. Caffeine reduced the onset of melatonin levels for women in the luteal phase, but it had little effect on melatonin levels for oral contraceptive users. The results for women in the luteal phase of the menstrual cycle are consistent with our previous findings in men. The results also suggest that oral contraceptives may alter the effects of caffeine on nighttime melatonin levels.

  17. Why do inadvertent pregnancies occur in oral contraceptive users? Effectiveness of oral contraceptive regimens and interfering factors.

    PubMed

    Fraser, I S; Jansen, R P

    1983-06-01

    Inadvertent pregnancies in combined pill users are not uncommon, and are usually due to errors of tablet taking. However, many factors may contribute to 'pill failure'. In this review the endocrine pharmacology of pill use and the changes reported with missed pills have been considered in detail. The influences of other factors including drug interactions have been reviewed and a series of recommendations made for reducing the risk of pregnancy in each of these circumstances. PMID:6413129

  18. Contraceptive use in acne.

    PubMed

    Lam, Charlene; Zaenglein, Andrea L

    2014-01-01

    Acne vulgaris is an inflammatory disorder of the pilosebaceous follicle. It is well established that androgen hormones play a major role in sebum production and excretion, and are vital in the pathogenesis of acne. Isotretinoin notwithstanding, hormonal therapies such as combined oral contraceptives (COCs) and spironolactone are the only treatments that can affect sebum production and the androgen component of acne. Contraceptives are also used during isotretinoin therapy for pregnancy prevention. It is important for a dermatologist to be familiar with all the available methods of contraception to provide essential counseling to patients. The aim of this paper is to review the role of hormones in acne pathogenesis, discuss the use of hormonal therapies for acne, and detail various alternative contraceptive methods in relation to isotretinoin treatment and pregnancy prevention. PMID:25017461

  19. Masculinizing effects on otoacoustic emissions and auditory evoked potentials in women using oral contraceptives.

    PubMed

    McFadden, D

    2000-04-01

    The otoacoustic emissions (OAEs) and auditory evoked potentials (AEPs) measured in two separate large scale studies were examined retrospectively for potential differences between those women using, and those not using, oral contraception (OC). Fourteen dependent variables were examined, all of which exhibited substantial sex differences. For 13 of those 14 dependent variables, the means for the users of OC were shifted away from the means of the non-users in the direction of the males. Specifically, for four different measures of OAE strength, for seven of eight measures of AEP latency or amplitude, and for two cognitive tests (mental rotation and water level), the means for the users of OC were located intermediate to those of the non-users of OC and the males. Few of these differences between users and non-users of OC achieved statistical significance, but the near universality of the direction of the difference suggests that oral contraceptives do produce a weak masculinizing effect on some auditory structures. These weak masculinizing effects appear to run contrary to the facts that the levels of both free testosterone and estradiol are lower in women using OC than in normal-cycling women. Past findings on auditory sex differences may have underestimated those sex differences. PMID:10748325

  20. Exogenous Hormone Use: Oral Contraceptives, Postmenopausal Hormone Therapy, and Health Outcomes in the Nurses’ Health Study

    PubMed Central

    Grodstein, Francine; Stampfer, Meir J.; Willett, Walter C.; Hu, Frank B.; Manson, JoAnn E.

    2016-01-01

    Objectives. To review the contribution of the Nurses’ Health Study (NHS) to our understanding of the complex relationship between exogenous hormones and health outcomes in women. Methods. We performed a narrative review of the publications of the NHS and NHS II from 1976 to 2016. Results. Oral contraceptive and postmenopausal hormone use were studied in relation to major health outcomes, including cardiovascular disease and cancer. Current or recent oral contraceptive use is associated with a higher risk of cardiovascular disease (mainly among smokers), melanoma, and breast cancer, and a lower risk of colorectal and ovarian cancer. Although hormone therapy is not indicated primarily for chronic disease prevention, findings from the NHS and a recent analysis of the Women’s Health Initiative indicate that younger women who are closer to menopause onset have a more favorable risk–benefit profile than do older women from use of hormone therapy for relief of vasomotor symptoms. Conclusions. With updated information on hormone use, lifestyle factors, and other variables, the NHS and NHS II continue to contribute to our understanding of the complex relationship between exogenous hormones and health outcomes in women. PMID:27459451

  1. Adiponectin and bone metabolism markers in female rowers: eumenorrheic and oral contraceptive users.

    PubMed

    Jürimäe, J; Vaiksaar, S; Mäestu, J; Purge, P; Jürimäe, T

    2011-12-01

    This study investigated whether adiponectin, bone formation (osteocalcin) and bone resorption [type I carboxyterminal telopeptide (ICTP)] values are influenced by menstrual cycle phase and oral contraceptive use in female rowers. Twenty-four rowers divided into normally cycling athletes (NOC; no.=15) and athletes taking oral contraceptive pills (OC; no.=9) participated in this study. Fasting blood samples, body composition and aerobic capacity measurements were taken during the follicular (FP) and the luteal (LP) phases of the menstrual cycle. Adiponectin, insulin, glucose, insulin resistance, body composition and aerobic capacity did not fluctuate significantly during menstrual cycle in both groups. Osteocalcin and ICTP were lower (p<0.05) in OC compared with NOC, but did not change significantly across menstrual cycle phases in both groups. Estradiol and progesterone were not related to adiponectin, osteocalcin or ICTP (r<0.147; p>0.05). Adiponectin was correlated (p<0.05) with osteocalcin (r=0.452) and fat free mass (r=0.428), and osteocalcin was related (p<0.05) to insulin (r=-0.413), glucose (r=-0.486) and insulin resistance (r=-0.528). In conclusion, adiponectin was not affected by menstrual cycle phase and OC use in female rowers, while bone metabolism markers were lower in OC compared to NOC groups. Adiponectin and osteocalcin were interrelated and may characterise energy homeostasis in female athletes. PMID:21169728

  2. The effects of short-term jump training on bone metabolism in females using oral contraceptives.

    PubMed

    Reiger, Jamie; Yingling, Vanessa R

    2016-01-01

    The purpose of this study was to determine the effect of oral contraceptive use on bone serum markers following a 3-week jumping protocol. Twenty-three females (18-25 years) were grouped as oral contraceptive users (OC+) or non-users (OC-). Following a 3-week observation period, participants completed a 3-week (15-day) jump protocol. Jump sessions consisting of ten 42 cm drop jumps with a 30 s rest interval between jumps were completed each day, 5 days per week. Peak vertical ground reaction force and loading rate were measured and the osteogenic index was calculated. Serum markers for bone formation, bone alkaline phosphatase (BAP) and bone resorption, C-terminal telopeptides of type I collagen (CTX) were measured at three time points (pre-, mid-, post-jump). BAP and CTX increased significantly (P = 0.0017, 0.0488) in both groups post-jump; however, bone metabolic markers were not different between the OC+ and OC- groups. Osteogenic index, ground reaction force and vertical jump height were similar between groups. Correlations between markers of bone metabolism and participants' age at menarche, weight, loading rate and years on OC were not significant. A 3-week jumping protocol was found to be effective in stimulating bone metabolism in both OC+ and OC- groups. PMID:26008875

  3. Paracetamol interaction with oral contraceptive steroids: increased plasma concentrations of ethinyloestradiol.

    PubMed Central

    Rogers, S M; Back, D J; Stevenson, P J; Grimmer, S F; Orme, M L

    1987-01-01

    The effect of a single dose of paracetamol (1 g) on plasma concentrations of the oral contraceptive steroids ethinyloestradiol (EE2) and levonorgestrel (LNG) has been studied in six healthy female volunteers. The area under the plasma concentration-time curve (AUC0-24) of EE2 was significantly increased following paracetamol administration by 22% (control 2221 +/- 291; following paracetamol, 2702 +/- 452 pg ml-1 h; mean +/- s.d.; P less than or equal to 0.05). The greatest effect was evident in the time period 0-3 h. There was a significant decrease in the AUC of EE2-sulphate after paracetamol (7736 +/- 3791 pg ml-1 h) compared with control (13161 +/- 4535 pg ml-1 h; P less than or equal to 0.05). Plasma concentrations of LNG were unaltered by concurrent paracetamol administration. We conclude that the administration of a single 1 g dose of paracetamol causes an increase in plasma concentrations of EE2 as a result of a reduction in the sulphation of the steroid. This interaction may be of clinical significance in women on oral contraceptive steroids who regularly take paracetamol. PMID:3111513

  4. Effects of the oral contraceptive pill cycle on physiological responses to hypoxic exercise

    NASA Technical Reports Server (NTRS)

    Sandoval, Darleen A.; Matt, Kathleen S.

    2003-01-01

    To test whether the oral contraceptive pill cycle affects endocrine and metabolic responses to hypoxic (fraction of inspired oxygen = 13%, P(IO2): 95 mmHg; H) versus normoxic (P(IO2):153 mmHg; N) exercise, we examined eight women (28 +/- 1.2 yr) during the third (PILL) and placebo (PLA) weeks of their monthly oral contraceptive pill cycle. Cardiopulmonary, metabolic, and neuroendocrine measurements were taken before, during, and after three 5-min consecutive workloads at 30%, 45%, and 60% of normoxic V(O2peak) in H and N trials. Heart rate response to exercise was greater in H versus N, but was not different between PILL and PLA. Lactate levels were significantly greater during exercise, and both lactate and glucose levels were significantly greater for 30 min after exercise in H versus N (p < 0.0001). When expressed relative to baseline, lactate levels were lower in PILL versus PLA, but glucose was greater in PILL versus PLA (p < 0.001). Cortisol levels were also significantly greater in PILL versus PLA (p < 0.001). Norepinephrine levels were significantly increased during exercise (p < 0.0001) and in H versus N (p < 0.0001). However, epinephrine levels were not different over time or with trial. Thus, the presence of circulating estradiol and progesterone during the PILL phase reduces glucose and lactate responses to hypoxic exercise.

  5. Contraceptive pills and thrombosis: effects of the French crisis on prescriptions and consequences for medicine agencies.

    PubMed

    Emmerich, J; Thomassin, C; Zureik, M

    2014-09-01

    The higher risk of venous thromboembolism with 3rd and 4th- generations combined oral contraceptives compared to 2nd generation triggered a media crisis in France. Exposure to 3rd or 4th-generation combined oral contraceptives led to an annual excess of around 100 premature deaths in Europe. In the absence of any demonstrated additional benefit of these combined oral contraceptives, measures were taken to decrease exposure of women to this illegitimate excess of risk. As a consequence, this crisis saw a 45% decrease in the prescription of 3rd and 4th-generations combined oral contraceptives, without adverse consequences. PMID:25041638

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

    PubMed Central

    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

  7. Nomegestrol acetate/estradiol hormonal oral contraceptive and breast cancer risk.

    PubMed

    Del Pup, Lino; Berretta, Massimiliano; Di Francia, Raffaele; Cavaliere, Carla; Di Napoli, Marilena; Facchini, Gaetano; Fiorica, Francesco; Mileto, Mario; Schindler, Adolf E

    2014-08-01

    Combined hormonal contraceptives (CHCs) contain estrogen and progestin, which can stimulate estrogen-sensitive and/or progesterone-sensitive breast cancer growth. Until recently, ethinylestradiol had been almost the only estrogen used for decades, and its dose has been greatly reduced over time. The first generations of birth control pills contained approximately five times more estrogen and four times more progestin than the latest contraceptives. Newer CHCs also contain steroids that more closely mimic the physiological estradiol (E2) and progesterone effects. The newer CHC formulations are thus expected to have less influence on the breast, although it is very difficult to demonstrate any difference among the recent available preparations in human studies. Recently, nomegestrol acetate (NOMAC), a neutral, nonandrogenic, progesterone-like profile progestin, has become available in combination with the 'natural' estrogen, E2. According to the literature, NOMAC/E2 is expected to have either a lesser stimulating effect or a neutral effect on estrogen-sensitive breast cancers. We performed an analysis of the available studies and a bibliographical review. The endocrine and metabolic effects of NOMAC/E2 formulation might lead to a lesser breast tissue stimulation. The data reported, confirmed through clinical studies, should be considered when choosing a hormonal contraceptive, especially when breast stimulation is a concern. PMID:24346139

  8. Oral contraception following abortion: A systematic review and meta-analysis.

    PubMed

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

    2016-07-01

    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 < 0.00001) compared with the control groups. Group II demonstrated a significant difference in vaginal bleeding time (P < 0.00001), the amount of vaginal bleeding (P = 0.0002), menstruation recovery period (P < 0.00001), and endometrial thickness at 2 (P = 0.003) and 3 (P < 0.00001) weeks postabortion compared with the control group. Similarly, a significant difference was observed in group III for reducing vaginal bleeding time (P < 0.00001) and the amount of vaginal bleeding (P < 0.00001), shortening the menstruation recovery period (P < 0.00001), and increasing endometrial thickness 2 and 3 weeks after surgical abortion (P < 0.00001, all

  9. [Test your knowledge: contraceptives].

    PubMed

    1998-06-01

    A brief self-administered quiz on contraceptive knowledge is presented. The 7 questions ask the reader to explain the mechanism of action of combined oral contraceptives, and why estrogens are used with progestins, and to indicate the main secondary effects of Depo-Provera and implants and the dosage of the "morning-after pill." A multiple-choice question concerns absolute contraindications to combined OC use. One clinical case involves selection of OCs for a woman with a family history of breast cancer and the other requires development of a strategy for reducing high-risk pregnancies and risk of AIDS. PMID:12321847

  10. Oral contraceptives, reproductive history and risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition

    PubMed Central

    Tsilidis, K K; Allen, N E; Key, T J; Bakken, K; Lund, E; Berrino, F; Fournier, A; Olsen, A; Tjønneland, A; Overvad, K; Boutron-Ruault, M-C; Clavel-Chapelon, F; Byrnes, G; Chajes, V; Rinaldi, S; Chang-Claude, J; Kaaks, R; Bergmann, M; Boeing, H; Koumantaki, Y; Stasinopoulou, G; Trichopoulou, A; Palli, D; Tagliabue, G; Panico, S; Tumino, R; Vineis, P; Bueno-de-Mesquita, H B; van Duijnhoven, F J B; van Gils, C H; Peeters, P H M; Rodríguez, L; González, C A; Sánchez, M-J; Chirlaque, M-D; Barricarte, A; Dorronsoro, M; Borgquist, S; Manjer, J; van Guelpen, B; Hallmans, G; Rodwell, S A; Khaw, K-T; Norat, T; Romaguera, D; Riboli, E

    2010-01-01

    Background: Oral contraceptive use and reproductive factors may initiate long-term changes to the hormonal milieu and thereby, possibly influence colorectal cancer risk. Methods: We examined the association of hormonal and reproductive factors with risk of colorectal cancer among 337 802 women in the European Prospective Investigation into Cancer and Nutrition, of whom 1878 developed colorectal cancer. Results: After stratification for center and age, and adjustment for body mass index, smoking, diabetes mellitus, physical activity and alcohol consumption, ever use of oral contraceptives was marginally inversely associated with colorectal cancer risk (hazard ratio (HR), 0.92; 95% confidence interval (CI), 0.83–1.02), although this association was stronger among post-menopausal women (HR, 0.84; 95% CI: 0.74–0.95). Duration of oral contraceptive use and reproductive factors, including age at menarche, age at menopause, type of menopause, ever having an abortion, parity, age at first full-term pregnancy and breastfeeding, were not associated with colorectal cancer risk. Conclusion: Our findings provide limited support for a potential inverse association between oral contraceptives and colorectal cancer risk. PMID:21045829

  11. No association between body size and frequency of sexual intercourse among oral contraceptive users

    PubMed Central

    Brunner Huber, Larissa R.; Stanley, Whitney A.; Broadhurst, Leah; Dmochowski, Jacek; Vick, Tara M.; Scholes, Delia

    2014-01-01

    Purpose This study aimed to describe frequency of sexual intercourse and whether body size was associated with weekly sexual intercourse among a diverse group of women using oral contraceptives. Methods This longitudinal, prospective cohort study recruited participants (n=185) from several clinics in Charlotte, NC. Body mass index (BMI) and waist-to-hip ratio (WHR) were used as measures of body size and sexual intercourse frequency was determined from self-reported information provided on daily diaries. Mean monthly frequencies of sexual intercourse were calculated and linear mixed models were used to assess if means remained constant over time. Generalized estimating equations were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Results Mean monthly frequency of sexual intercourse was similar for women classified as normal/underweight or obese by BMI during each month of data collection, but was highest for women classified as overweight. After adjustment, obesity-sexual intercourse associations were attenuated (BMI ≥30 vs. <25.0: OR=0.78, 95% CI: 0.43, 1.42 and WHR ≥0.85 vs. <0.85: OR=1.11; 95% CI: 0.62, 2.01). Conclusions This study found no association between BMI or WHR and weekly sexual intercourse. However, more research is warranted given the importance of this possible relationship for future studies of fertility, contraceptive effectiveness, and sexual health. PMID:25034574

  12. A case-control study of the possible association between oral contraceptives and malignant melanoma.

    PubMed Central

    Adam, S. A.; Sheaves, J. K.; Wright, N. H.; Mosser, G.; Harris, R. W.; Vessey, M. P.

    1981-01-01

    In a case-control study, we investigated 169 women aged 15-49 years with malignant melanoma notified to the Oxford and South Western cancer registries during the years 1971-1976, together with 507 matched controls. Data about medical, reproductive, drug and smoking histories were obtained both by reviewing general practitioner (GP) records and from the women themselves by postal questionnaires. There was no significant evidence of any overall increase in the risk of melanoma in oral contraceptive (OC) users (data from GP records-ever use vs never use, relative risk (RR) 1.34, 95% confidence limits 0.92-1.96; corresponding data from postal questionnaires-RR 1.13, limits 0.73-1.75). However, although not significant, the risk estimated from data in the postal questionnaires was higher in women who had used OCs for 5 years or more (use greater than or equal to 5 years vs never use, RR 1.57, limits 0.83-3.03). Previously demonstrated risk factors for melanoma, such as fair skin, blond or red hair and Celtic origin were found to be commoner in the cases than in the controls. Data from the Oxford/Family Planning Association contraceptive study were also examined. Unexpectedly there was a strong suggestion of a negative association between OC use and melanoma risk, but the analysis was based on only 12 women with the disease. PMID:7259960

  13. Bone Mineral Density in Adolescent Females Using Injectable or Oral Contraceptives: A 24 Month Prospective Study

    PubMed Central

    Cromer, Barbara A.; Bonny, Andrea E.; Stager, Margaret; Lazebnik, Rina; Rome, Ellen; Ziegler, Julie; Camlin-Shingler, Kelly; Secic, Michelle

    2008-01-01

    Study Objective To determine whether bone mineral density (BMD) is lower in hormonal contraceptive users than that in an untreated, comparison group. Design Observational, prospective cohort; duration: 24 months. Setting Adolescent clinics in a midwestern, metropolitan setting. Patients 433 postmenarcheal girls, aged 12–18 years, on depot medroxyprogesterone acetate (DMPA) [n=58], oral contraceptives (OC) [n=187], or untreated (n=188). Intervention DMPA and OC containing 100 mcg levonorgestrel and 20 mcg ethinyl estradiol. Main Outcome Measure BMD measurements at spine and femoral neck were obtained with dual x-ray absorptiometry (DXA) at baseline and 6-month intervals. Results Over 24 months, mean percent change in spine BMD was: DMPA −1.5%, OC +4.2%, and untreated +6.3%. Mean percent change in femoral neck BMD was: DMPA −5.2%, OC +3.0%, untreated +3.8%. Statistical significance was found between the DMPA group and other two groups (p<.001). In the DMPA group, mean percent change in spine BMD over the first 12 months was −1.4%; the rate of change slowed to −0.1% over the second 12 months. No bone density loss reached the level of osteopenia. Conclusions Adolescent girls receiving DMPA had significant loss in BMD compared with bone gain in the OC and untreated group. However, its clinical significance is mitigated by slowed loss after the first year of DMPA use and general maintenance of bone density values within the normal range. PMID:18222431

  14. Effects of oral contraceptive pill use on vaginal flora and vaginal epithelium.

    PubMed

    Eschenbach, D A; Patton, D L; Meier, A; Thwin, S S; Aura, J; Stapleton, A; Hooton, T M

    2000-09-01

    The objective of this study was to examine the effect of oral contraceptive (OC) use on vaginal discharge, epithelium, and flora. Thirty women who planned to use OC for contraception were evaluated before and 2 months after the start of OC use. At both visits, genital symptoms and exposures were assessed by questionnaire; vaginal signs were assessed by speculum examination and colposcopy; vaginal microflora was evaluated by quantitative culture; and a vaginal biopsy was obtained for histopathologic evaluation. Variables were compared between the initial visit and after 2 months of OC use. It was found that OC use did not change the gross, colposcopic, or histologic appearance of the vaginal epithelium or characteristics of vaginal or cervical discharge. Vaginal flora essentially remained unchanged after 2 months of OC use, except that a small decrease occurred in the number of subjects with > or =10(5) colony forming units/mL of H(2)O(2) producing Lactobacillus from 16 at baseline to 9 (p = 0.04) and in the total number of subjects with Ureaplasma urealyticum from 17 at baseline to 10 of 29 (p = 0.04). The results indicate minimal effect of OC use on the vaginal epithelium and vaginal and cervical discharge, and a small effect on vaginal flora. PMID:11124356

  15. Statement on postcoital contraception.

    PubMed

    1981-12-01

    For the woman exposed to a single unexpected and unprotected act of sexual intercourse, postcoital contraception can be used to avoid an unwanted pregnancy. Since the mid-1960s postcoital contraception using orally administered hormones has been found to be highly effective. This should be, however, considered as a 1-time procedure rather than a routine approach to contraception. The recommended oral methods are combined oral contraceptives (OCs) containing ethinyl estradiol 50 mcg and levonorgestrel 0.25 mg. Other similar formulations may also have high efficacy. The dosage schedule is 2 tablets at once followed by 2 tablets after 12 hours. This method is indicated in women exposed to unexpected and unprotected sexual intercourse, such as in cases of rape. It is effective only if it is instituted within 72 hours of the exposure. Data suggest this regime is as effective as that using diethylstilbestrol but with fewer side effects. As with all hormonal contraceptives, the method is contraindicated where a pregnancy is already established. Possible side effects include nausea and vomiting, irregular uterine bleeding, breast tenderness, and headache. The woman should be advised to return after 1 month to reinforce the need for elective contraception or, in the case of failure, to diagnose pregnancy and initiate counseling. In the event of a pregnancy, the woman should be reassured that no evidence exists to associate this regime of OC steroid administration with teratogenesis. Recent evidence indicates that effective postcoital contraceptive can be achieved by the insertion of a copper-containing IUD within 5 days of unprotected, mid-cycle sexual intercourse. PMID:12263975

  16. The relationship between oral contraceptive use and sensitivity to olfactory stimuli.

    PubMed

    Renfro, Kaytlin J; Hoffmann, Heather

    2013-03-01

    The present study examined differences in olfactory sensitivity between 16 naturally cycling (NC) women and 17 women taking monophasic oral contraceptives (OCs) to six odors: lemon, peppermint, rose, musk, androstenone and androsterone. Thresholds were assessed twice for both groups of women (during the periovulatory and luteal phases of their cycles) via a forced-choice discrimination task. NC women in the periovulatory phase were significantly more sensitive to androstenone, androsterone, and musk than women taking OCs. These findings give support to odor-specific hormonal modulation of olfaction. Further, due to the social and possibly sexual nature of these odors, future work should address whether there is a relationship between decreased sensitivity to these odors and reported behavioral side effects among women taking OCs. PMID:23321429

  17. Influence of menstrual cycle, parity and oral contraceptive use on steroid hormone receptors in normal breast.

    PubMed Central

    Battersby, S.; Robertson, B. J.; Anderson, T. J.; King, R. J.; McPherson, K.

    1992-01-01

    Steroid receptor was assessed immunohistochemically in 158 samples of normal breast for variation through the menstrual cycle. Patterns and intensity of reaction were used in a semi-quantitative scoring system to examine the influence of cycle phase, cycle type, parity and age. The changes in oestrogen receptor for natural cycle and oral contraceptive (OC) cycles indicated down-regulation by progestins. Progesterone receptor did not vary significantly in natural cycles, but increased steadily through OC cycles. This study provides strong evidence that both oestrogen and progesterone influence breast epithelium, but dissimilarities from the endometrium are apparent. The interval since pregnancy had a significant negative effect on frequency and score of oestrogen receptor and score of progesterone receptor. Multivariate analysis established the phase of cycle and OC use as independent significant influences on oestrogen receptor. The interval since pregnancy was an independent significant factor for both oestrogen and progesterone receptor presence. Images Figure 1 Figure 2 PMID:1562470

  18. Knowledge-attitude-practice survey among Portuguese gynaecologists regarding combined hormonal contraceptives methods.

    PubMed

    Bombas, Teresa; Costa, Ana Rosa; Palma, Fátima; Vicente, Lisa; Sá, José Luís; Nogueira, Ana Maria; Andrade, Sofia

    2012-04-01

    ABSTRACT Objectives To evaluate knowledge, attitude and practices of Portuguese gynaecologists regarding combined hormonal contraceptives. Methods A cross-sectional survey was conducted among 303 gynaecologists. Results Ninety percent of the gynaecologists considered that deciding on contraceptive methods is a process wherein the woman has her say. Efficacy, safety and the woman's preference were the major factors influencing gynaecologists, while efficacy, tolerability and ease of use were the major factors perceived by the specialists to influence the women's choice. Gynaecologists believed that only 2% of women taking the pill were 100% compliant compared to 48% of those using the patch and 75% of those using the ring. The lower risk of omission was the strong point for the latter methods. Side effects were the main reason to change to another method. Vaginal manipulation was the most difficult topic to discuss. Conclusions Most gynaecologists decided with the woman on the contraceptive method. The main reasons for the gynaecologist's recommendation of a given contraceptive method and the women's choice were different. Counselling implies an open discussion and topics related to sexuality were considered difficult to discuss. Improving communication skills and understanding women's requirements are critical for contraceptive counselling. PMID:22200109

  19. Metabolic effects of low-dose fluconazole in healthy female users and non-users of oral contraceptives.

    PubMed

    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) PMID:2547410

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

    PubMed

    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. PMID:26726092

  1. Modern trends in contraception.

    PubMed

    Burkman, R T

    1990-12-01

    Substantial improvements have been made in oral contraceptives, a new injectable contraceptive (Norplant), and the intrauterine device (IUD). Major risks with oral contraceptives have declined substantially, and a number of noncontraceptive health benefits have been discovered. Norplant is probably the first new contraceptive in recent years, and offers long-term contraception with high efficacy and modest risks. The IUD, by carefully selecting users, is a safe and efficacious contraceptive method. The major risk, pelvic inflammatory disease (PID), is far less common if one avoids use in the presence of risk factors for PID. PMID:2128711

  2. [Contraception and pregnancy in adolescence

    PubMed

    Herter, L D; Accetta, S G

    2001-11-01

    OBJECTIVE: To review and discuss different contraceptive methods currently used by adolescents, and also discuss adolescent pregnancy, including the associated risks and the importance of prenatal care. METHODS: Review of literature and clinical experience with different contraceptive methods and with adolescent pregnancy. RESULTS: The oral contraceptive pill is the most common method used by teenagers due to its low failure rate and other non-contraceptive effects. Emergency contraception is a good option in cases of rape, unplanned sexual intercourse, condom rupture, nonuse of oral contraceptives during short intervals. In this case, the pill should be taken within 72 hours after the intercourse (preferably before 24 hours for best effect). Most problems related to adolescent pregnancy have a social or economic origin; however, some medical complications such as preterm labor and anemia are frequently reported. CONCLUSIONS: The use of male and female condoms combined with other contraceptive methods should be encouraged to prevent sexually transmitted diseases. If pregnancy is confirmed, prenatal care must be implemented as soon as possible in order to minimize the risks of complication and to allow for an effective multidisciplinary approach. PMID:14676880

  3. Pro/antioxidant status in young healthy women using oral contraceptives.

    PubMed

    Kowalska, Katarzyna; Milnerowicz, Halina

    2016-04-01

    The aim of the study was to analyze the effects of oral contraceptives (OCs) on pro/antioxidant status in the blood of healthy women aged 20-25 years. Individuals were divided into OCs users and OCs nonusers. Markers of oxidative stress in the blood such as Cu, Cu/Zn ratio, malondialdehyde (MDA), glutathione oxidized (GSSG), and gamma-glutamyl transpeptidase (GGT) were determined. Antioxidants such as glutathione reduced (GSH), catalase (CAT), glutathione reductase (GR), glutathione peroxidase (GPx), glutathione S-transferase (GST), and superoxide dismutase (SOD) were estimated. Higher Cu concentrations, Cu/Zn ratio and GGT activity in women taking OCs were noted. A significant increase in MDA concentrations in oral OCs users was observed. Heightened activity of CAT in plasma was observed in OCs users, whereas SOD activity remained unchanged in plasma and erythrocyte lysate. A decline of GSH and GSSG in whole blood and glutathiono-dependent enzymes (GPx in plasma, GR in plasma and GST in lysate) was shown. Use of OCs leads to a pro/antioxidant imbalance. The results in the present study confirmed that GGT is an early marker of oxidative stress. Catalase is the main antioxidant, involved in the removal of free radicals in OCs users. PMID:26921793

  4. Matched-pairs analysis of ovarian suppression during oral versus vaginal hormonal contraceptive use

    PubMed Central

    Petrie, Kelsey A.; Torgal, Anu H.; Westhoff, Carolyn L.

    2011-01-01

    Background This study was conducted to compare ovarian suppression during oral versus vaginal hormonal contraceptive use. Secondary aims included comparison of endometrial thickness and bleeding patterns. Methods In two open-label trials assessing ovarian suppression, 33 compliant women completed both studies. They first used OCs [randomized to either 20 mcg ethinyl estradiol (EE)/100 mcg levonorgestrel (LNG) or 30 mcg EE/150 mcg LNG] and subsequently used contraceptive vaginal rings (CVR) (daily release of 15 mcg EE/120 mcg etonogestrel), all 21/7 day regimens. Participants had at least one run-in cycle using each contraceptive method prior to evaluation. During one cycle of each method, women underwent bi-weekly transvaginal sonography to measure ovarian follicular diameters and endometrial thickness. We also noted presence of a corpus luteum or a ruptured follicle as a marker of ovulation. Participants recorded bleeding days on paper calendars. We used matched pairs analyses as appropriate. Results During follow-up, we identified at least one ovarian follicle ≥8 mm in 20/33 (61%) OC users and 12/33 (36%) CVR users (matched pairs analysis, p=0.02). Similar trends were seen for larger follicles; however we had limited statistical power to evaluate these differences. Median follicular diameter among OC users was larger than median follicular diameter among CVR users (p=0.01). We did not observe a corpus luteum or ruptured follicle in any participant during either study. Endometrial thickness was similar during OC and CVR use (mean 4.1 ± 1.4 mm versus 4.1 ± 1.6 mm, p=0.9) as was the number of bleeding or spotting days (mean 2.1 ± 2.4 versus 1.9 ± 2.1, p=0.8). OC dose was unrelated to follicle diameter, endometrial thickness, or bleeding. Conclusions Ovarian follicles ≥8 mm were more common in 33 compliant women during OC use than during CVR use indicating CVR use results in greater ovarian suppression than OC use. PMID:22018131

  5. Serum metabolomic profiles suggest influence of sex and oral contraceptive use

    PubMed Central

    Ruoppolo, Margherita; Campesi, Ilaria; Scolamiero, Emanuela; Pecce, Rita; Caterino, Marianna; Cherchi, Sara; Mercuro, Giuseppe; Tonolo, Giancarlo; Franconi, Flavia

    2014-01-01

    Aim: Considering that the effects of sex and oral contraceptives (OCs) on blood metabolites have been scarcely studied and the fact that protocol designs for clinical trials emphasise the use of contraception for women of childbearing potential, we examined if OCs and sex affect the serum levels of the physiologically relevant amino acids, carnitine and acylcarnitines, using metabolomics approaches. Methods: Healthy adult men and women were enrolled. They were drug free with the exception of women taking cyclic format OCs (ethinylestradiol + different progestins). OCs-free women were analysed during the follicular phase, and amino acids, free carnitine and acylcarnitines were measured using HPLC or LC-MS/MS, respectively. Results: Men had significantly higher leucine, isoleucine, methionine, asparagine, proline, valine, tyrosine, glutamine+glutamate, glutamate, histidine and citrulline than OCs-free women, while tryptophan was significantly lower in men. OCs use significantly decreased the levels of glycine, proline, histidine, lysine, hydroxyproline and ornithine and increased isoleucine levels when compared with non-user women. OCs use reduced, although not significantly, carnitine levels in women. Total esterified carnitines were higher in untreated women than in OCs users. Globally, the effect of OCs and sex was specific for the individual esterified carnitine. The observed metabolic changes were not attributable to renal or hepatic functions or to differences in body weight. Conclusions: The assessed parameters were specifically influenced by sex, highlighting the need to have reference values for women and men. The major novelty of this study is the demonstration that OCs specifically change the profiles of serum amino acids and carnitine, which suggests that OCs users and non-users should be represented in clinical trials. PMID:25360225

  6. Pre-gravid oral contraceptive use in relation to birth weight: a prospective cohort study.

    PubMed

    Hatch, Elizabeth E; Hahn, Kristen A; Mikkelsen, Ellen M; Riis, Anders H; Sorensen, Henrik Toft; Rothman, Kenneth J; Wise, Lauren A

    2015-11-01

    Few studies have evaluated the association between pregravid oral contraceptive (OC) use and birth weight, and findings have been conflicting. We conducted a prospective cohort study of 5921 pregnancy planners in Denmark to evaluate recency, duration, and type of OC used before conception in relation to infant birth weight. Participants completed online questionnaires and reported detailed information on contraceptive history and covariates at baseline. Participants completed bimonthly follow-up questionnaires to update their pregnancy status for up to 12 months or until conception occurred. Birth weight data were ascertained from the Danish Medical Birth Registry for 4046 live births delivered by study participants between 2008 and 2010. We used multivariable linear and log-binomial regression analyses to control for confounding. Mean birth weight was higher among women who had used OCs within 0-1 months (mean difference = 97 g, CI 26, 168) or 2-6 months (mean difference = 40 g, CI -5, 85) before conception, compared with more than 12 months before conception. Mean birth weight was lower among women who had used OCs for long durations (mean difference comparing ≥12 with <4 years of OC use = -85 g, CI -158, -11). Our findings indicate that pregravid OC use within 6 months of conception may be associated with a small increase in birth weight, but that long duration of use may have the opposite effect. Results were stronger among male infants, among 2nd and 4th generation OC users, and among users of OCs with a higher estrogen dose. PMID:26076921

  7. Emergency contraception.

    PubMed

    Grimes, David A; Raymond, Elizabeth G

    2002-08-01

    Emergency contraception is used to prevent pregnancy after a coital act not adequately protected by a regular method of contraception. In contrast to early medical abortion, emergency contraception prevents a pregnancy from starting and does not disrupt an established pregnancy. The most commonly used approaches consist of two oral doses of contraceptive steroids. The levonorgestrel-only regimen (levonorgestrel, 0.75 mg, repeated in 12 hours) appears to be more effective and better tolerated than the Yuzpe regimen (ethinyl estradiol, 100 microg, and levonorgestrel, 0.5 mg, repeated in 12 hours). In the largest randomized, controlled trial to date, levonorgestrel prevented about 85% of pregnancies that would have occurred without its use. Hormonal emergency contraception has no known medical contraindications, although it is not indicated for suspected or confirmed pregnancy. However, if hormonal emergency contraception is inadvertently taken in early pregnancy, neither the woman nor the fetus will be harmed. Nausea and vomiting associated with the Yuzpe regimen can be reduced by prophylactic use of meclizine. A strong medical and legal case exists for making hormonal emergency contraception available over the counter, as has happened in countries other than the United States. Easier access to and wider use of emergency contraception could dramatically lower the high rates of unintended pregnancy and induced abortion in the United States. PMID:12160366

  8. [Pharmacological, metabolic and clinical aspects of new oral contraceptive associations containing natural estrogens].

    PubMed

    Ferrari, S; Piacenti, I; Napolitano, A; Cagnacci, A

    2014-02-01

    Introduction of new compounds containing natural estrogens represented a major development in the field of hormonal contraception. Micronized estradiol (E2) and its estere valerate (EV), is more easily metabolized by the liver than ethynylestradiol (EE). This causes minimal metabolic impact, but the weak estrogenic activity needs not be antagonized by androgenic progestin and requires progestin capable to stabilize the endometrium. Dienogest (DNG), an antiandrogenic progestin with a short half-life, is associated with estradiol valerate (EV) in a quadriphasic fashion. In comparison to EE/levonorgestrel (LNG), EV/DNG is more neutral on metabolism and coagulation. Furthermore, it does not seem to negatively affect the cardiovascular system and breast. Cycle control is optimal with a higher prevalence of amenorrhea and reduction of menstrual flow. For this reason EV/DNG can be tehrapeutic for heavy menstrual bleedings. Nomegestrol acetate (NOMAc), an anti-andogen progestin with a long half-life is combined in monophasic regimen with micronized E2. E2/NOMAc is more neutral than EE/LNG on metabolism and more neutral than EE/DRSP on coagulation. NOMAc reduces peripheral tissue estrogen formation, and this may be beneficial for the breast. The two formulations exert a high contraceptive efficacy similar to the ones containing EE, but with less estrogen-related side-effects. The additional benefits due to DNG and NOMAc need to be further explored. PMID:24569408

  9. Effects of oral contraceptives, or lanosterol, on ADP-induced aggregation and binding of /sup 125/I-fibrinogen to rat platelets

    SciTech Connect

    McGregor, L.; Toor, B.; McGregor, J.L.; Renaud, S.; Clemetson, K.J.

    1984-03-01

    The aggregation to ADP and the binding of /sup 125/I-fibrinogen to platelets from rats treated with oral contraceptives or normal platelets treated in vitro with lanosterol were compared to their respective controls. Both types of platelets showed a significant increase in ADP-induced aggregation and in binding of fibrinogen, indicating that the effect of oral contraceptives could be partly due to increased levels of lanosterol in platelet membrane.

  10. Effect of oral contraceptives and hormone replacement therapy on bone mineral density in premenopausal and perimenopausal women: a systematic review

    PubMed Central

    Liu, S L; Lebrun, C M

    2006-01-01

    Seventy five articles on the effect of oral contraceptives and other hormone replacement on bone density in premenopausal and perimenopausal women were reviewed. The evidence was appraised using the Oxford Centre for Evidence‐Based Medicine levels of evidence. There is good evidence for a positive effect of oral contraceptives on bone density in perimenopausal women, and fair evidence for a positive effect in “hypothalamic” oligo/amenorrhoeic premenopausal women. There is limited evidence for a positive effect in healthy and anorexic premenopausal women. In hypothalamic oligo/amenorrhoeic women, baseline bone density has been shown to be significantly lower than that in healthy controls, therefore the decision to treat is clinically more important. The ideal formulation(s) and duration of treatment remain to be determined by further longitudinal and prospective randomised controlled trials in larger subject populations. PMID:16371485

  11. [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].

    PubMed

    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. PMID:20085215

  12. Prevalence Rates of Uterine Cervical Carcinoma in situ for Women Using the Diaphragm or Contraceptive Oral Steroids*

    PubMed Central

    Melamed, Myron R.; Koss, Leopold G.; Flehinger, Betty J.; Kelisky, Richard P.; Dubrow, Hilliard

    1969-01-01

    Study of the prevalence rates of uterine cervical carcinoma in situ among women attending centres of Planned Parenthood of New York City, Inc., showed a small but statistically significant difference between the population choosing and using the diaphragm and the population choosing and using oral steroids for contraception. This can be attributed either to a decreased prevalence rate for women using the diaphragm or to an increased rate for women using oral steroids. The reason for the difference is not apparent from these data. PMID:5792609

  13. Influence of oral contraceptives on endogenous pain control in healthy women.

    PubMed

    Rezaii, Taraneh; Ernberg, Malin

    2010-06-01

    This study investigated the influence of oral contraceptives (OC) on diffuse noxious inhibitory control (DNIC) in healthy women. Fifteen women taking OC and 17 normally menstruating women (No-OC) were tested during high and low endogenous estrogens sessions. Saliva was sampled for analysis of endogenous estradiol level. Mechanical pressure (test stimuli) was applied to the masseter muscle and finger. The pain induced by this pressure was assessed on a 0-10 numerical rating scale (NRS) before, during, and after immersion of the contralateral hand in ice-cold water (cold pressor test, CPT) to induce DNIC. For all subjects, pain induced by the test stimuli decreased significantly during the CPT (P < 0.001). The decrease in general was larger in the No-OC group, with a significant difference between groups in the masseter muscle in the low session (P < 0.027). There were no significant differences between groups or sessions in estradiol levels. These results indicate that endogenous pain modulation may be less effective in OC users. PMID:20419369

  14. Oral contraceptive pill use is associated with localized decreases in cortical thickness

    PubMed Central

    Petersen, Nicole; Touroutoglou, Alexandra; Andreano, Joseph M.; Cahill, Larry

    2015-01-01

    Oral contraceptive pills (OCs), which are used to prevent pregnancy by the majority of women in the United States, contain steroid hormones that may affect the brain’s structure and function. In this investigation, we tested the hypothesis that OC use is associated with differences in brain structure using a hypothesis-driven, surface-based approach. In 90 women, (44 OC users, 46 naturally-cycling women), we compared the cortical thickness of brain regions that participate in the salience network and the default mode network, as well as the volume of subcortical regions in these networks. We found that OC use was associated with significantly lower cortical thickness measurements in the lateral orbitofrontal cortex and the posterior cingulate cortex. These regions are believed to be important for responding to rewards and evaluating internal states/incoming stimuli, respectively. Further investigations are needed to determine if cortical thinning in these regions are associated with behavioral changes, and also to identify whether OC use is causally or only indirectly related to these changes in brain morphology. PMID:25832993

  15. Elevated eating disorder symptoms in women with a history of oral contraceptive side effects.

    PubMed

    Bird, Jessica L; Oinonen, Kirsten A

    2011-08-01

    Previous research suggests a link between gonadal hormones and eating disorder symptomatology. This study examined the role of gonadal hormones and hormonal sensitivity in eating disorder (ED) symptoms by using oral contraceptive (OC) side effect history as an indicator of hormonal sensitivity. A questionnaire containing two scales of the Eating Disorder Inventory-2 and an OC side effect scale was completed by 174 healthy women who had used OCs. Histories of emotional and physical OC side effects were evaluated as predictors of body dissatisfaction and drive for thinness. Women with a history of negative OC side effects had higher levels of ED symptoms. After controlling for body mass index (BMI) and depression scores, OC side effect history remained a significant predictor of body dissatisfaction and drive for thinness. The experience of OC side effects may indicate a greater risk for increased eating disorder symptoms. The findings provide further support for a hormonal link to ED symptoms, as women who are more "sensitive" to exogenous gonadal hormones also experience more ED symptoms. PMID:21725835

  16. Oral contraceptive use by teenage women does not affect peak bone mass: a longitudinal study.

    PubMed

    Lloyd, T; Taylor, D S; Lin, H M; Matthews, A E; Eggli, D F; Legro, R S

    2000-10-01

    This longitudinal observational study determined the effect of oral contraceptive (OC) use during adolescence on peak bone mass (PBM). The sample comprised 62 non-Hispanic, White females in The Penn State Young Women's Health Study, who were studied for 8 years between the ages of 12 and 20. There were 28 OC users who used OCs for a minimum of 6 months and were still using them at age 20, and 34 nonusers who had never used the regimen. Total body bone, dedicated hipbone, and body composition measurements were made by dual-energy roentgenogram absorptiometry. There was no difference between OC users and nonusers in the anthropometric, body composition, or total body bone measurements. By age 20, the average duration of OC use by the user group was 22 months. At this age, the groups remained indistinguishable in anthropometric, body composition, total body, and hipbone measurements, and in age of menarche and sports exercise scores. These findings suggest that OC use by healthy, White, teenage females does not affect acquisition of PBM. PMID:11020515

  17. Oral contraceptive use and bone density in adolescent and young adult women

    PubMed Central

    Scholes, Delia; Ichikawa, Laura; LaCroix, Andrea Z.; Spangler, Leslie; Beasley, Jeannette M.; Reed, Susan; Ott, Susan M.

    2009-01-01

    Background Most of the millions of oral contraceptive (OC) users are under age 30 years and in the critical period for bone mass accrual. Study Design This cross-sectional study of 606 women aged 14–30 years examined both OC duration and estrogen dose and their association with bone mineral density (BMD) at the hip, spine, and whole-body (DEXA). Results Of 389 OC users and 217 nonusers enrolled, 50% were adolescents (14–18 years). Of OC users, 38% used “low-dose” OCs [<30 mcg ethinyl estradiol (EE)]. In adolescents, mean BMD differed by neither OC duration nor EE dose. However, 19–30 year-old women’s mean BMD was lower with longer OC use for spine and whole-body (p=0.004, p=0.02, respectively) and lowest for >12 months of low-dose OCs for the hip, spine and whole-body (p=0.02, 0.003 and 0.002, respectively). Conclusions Prolonged use of today’s OCs, particularly <30 mcg EE, may adversely impact young adult women’s bone density while ingesting these agents. PMID:20004271

  18. Evaluation of cerebral venous thrombosis secondary to oral contraceptive use in adolescents.

    PubMed

    Özdemir, Hasan H; Varol, Sefer; Akıl, Eşref; Acar, Abdullah; Demir, Caner F

    2015-01-01

    Our goal was to evaluate the clinical patterns, additional risk factors, treatment and outcome of cerebral venous thrombosis (CVT) related to adolescent oral contraceptive pill (OCP) usage. We evaluated 22 patients with CVT related to OCPs admitted to Firat and Dicle University Hospitals from January 2008 to January 2013. We assessed the clinical features, risk factors, imaging results and prognosis. Magnetic resonance imaging (MRI) and magnetic resonance were the preferred procedures for the diagnosis of CVT. MRI revealed parenchymal lesions in 11 (50 %) patients, and the remaining patients had normal MRIs. The sinuses most frequently affected by thrombosis were the superior sagittal sinus and the transverse sinus. The additional risk factors identified for CVT were antiphospholipid syndrome, protein C deficiency, protein C and S deficiency, factor V Leiden associated with heterozygous antithrombin III deficiency, methylenetetrahydrofolate reductase and prothrombin gene mutations. CVT may be overlooked in adolescents because it is more common among middle-aged and elderly adults. CVT should be suspected in the presence of neurological symptoms in adolescents, especially in those using OCPs. PMID:25092566

  19. Sex steroids, sexual behavior, and selection attention for erotic stimuli in women using oral contraceptives.

    PubMed

    Alexander, G M; Sherwin, B B

    1993-01-01

    The relationship between sex steroids and sexual behavior was examined in 19 oral contraceptive users. Retrospective assessment of sexual attitudes were obtained and women completed daily ratings of sexual behavior and well-being for 28 days. Plasma levels of free testosterone (T), estradiol, and progesterone were measured at weekly intervals. In addition, women performed a novel selective attention task designed to measure the strength of the tendency to be distracted by sexual stimuli. Multiple regression analyses using average sexual behavior variables as dependent variables, and hormone levels sexual attitudes and well-being as predictor variables, showed that free T was strongly and positively associated with sexual desire, sexual thoughts, and anticipation of sexual activity. A role for T in attention to sexual stimuli was also supported by the positive correlation between free T and the bias for sexual stimuli in a subgroup of women. These results are consistent with the hypothesis that T may enhance cognitive aspects of women's sexual behavior. PMID:8493300

  20. Ultrasound image attributes of human ovarian dominant follicles during natural and oral contraceptive cycles

    PubMed Central

    Birtch, Rebecca L; Baerwald, Angela R; Olatunbosun, Olufemi A; Pierson, Roger A

    2005-01-01

    Background Computer-assisted analyses were used to examine ultrasound image attributes of human dominant ovarian follicles that developed during natural and oral contraceptive (OC) cycles. We hypothesized that image attributes of natural cycle follicles would quantitatively differ from those in OC cycles and that OC cycle follicles would possess image attributes indicative of atresia. Methods Dominant ovarian follicles of 18 clinically normal women were compared using transvaginal ultrasonography for the 7 days before ovulation during a natural cycle (n = 9) or the 7 days before peak estradiol in women using OC (n = 11). Follicles were analyzed using region and line techniques designed to compare the image attributes numerical pixel value (NPV), pixel heterogeneity (PH) and area under the curve (AUC). Results NPV was higher in OC cycle follicles with region analysis and tended to be higher with line analysis (p = 0.005 and p = 0.06, respectively). No differences were observed in two other image attributes (AUC and PH), measured with either technique, between natural and OC cycle follicles. Conclusion The increased NPV value of OC cycle follicles and lack of differences in PH and AUC values between natural cycle and OC cycle follicles did not support the hypothesis that OC cycle follicles would show ultrasonographically detectable signs of atresia. Image attributes observed in OC cycle follicles were not clearly indicative of atresia nor were they large enough to preclude preovulatory physiologic status in OC cycle follicles. PMID:15829004

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

    PubMed

    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. PMID:25720656

  2. Differential effects of isoniazid and oral contraceptive steroids on antipyrine oxidation and acetaminophen conjugation.

    PubMed

    Ochs, H R; Greenblatt, D J; Verburg-Ochs, B; Abernethy, D R; Knüchel, M

    1984-01-01

    Factors influencing hepatic oxidation of antipyrine and conjugation of acetaminophen were evaluated in volunteers who received 1.0 g of antipyrine intravenously and on a different occasion a 650 mg intravenous dose of acetaminophen. In study one, subjects received both drugs in the control state and at another time during coadministration of isoniazid (INH), 180 mg daily. In control versus INH conditions, mean clearance of antipyrine was reduced from 0.67 to 0.60 ml/min/kg as was clearance of acetaminophen from 4.97 to 4.23 ml/min/kg, but these differences were not statistically significant. In study two, females on low-dose estrogen oral contraceptives (OC) and drug-free controls matched for age received both drugs. Compared to controls, OC users had reduced total clearance of antipyrine (0.71 vs. 0.50 ml/min/kg; p less than 0.005) and prolonged antipyrine t1/2 (9.6 vs. 13.3 h; p less than 0.005). For acetaminophen, however, OC users had higher clearance (5.2 vs. 6.1 ml/min/kg) and shorter t1/2 (2.2 vs. 1.9 h) although differences did not attain statistical significance. Clearance of antipyrine and acetaminophen across both studies was not statistically significantly correlated within individuals (r = 0.22). The capacities for drug oxidation and conjugation appear to be controlled by different mechanisms. PMID:6728897

  3. Thrombotic microangiopathy caused by oral contraceptives in a kidney transplant recipient.

    PubMed

    Shirai, Hiroyuki; Yashima, Jun; Tojimbara, Tamotsu; Honda, Kazuho

    2016-07-01

    Thrombotic microangiopathy (TMA) after kidney transplantation has various aetiologies, including acute antibody-mediated rejection, bacterial or viral infection and immunosuppressive drugs, particularly calcineurin inhibitors. We present the case of a 28-year-old woman who developed TMA 30 months after the transplantation of an ABO-incompatible kidney from a living unrelated donor. The patient developed a sudden onset of allograft renal dysfunction and became uremic. She was transferred to our institution from a community hospital with strongly suspected acute allograft rejection. Intensive treatments for both T- and B-cell mediated acute rejection, including steroid pulse therapy, double-filtration plasmapheresis, antithymocyte globulin (1.5 mg/kg × 14 days) and rituximab (100 mg), were initiated during haemodialysis. However, her renal allograft function did not improve. Histopathological analysis 8 days after the treatment indicated TMA, despite the absence of apparent acute T-cell- or acute antibody-mediated rejection. There were no symptoms of infectious diseases, such as intestinal haemorrhagic colitis or viral infection. We concluded that the use of oral contraceptives, which had been initiated 3 weeks before TMA onset for the treatment of irregular vaginal bleeding, was the aetiologic agent. PMID:26970708

  4. Salivary SIgA responses to acute moderate-vigorous exercise in monophasic oral contraceptive users.

    PubMed

    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. PMID:26300012

  5. Comparison of prospective daily diaries and retrospective recall to measure oral contraceptive adherence

    PubMed Central

    Huber, Larissa R. Brunner; Broel, Elizabeth C.; Mitchelides, Ashley N.; Dmochowski, Jacek; Dulin, Michael; Scholes, Delia

    2013-01-01

    BACKGROUND The purpose of this study was to determine if retrospective recall of oral contraceptive (OC) adherence provides data that are similar to data collected via daily diaries over the same time period. Factors associated with inconsistent agreement between prospective and retrospective measurements of adherence also were explored. STUDY DESIGN A total of 185 women participated in a longitudinal, prospective cohort of OC users and 113 of these women provided complete information on OC adherence during follow-ups. Concordance beyond chance was assessed using weighted kappa statistics and logistic regression was used to identify factors associated with inconsistent reporting of adherence. RESULTS There was substantial agreement between prospective and retrospective adherence information (weighted kappa=0.64; 95% CI: 0.52, 0.77). Participants with a high school education or less and those who had problems with feeling sad while using OCs had increased odds of inconsistent reporting of adherence (OR=4.38, 95% CI: 1.41, 13.61 and OR=3.52, 95% CI: 1.25, 9.94; respectively). CONCLUSION While prospective data collection via diaries may improve accuracy, the added expense and burden on study participants may not be necessary. However, the use of retrospective recall may not be appropriate for all study populations. PMID:23582236

  6. Oral Contraceptive Use and the ECG: Evidence of an Adverse QT Effect on Corrected QT Interval

    PubMed Central

    Sedlak, Tara; Shufelt, Chrisandra; Iribarren, Carlos; Lyon, Liisa L; Merz, C. Noel Bairey

    2013-01-01

    Background A prolonged corrected QT (QTc) interval is a marker for an increased risk of sudden cardiac death. We evaluated the relationship between oral contraceptive (OC) use, type of OC, and QTc interval. Methods We identified 410,782 ECGs performed at Northern California Kaiser Permanente on female patients between 15–53 years from January, 1995 to June, 2008. QT was corrected for heart rate using log-linear regression. OC generation (first, second and third) was classified by increasing progestin androgenic potency, while the fourth generation was classified as anti-androgenic. Results Among 410,782 women, 8.4% were on OC. In multivariate analysis after correction for comorbidities, there was an independent shortening effect of OCs overall (slope = −0.5ms; SE = 0.12, p<0.0002). Users of first and second generation progestins had a significantly shorter QTc than non-users (p<0.0001), while users of fourth generation had a significantly longer QTc than non-users (slope = 3.6ms, SE = 0.35, p<0.0001). Conclusion Overall, OC use has a shortening effect on the QTc. Shorter QTc is seen with first and second generation OC while fourth generation OC use has a lengthening effect on the QTc. Careful examination of adverse event rates in fourth generation OC users is needed. PMID:23879279

  7. Duration of oral contraceptive use predicts women's initial and subsequent subjective responses to sexual stimuli.

    PubMed

    Renfro, Kaytlin J; Rupp, Heather; Wallen, Kim

    2015-09-01

    Recent work suggests that a woman's hormonal state when first exposed to visual sexual stimuli (VSS) modulates her initial and subsequent responses to VSS. The present study investigated whether women's initial hormonal state was related to their subjective ratings of VSS, and whether this relationship differed with VSS content. We reanalyzed previously collected data from 14 naturally cycling (NC) women and 14 women taking oral contraceptives (OCs), who subjectively rated VSS at three hormonal time-points. NC women's ratings of 216 unique sexual images were collected during the menstrual, periovulatory, and luteal phases of their menstrual cycles, and OC women's ratings were collected at comparable time-points across their pill-cycles. NC women's initial hormonal state was not related to their ratings of VSS. OC women's initial hormonal state predicted their ratings of VSS with minimal contextual information and of images depicting female-to-male oral sex. Specifically, women who entered the study in the third week of their pill-cycle (OC-3 women) rated such images as less attractive at all testing sessions than did all other women. OC-3 women were also the only women to rate decontextualized VSS as unattractive at all testing sessions. These results corroborate previous studies in which women's initial hormonal state was found to predict subsequent interest in sexual stimuli. Future work, with larger samples, should more directly investigate whether OC-3 women's negative assessment of specific types of VSS reflects a reaction to the laboratory environment or a broader mechanism, wherein OC women's sexual interests decrease late in their pill-cycle. PMID:26204805

  8. An assessment of the quality of advice provided by patent medicine vendors to users of oral contraceptive pills in urban Nigeria

    PubMed Central

    Ujuju, Chinazo; Adebayo, Samson B; Anyanti, Jennifer; Oluigbo, Obi; Muhammad, Fatima; Ankomah, Augustine

    2014-01-01

    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 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. Conclusion 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

  9. Oral contraceptive use in women changes preferences for male facial masculinity and is associated with partner facial masculinity.

    PubMed

    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. PMID:23528282

  10. Emerging Options for Emergency Contraception

    PubMed Central

    Koyama, Atsuko; Hagopian, Laura; Linden, Judith

    2013-01-01

    Emergency post-coital contraception (EC) is an effective method of preventing pregnancy when used appropriately. EC has been available since the 1970s, and its availability and use have become widespread. Options for EC are broad and include the copper intrauterine device (IUD) and emergency contraceptive pills such as levonorgestrel, ulipristal acetate, combined oral contraceptive pills (Yuzpe method), and less commonly, mifepristone. Some options are available over-the-counter, while others require provider prescription or placement. There are no absolute contraindications to the use of emergency contraceptive pills, with the exception of ulipristal acetate and mifepristone. This article reviews the mechanisms of action, efficacy, safety, side effects, clinical considerations, and patient preferences with respect to EC usage. The decision of which regimen to use is influenced by local availability, cost, and patient preference. PMID:24453516

  11. [Time course of inhibition of caffeine elimination in response to the oral depot contraceptive agent Deposiston. Hormonal contraceptives and caffeine elimination].

    PubMed

    Meyer, F P; Canzler, E; Giers, H; Walther, H

    1991-01-01

    In the course of six months, the influence of the oral depot contraceptive, Deposiston (3 mg ethinylestradiol sulphonate and 10 mg norethisterone acetate per menstrual cycle) on the pharmacokinetics of caffeine as a model substance was studied in seven women in intraindividual comparison. The first examination began prior to administration of Deposition. The women were subjected to little challenge as saliva was used as the measuring compartment. Deposiston was found markedly delay the elimination half-life life of caffeine (p less than 0.05): t1/2 prior to therapy 4.9 +/- 2.6 h and, after as little as 2 mg ethinylestradiol sulphonate 8.0 +/- 3.5 h. In contrast to the effect observed for preparations containing less estrogen, these longer half-lives persisted throughout the trial. As expected, the AUC values were slightly elevated during this period, whereas clearance values were reduced. PMID:2058339

  12. Biotransformation of oral contraceptive ethynodiol diacetate with microbial and plant cell cultures

    PubMed Central

    2012-01-01

    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. PMID:23021311

  13. Pre-gravid oral contraceptive use and time to pregnancy: a Danish prospective cohort study

    PubMed Central

    Mikkelsen, Ellen M.; Riis, Anders H.; Wise, Lauren A.; Hatch, Elizabeth E.; Rothman, Kenneth J.; Toft Sørensen, Henrik

    2013-01-01

    STUDY QUESTION Is there an association between oral contraceptive (OC) use (age at the start of use, duration of use, ethinylestradiol dose and generation) and time to pregnancy (TTP)? SUMMARY ANSWER Although OC use was associated with a transient delay in the return of fertility, we found no evidence that long-term OC use deleteriously affects fecundability. WHAT IS KNOWN ALREADY Studies using retrospective data on TTP have reported a short-term delay in the return of fertility after OC use. However, little is known about the long-term OC use and TTP. STUDY DESIGN, SIZE, DURATION Data were derived from ‘Snart Gravid.dk’, a prospective cohort study that enrolled participants from 1 June 2007 to 31 May 2010. The final study population consisted of 3727 women. PARTICIPANTS, SETTING, METHODS Eligible women were Danish pregnancy planners, aged 18–40 years, who completed a baseline questionnaire and bimonthly follow-up questionnaires until conception or for 12 months, whichever came first. Cohort retention was 80%. We used proportional probability regression models to estimate fecundability ratios (FRs) and 95% confidence intervals (CIs), with adjustment for potential confounders. MAIN RESULTS AND ROLE OF CHANCE Compared with barrier methods, the use of OCs as the last contraception method before attempting to conceive was associated with a short-term delay in return of fertility (FR = 0.87, 95% CI: 0.79–0.96). Longer term OC use was associated with higher fecundability: compared with OC use for less than 2 years; FRs were 0.98 (95% CI: 0.83–1.15) for 2–3 years, 1.16 (95% CI: 0.98–1.37) for 4–5 years, 1.10 (95% CI: 0.93–1.29) for 6–7 years, 1.17 (95% CI: 0.99–1.38) for 8–9 years, 1.23 (95% CI: 1.04–1.46) for 10–11 years and 1.28 (95% CI: 1.07–1.53) for ≥12 years of OC use. LIMITATIONS, REASONS FOR CAUTION Because this was a non-experimental study, where study volunteers provided information about their history of contraceptive use at

  14. The 1998 Canadian Contraception Study.

    ERIC Educational Resources Information Center

    Fisher, William A.; Boroditsky, Richard; Bridges, Martha L.

    1999-01-01

    Describes the 1998 Canadian Contraception Study, a mailed survey which asked women about contraceptive practices past, present, and future (including use of oral contraceptives, condoms, and sterilization); familiarity with and opinion about different contraception methods; and general sexual and reproductive health. The paper also examines…

  15. Antigonadotropic progestogens as contraceptive agents in women with contraindication to combined pill.

    PubMed

    Maitrot-Mantelet, Lorraine; Agopian, Anahid; Gompel, Anne

    2010-12-01

    Synthetic progestogens belong to different pharmacological classes and are mixed steroids. They display different properties due to their various affinities to the different steroid receptors. In addition, the dosage used can modify their side effects. Normethyltestosterone used at minimal doses, also called progestogen only pill (POP), constitute the standard recommended hormonal contraception for women with vascular and metabolic contraindications to combined pill (COC). However, POP efficacy and gynecological tolerance are limited. We have developed for more than 20 years in France the use of two pregnane derivatives as contraceptive agents in women with contraindication to COC. Chlormadinone acetate and cyproterone acetate have different antigonadotropic potencies but remain neutral on vascular risk. We have analyzed the efficacy, vascular and gynecological tolerances in 187 women with systemic lupus erythematous with or without antiphospholipids. Venous thrombosis and arterial events rates were lower than those reported in the literature. The current experience in women with thrombophilia is similar as reported in a series of 150 patients. In addition, we have also used antigonadotropic progestins in women with hereditary angioedema (HAE) types I, II or III. HAE symptoms can be induced or worsened by COC. We could demonstrate a significant improvement of the symptoms in most women with HAE under antigonadotropic progestins. Gynecological and general tolerances were satisfactory. In conclusion, antigonadotropic progestins could have clinical positive benefits as contraceptive agents in women with contraindication to COC. PMID:25961217

  16. FDA moves to permit oral contraceptive prescriptions without initial pelvic exam.

    PubMed

    1993-05-28

    The Planned Parenthood Federation of America (PPFA) submitted recommendations to the US Food and Drug Administration's (FDA) Fertility and Maternal Health Drugs Advisory Committee. The PPFA wanted the FDA to remove requirements for a pelvic examination and blood tests before an oral contraceptive (OC) is prescribed. Two representatives of the Family Planning Council of Southeastern Pennsylvania told the FDA advisory committee about the evaluation results of its Smart Start program. 23% of teenagers wanting to use OCs opted to delay the pelvic examination, and 40% opted to delay the blood tests. 83% of these same teenagers were already sexually active. 69% returned for pelvic exams at 3 months. Increased education and counseling over several sessions probably explained why more study participants used condoms and fewer of them became pregnant during the 6-month study. Physicians from the American College of Obstetricians and Gynecologists and the American Fertility Society also attended the committee hearing and supported PPFA's recommendations. The National Women's Health Network wanted to delay the discussion until the committee could also address the sale of OCs over-the-counter. The statements convinced the committee to allow physicians to defer to full physical examination as long as there are no contraindications. This May 20, 1993 approval emphasized the need for physicians to continue taking a complete medical history and conducting other tests that may uncover contraindications (e.g. pregnancy and blood pressure). FDA staff now must write the exact language needed for the OC labeling change to be approved by the FDA commissioner. PMID:12286460

  17. Oral Contraceptive Use and Colorectal Cancer in the Nurses’ Health Study I and II

    PubMed Central

    Charlton, Brittany M.; Wu, Kana; Zhang, Xuehong; Giovannucci, Edward L.; Fuchs, Charles S.; Missmer, Stacey A.; Rosner, Bernard; Hankinson, Susan E.; Willett, Walter C.; Michels, Karin B.

    2015-01-01

    Background It remains unclear if oral contraceptive (OC) use is associated with the incidence of colorectal cancer. Few studies have examined this association by duration of OC use, time since last OC use, and different cancer subsites. Methods Among 88,691 participants of the Nurses’ Health Study I (NHSI) and 93,080 participants of the Nurses’ Health Study II (NHSII), we assessed OC use every 2 years between 1976-2010 and categorized it as ever use, duration of use, and time since last use. We included incident colorectal cancer cases through 2010 (NHSI: age at diagnosis=36-88, N=1,764, NHSII: age at diagnosis=33-64, N=206). Multivariable hazard ratios and 95% confidence intervals [HR (95% CIs)] were estimated using Cox proportional hazards regression models. Results Ever OC use was not associated with colorectal cancer in NHSI [1.01 (0.91, 1.12)] nor NHSII [1.03 (0.69, 1.53)]. In NHSII, when compared to never-users, longer durations (5+ years) of OC use were inversely associated with the risk of colon cancers (test for trend p=0.02) but the number of endpoints was limited. No other colorectal cancer subsites were associated with OC durations or times since last OC use in either cohort. Conclusions In two large prospective cohorts, we found little evidence that OC use may be protective for colorectal cancer, except potentially with longer durations of use among younger women. Impact Our results do not support the previous initial studies that reported an inverse association of recent OC use with colorectal cancer but instead support newer, larger studies demonstrating no such association. PMID:26063479

  18. Comparison of Postprandial Lipemia between Women who are on Oral Contraceptive Methods and Those who are not

    PubMed Central

    Petto, Jefferson; Vasques, Leila Monique Reis; Pinheiro, Renata Leão; Giesta, Beatriz de Almeida; dos Santos, Alan Carlos Nery; Gomes Neto, Mansueto; Ladeia, Ana Marice Teixeira

    2014-01-01

    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 (∆1) and between fasting and 240 minutes (∆2). 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 ∆1 and ∆2 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. PMID:25317941

  19. Normal vaginal microbiology of women of childbearing age in relation to the use of oral contraceptives and vaginal tampons.

    PubMed

    Morris, C A; Morris, D F

    1967-07-01

    The vaginal microbiology of women attending a family planning clinic was found to be unrelated to the use of oral contraceptives and vaginal tampons. Beta haemolytic streptococci isolated from this ;normal' population were compared with those from 1,104 women attending general practitioners complaining of vaginal discharge. There is a caution regarding the indications for antibiotic therapy. Observations were made on the effects of contamination of vaginal swabs with yeasts and beta-haemolytic streptococci from the vulva. The persistent character of the vaginal flora over a six-month period is described. PMID:5602581

  20. Osteoporosis in anorexia nervosa: the influence of peak bone density, bone loss, oral contraceptive use, and exercise.

    PubMed

    Seeman, E; Szmukler, G I; Formica, C; Tsalamandris, C; Mestrovic, R

    1992-12-01

    Anorexia nervosa occurs early in life and predisposes to osteoporosis. Exercise may be protective. We asked: (1) Does failure to attain peak bone density contribute to the deficit in bone density? (2) Does oral contraceptive use protect against osteoporosis? (3) Is any protective effect of exercise confined to weight-bearing sites? Areal bone density (g/cm2) and body composition were measured by dual x-ray absorptiometry in 65 patients with anorexia nervosa and 52 controls. Comparing the 12 patients with primary amenorrhea and the 37 patients with secondary amenorrhea, bone density (mean +/- SEM) at the lumbar spine was 0.88 +/- 0.04 versus 1.06 +/- 0.03 (P = 0.001), respectively. Bone density at the femoral neck was 0.80 +/- 0.04 versus 0.92 +/- 0.03 (P < 0.05), respectively. These values differed before, but not after, adjusting for the respective duration of illness (73.0 +/- 10.3 versus 34.1 +/- 4.8 months, P < 0.001) and fat-free mass (31.6 +/- 1.3 versus 35.4 +/- 0.5 kg, P < 0.01). Bone density at the lumbar spine in the 16 patients with 31.8 +/- 8.3 months of contraceptive exposure was higher than in the 49 patients with no contraceptive exposure (1.14 +/- 0.05 versus 1.02 +/- 0.02 P < 0.02) but was lower than in controls (1.14 +/- 0.05 versus 1.27 +/- 1.02, P < 0.01). No protective effect of contraceptive exposure was detectable at the femoral neck.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1481732

  1. Meeting Rural Demand: A Case for Combining Community-Based Distribution and Social Marketing of Injectable Contraceptives in Tigray, Ethiopia

    PubMed Central

    Prata, Ndola; Weidert, Karen; Fraser, Ashley; Gessessew, Amanuel

    2013-01-01

    Background In Sub-Saharan Africa, policy changes have begun to pave the way for community distribution of injectable contraceptives but sustaining such efforts remains challenging. Combining social marketing with community-based distribution provides an opportunity to recover some program costs and compensate workers with proceeds from contraceptive sales. This paper proposes a model for increasing access to injectable contraceptives in rural settings by using community-based distributers as social marketing agents and incorporating financing systems to improve sustainability. Methods This intervention was implemented in three districts of the Central Zone of Tigray, Ethiopia and program data has been collected from November 2011 through October 2012. A total of 137 Community Based Reproductive Health Agents (CBRHAs) were trained to provide injectable contraceptives and were provided with a loan of 25 injectable contraceptives from a drug revolving fund, created with project funds. The price of a single dose credited to a CBRHA was 3 birr ($0.17) and they provide injections to women for 5 birr ($0.29), determined with willingness-to-pay data. Social marketing was used to create awareness and generate demand. Both quantitative and qualitative methods were used to examine important feasibility aspects of the intervention. Results Forty-four percent of CBRHAs were providing family planning methods at the time of the training and 96% believed providing injectable contraceptives would improve their services. By October 2012, 137 CBRHAs had successfully completed training and provided 2541 injections. Of total injections, 47% were provided to new users of injectable contraceptives. Approximately 31% of injections were given for free to the poorest women, including adolescents. Conclusions Insights gained from the first year of implementation of the model provide a framework for further expansion in Tigray, Ethiopia. Our experience highlights how program planners can

  2. Depo-Provera in adolescents: effects of early second injection or prior oral contraception.

    PubMed

    Harel, Z; Biro, F M; Kollar, L M

    1995-05-01

    The capability of an early second injection or prior use of oral contraceptives (OCs) to improve satisfaction and long-term continuation of Depo-Provera in adolescents was investigated in a clinical trial involving 78 females 12-20 years of age (average, 15.9 years) recruited from a hospital-based adolescent health clinic. 36 subjects received injection of 150 mg of Depo-Provera every three months (Group 1), 27 received the second injection after only six weeks (Group 2), and 15 switched directly from OCs to the standard Depo-Provera regimen (Group 3). There was no difference between Groups 1 and 2 in terms of duration or frequency of menstrual bleeding; however, prior OC users experienced a significant reduction in the duration and intensity of bleeding in the first six months of Depo-Provera use (when estrogen was still present in the women's systems). Overall, 64% of study subjects reported less dysmenorrhea while on Depo-Provera. A slightly greater change in body mass index was observed among girls in Group 2 than in Groups 1 and 3; moreover, 70% of those in the early injection group reported increased appetite and weight gain compared to 39% of those on the standard schedule. The most commonly reported side effects included initial pain and soreness at the injection site (27%), decreased libido (56%), mood changes (31%), depression (26%), frequent headache (25%), fatigue (24%), and increase in acne (15%); there were no significant differences by group. 17 adolescents (22%) discontinued Depo-Provera, generally after two injections and due to bleeding irregularities or weight gain. 87% of adolescents who were prior OC users, 52% of those on the regular schedule, and 39% of those who received an early injection stated they were very satisfied with Depo-Provera. These findings indicate that early second Depo-Provera injection offers no advantages; use of OCs immediately prior to Depo-Provera should be further investigated, however, given its potential to minimize

  3. Low dosage monophasic oral contraceptive use and intermittent exercise performance and metabolism in humans.

    PubMed

    Lynch, N J; De Vito, G; Nimmo, M A

    2001-04-01

    Nine untrained women using low dosage monophasic oral contraceptives (OC) performed an intermittent treadmill test on two different occasions within one pill-cycle to determine the effect of OC on performance and some commonly used metabolic markers. The first test was performed after 5-8 days of resuming the OC agents after menstrual bleeding while the other test was performed after 19-21 days. Performance time on the final exhausting run of six intermittent high intensity 20 s runs was no different between trials [mean days 5-8: 22.3 (SEM 1.2) s vs days 19-21: 22.7 (SEM 1.1) s]. There was no difference in heart rate [peak heart rate days 5-8: 183 (SEM 3) beats.min-1 vs days 19-21: 186 (SEM 2) beats.min-1], oxygen consumption during any run [run 5 of days 5-8: 1,392 (SEM 51) ml.min-1 vs run 5 of days 19-21: 1,494 (SEM 3) ml.min-1] or in any of the metabolic variables measured at any time in venous blood [peak blood lactate concentration days 5-8: 8.4 (SEM 0.3) mmol.l-1 vs days 19-21: 8.1 (SEM 0.5) mmol.l-1; peak blood glycerol concentration days 5-8: 0.39 (SEM 0.02) mmol.l-1 vs days 19-21: 0.38 (SEM 0.02) mmol.l-1; resting free fatty acids concentration days 5-8: 0.25 (SEM 0.05) mmol.l-1 vs days 19-21: 0.29 (SEM 0.07) mmol.l-1; peak blood glucose concentration days 5-8: 6.7 (SEM 0.5) mmol.l-1 vs days 19-21: 6.6 (SEM 0.2) mmol.l-1; peak capillary blood ammonia concentration days 5-8: 139 (SEM 18.3) mumol.l-1 vs days 19-21: 170 (SEM 18.0) mumol.l-1]. These results suggest neither intermittent high intensity exercise performance nor energy metabolism change between days 5-8 and days 19-21 of a low dosage monophasic OC pill during one pill-cycle. PMID:11374113

  4. [Improving oral contraception compliance. The "ringing card": memory aid or new ritual?].

    PubMed

    Lachowsky, M; Levy-Toledano, R

    2000-04-01

    compliance card is an easy and reliable device that improves the compliance of women using oral contraceptives by helping them to establish a ritual. PMID:10859894

  5. Correcting oral contraceptive pharmacokinetic alterations due to obesity. A randomized controlled trial

    PubMed Central

    Edelman, Alison B; Cherala, Ganesh; Munar, Myrna Y.; McInnis, Martha; Stanczyk, Frank Z.; Jensen, Jeffrey T

    2014-01-01

    Objective To determine if increasing the hormone dose or eliminating the hormone-free interval improves key pharmacokinetic (PK) alterations caused by obesity during oral contraceptive (OC) use. Study design Obese (BMI ≥ 30 kg/m2), ovulatory, otherwise healthy, women received an OC containing 20 mcg ethinyl estradiol (EE)/100 mcg levonorgestrel (LNG) dosed cyclically (21 days active pills with 7-day placebo week) for two cycles and then were randomized for two additional cycles to: Continuous Cycling [CC, a dose neutral arm using the same OC with no hormone-free interval] or Increased Dose [ID, a dose escalation arm using an OC containing 30 mcg EE/150 mcg LNG cyclically]. During Cycle 2, 3, and 4, outpatient visits were performed to assess maximum serum concentration (Cmax), area under the curve (AUC0-∞), and time to steady state as well as pharmacodynamics. These key PK parameters were calculated and compared within groups between baseline and treatment cycles. Results A total of 31 women enrolled and completed the study (CC group n = 16; ID group n = 15). Demographics were similar between groups [mean BMI: CC 38kg/m2 (SD 5.1), ID 41kg/m2 (SD 7.6)]. At baseline, the key LNG PK parameters were no different between groups; average time to reach steady-state was 12 days in both groups; Cmax were CC: 3.82 ± 1.28 ng/mL and ID: 3.13 ± 0.87 ng/mL; and AUC0-∞ were CC: 267 ± 115 hr*ng/mL and ID: 199±75 hr*ng/mL. Following randomization, the CC group maintained steady-state serum levels whereas the ID group had a significantly higher Cmax (p< 0.001) but again required 12 days to achieve steady-state. However, AUC was not significantly different between CC (412 ± 255 hr*ng/mL) and ID (283 ± 130 hr*ng/mL). Forty-five percent (14/31) of the study population had evidence of an active follicle-like structure prior to randomization and afterwards this decreased to 9% (3/31). Conclusion Both increasing the OC dose and continuous dosing appear to counteract the impact

  6. [Frequency and reasons for switching/stopping use of oral contraceptives. Results of the German Cohort Study on Women Health].

    PubMed

    Heinemann, L A; Thiel, C; Assmann, A; Möhner, S

    2001-10-01

    Frequency and reasons for switching/stopping use of oral contraceptives. Results of the German Cohort Study on Women Health. Use of oral contraceptives is the safest and most commonly used method of contraception. The frequency of use underscores the importance of research on benefits, risks, and acceptability of long-term use. - An interim analysis of the German Cohort Study on Women's Health (aged 15-65 years) was performed to analyse frequency and reason of switching or stop of OC-use. We got for this analysis over 10 000 women with almost 100 000 years of observation from first to last (or current) OC use. - The prevalence of ever use of OCs was 85.5 % in our cohort. Switching or stop of OC use was observed in 93 % of the women. The frequency of switching increased with age and duration of use. Social parameter such as education, employment status, and living in the old or the new Federal States were not materially associated with the frequency of switching or stopping OC use. Satisfaction with general health, psychic stability, and sexual life was slightly associated with the frequency of switching: The better satisfaction the lower frequency of switching, but the sequence of cause and consequence is unclear. The most frequent categories of reasons for switching were observed side effects and personal reasons. Desire to get pregnant was the number one single reason, followed by headache/migraine, and bleeding problems. The frequency of more than 50 single reasons is listed. - The frequency and the knowledge of reason for switching or stopping OC use underlines the need for a good collaboration between physician and treated woman. However, also research on long-term compliance is required and the development of OCs with even less side effects. PMID:11753811

  7. Controversies in contraception for women with epilepsy

    PubMed Central

    Thomas, Sanjeev V.

    2015-01-01

    Contraception is an important choice that offers autonomy to women with regard to prevention of unintended pregnancies. There is wide variation in the contraceptive practices between continents, countries, and societies. The medical eligibility for contraception for sexually active women with epilepsy (WWE) is determined by the type of anti-epileptic drugs (AEDs) that they use. Enzyme inducing AEDs such as phenobarbitone, phenytoin, carbamazepine, and oxcarbazepine increase the metabolism of orally administered estrogen (and progesterone to a lesser extent). Estrogen can increase the metabolism of certain AEDs, such as lamotrigine, leading to cyclical variation in its blood level with resultant adverse effect profile or seizure dyscontrol. AEDs and sex hormones can increase the risk of osteoporosis and fracture in WWE. The potential interactions between AEDs and hormonal contraception need to be discussed with all women in reproductive age-group. The alternate options of oral contraception such as intrauterine copper device, intrauterine levonorgestrel release system, and supplementary protection with barriers need to be presented to them. World Health Organization has recommended to avoid combination contraceptive pills containing estrogen and progesteron in women who desire contraception and in breastfeeding mothers. Care providers need to consider the option of non-enzyme-inducing AEDs while initiating long-term treatment in adolescent and young WWE. PMID:26425002

  8. Controversies in contraception for women with epilepsy.

    PubMed

    Thomas, Sanjeev V

    2015-01-01

    Contraception is an important choice that offers autonomy to women with regard to prevention of unintended pregnancies. There is wide variation in the contraceptive practices between continents, countries, and societies. The medical eligibility for contraception for sexually active women with epilepsy (WWE) is determined by the type of anti-epileptic drugs (AEDs) that they use. Enzyme inducing AEDs such as phenobarbitone, phenytoin, carbamazepine, and oxcarbazepine increase the metabolism of orally administered estrogen (and progesterone to a lesser extent). Estrogen can increase the metabolism of certain AEDs, such as lamotrigine, leading to cyclical variation in its blood level with resultant adverse effect profile or seizure dyscontrol. AEDs and sex hormones can increase the risk of osteoporosis and fracture in WWE. The potential interactions between AEDs and hormonal contraception need to be discussed with all women in reproductive age-group. The alternate options of oral contraception such as intrauterine copper device, intrauterine levonorgestrel release system, and supplementary protection with barriers need to be presented to them. World Health Organization has recommended to avoid combination contraceptive pills containing estrogen and progesteron in women who desire contraception and in breastfeeding mothers. Care providers need to consider the option of non-enzyme-inducing AEDs while initiating long-term treatment in adolescent and young WWE. PMID:26425002

  9. [Contraception in immigrant women: influence of sociocultural aspects on the choice of contraceptive method].

    PubMed

    Paraíso Torras, B; Maldonado Del Valle, M D; López Muñoz, A; Cañete Palomo, M L

    2013-01-01

    There are currently 6 million immigrants living in Spain. Half of them are women, the majority of whom are of childbearing age. These women, who suffer high rates of induced abortion, form a special group who require a special approach to their reproductive health. In order to study the use of contraceptive methods in this population, a review was made of 1100 clinical histories from our Sexual Health and Reproduction Clinic. Latin American women were the most prevalent group who came to seek information about contraception, followed by Eastern Europeans and Moroccans. Fewer Asian and Sub-Saharan women sought these services. The contraceptives most frequently used were the intrauterine device (used mostly by Latin American and Eastern European women), and combined oral contraception, most used by Moroccan women. It is important to advise the immigrant women about contraceptive methods, taking into account their preferences, in order to improve adherence to the method. PMID:23583187

  10. Contraception today.

    PubMed

    Benagiano, Giuseppe; Bastianelli, Carlo; Farris, Manuela

    2006-12-01

    Modern contraceptive methods represent more than a technical advance: they are the instrument of a true social revolution-the "first reproductive revolution" in the history of humanity, an achievement of the second part of the 20th century, when modern, effective methods became available. Today a great diversity of techniques have been made available and-thanks to them, fertility rates have decreased from 5.1 in 1950 to 3.7 in 1990. As a consequence, the growth of human population that had more than tripled, from 1.8 to more than 6 billion in just one century, is today being brought under control. At the turn of the millennium, all over the world, more than 600 million married women are using contraception, with nearly 500 million in developing countries. Among married women, contraceptive use rose in all but two developing countries surveyed more than once since 1990. Among unmarried, sexually active women, it grew in 21 of 25 countries recently surveyed. Hormonal contraception, the best known method, first made available as a daily pill, can today be administered through seven different routes: intramuscularly, intranasally, intrauterus, intravaginally, orally, subcutaneously, and transdermally. In the field of oral contraception, new strategies include further dose reduction, the synthesis of new active molecules, and new administration schedules. A new minipill (progestin-only preparation) containing desogestrel has been recently marketed in a number of countries and is capable of consistently inhibiting ovulation in most women. New contraceptive rings to be inserted in the vagina offer a novel approach by providing a sustained release of steroids and low failure rates. The transdermal route for delivering contraceptive steroids is now established via a contraceptive patch, a spray, or a gel. The intramuscular route has also seen new products with the marketing of improved monthly injectable preparations containing an estrogen and a progestin. After the first

  11. Frovatriptan vs. other triptans for the acute treatment of oral contraceptive-induced menstrual migraine: pooled analysis of three double-blind, randomized, crossover, multicenter studies.

    PubMed

    Allais, G; Tullo, V; Omboni, S; Pezzola, D; Zava, D; Benedetto, C; Bussone, G

    2013-05-01

    Oral contraceptive-induced menstrual migraine (OCMM) is a particularly severe form of migraine triggered by the cyclic hormone withdrawal. To review the efficacy of frovatriptan vs. other triptans, in the acute treatment of OCMM through a pooled analysis of three individual randomized Italian studies. With or without aura migraineurs were randomized to frovatriptan 2.5 mg or rizatriptan 10 mg (study 1), frovatriptan 2.5 mg or zolmitriptan 2.5 mg (study 2), frovatriptan 2.5 mg or almotriptan 12.5 mg (study 3). All studies had a multicenter, randomized, double-blind, crossover design. After treating 1-3 episodes of migraine in 3 months with the first treatment, patients switched to the other treatment for the next 3 months. In this analysis, the subset of 35 of the 280 women of the intention-to-treat population taking combined oral contraceptives and experiencing a migraine attack during the withdrawal phase, were analyzed. The proportion of pain free and pain relief at 2 h were 25 and 51 % with frovatriptan and 28 and 48 % with comparators (p = NS). At 24 h, 71 and 83 % of frovatriptan-treated patients and 60 and 76 % of comparator-treated patients were pain free (p < 0.05 between treatments) and had pain relief (p = NS), respectively. Relapse at 24 and 48 h was significantly (p < 0.05) lower with frovatriptan (17 and 21 %) than with the comparators (27 and 31 %). Our results suggest that, due to its sustained antimigraine effect, frovatriptan may be particularly suitable for the management of OCMM than other triptans. PMID:23695052

  12. [Contraception news].

    PubMed

    Vincent-Rohfritsch, A; Pernin, E; Chabbert-Buffet, N

    2012-04-01

    Although contraception is widely available in France, contraceptive failure remains high. However a number of modifications in contraceptive methods have been developed and should help reduce contraceptive failure. Among those, information and improvement of access to contraception are very important. Recent advances in contraceptive practice have also contributed to improve clinical tolerance and subsequently compliance. Finally, emergency contraception has evolved as well. PMID:22079029

  13. Emergency contraception with a Copper IUD or oral levonorgestrel: an observational study of 1-year pregnancy rates

    PubMed Central

    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

  14. A New Combination of Testosterone and Nestorone Transdermal Gels for Male Hormonal Contraception

    PubMed Central

    Ilani, Niloufar; Roth, Mara Y.; Amory, John K.; Swerdloff, Ronald S.; Dart, Clint; Page, Stephanie T.; Bremner, William J.; Sitruk-Ware, Regine; Kumar, Narender; Blithe, Diana L.

    2012-01-01

    Context: Combinations of testosterone (T) and nestorone (NES; a nonandrogenic progestin) transdermal gels may suppress spermatogenesis and prove appealing to men for contraception. Objective: The objective of the study was to determine the effectiveness of T gel alone or combined with NES gel in suppressing spermatogenesis. Design and Setting: This was a randomized, double-blind, comparator clinical trial conducted at two academic medical centers. Participants: Ninety-nine healthy male volunteers participated in the study. Interventions: Volunteers were randomized to one of three treatment groups applying daily transdermal gels (group 1: T gel 10 g + NES 0 mg/placebo gel; group 2: T gel 10 g + NES gel 8 mg; group 3: T gel 10 g + NES gel 12 mg). Main Outcome Variable: The main outcome variable of the study was the percentage of men whose sperm concentration was suppressed to 1 million/ml or less by 20–24 wk of treatment. Results: Efficacy data analyses were performed on 56 subjects who adhered to the protocol and completed at least 20 wk of treatment. The percentage of men whose sperm concentration was 1 million/ml or less was significantly higher for T + NES 8 mg (89%, P < 0.0001) and T + NES 12 mg (88%, P = 0.0002) compared with T + NES 0 mg group (23%). The median serum total and free T concentrations in all groups were maintained within the adult male range throughout the treatment period. Adverse effects were minimal in all groups. Conclusion: A combination of daily NES + T gels suppressed sperm concentration to 1 million/ml or less in 88.5% of men, with minimal adverse effects, and may be further studied as a male transdermal hormonal contraceptive. PMID:22791756

  15. Contraception and Diabetes.

    PubMed

    Afsana, Faria

    2016-09-01

    Contraception for women with diabetes mellitus is an important issue mainly as the pregnancy outcome depends on glycaemic control before conception among women with diabetes. Type of diabetes as type 1 or type 2 Diabetes, women with history of gestational diabetes and breast feeding diabetic mothers may be a consideration in selecting a contraceptive .On the other hand presence of diabetic complications is a significant determinant. Different methods of contraception as oral, injectable, implant, intrauterine devices are available. Patient\\'s choice and health issues both should be considered while prescribing a contraceptive to a woman with diabetes. Emergency contraception is sometimes required in situations where there is chance of contraceptive failure. This review article highlights different contraceptive methods, their use and limitations and will guide to make a rational choice for a woman with diabetes. PMID:27582166

  16. CONTRACEPTION TECHNOLOGY: PAST, PRESENT AND FUTURE

    PubMed Central

    Sitruk-Ware, Regine; Nath, Anita; Mishell, Daniel R.

    2012-01-01

    Steady progress in contraception research has been achieved over the past 50 years. Hormonal and non-hormonal modern contraceptives have improved women’s lives by reducing different health conditions that contributed to considerable morbidity. However the contraceptives available today are not suitable to all users and the need to expand contraceptive choices still exists. Novel products such as new implants, contraceptive vaginal rings, transdermal patches and newer combinations of oral contraceptives have recently been introduced in family planning programs and hormonal contraception is widely used for spacing and limiting births. Concerns over the adverse effects of hormonal contraceptives have led to research and development of new combinations with improved metabolic profile. Recent developments include use of natural compounds such as estradiol (E2) and estradiol valerate (E2V) with the hope to decrease thrombotic risk, in combination with newer progestins derived from the progesterone structure or from spirolactone, in order to avoid the androgenic effects. Progesterone antagonists and progesterone receptor modulators are highly effective in blocking ovulation and preventing follicular rupture and are undergoing investigations in the form of oral pills and in semi long-acting delivery systems. Future developments also include the combination of a contraceptive with an antiretroviral agent for dual contraception and protection against sexually transmitted diseases, to be used before intercourse or on demand, as well as for continuous use in dual-protection rings. Alhough clinical trials of male contraception have reflected promising results, limited involvement of industry in that area of research has decreased the likelihood of having a male method available in the current decade. Development of non-hormonal methods are still at an early stage of research, with the identification of specific targets within the reproductive system in ovaries and testes, as

  17. [Forgetting hormonal contraceptive methods: expert opinion about their daily management in clinical routine practice].

    PubMed

    Jamin, C; André, G; Audebert, A; Christin-Maître, S; Elia, D; Harvey, T; Letombe, B; Lopes, P; Moreau, C; Nisand, I; Pélissier, C

    2011-11-01

    Many guidelines regarding the daily management of regular oral hormonal contraceptive methods have been proposed worldwide. Some of them may even appear to be conflicting. The search for the maximal contraceptive protection leads to a low acceptance of these guidelines, probably because of their complexity and their apparent discrepancy. We are deeply convinced that simplicity and pragmatism of guidelines should pave the way to both their better acceptance and compliance and, consequently, to their improved real-life effectiveness. We have considered physiology and pharmacodynamics before proposing the following rules for an effective management of hormonal contraceptive failures. We conclude that the risk of unwanted pregnancy is higher in case of a unique contraception misuse/a delayed start during the first week of the contraceptive cycle (or in case of multiple days of contraceptive misuses during the following weeks) for a combined contraception or at every cycle day for a non anti-ovulatory progestin only contraception. In such risky situations, we firmly recommend the restart of the regular contraceptive method and the use of condoms for the following 72 hours, provided no sexual intercourse has occurred during the past 5 days before the contraceptive failure. If sexual intercourse has occurred during the past 5 days before the contraceptive failure, we firmly recommend the intake of an emergency contraception, ulipristal acetate, the restart the regular contraceptive method and in this case, the use of condoms for, at least, the following 7 days. PMID:22000833

  18. A prospective study of a monophasic oral contraceptive containing 30 mcg ethinyl oestradiol and 150 mcg desogestrel (Marvelon).

    PubMed

    Ismail, M T

    1994-06-01

    Marvelon, a monophasic oral contraceptive (OC) containing 30 mcg of ethinyl estradiol and 150 mcg of desogestrel, has been available to Malaysian women through the national family planning program since 1982. To assess the safety, effectiveness, and side effects associated with this OC, 247 women who requested the pill were enrolled in a multicenter prospective study that included follow-up after the first, third, and sixth cycles of use. 81% of participants had never used any form of contraception before Marvelon. 194 women (79%) completed the 6-month study. There were no pregnancies recorded. Although women reported a slightly increased incidence of nausea, breast tenderness, and headache in the first treatment cycle, these side effects had abated by the end of the third cycle. After six cycles, mean body weight had decreased by an average of 0.4 kg. Both systolic and diastolic blood pressure were unaffected. An unexpected finding was a decrease in the severity of acne with continuous use of Marvelon. Although both spotting and breakthrough bleeding increased slightly in the first two cycles, irregular bleeding returned to pretreatment levels by the third cycle. The length of the withdrawal bleed in the pill-free week was reduced. The incidence of irregular bleeding and other side effects was substantially lower in this sample of Malaysian women than in Asian and Caucasian Marvelon users surveyed in other studies. PMID:12320338

  19. Increased risk of stroke in oral contraceptive users carried replicated genetic variants: a population-based case-control study in China.

    PubMed

    Wang, Chun; Li, Ying; Li, Huiqiao; Sun, Tao; Jin, Guangfu; Sun, Zhiming; Zhou, Jian; Ba, Lei; Huang, Zhizheng; Bai, Jianling

    2012-08-01

    Combined oral contraceptives (COC) use is a unique risk factor for stroke in women, and may modify the associations between genetic polymorphisms and stroke. To investigate whether the genetic variants identified in a recent genome-wide association study (GWAS) could be replicated in Chinese women, as well as, whether related risk was different in COC users, 451 stroke cases and 831 age- and region-matched controls were recruited from our cohort. Genotyping of 3 SNPs (rs700651, rs10958409, and rs1333040) was performed by the polymerase chain reaction assay with TaqMan probes. The history of contraceptive use and relevant information were obtained from a face-to-face interview. Odds ratios (OR) with 95 % confidence interval (CI) were estimated under conditional logistic regression model after adjustment for cardiovascular covariates. Our study replicated the associations of rs10958409 and rs1333040, with the risk of stroke, especially hemorrhagic subtype, but failed to confirm association of rs700651. COC use was associated with a 1.56-fold (OR 1.56, 95 % CI 1.21-2.01) increased risk of stroke. COC users with rs10958409 GA/AA or rs1333040 CT/TT genotypes had an increased risk of overall stroke by 1.59-fold (OR 2.59, 95 % CI 1.59-4.19) and 3.24-fold (OR 4.24, 95 % CI 1.71-10.49), respectively, compared with the non-users with wild-type genotypes. Moreover, the risk of hemorrhagic stroke increased by 4.81- and 15.06-fold when risk allele carriers of rs10958409 or rs1333040 who took COC. Our results confirmed the associations of two GWAS SNPs, also suggested combination effects of these genetic variants and COC use on stroke risk. PMID:22476622

  20. Contraception for the HIV-Positive Woman: A Review of Interactions between Hormonal Contraception and Antiretroviral Therapy

    PubMed Central

    Robinson, Jennifer A.; Jamshidi, Roxanne; Burke, Anne E.

    2012-01-01

    Background. Preventing unintended pregnancy in HIV-positive women can significantly reduce maternal-to-child HIV transmission as well as improve the woman's overall health. Hormonal contraceptives are safe and effective means to avoid unintended pregnancy, but there is concern that coadministration of antiretroviral drugs may alter contraceptive efficacy. Materials and Methods. We performed a literature search of PubMed and Ovid databases of articles published between January 1980 and February 2012 to identify English-language reports of drug-drug interactions between hormonal contraceptives (HCs) and antiretroviral drugs (ARVs). We also reviewed the FDA prescribing information of contraceptive hormone preparations and antiretrovirals for additional data and recommendations. Results. Twenty peer-reviewed publications and 42 pharmaceutical package labels were reviewed. Several studies of combined oral contraceptive pills (COCs) identified decreased serum estrogen and progestin levels when coadministered with certain ARVs. The contraceptive efficacy of injectable depot medroxyprogesterone acetate (DMPA) and the levonorgestrel intrauterine system (LNG-IUS) were largely unaffected by ARVs, while data on the contraceptive patch, ring, and implant were lacking. Conclusions. HIV-positive women should be offered a full range of hormonal contraceptive options, with conscientious counseling about possible reduced efficacy of COCs and the contraceptive implant when taken with ARVs. DMPA and the LNG-IUS maintain their contraceptive efficacy when taken with ARVs. PMID:22927715

  1. [Hemoperitoneum caused by rupture of a benign tumor of the liver in women taking oral contraceptives. 2 cases].

    PubMed

    Nicodeme, J P; Levy, J B; Gendrel, T; Costet, H; Prestat, J; Reynes, M; James, J M

    1976-06-01

    2 cases of rupture of benign liver tumors in women who had received oral contraceptive (OC) treatment for over 7 years are reported. Although the number of cases of benign liver tumor is very small, it has been increasing in recent years. The role of OCs in determining them is still unproven, and the risk appears to be extremely low (between 1 in 500,000 and 1 in 1,000,000); however, it is possible that favor the growth of preexisting lesions or the occurrence of rupture with hemorrhages. It is concluded that the possibility of such cases must be considered by physicians, and that early detection and surgery are required in order to remove the tumor before its rupture and consequent hemorrhage. PMID:934872

  2. Emergency Contraception.

    PubMed

    Batur, Pelin; Kransdorf, Lisa N; Casey, Petra M

    2016-06-01

    Emergency contraception (EC) may help prevent pregnancy in various circumstances, such as contraceptive method failure, unprotected sexual intercourse, or sexual assault, yet it remains underused. There are 4 approved EC options in the United States. Although ulipristal acetate requires a provider's prescription, oral levonorgestrel (LNG) is available over the counter for women of all ages. The most effective method of EC is the copper intrauterine device, which can be left in place for up to 10 years for efficacious, cost-effective, hormone-free, and convenient long-term primary contraception. Ulipristal acetate tends to be more efficacious in pregnancy prevention than is LNG, especially when taken later than 72 hours postcoitus. The mechanism of action of oral EC is delay of ovulation, and current evidence reveals that it is ineffective postovulation. Women who weigh more than 75 kg or have a body mass index greater than 25 kg/m(2) may have a higher risk of unintended pregnancy when using oral LNG EC; therefore, ulipristal acetate or copper intrauterine devices are preferable in this setting. Providers are often unaware of the range of EC options or are unsure of how to counsel patients regarding the access and use of EC. This article critically reviews current EC literature, summarizes recommendations, and provides guidance for counseling women about EC. Useful tips for health care providers are provided, with a focus on special populations, including breast-feeding women and those transitioning to long-term contraception after EC use. When treating women of reproductive age, clinicians should be prepared to counsel them about EC options, provide EC appropriately, and, if needed, refer for EC in a timely manner. PMID:27261868

  3. Emergency contraception.

    PubMed

    Gold, M A

    2000-01-01

    High rates of adolescent pregnancy remain a challenge for health care providers. For most sexually active adolescents, pregnancy is unintended. Emergency contraception, also called the "morning-after-pill" or postcoital contraception, is a way to prevent pregnancy after unprotected intercourse. In the United States, three forms of emergency contraception currently are available: high-dose combination estrogen and progestin pills, high-dose progestin-only pills, and postcoital insertion of a copper intrauterine device. The postcoital intrauterine device is used infrequently. When emergency contraceptive pills (ECPs) are taken within 72 hours of unprotected intercourse, they reduce the risk of pregnancy by at least 75%. However, they are most effective if taken within 24 hours of coitus. Eleven brands of pills currently are marketed in the United States that conform to the regimens approved by the Food and Drug Administration (FDA) for this indication. Recently, two prepackaged ECPs were approved by the FDA. The only medical contraindication to prescribing ECPs is pregnancy. The most common side effects are nausea and vomiting, followed by menstrual disturbances, breast tenderness, abdominal cramping, dizziness, headache, and mood changes. Because vomiting can compromise the efficacy of ECPs, routine pretreatment with an antiemetic is recommended. Primary care providers can reduce unintended adolescent pregnancy by routinely counseling adolescents at all office visits about the existence of emergency contraception and by prescribing it in advance and over the telephone. PMID:10959448

  4. The effects of steroidal contraceptives on the well-being and sexuality of women: a double-blind, placebo-controlled, two-centre study of combined and progestogen-only methods.

    PubMed

    Graham, C A; Ramos, R; Bancroft, J; Maglaya, C; Farley, T M

    1995-12-01

    A placebo-controlled, double-blind study was carried out to assess the direct hormonal effects of combined and progestogen-only oral contraceptives on well-being and sexuality of women in two contrasting cultures. One-hundred-fifty women, who had been sterilised or whose partners had been vasectomised, were recruited from two centres-Manila, Philippines, and Edinburgh, Scotland. After one month pretreatment assessment, women were randomly assigned to one of three treatments (combined oral contraceptive (COC), progestogen-only pill (POP), or placebo; 50 within each treatment group, 25 per centre) and continued on treatment for four months. Assessment was by daily ratings, questionnaires and interviews. The COC adversely affected sexuality in the Edinburgh women, with 12 of the 25 women in this group also reporting the side effect of reduced sexual interest. There were modest negative effects of the combined pill on mood, more noticeable in the Edinburgh women. The POP was associated with no adverse effects on sexuality and some improvement in well-being in both centres. Possible explanations for the apparent lack of adverse effects in the Manila women are discussed. The negative effects reported may be less evident in women using the COC for contraceptive purposes but may lead to discontinuation in some women and warrant further investigation. PMID:8749600

  5. Contraception and Breastfeeding.

    PubMed

    Pieh Holder, Kelly Lynne

    2015-12-01

    Postpartum contraception is important to lengthening birth intervals and improving the health of women and children. For breastfeeding women the choice and timing of contraception may influence breastfeeding and infant growth patterns. Nonhormonal methods of contraception are the preferred choice for breastfeeding women. Progestin-only methods comprise a viable next option. Combined hormonal methods of contraception containing estrogen and progestin may be considered as a third option for birth control in breastfeeding women. The objective of this chapter is to review the current literature and recommendations for the use of hormonal and nonhormonal methods of contraception while breastfeeding. PMID:26457854

  6. Single, Escalating Dose Pharmacokinetics, Safety and Food Effects of a New Oral Androgen Dimethandrolone Undecanoate in Man: A prototype oral male hormonal contraceptive

    PubMed Central

    Swerdloff, Ronald S.; Nya-Ngatchou, Jean Jacques; Liu, Peter Y.; Amory, John K.; Leung, Andrew; Hull, Laura; Blithe, Diana L.; Woo, Jason; Bremner, William J.; Wang, Christina

    2014-01-01

    The novel androgen, dimethandrolone (DMA) has both androgenic and progestational activities, properties that may maximize gonadotropin suppression. We assessed the pharmacokinetics of dimethandrolone undecanoate (DMAU), an orally bioavailable, longer-acting ester of DMA, for male contraceptive development. Our objective was to examine the safety and pharmacokinetics of single, escalating doses of DMAU (powder in capsule formulation) administered orally with or without food in healthy men. We conducted a randomized, double-blind Phase 1 study. For each dose of DMAU (25 to 800 mg), ten male volunteers received DMAU and two received placebo at two academic medical centers. DMAU was administered both fasting and after a high fat meal (200–800 mg doses). Serial serum samples were collected over 24h following each dose. DMAU was well tolerated without significant effects on vital signs, safety laboratory tests or electrocardiograms. When administered while fasting, serum DMA (active compound) was detectable in only 4/10 participants after the 800mg dose. When administered with a 50% fat meal, serum DMA was detectable in all participants given 200mg DMAU and showed a dose-incremental increase up to 800mg, with peak levels 4 to 8h after taking the dose. Serum gonadotropins and sex hormone concentrations were significantly suppressed 12h after DMAU administration with food at doses above 200mg. This first-in-man study demonstrated that a single, oral dose of DMAU up to 800 mg is safe. A high-fat meal markedly improved DMAU/DMA pharmacokinetics. PMID:24789057

  7. [Contraceptive pancreopathy].

    PubMed

    Riederer, J

    1973-01-26

    In a private practice an increasing number of young women or girls are being observed with sudden onset of acute stomach pains of unknown origin. Clinically the pancreas is sensitive to pressure and there is an alpha-amylase elevation in the urine often accompanied by moderate leukocytosis. A slight elevation of the transaminase count is usual in such cases. There are no indications of alchohol abuse or pancreatic disorders in the anamnese and x-rays reveal an adequately functionning gall bladder without stones. Without exception all the women have been on oral contraceptives. With spasmolytics and a diet low in fats the symptoms disappear, often without discontinuation of the contraceptive. More data are needed on this problem, and prospective research should determine which additional factors must be present for the activation of such pancreatic disorders. PMID:4684016

  8. [Choosing contraception for adolescents].

    PubMed

    Wemeau-jacquemont, C

    1985-02-01

    Earlier and more frequent sexual activity and the significant risk of pregnancy have increased the need for contraception among young adolescent girls. The problem for the physician is to choose a contraceptive method which will not affect future fertility or the psychological and biological maturity of adolescents. Condoms, diaphragms, and spermicides are quite effective if used correctly; they have no deleterious side effects, and they provide protection against sexually transmitted diseases. They appear to be well-adapted to the sporadic sexual activity of adolescents. The efficacy of combined oral contraceptives (OCs) is also high. Side effects depend on the synthetic estrogen component and are dose dependent. Absolute contraindications to OC use in women of any age include thromboembolic disease, cerebral vascular accidents, severe cardiac or hepatic disorders, breast or genital cancer, pregnancy, undiagnosed genital bleeding, and pituitary adenoma. Relative contraindications include hypertension, diabetes, hyperlipidemia, obesity, history of hepatitis, migraines, epilepsy, asthma, renal insufficiency, cystic breast disease, and mammary fibroadenomas. Combined OCs do not seem to interfere with subsequent maturation of the hypothalamopituitary axis. The frequency of ovulatory cycles in adolescents who have discontinued pill use is the same as that in adolescents who have never used pills. However, estrogens accelerate the process of maturation in the bones, so combined OCs should never be prescribed for girls who have not terminated their growth. Minidose OCs containing 30-45 mcg of ethinyl estradiol aggravate the relative hyperestrogenism of adolescents and are associated with menstrual problems, functional ovarian cysts, and breast problems. They should only be prescribed for adolescents with regular sexual activity, no less than 3 years following menarche, with regular ovulatory menstrual cycles and no history of breast disorders. Otherwise, a standard

  9. [Contraception and endometriosis].

    PubMed

    Brun, G

    1993-01-01

    . Subsequently, a hydroxyprogesterone derivative such as cyproterone acetate can be used, as can a norpregnane derivative or a combined oral contraceptive with predominant progestin action. Monophasic pills containing norethisterone are also acceptable. In case of metabolic problems, a pill containing gestodene may be used. A vaginal contraceptive should be used in cases of adenomyosis. PMID:12286894

  10. Hormonal contraception and HIV acquisition: reanalysis using marginal structural modeling.

    PubMed

    Morrison, Charles S; Chen, Pai-Lien; Kwok, Cynthia; Richardson, Barbra A; Chipato, Tsungai; Mugerwa, Roy; Byamugisha, Josaphat; Padian, Nancy; Celentano, David D; Salata, Robert A

    2010-07-17

    Hormonal contraceptives are used widely worldwide; their effect on HIV acquisition remains unresolved. We reanalyzed data from the Hormonal Contraception and HIV Study using marginal structural modeling to reduce selection bias due to time-dependent confounding. Replicating our original analysis closely, we found that depo-medroxyprogesterone acetate (DMPA) but not combined oral contraceptive (COC) was associated with increased HIV acquisition. Also, young (18-24 years) but not older women who used DMPA and COCs were at increased HIV risk. PMID:20588106

  11. The Drop That Spilled the Cup: Acute Myocardial Infarction in a Young Woman with Underlying Thrombophilic Polymorphisms and Oral Contraceptive Use

    PubMed Central

    Capilli, Gianfranco; Patané, Anella Antonietta

    2014-01-01

    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. PMID:25587456

  12. The drop that spilled the cup: acute myocardial infarction in a young woman with underlying thrombophilic polymorphisms and oral contraceptive use.

    PubMed

    Russo, Nunzio; Franzì, Enrico; Capilli, Gianfranco; Patané, Anella Antonietta; Russo, Silvia Paola; Evola, Rosario

    2014-01-01

    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. PMID:25587456

  13. Contraception in the 1990s.

    PubMed

    Shoupe, D

    1996-06-01

    Contraceptive technology has recently provided the market place with new barrier methods, new progestin oral contraceptives, an injectable contraceptive, the female condom, new male condoms, and the contraceptive implant. During the last decade, epidemiologists have clearly defined the non-contraceptive benefits of current contraceptive methods that include decreased infections, protection from various cancers, protection from many gynecologic problems that lead to surgery, as well as symptomatic relief from many gynecologic conditions. In conjunction with medical specialists, contraceptive researchers have established the increased safety and benefits of various contraceptive choices in women with medical conditions that, until recently, were contra-indications for their use. That these advances have occurred despite multiple legal and scientific assaults gives hope that the field will continue to grow. PMID:8818532

  14. Emergency Contraception

    MedlinePlus

    ... contraception are available: emergency contraceptive pills and the copper-containing intrauterine device (IUD). Emergency contraceptive pills include ... for emergency use, talk to your doctor. The copper-containing IUD (brand name: Paragard) is a small, ...

  15. Emergency Contraception

    MedlinePlus

    f AQ FREQUENTLY ASKED QUESTIONS FAQ114 CONTRACEPTION Emergency Contraception • What is emergency contraception (EC)? • How does EC work? • What are the different types of EC? • What is the most ...

  16. New and emerging contraceptives: a state-of-the-art review

    PubMed Central

    Bahamondes, Luis; Bahamondes, M Valeria

    2014-01-01

    Background The first hormonal contraceptive was introduced onto the market in several countries 50 years ago; however, the portfolio of contraceptive methods remains restricted with regards to their steroid composition, their cost, and their ability to satisfy the requirements of millions of women/couples in accordance with their different reproductive intentions, behaviors, cultures, and settings. Methods A literature review was conducted using Medline, Embase, and Current Contents databases, up to September 1, 2013 to identify publications reporting new contraceptives in development using combinations of the search terms: contraception, contraceptives, oral contraceptives, patch, vaginal ring, implants, intrauterine contraceptives, and emergency contraception (EC). Also, several experts in the field were also consulted to document ongoing projects on contraception development. Additionally, the Clinicaltrial.gov website was searched for ongoing studies on existing contraceptive methods and new and emerging female contraceptives developed over the past 5 years. Information was also obtained from the pharmaceutical industry. Results Early sexual debut and late menopause means that women may require contraception for up to 30 years. Although oral, injectable, vaginal, transdermal, subdermal, and intrauterine contraceptives are already available, new contraceptives have been developed in an attempt to reduce side effects and avoid early discontinuation, and to fulfill women’s different requirements. Research efforts are focused on replacing ethinyl-estradiol with natural estradiol to reduce thrombotic events. In addition, new, less androgenic progestins are being introduced and selective progesterone receptor modulators and new delivery systems are being used. In addition, research is being conducted into methods that offer dual protection (contraception and protection against human immunodeficiency virus transmission), and contraceptives for use “on demand

  17. Effect of the oral contraceptive pill on protein S and antithrombin-III levels in Malaysian women.

    PubMed

    Wong, K K; Ng, S C; Koong, P L

    Studies focusing on the relationship between oral contraceptive (OC) usage and occurrence of thromboembolism have been conducted for over 3 decades. Those studies centered on the effects OC use has on blood proteins and on measurable physiological changes that occurred in women with venous thrombosis. This article reports the findings of a study that investigated the effects of OC use on the levels of the anticoagulants antithrombin-III (AT-III), protein C (PC), and protein S (PS) in a group of Asian women. Previous studies had mostly been based on Caucasian women. Of the 21 women studied, 16 were Malaysian, 3 were Chinese, and 2 were Indian. Low-dose OCs containing 30 mcg of ethinyl estradiol and 150 mcg of either desogestrel or levonorgestrel were used. Blood was tested before OC use and 3 and 6 months after starting OC use. Levels of AT-III and PS were measured using the Laurell rocket immunoelectrophoresis technique. Statistical analysis was performed using the paired Student's t-test and an analysis of variance test. No statistically significant differences were found for the mean levels of AT-III and total PS when comparing the pre-OC with the 3- and 6-month post-OC values. Earlier studies based mostly on Caucasian women have reported lower levels of both total PS and free PS in OC users. PMID:12288974

  18. The effect of a biphasic desogestrel-containing oral contraceptive on carbohydrate metabolism and various hormonal parameters.

    PubMed

    Kuhl, H; Jung-Hoffmann, C; Weber, J; Boehm, B O

    1993-01-01

    During 6 cycles of treatment of 19 women, the effect of a low-dose biphasic oral contraceptive containing 40 micrograms ethinylestradiol + 25 micrograms desogestrel (7 tablets) and 30 micrograms ethinylestradiol + 125 micrograms desogestrel (15 tablets) on various hormonal parameters and glucose metabolism was compared with the values of the pre- and post-treatment cycle. There was a profound reduction in gonadotropin secretion and ovarian steroid synthesis. The serum levels of testosterone were reduced by 35%, free testosterone by 55%, and DHEA-S by 30%. Cortisol increased by 100%, SHBG by 250%, and TBG by 60%, while FT3 and FT4 were only marginally influenced. Fasting levels of glucose and insulin did not change significantly, but the glucose load revealed a slight impairment of glucose tolerance. Three weeks after termination of pill intake, the various parameters returned to pretreatment levels, except for SHBG and TBG which were still elevated by 20 to 30%. The results demonstrate a marked preponderance of the effect of the estrogen component, a reliable inhibition of ovulation and very good cycle control during treatment with the biphasic formulation. PMID:8436002

  19. Oral contraceptive use and breast cancer in young women. A joint national case-control study in Sweden and Norway.

    PubMed

    Meirik, O; Lund, E; Adami, H O; Bergström, R; Christoffersen, T; Bergsjö, P

    1986-09-20

    The possible association between oral contraceptive (OC) use and the risk of breast cancer developing before the age of 45 was investigated by means of a population based case-control study in Sweden and Norway. Information was obtained by personal interview from 422 (89.2%) of all eligible patients with a newly diagnosed breast cancer from May, 1984, to May, 1985, and from 722 (80.6%) of all contacted age-matched controls. A multivariate analysis, which accounted for several possible confounding factors, revealed a significant (p = 0.03) association between total duration of OC use and breast cancer risk. The relative risk (RR) of breast cancer after 12 or more years of OC use was 2.2 (1.2-4.0). OC use for more than 7 years before first full-term pregnancy entailed an increased breast cancer risk (RR = 2.0 [1.0-4.2]) which was of borderline significance. When total duration of use was considered, the risk of breast cancer was virtually unrelated to age at first OC use and latency from first use. The results suggest that long-term use of OCs may increase the risk of breast cancer in young women. PMID:2876135

  20. Hormone replacement therapy and oral contraceptives and risk of oesophageal adenocarcinoma: a systematic review and meta-analysis.

    PubMed

    Lagergren, Katarina; Lagergren, Jesper; Brusselaers, Nele

    2014-11-01

    There is an unexplained strong male predominance in the aetiology of oesophageal adenocarcinoma (OAC). The hypothesis that oestrogens are protective, deserves attention. A potential protective influence of exogenous oestrogen exposure, that is, hormone replacement therapy (HRT) and oral contraceptives (OC) has been addressed only in studies of limited statistical power, and the individual studies have not provided conclusive results. We conducted a systematic literature search and meta-analysis on HRT and OC and the risk of OAC. We used the databases PubMed and the Web of Science. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by the Mantel-Haenszel random-effect method. A total of five studies were included. Compared to never users, ever users of HRT had a statistically significantly decreased risk of OAC (pooled OR = 0.75; 95% CI: 0.58-0.98), and ever users of OC had a borderline significantly decreased risk of this cancer (pooled OR = 0.76; 95% CI: 0.57-1.00). In conclusion, HRT and OC use seems to be associated with a decreased risk of OAC. However, further research is warranted. PMID:24676860

  1. A Comparison of Self-reported Oral Contraceptive Use and Automated Pharmacy Data in Peri- and Early Postmenopausal Women

    PubMed Central

    Spangler, Leslie; Ichikawa, Laura; Hubbard, Rebecca; Operskalski, Belinda; LaCroix, Andrea; Ott, Susan; Scholes, Delia

    2014-01-01

    Purpose Oral contraceptive (OC) use can occur throughout a woman’s reproductive lifespan with the potential for long- term impacts on health. To assess potential measurement error in prior OC use, this study compared level of agreement between self-reported prior OC use and pharmacy dispensing data in peri-/early postmenopausal women. Methods The study’s 1,399 women (ages 45–59 years) were participants in a population based case-control study of the association between OC use and fracture risk. Episodes of lifetime self-reported OC use (in months) were collected, by telephone interview, for 1/1/2008 through 11/25/2012. Pharmacy fills, back to 1980, were collected from automated data. Agreement was measured using the Prevalence Adjusted and Bias Adjusted Kappa Index (PABAK). Results The number of women with OC pharmacy fills was 11–45% higher than those who reported OC use during each time period. Between-measures agreement was better for more recent use. PABAK values ranged from 0.88 (95% CI 0.85–0.90) within 5 years from the reference date to 0.65 (95% CI 0.59–0.71) within 15–20 years. Conclusion For studies designed to assess the long term effects of OC use, the current results are reassuring in noting moderate agreement between self-reported OC use and pharmacy data for up to 15–20 years before the interview. PMID:25453353

  2. The cervico-vaginal epithelium during 20 cycles' use of a combined contraceptive vaginal ring.

    PubMed

    Roumen, F J; Boon, M E; van Velzen, D; Dieben, T O; Coelingh Bennink, H J

    1996-11-01

    The aim of the study was to evaluate the influence of a combined contraceptive vaginal ring (CCVR) made of Silastic on the cervico-vaginal epithelium during 20 cycles of use. A total of 76 volunteers used the CCVR releasing 0.120 mg etonogestrel and 0.015 mg ethinyloestradiol daily. Cytological samples were taken of the vaginal epithelium, the ectocervix and the endocervix before the start, at 4 and 12 months, and at the end of the study. Cytology, hormonal profiles, human papilloma virus (HPV) status, DNA-flow cytometry, bacterial flora, and morphometry was performed on these samples. Colposcopy and histopathology of biopsy specimens were performed at the end. No cytological changes of the squamous epithelium or the columnar epithelium were found. HPV was detected in three samples of three different women. At least two of them reverted to HPV negative during the rest of the study period. Aneuploidy was diagnosed in 11 women before the study. Seven of them changed to diploid during the study. No changes from diploid to aneuploid were seen. Aneuploidy was not seen in any of the HPV positive samples. Although bacterial flora showed considerable variation during the study, no significant influence of the CCVR could be established. Morphometrical analysis showed an increasing nucleus:cytoplasm ratio of the squamous cells during the study. Mild dysplasia was detected in one woman at the end of the study. It was concluded that no unfavourable cytological or bacteriological changes of the cervico-vaginal epithelium were demonstrated during 20 cycles of CCVR use. The vaginal epithelium became more progestogenic during the study. PMID:8981130

  3. Oral contraceptives alter circadian rhythm parameters of cortisol, melatonin, blood pressure, heart rate, skin blood flow, transepidermal water loss, and skin amino acids of healthy young women.

    PubMed

    Reinberg, A E; Touitou, Y; Soudant, E; Bernard, D; Bazin, R; Mechkouri, M

    1996-08-01

    Sixteen healthy women users and nonusers of oral contraceptives (OC) volunteered to document a set of circadian rhythms. Nine were taking OC providing ethynyl estradiol (0.03-0.05 mg/24h, 21 days/month) combined with DL- or L-norgestrel or norethisterone. There was no group difference (p > 0.05) in median age (22 years), weight (57 kg), and height (162) cm). Data were obtained at fixed hours, 5 times/24h, during a 48-h span, in November. (Day activity from approximately 08:00 to approximately 23:00 h and night rest). Environmental conditions were controlled, using air-conditioned rooms of constant temperature (26 degrees +/- 0.5) and relative humidity 45% +/- 1. Both cosinor and ANOVA were used for statistical analyses. All circadian rhythms were validated with one exception: that of salivary melatonin was not detected in OC users. The 24h mean (M) exhibited group differences for certain variables: M was greater in OC than non-OC users for systolic blood pressure (p < 0.0001), heart rate (p < 0.01), skin blood flow (p < 0.04), and transepidermal water loss (p < 0.02). M was lower in OC than non-OC users in salivary cortisol (p < 0.04) and skin amino acids (p < 0.003). No group difference was detected in any other documented rhythms: diastolic blood pressure, grip strength of both hands, oral temperature, self-rated fatigue, and the skin variables of urea, lactate, triglycerides, and acid phosphatase activity. PMID:8874983

  4. Views and attitudes of oral contraceptive users towards their availability without a prescription in the Republic of Ireland

    PubMed Central

    Barlassina, Luigi

    2015-01-01

    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 27.3% on their

  5. Metabolic effects of contraceptive steroids.

    PubMed

    Sitruk-Ware, Regine; Nath, Anita

    2011-06-01

    Estrogen and progestins have been used by millions of women as effective combined contraceptives. The safety of hormonal contraceptives has been documented by years of follow-up and serious adverse events that may be related to their use are rare in the young population exposed to these agents. The balance between the benefits and the risks of contraceptive steroids is generally positive in particular when comparing to the risks of pregnancy and especially in women with risk factors. The metabolic changes induced by the synthetic steroids used in contraception, such as lipoprotein changes, insulin response to glucose, and coagulation factors have been considered as potential markers of cardiovascular and venous risk. Observations of these effects have led to modifications of the composition of hormonal contraceptive in order to minimize these changes and hence potentially decrease the risks. The synthetic estrogen Ethinyl-Estradiol (EE) exerts a stronger effect that natural estradiol (E2) on hepatic metabolism including estrogen-dependent markers such as liver proteins. This stronger hepatic impact of EE has been related to its 17α-ethinyl group which prevents the inactivation of the molecule and results in a more pronounced hepatic effect of EE as compared to estradiol. Due to its strong activity, administering EE via a non-oral route does not prevent its impact on liver proteins. In order to circumvent the metabolic changes induced by EE, newer products using more natural compounds such as estradiol (E2) and estradiol valerate (E2V) have been introduced. The synthetic progestins used for contraception are structurally related either to testosterone (T) (estranes and gonanes) or to progesterone (pregnanes and 19-norpregnanes). Several new progestins have been designed to bind more specifically to the progesterone receptor and to minimize side-effects related to androgenic, estrogenic or glucocorticoid receptor interactions. Dienogest (DNG), and drospirenone (DRSP

  6. Unexpected sequelae of contraception.

    PubMed

    Dunn, H P

    1996-01-01

    Dissident Roman Catholic theologians who promote the use of contraception have ignored the fact that contraception separates the loving aspect of sex from its fertile nature (which does not imply fecundity). While there is no obligation for Roman Catholics to achieve pregnancy, no interference with fertility is allowed. The importance of this seeming technicality can be seen when considering that contraception offers sex without babies and in vitro fertilization allows babies to be conceived without sexual intercourse. Barrier methods of contraception make sexual intercourse impure in a way similar to masturbation, oral contraceptives generally suppress ovulation but may also act as an abortifacient, and the IUD is an abortifacient, as are other hormonal methods and menstrual extraction. Sterilization and abortion are serious moral faults. Contraception is the first step towards the prevailing antinatalism that will cause demographic collapse in rich countries because there is a progression from contraception to sterilization to abortion. Rather than leading to fewer abortions, acceptance of contraception leads to more. This distressing sequence can be extended to include masturbation at one end and homosexuality at the other. Acceptance of contraception encourages all premarital and extramarital sexual intercourse and has depreciated the value of marriage. Rejection of child-bearing has exacerbated the estrangement of teenagers from parents who chose sterile sex and money over siblings for their children. Contraception fuels fears about a population explosion when people should be regarded as important resources. Finally, contraception has contributed to the shortage of those choosing religious vocations because it has demeaned their sacrifice of celibacy. The only permitted method of family limitation, therefore, is ovulation detection. PMID:12320545

  7. Depo-provera: contraceptive risk?

    PubMed

    Rosenfield, A

    1980-04-01

    This writer agrees with Carol Levine that the issue involving depo-provera is both complex and confusing. Comment is offered on some of the conclusions reached by Levine in her article, "Depo-Provera and Contraceptive Risk: A Case Study of Values and Conflicts". In the discussion of risks and benefits, problems with administration of estrogens are rarely recommended for depo-provera users. The metabolic side-effects which are identified are also seen among oral contraceptive (OC) users and, with the exception of weight gain, appear to have a smaller impact than the combination oral steroids. Exception is taken with the description of delayed return of fertility as a "particularly serious side-effect," for delay in return appears to be a matter of months only. In regard to carcinogenicity, there is no statistically valid evidence of danger relating depo-provera to breast or cervical cancer in the human. Levine's article gives the impression that depo-provera is intended for poor women or "2nd class" citizens and this fails to accurately reflect what probably would occur were the drug available in the United States. This writer believes depo-provera to be a safer contraceptive method than the OC and to be more effective in practice. PMID:6445344

  8. Users of withdrawal method in the Islamic Republic of Iran: are they intending to use oral contraceptives? Applying the theory of planned behaviour.

    PubMed

    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. PMID:24313039

  9. Contraception in Turkey.

    PubMed

    1967-01-01

    Population control and the use of contraceptives were discusses at the biannual meeting of the Turkish Academy of Medicine in September 1966. This was of special importance because contraception and dissemination of information about it were illegal in Turkey for many years before 1965. Thus, until quite recently Turkish doctors had only limited experience of modern contraceptive methods. Oral contraceptives and IUDs were discussed at the Academy meeting, and Dr Nusret Fisek has sent the Bulletin a summary of the main points raises. Oral contraceptives: Only minor side-effects were found and were ignored or easily treated; they disappeared when the oral contraception was stopped. Serious conditions such as liver dysfunction, thromboembolic phenomena, and diabetes have not been found. Intra-uterine devices: Endometritis requiring treatment is infrequent. In 23 of 45 women who had used IUDs for six months, endometrial histology showed diffuse bleeding, endometrial oedema or lymphocyctic endometritis. Expulsion and medical removal rates for IUDs over a six-month period were 5% in one clinic and 12% in another, with a pregnancy rate of between 1.2%. There was only one perforation in 6000 insertions. The doctor's attitude had a great influence on removal and discontinuation rates. In a large maternity hospital the Medical Board accepted, as a medical reason for induced abortion, accidental pregnancies that occurred in women wearing IUDs. PMID:12304991

  10. Effect of the hepatitis C virus protease inhibitor faldaprevir on the pharmacokinetics of an oral contraceptive containing ethinylestradiol and levonorgestrel in healthy female volunteers.

    PubMed

    Sabo, John P; Lang, Benjamin; Elgadi, Mabrouk; Huang, Fenglei

    2015-01-01

    Faldaprevir is a potent hepatitis C virus (HCV) NS3/4A protease inhibitor. Faldaprevir is known to inhibit P-glycoprotein, CYP3A4, and UDP-glucuronosyltransferase 1A1. This study evaluated the effect of steady-state 240 mg faldaprevir on the pharmacokinetics (PK) of an oral contraceptive containing ethinylestradiol (EE) and levonorgestrel (LNG) in healthy premenopausal women. In period 1, subjects received EE/LNG once daily (QD) for 14 days. Blood samples were taken on days 1, 11, and 12, with intensive PK blood sampling for EE and LNG on day 13. In period 2, subjects received EE-LNG QD and 240 mg faldaprevir QD on days 14 to 21 (240 mg faldaprevir twice daily on day 14). Blood samples were taken on days 14, 19, and 20, with PK profiling samples obtained for EE and LNG on day 21. A total of 15/16 subjects completed the study. Overall, EE and LNG exposure (assessed by the area under the curve) was approximately 1.4-fold higher when EE and LNG were coadministered with faldaprevir than when administered alone. Median t1/2 (terminal half-life in plasma at steady state) values were prolonged for both EE (2.4 h longer) and LNG (4.7 h longer) when EE and LNG were coadministered with faldaprevir. The mean oral clearance and apparent volume of distribution of both EE and LNG were lower (∼ 30%) when EE and LNG were coadministered with faldaprevir. Coadministration of faldaprevir and an oral contraceptive resulted in a moderate increase in exposure to both EE and LNG. However, this increase was not considered clinically meaningful, and no dose adjustment of oral contraceptives was deemed necessary. (This study has been registered at ClinicalTrials.gov under registration number NCT01570244.). PMID:25385099

  11. Should dermatologists prescribe hormonal contraceptives for acne?

    PubMed

    Harper, Julie C

    2009-01-01

    ABSTRACT One of the primary factors contributing to the development of acne vulgaris is excess sebum. Sebaceous glands and sebum excretion are regulated, at least in part, by androgen hormones. Acne treatments that block this androgen effect include spironolactone and combination oral contraceptives (COC). Three COC are now FDA approved to treat moderate acne. Dermatologists must become experts at prescribing these hormonal contraceptives. Likewise, it is vital to be aware of contraindications to hormonal contraceptive therapy. Proper patient selection relies on an appropriate medical history and an assessment of blood pressure. A pelvic exam and/or Papanicolaou smear are not required prior to initiating therapy with a COC. It is important to counsel patients about potential adverse effects of COC pills and to establish appropriate expectations concerning acne improvement. PMID:19845722

  12. Aesthetic and incentive salience of cute infant faces: studies of observer sex, oral contraception and menstrual cycle.

    PubMed

    Sprengelmeyer, Reiner; Lewis, Jennifer; Hahn, Amanda; Perrett, David I

    2013-01-01

    Infant cuteness can influence adult-infant interaction and has been shown to activate reward centres in the brain. In a previous study, we found men and women to be differentially sensitive to small differences in infant facial cuteness, with reproductive hormone status as the potential underlying cause. It is unclear, however, whether reproductive hormone status impacts on the aesthetic and incentive salience of infant faces. To address this question, we conducted two interlinked studies. We used static images of the same smiling and neutral-looking infant faces in both a rating task, in which participants had to rate the cuteness of infant faces (aesthetic salience - 'liking'), and a key-press task, in which participants could prolong or shorten viewing time of infant faces by rapid alternating key-presses (incentive salience - 'wanting'). In a first study, we compared the performance of men, women who are taking oral contraceptives, and regularly cycling women. In this study, we found a significant correlation between cuteness ratings within and between groups, which implies that participants had the same concept of cuteness. Cuteness ratings and effort to look at faces was linked regardless of sex and reproductive hormone status, in that cute faces were looked at for longer than less cute faces. A happy facial expression contributed only marginally to the incentive salience of the face. To explore the potential impact of reproductive hormone status in more detail, we followed a subset of regularly cycling women during the menstrual, follicular and luteal phases of their cycle. The aesthetic and incentive salience of infant faces did not change across the menstrual cycle. Our findings suggest that reproductive hormone status does not modulate the aesthetic and incentive value of infant faces. PMID:23734262

  13. Effect of administration of oral contraceptives in vivo on collagen synthesis in tendon and muscle connective tissue in young women.

    PubMed

    Hansen, M; Miller, B F; Holm, L; Doessing, S; Petersen, S G; Skovgaard, D; Frystyk, J; Flyvbjerg, A; Koskinen, S; Pingel, J; Kjaer, M; Langberg, H

    2009-04-01

    Women are at greater risk than men for certain kinds of diseases and injuries, which may at least partly be caused by sex hormonal differences. We aimed to test the influence of estradiol in vivo on collagen synthesis in tendon, bone, and muscle. Two groups of young, healthy women similar in age, 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 and vastus lateralis in both legs. Simultaneously, microdialysis catheters were inserted in vastus lateralis and in front of the patellar tendon for measurement of insulin-like growth factor I (IGF-I) and its binding proteins. Serum NH(2)-terminal propeptide of type I collagen (PINP) and urine COOH-terminal telopeptides of type-I collagen (CTX-I) were measured as markers for bone synthesis and breakdown, respectively. Tendon FSR and PINP were lower in OC compared with control. An increase in muscle collagen FSR postexercise was only observed in control (P < 0.05). Furthermore, the results indicate a lower bioavailability of IGF-I in OC. In conclusion, synthetic female sex hormones administered as OC had an inhibiting effect on collagen synthesis in tendon, bone, and muscle connective tissue, which may be related to a lower bioavailability of IGF-I. PMID:18845777

  14. Changes in weight, total fat, percent body fat, and central-to-peripheral fat ratio associated with injectable and oral contraceptive use

    PubMed Central

    BERENSON, Abbey B.; RAHMAN, Mahbubur

    2010-01-01

    Objective To determine changes in body weight and composition resulting from hormonal contraception. Study design Dual-energy X-ray absorptiometry was performed at baseline and every 6 months for 3 years on 703 women (200 Black, 247 White, 256 Hispanic) initiating use of oral contraception (OC, n = 245), depot medroxyprogesterone acetate (DMPA, n = 240), or nonhormonal contraception (NH, n = 218). DMPA discontinuers were followed for up to 2 years to examine the reversibility of observed changes. Results Over 36 months, DMPA users increased their weight (+5.1 kg), body fat (+4.1 kg), percent body fat (+3.4%), and central-to-peripheral fat ratio (+0.1) more than OC and NH users (P<.01). OC use did not cause weight gain. After DMPA discontinuation, NH users lost 0.42 kg/6 months while OC users gained 0.43 kg/6 months. Conclusions Body weight and fat significantly increase while using DMPA. After discontinuation, some decrease occurs when NH is used. PMID:19254592

  15. The Effect of Combined Antenatal and Postnatal Counselling on Postpartum Modern Contraceptive Use: Prospective Case-Control Study in Kocaeli, Turkey

    PubMed Central

    Vural, Birol; Cakiroglu, Yigit

    2016-01-01

    Introduction The integration of family planning education into obstetric care has been suggested to increase postpartum contraception use. However, ideal time and type of counseling is controversial. There is no prospective study about combining prenatal and postnatal education on the postpartum modern contraceptive use (PPMC). Aim This study was aimed to explore the effects of the addition of postpartum contraceptive counselling to antenatal education on PPMC. Materials and Methods Family planning counselling was given to all participating patients throughout antenatal care (ANC) via brief communications. After delivery, the women were categorised into two age-matched groups with a 1:1 allocation ratio in the order of the birth date. No further intervention was performed for Group I (n: 98). Women in Group II (n: 102) received further contraceptive education at six weeks after hospital discharge. Six months after delivery, PPMC was compared between the two groups. Results PPMC was similar between Group I and II (p>0.05). Previous contraceptive experiences, obstetric care service intensity and partner’s support were the factors related to postnatal contraceptive use. Logistic regression analysis showed that PPMC was independent of confounding factors in each group. Conclusion The addition of postnatal counseling to antenatal one did not further increase PPMC. The results of this study suggested that family planning counseling should be provided antenatally. PMID:27190896

  16. Comparative effects of Lunelle monthly contraceptive injection (medroxyprogesterone acetate and estradiol cypionate injectable suspension) and ortho-Novum 7/7/7 oral contraceptive (norethindrone/ethinyl estradiol triphasic) on lipid profiles. Investigators from the Lunelle Study Group.

    PubMed

    Cromie, M A; Maile, M H; Wajszczuk, C P

    2000-01-01

    As part of a 60-week, open-label, nonrandomized, parallel, controlled study comparing a monthly contraceptive injection containing medroxyprogesterone acetate (MPA) 25 mg and estradiol cypionate (E(2)C) 5 mg (Lunelle Monthly Contraceptive Injection) and a norethindrone 0.5, 0.75, 1.0 mg/0.035 mg ethinyl estradiol (NET/EE) triphasic oral contraceptive (Ortho-Novum(R) 7/7/7), a longitudinal examination of lipid profiles was conducted. Lipid parameters were assessed at screening and at weeks 20, 40, and 60 (or the final visit) in 114 women using MPA/E(2)C and 93 using NET/EE (lipid analysis population). Extra blood samples were obtained at weeks 21, 22, and 23 in 61 MPA/E(2)C users and 51 NET/EE users (index-cycle analysis population) to investigate lipid changes during one cycle of use. In the index-cycle population, median changes from screening to week 60 showed a decrease in apolipoprotein (apo) A-I and apo A-II in both groups. MPA/E(2)C users had a decrease in total cholesterol (C), total triglycerides, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), with maintenance of the total C/HDL-C ratio. NET/EE users showed an increase in total C and LDL-C, with no change in HDL-C or the total C/HDL-C ratio. Within the index cycle (weeks 20 to 23), median changes in lipid values in both MPA/E(2)C and NET/EE users were generally greatest during the first week after the injection or the start of the pill pack. The results of this first longitudinal examination of serum lipids in US women using MPA/E(2)C confirm earlier findings in women in other countries. However, a direct comparison of the effects of MPA/E(2)C and NET/EE on lipid profiles was not possible in this study because of its design and because of the baseline and pharmacokinetic/pharmacodynamic differences between the two contraceptive groups. The results of this analysis showed that, although overall lipid values decreased, including a significant decrease in HDL

  17. A 13-month multicenter clinical experience of a low-dose monophasic oral contraceptive containing 20 microg ethinylestradiol and 75 microg gestodene in Latin American women.

    PubMed

    Bassol, Susana; Alvarado, Gloria; Arreola, Ranferi Gaona; Celis-Gonzalez, Cuauhtemoc; Peña, Efrain Perez; Flores, Josue Garza; Ahued, Jose R; Ricalde, Roger Lara; Lopez, Carlos R; Prieto, Gustavo; Gurucharri, Carlos; Heredia, Monica G; Ortiz, Oscar Contreras; Percossi, Gabriela; Figueroa Casas, Pedro R; Botto, Elida; Tozzini, Roberto Italo; Botti, Gustavo; Nuñez de Pierro, Anibal; Fernandez, Mirta; Lastreto, Enrique; Nañez, Monica; Carneiro de Oliveira, Hildoberto; Diogenes Holanda Yazlle, Martha E; Silva, Jaime; Salazar, German; Gomez, Jorge; Penagos, Gloria; Cifuentes, Rodrigo; Torres, Luz A; Reyes-Marquez, Roberto; Albrecht, Gerhard

    2003-05-01

    This prospective, multicenter study was conducted to evaluate the contraceptive reliability, cycle control and tolerability of a 21-day oral contraceptive regimen containing 20 microg ethinylestradiol and 75 microg gestodene in four Latin American countries (Mexico, Argentina, Brazil and Colombia). Participants took trial medication daily for 21 days. Contraceptive efficacy, cycle control and tolerability were evaluated over a period of 13 cycles. Efficacy data gathered from 5,109 treatment cycles were obtained from 393 participants. The trial medication proved to be an effective contraceptive and provided good cycle control. One pregnancy because of poor compliance was recorded. This resulted in a study Pearl index of 0.25. Forty-six percent of Latin American women reported one intracyclic spotting bleeding episode and 37.6% reported one intracyclic breakthrough bleeding (medium/excessive bleeding) episode during cycles 2-4 (primary target). Overall, intracyclic bleeding was reported in 41%. Overall, there was a trend towards a lower incidence of spotting in all the countries and this difference had statistical significance between Argentina and the others three countries (p < 0.05) during cycles 2-4. This trend was also apparent with respect to breakthrough bleeding, but again the difference did not achieve statistical significance. The discontinuation rate because of adverse events was low (3%); no serious adverse events were reported. More than 78% of the women in the four countries maintained constant body weight or lost weight (2 kg) during the study. The treatment effect on blood pressure was negligible. There were no appreciable changes in mean laboratory values over the course of the study. PMID:12742559

  18. Emergency contraception

    MedlinePlus

    Morning-after pill; Postcoital contraception; Birth control - emergency; Plan B ... Emergency contraception most likely prevents pregnancy in the same way as regular birth control pills: By preventing or delaying ...

  19. Effect of emergency oral contraceptive use on condom utilization and sexual risk taking behaviours among university students, Northwest Ethiopia: a cross-sectional study

    PubMed Central

    2012-01-01

    Background Young people between the ages of 15 and 24 years are both the most at risk of HIV and the greatest hope for turning the tide against HIV/AIDS. Although various surveys have been done on sexual behaviour of youth in Ethiopia, studies assessing the effect of emergency oral contraceptives on condom utilization of university students are lacking. Methods A cross-sectional study was conducted in two major universities of Ethiopia from January to May 2011 using structured self administered questionnaire with the aim to assess the effect of introducing oral emergency contraceptive pills on condom utilization and sexual risk taking behaviours among female university students. Study participants were selected by simple random sampling using the list from the associate registrars of each University. Data were entered, cleaned and analyzed using SPSS version 17.0. Bivariate and multiple logistic regression analyses were used to determine factors associated with condom utilization. Results a total of 623 students out of 660 were included giving response rate of 94.4%. A total of 103(16.5%) had history of sexual intercourse and nearly half (45.6%) of them had sex before the age of 20 years. Forty (6.4%) students had history of sexually transmitted infections (STI). Sixty seven percent of students had heard about emergency oral contraceptives. One hundred and ninety one (45.7%) of students believe that EOC is effective in preventing pregnancy. Believing that EOC is effective in preventing pregnancy (adjusted Odds ratio, AOR = 0.22 95% CI 0.06, 0.87), condom prevents STI (AOR = 10.37, 95% CI 1.73, 62.24) and younger age below 20 years (AOR = 11.68 95% CI 1.25, 109.19) were statistically significantly associated with condom use. Conclusion a significant number of students had history of sexual intercourse and used emergency contraception. The belief in the effectiveness of EOC negatively affects condom use. The preference for the pill may make

  20. [The cervix and hormonal contraception].

    PubMed

    Gorins, A

    1985-01-01

    This article reviews the histological effects of hormonal contraceptives on the cervix and assesses statistical studies examining the relationship between oral contraceptive (OC) usage and cancerous lesions of the cervix. The cervix acquires a pseudopregnant appearance under the influence of combined OCs. The Malpighian epithelium acquires a richly vascularized stroma characterized by accelerated maturation and the endocervical ectropion may be swollen, frequently with epidermoid metaplasia. Such changes increase with the duration of hormonal contraception and are more pronounced with combined than with sequential OCs. Among pathological changes that may occur are active adenomatous hyperplasia and epithelial abnormalities including dysplasia involving dyscaryotic cells with regular nuclei and no mitotic abnormality. Epithelial anomalies may present various histocytological features and are sometimes difficult to interpret. Epidemiologic study of the cervix is difficult because of the number of parameters to be considered: age at 1st intercourse, frequency of intercourse, number of partners, the formulation of the OC, and the variable duration of use which may have been interrupted by use of another method such as the IUD. Statistical studies have yielded contradictory results, with the earliest reports showing a higher incidence of dysplasia among women using OCs and most later studies showing a possible increased incidence of moderate dysplasia but no increased incidence of carcinoma in situ or invasive carcinoma. The recent study by Vessey et al. which compared 6838 parous OC users with 3154 parous IUD users over 10 years revealed invasive cancer in 13 women all of whom used OCs, with carcinomas in situ and dysplasias also more frequent in women using OCs. The duration of use was found to be a significant factor. Age and dates of marriage and 1st pregnancy were similar in subjects and controls, but no data were provided on age at 1st intercourse or number of

  1. [Community marketing of contraceptives].

    PubMed

    Urrutia, J M

    1987-09-01

    The 5-year-old community contraceptive distribution program developed by PROFAMILIA, Colombia's private family planning organization, has given excellent results, but several cost-effectiveness comparisons with social marketing programs have suggested that commercial distribution programs are superior. The community contraceptive distribution program has a high content of information and education activities, which produced significant increases in knowledge and use of contraception in the communities covered. It has been a fundamental support for the social marketing program, creating much of the demand for contraceptive products that the social marketing program has filled. The social marketing program has given good results in terms of volume of sales and in cost-effectiveness since 1976, prompting calls for replacement of the community contraceptive distribution program by the social marketing program in those sectors where knowledge and use of contraception have achieved acceptable levels. An experiment in the Department of Santander in 1984 and 1985 gave very favorable results, suggesting that community contraceptive distribution programs should be replaced by social marketing programs in all more developed markets. But economic problems in 1985 and the decision of manufacturers to decrease the profit margin for PROFAMILIA jeopardized the social marketing program. The community distribution program covered about 20% of the market. Reduced profits in the social marketing program threatened its continued expansion, at the same time that potential demand was growing because of increases in the fertile aged population and increased use of contraception. To meet the need, PROFAMILIA combined the community contraceptive distribution and social marketing programs into a new entity to be called community marketing. The strategy of the community marketing program will be to maintain PROFAMILIA's participation in the market and aid the growth of demand for

  2. A possible mechanism of action of danazol and an ethinylestradiol/norgestrel combination used as postcoital contraceptive agents.

    PubMed

    Rowlands, S; Kubba, A A; Guillebaud, J; Bounds, W

    1986-06-01

    Twenty-seven women requesting postcoital contraception were randomly allocated to take an ethinylestradiol/dl-norgestrel combination or danazol. Urine specimens were assayed for luteinising hormone (LH) and pregnanediol-3-glucuronide (P3G) levels from the day of the postcoital treatment to the next period. In addition, the urine samples of these recruits and 12 additional women were assayed for the Beta-subunit of human chorionic gonadotropin (B-hCG). A consistent pattern of alteration in urinary steroids was lacking, indicating a heterogeneous effect on ovarian function. There was no evidence of early pregnancy in successfully treated cases. We suggest that the main mechanism of action of these drugs is at the endometrial level. PMID:3533419

  3. Contraception in Sweden.

    PubMed

    Riphagen, F E; von Schoultz, B

    1989-06-01

    In 1987, a survey of contraceptive use, knowledge and attitudes was conducted in Sweden by the International Health Foundation (IHF) as part of a multi-country study that has so far involved six other countries in Europe. The women involved, who were aged 15-44, completed a standard questionnaire. The overall percentage use of contraceptive methods, especially the reliable ones, was found to be high (95%). Oral contraception was the most frequently used method, followed by barrier methods and the intrauterine device (IUD). Contraceptive methods were chosen or abandoned mainly because of health reasons and better reliability. Knowledge of fertility proved to be generally good. Medical methods such as oral contraceptives and IUDs were associated with health hazards. In the case of the pill, fears of cardiovascular risks, thrombosis and cancer were widespread, while infection risk and menorrhagia were the most frequently quoted perceived disadvantages of the IUD. Indeed, these two methods suffer from a very negative image among Swedish users. PMID:2752752

  4. Fertility and Contraception in Women With Inflammatory Bowel Disease.

    PubMed

    Martin, Jason; Kane, Sunanda V; Feagins, Linda A

    2016-02-01

    Inflammatory bowel disease (IBD) carries a high burden in women during their reproductive years, and family planning issues are often a significant cause of concern. Fertility is normal in women with nonsurgically treated ulcerative colitis and similar or slightly reduced in women with Crohn's disease. Women who undergo ileal pouch anastomosis have reduced fertility. Fertility is likely worsened by disease activity but unaffected by medications used to treat IBD. Infertile patients with IBD respond as well as non-IBD patients to in vitro fertilization (IVF). Despite normal fertility, patients with IBD have fewer children due to concerns regarding infertility, disease inheritance, congenital abnormalities, and disease-related sexual dysfunction. Patients rarely discuss these issues with a physician. When discussion does occur, it may lead to changes in decision-making. Contraceptives are an important part of family planning, particularly during times of high disease activity. All forms of contraceptives are acceptable in patients with IBD, although there are specific considerations. The risks of combined oral contraceptives outweigh the benefits in patients with active disease and patients with prior or high risk for thromboembolism. Oral contraceptives and IBD are independently associated with an increased risk for thromboembolism, although it is not known whether this effect is compounding. Depot medroxyprogesterone acetate injection should be avoided in patients with or at risk for osteopenia. Intrauterine devices and implants are the most effective form of contraception and should be a first-line recommendation. The use of oral contraceptives is associated with the development of IBD, although there is no increased risk of disease relapse with the use of any form of contraceptive. PMID:27182211

  5. Fertility and Contraception in Women With Inflammatory Bowel Disease

    PubMed Central

    Martin, Jason; Kane, Sunanda V.

    2016-01-01

    Inflammatory bowel disease (IBD) carries a high burden in women during their reproductive years, and family planning issues are often a significant cause of concern. Fertility is normal in women with nonsurgically treated ulcerative colitis and similar or slightly reduced in women with Crohn’s disease. Women who undergo ileal pouch anastomosis have reduced fertility. Fertility is likely worsened by disease activity but unaffected by medications used to treat IBD. Infertile patients with IBD respond as well as non-IBD patients to in vitro fertilization (IVF). Despite normal fertility, patients with IBD have fewer children due to concerns regarding infertility, disease inheritance, congenital abnormalities, and disease-related sexual dysfunction. Patients rarely discuss these issues with a physician. When discussion does occur, it may lead to changes in decision-making. Contraceptives are an important part of family planning, particularly during times of high disease activity. All forms of contraceptives are acceptable in patients with IBD, although there are specific considerations. The risks of combined oral contraceptives outweigh the benefits in patients with active disease and patients with prior or high risk for thromboembolism. Oral contraceptives and IBD are independently associated with an increased risk for thromboembolism, although it is not known whether this effect is compounding. Depot medroxyprogesterone acetate injection should be avoided in patients with or at risk for osteopenia. Intrauterine devices and implants are the most effective form of contraception and should be a first-line recommendation. The use of oral contraceptives is associated with the development of IBD, although there is no increased risk of disease relapse with the use of any form of contraceptive. PMID:27182211

  6. Hormonal contraception and platelet function.

    PubMed

    Saleh, A A; Ginsburg, K A; Duchon, T A; Dorey, L G; Hirata, J; Alshameeri, R S; Dombrowski, M P; Mammen, E F

    1995-05-15

    73 healthy women (29 controls, 25 using OCs, and 19 using Norplant) were selected from the clinic population at North Oakland Medical Center for inclusion in this study after obtaining informed consent. Age, race, height, weight, blood pressure, and cigarette smoking were recorded for each subject. 12 patients were on monophasic OCs while 13 were on triphasic preparations. Both hormonal contraceptive groups had used their particular contraceptive for at least 3 months prior to blood drawing. Platelet tests were performed within 2 hours of sample collection: platelet counts (PLC) and mean platelet volume (MPV) were determined on an Automated Platelet Counter (Baker 810 Platelet Analyzer). Whole blood aggregation was performed on a platelet aggregometer (Chrono-Log, Model 550) using both ADP (ADP, 5 mM) and collagen (COLL, 2 mcg/ml) as inducing agents. Demographic differences were not significant (p 0.05) among the 3 treatment groups, whose average age was 25.3-25.8 years old. Furthermore, no significant differences (p 0.05) in platelet function were detected among controls or subjects receiving either oral contraceptives or Norplant, compared to control patients. The mean platelet counts (X 10/9/L) were 223 for OC users, 231 for Norplant users, and 232 for controls. The respective platelet aggregation (ADP, ohms) values were 12.5, 18.0, and 19.2 as well as (COLL, ohms) 35.6, 40.7, and 39.0. These results demonstrated that there is no evidence for altered platelet function, with the testing methods employed, in women using either Norplant or combination low dose oral contraceptives. To date, several studies have examined this issue, with contradictory reports about the effects of hormonal contraceptives in platelet function. After controlling for differences between various steroid preparations and other such confounding variables, some of these conflicting conclusions could be the result of a lack of uniformity among the methods used to evaluate platelet aggregation

  7. Trends of contraception among ladies of local population in Pakistan; why, how, when and what?

    PubMed Central

    Atif, Khaula; Afsheen, Afeera; Naqvi, Syed Abid Hassan; Niazi, Saleem Asif; Ullah Khan, Habib

    2016-01-01

    Objective: To analyze trends of use of methods of contraception along with study of impact of various demographic and social factors on contraception in Peshawar, Pakistan. Methods: A cross-sectional descriptive study with random purposive sampling was conducted at Combined Military Hospital Peshawar, from Mar 2015-Nov 2015. Self-designed questionnaire with demographic details and questions pertinent to contraceptive practices was utilized as study instrument. Females reporting to concerned hospital for contraceptive advice and prescription were distributed with questionnaire and written informed consent form. Formal approval was taken from ethical committee of hospital. Data was analyzed via descriptive analysis (SPSS-21), qualitative data was expressed as frequencies and percentages; quantitative as mean±standard deviation (SD). Main outcome variable i-e contraceptive device used; was cross-tabulated with independent variables. Results: Response rate was 53.2% (n-426). Usage of contraceptive device was as follows; 51.2% Nil, 9.4% barriers, 22.3% oral/injectable hormones, 13.4% IUCDs, 3.8% sterilization. There was a strong relationship between type of contraceptives used and age (p<0.001), client’s education (p<0.001), husband’s education (p<0.001), number of children (p<0.001), religion (p0.013), socioeconomic class (p<0.001), and religious beliefs about use of contraceptives (p<0.001). More Muslims considered contraception irreligious than non-Muslims (p 0.02). There was no significant impact of husbands’ pressure to not to use contraceptives on type of contraception practised (p 0.114). Conclusion: Contraceptive devices are under-utilized in the study participants. Multidisciplinary approach should be applied to enhance client education, awareness and counseling to utilize these devices more appropriately and regularly. PMID:27375727

  8. Male contraception: a clinically-oriented review.

    PubMed

    Kanakis, George A; Goulis, Dimitrios G

    2015-01-01

    Despite the variety of available female contraceptive methods, many pregnancies (~50%) are still undesired. Many men (>60%) want to participate equally with their partner in family planning; however, male contraceptive methods (MCMs) account for only 14% of those used worldwide and no pharmaceutical MCM is available so far. The only two MCMs currently available are condoms, which despite protecting against sexually transmitted diseases have high failure rates (~19%), and vasectomy, which though very efficient (99%) is poorly reversible (<50%). Among MCMs under investigation, male hormonal contraceptives (MHCs) are those that have come closest to commercialization. The action of MHCs relies on the disruption of spermatogenesis that exogenous androgen administration evokes by suppressing the hypophyseal-gonadal axis. Various regimens of androgens as monotherapy or in combination with progestins have been tested in clinical trials achieving a Pearl Index <1.0 (equal to that of the female oral contraceptive pill); however, concerns regarding the variable response rates observed (non-responders: 5-20%), the impracticality of parenteral administration and long-term prostate-associated or cardiovascular morbidity have deflected the interest of the pharmaceutical industry from further research. Non-hormonal contraception methods may be, at least theoretically, more specific by selectively disrupting spermatogenesis and sperm transport or fertilizing ability. Nevertheless, only a few have been tested in clinical trials (Reversible Inhibition of Sperm Under Guidance, RISUG, and Intra Vas Plugs); most of them are still in pre-clinical development or have been abandoned due to toxicity (gossypol). Consequently, until a reliable, safe and practical MCM is developed, women will continue to bear most of the contraception burden. PMID:26732151

  9. The effect of price increases on contraceptive sales in Bangladesh.

    PubMed

    Ciszewski, R L; Harvey, P D

    1994-01-01

    In April 1990, the prices of five brands of contraceptives in the Bangladesh social marketing project were increased, by an average of 60%. The impact on condom sales was immediate and severe, with sales for the following 12 months dropping by 46% from the average during the preceding 12 months. The effect on oral contraceptive sales was less dramatic: average sales in the year following the increases dropped slightly despite a previously established pattern of rapidly rising sales. There appears no reasonable combination of events other than the price increase itself to explain most of the difference. PMID:8200877

  10. Relationship between contraceptive method and vaginal flora.

    PubMed

    Peddie, B A; Bishop, V; Bailey, R R; McGill, H

    1984-08-01

    This study was undertaken to assess whether the vaginal flora was affected by the method of contraception, and in particular as to whether the incidence of vaginal candidiasis increased when oral contraceptives were used. One thousand and two consecutive vaginal or cervical swabs from women attending a family planning centre were cultured. Candida albicans was isolated from 13% of women using no contraception, 16% using oral contraceptives, and from 9%, 19% and 18% of those using diaphragms, intrauterine contraceptive devices (IUCD) and condoms respectively. These differences were not statistically significant. Women using an IUCD had significantly more Gram-positive cocci cultured than women in any other group, while those using diaphragms had significantly more Gram-negative bacilli. Our clinical impression that the use of oral contraceptives led to an increase in vaginal candidiasis, was not confirmed by this study. PMID:6596089

  11. Contraceptive Evaluation.

    ERIC Educational Resources Information Center

    Hulka, Barbara S.; And Others

    The objective of research in contraceptive evaluation is to improve the ability of individuals to choose contraceptive methods best suited to their needs and circumstances and to provide information that will lead to the development of safer and more effective methods. There are usually three considerations in judging the importance of a method of…

  12. Contraceptive Equity

    PubMed Central

    Temkin, Elizabeth

    2007-01-01

    The Equity in Prescription Insurance and Contraceptive Coverage Act, introduced in Congress in 1997 and still unpassed, seeks to redress health insurers’ failure to pay for birth control as they pay for other prescription drugs, most paradoxically Viagra. In 1936 the International Workers Order (IWO), a fraternal society, became the first insurer to include contraception in its benefits package. A forerunner in the movement for prepaid medical care, the IWO offered its members primary care and contraceptive services for annual flat fees. Founded at a time when the legal status of contraception was in flux, the IWO’s Birth Control Center was the only such clinic to operate on an insurance system. Recent state laws and judicial actions have revived the IWO’s groundbreaking view of contraception as a basic preventive service deserving of insurance coverage. PMID:17761562

  13. Women with Polycystic Ovary Syndrome Taking Combined Oral Contraceptives Have Greater Risk of Blood Clots

    MedlinePlus

    ... Working Papers & HHS Recovery Act Projects PCOR AHRQ Projects funded by the Patient-Centered Outcomes ... Populations (OEREP) Office of Management Services (OMS) Center for Delivery, Organization, and Markets ( ...

  14. Initial dual oral combination therapy in pulmonary arterial hypertension.

    PubMed

    Sitbon, Olivier; Sattler, Caroline; Bertoletti, Laurent; Savale, Laurent; Cottin, Vincent; Jaïs, Xavier; De Groote, Pascal; Chaouat, Ari; Chabannes, Céline; Bergot, Emmanuel; Bouvaist, Hélène; Dauphin, Claire; Bourdin, Arnaud; Bauer, Fabrice; Montani, David; Humbert, Marc; Simonneau, Gérald

    2016-06-01

    Treatment for pulmonary arterial hypertension (PAH) has been underpinned by single-agent therapy to which concomitant drugs are added sequentially when pre-defined treatment goals are not met.This retrospective analysis of real-world clinical data in 97 patients with newly diagnosed PAH (86% in New York Heart Association functional class III-IV) explored initial dual oral combination treatment with bosentan plus sildenafil (n=61), bosentan plus tadalafil (n=17), ambrisentan plus tadalafil (n=11) or ambrisentan plus sildenafil (n=8).All regimens were associated with significant improvements in functional class, exercise capacity, dyspnoea and haemodynamic indices after 4 months of therapy. Over a median follow-up period of 30 months, 75 (82%) patients were still alive, 53 (71%) of whom received only dual oral combination therapy. Overall survival rates were 97%, 94% and 83% at 1, 2 and 3 years, respectively, and 96%, 94% and 84%, respectively, for the patients with idiopathic PAH, heritable PAH and anorexigen-induced PAH. Expected survival rates calculated from the French equation for the latter were 86%, 75% and 66% at 1, 2 and 3 years, respectively.Initial combination of oral PAH-targeted medications may offer clinical benefits, especially in PAH patients with severe haemodynamic impairment. PMID:26989105

  15. Barrier methods of contraception.

    PubMed

    Skrine, R L

    1985-05-01

    Barrier methods of contraception make up an essential part of the present contraceptive range, and doctors need to know in detail how to choose and fit them as well as how to instruct patients in their use. This discussion reviews the mode of action of the barrier method and then focuses on the vaginal diaphragm, the cervical or vault cap, the collatex (Today) sponge, condoms, emotionl problems associated with the use of barrier methods, advantages of barrier methods, and future developments. Barrier methods of contraception are only effective if used consistently and carefully. Failure rates vary greatly between studies, but in selected populations the failure rate for the diaphragm with spermicide can be as low as 1.9/100 woman years (wy) and for the condom 3.6 per 100wy (Vessey et al., 1982). If known user failures are removed, the figure for the condom can drop to as low as 0.4 per 100wy (John, 1973), which compares favorably with that of the combined oral contraceptive. Other studies quote failure rates of 10 per 100wy or more. These methods call for considerable participation by the patient at or before each act of intercourse and there is, therefore, great scope for inefficient use, either as a result of poor instruction or because couples find that they interfere with happy, relaxed sexual activity -- or fear that they may do so. Doctors need to understand the feelings of their patients before recommending them. The aim of a barrier method is to prevent live sperm from meeting the ovum. This is accomplished by the combination of a physical barrier with a spermicide. In the case of the condom, the integrity of the physical barrier is the most important factor, although some patients feel more secure with an additional spermicide. The vaginal barriers used at present do not produce a "water-tight" fit, and the principle is that the spermicide is held over the cervix by the barrier. It is also possible that the device acts partially by holding the alkaline

  16. Massive pulmonary embolism associated with Factor V Leiden, prothrombin, and methylenetetrahydrofolate reductase gene mutations in a young patient on oral contraceptive pills: a case report.

    PubMed

    Charafeddine, Khalil M; Mahfouz, Rami A; Ibrahim, Georges Y; Taher, Ali T; Hoballah, Jamal J; Taha, Assad M

    2010-10-01

    Factor V Leiden (Factor V G1691A), prothrombin gene mutation G20210A, and homozygous C677T mutation in the methylenetetrahydrofolate reductase (MTHFR) gene are known to predispose venous thromboembolism (VTE). We present herein a rare case of a young woman heterozygous for these mutations and taking oral contraceptive pills for less than 2 months, diagnosed to have massive deep venous thrombosis and bilateral pulmonary embolism. The patient was managed for 10 days in the hospital and discharged home on oral anticoagulants. This case suggests that screening for these factors in people with family history of thrombosis and in relatives of patients with these mutations is highly recommended to prevent fatal consequences. In addition, a new guideline for treatment and prophylaxis with anticoagulant for these patients and others who are at risk of developing VTE (American College of Chest Physicians [ACCP] guidelines-Chest 2008) has been published recently. Our recommendation is to promote for the internationally published algorithms through their application, where necessary, to prevent any future thrombotic morbidity or mortality incidents. PMID:19520679

  17. Is oral contraceptive-induced headache dependent on patent foramen ovale? Clinical dynamics, evidence-based hypothesis and possible patient-oriented management.

    PubMed

    Chiofalo, Benito; Laganà, Antonio Simone; Imbesi, Giovanna; Vitale, Salvatore Giovanni; Catena, Ursula; Campolo, Federica; Lanzo, Gabriele; Centini, Gabriele; Triolo, Onofrio

    2016-09-01

    Secondary headache is one of the most common side effect during oral contraceptive (OC) treatment and it leads many patients to stop the therapy. Patent foramen ovale (PFO) is an interatrial communication that spontaneously closes at birth in about 75% of the population. However, in the rest of adults PFO maintains a direct communication between the right and left side of circulation. In these patients PFO is a tunnel-like structure that could allow a blood clot to pass from the right to the left side of circulation, thus can cause paradoxical embolization. Although an increased frequency of PFO in patients with migraine was already reported, the relationship between PFO and migraine remains uncertain. In patients with migraine, the prevalence of moderate or large PFO is 35% and seems not associated with the presence of aura or the frequency of headache. Basing on these assumptions, we hypothesize that asymptomatic PFO could play a role in secondary headache due to OC. The procoagulant effect of OC improves the production of microemboli that through the POF could pass from the right to the left atrium and than to the brain, where they could be responsible of secondary headache. If our hypothesis would be confirmed in future studies, it would be possible to identify high-risk patients for developing OC-induced headache and other cerebrovascular major diseases through transcranial Doppler and transesophageal echocardiography. This scenario may radically change the management of reproductive-age woman who have to undergo OC therapy for contraception or other medical conditions. PMID:27515209

  18. [Emergency contraception].

    PubMed

    Bastianelli, C; Farris, M; Di Miscia, A

    2006-06-01

    A specific formulation has been approved for use in Italy for emergency contraception (EC) in 2000. As expected, marketing of this levonorgestrel (LNG) only formulation has been accompanied by an increased interest and, often, controversies leading to even strong opposition on the part of those ethically opposed to the use of any method that may act after fertilization. At present, several trials on the exact mechanism of action and safety have been conducted, giving good reason for simplifying access, providing it free or over the counter, in several European countries. EC, also known as ''the morning after pill'' or postcoital contraception, is a modality of preventing the establishment of an unwanted pregnancy after unprotected intercourse and thus, probably, of reducing the number of voluntary pregnancy terminations. Two different forms are available: the hormonal and the intrauterine. Hormonal estrogen only EC was first proposed in the 60s and in 1974 Yuzpe following his studies proposed for the first time his combined regimen, that showed better efficacy and lower side effects. More recently, a new regimen, consisting of LNG, administered alone at the dose of 1.5 mg, was introduced and found in clinical trials to be more effective than the Yuzpe regimen, if taken as early as possible, within 72 h, thereby replacing the latter in common use. Mechanism of action of both hormonal preparations used for EC is inhibiting or delaying ovulation, therefore a prefertilization action. No effect has been reported on the process of implantation nor on an ongoing pregnancy. The WHO have developed a third regimen based on the use of the selective progesterone receptor modulator (antiprogestin) Mifepristone and conducted trials with different dosages, reporting similar efficacy and safety compared to LNG. Intrauterine EC was first proposed by Lippes in 1976. It has the advantage of being effective if inserted within 5 days after unprotected intercourse and the disadvantage

  19. Australian scientists develop male contraceptive.

    PubMed

    1974-05-20

    The Australian Information Service in Canberra reports that Australian scientists have formulated a contraceptive pill to temporarily stop spermatogenesis in man, thus producing infertility. The research was done by a team consisting of Dr. Henry Burger, director of the Medical Reserach Center at Prince Henry's Hospital in Melbourne, Dr. Bryan Hudson, Principal Research Fellow at the Howard Florey Institute of Experimental Medicine at the Univeristy of Melbourne, and Dr. David de Kretser, senior lecturer in Monash University's Department of Medicine at Prince Henry's Hospital. The contraceptive pill consists of progestagen (d-norgestrel) with androgen (methyltestosterone), a combination that suppresses the production of the sperm but conserves libido and potency. The testing program has yet to be undertaken in human volunteers. There will be three phases to the drug trial: pretreatment, during which the health of the volunteers and the safety of the drug will be established; the treatment phase, lasting six months, during which the volunteers will be given daily oral dose of the drugs; and the recovery phase, lasting at least three months, during which the restoration of normal spermatogenesis will be observed. PMID:12333267

  20. Ambulatory blood pressure monitoring (ABPM) in the normal menstrual cycle and in women using oral contraceptives. Comparison with conventional blood pressure measurement.

    PubMed

    Williamson, P M; Buddle, M L; Brown, M A; Whitworth, J A

    1996-10-01

    This study was undertaken to determine if blood pressures (BP) assessed by routine sphygmomanometry and 24 h ambulatory monitoring (ABPM) alter throughout the normal menstrual cycle or in the cycle of women using oral contraceptive pills (OCP), and the interrelationships between urinary sodium (Na) and potassium (K) excretion and ABPM throughout the menstrual cycle. Eleven women with a normal ovulatory cycle (ovulatory) and ten age-matched women taking an oral contraceptive pill (OCP) were studied three times in random order during their menstrual cycle, within days 1 to 5, 13 to 16, and 25 to 28. Twenty-four hour urine Na, K, and creatinine (Cr) excretion and serum Na, K, Cr, cortisol, estradiol, progesterone and plasma renin, angiotensinogen, and aldosterone concentrations were measured. BP was measured by a mercury sphygmomanometer and by 24 h BP (Accutracker II). On days 1 to 5, daytime systolic BP was higher in OCP [mean: 123 mm Hg, 95% confidence interval: 117, 128] than ovulatory women [114 mm Hg (109, 118); P = .011] though daytime diastolic BPs were similar [OCP: 71 (68, 75), ovulatory: 69 (66, 72)]. This difference in daytime systolic BP between groups was also apparent at both of the other stages of the menstrual cycle. Nighttime systolic BPs were significantly higher in OCP users on days 13 to 16 (P < .05) and days 25 to 28 (P < .01). In women taking OCPs, daytime ABPM for days 1 to 5 were higher than their office readings by 15 (7,23)/11 (7,15) mm Hg (P = .001), whereas office and ABPM readings were similar in ovulatory women. This pattern was evident at all three stages. There was no significant change in BP throughout the menstrual cycle within either group, and no correlation between urine Na or K and BP. Systolic BPs are higher throughout the menstrual cycle in women who take OCPs than in ovulatory women but this difference is only detected when ambulatory blood pressure is assessed. Blood pressure does not change subsequently in either ovulatory

  1. New regulations for oral contraceptive prescription in France in 2013: what is the impact on adult female acne?

    PubMed

    Leclerc-Mercier, Stéphanie; Buisson, Virginie; Dreno, Brigitte

    2016-08-01

    In 2012, a young French woman lodged a complaint against a pharmaceutical company having suffered a cerebral stroke. The French health authority recommended all prescribers of hormonal contraception (HCP) to favour second-generation HCP. To evaluate the consequences of these recommendations on female acne. A prospective multicentre study using a standardised questionnaire completed by 1,724 women. The mean age was 26.57 years; 58.7% of the women had changed their HCP during the last 12 months. The initial ratio of first or second/third or fourth-generation drugs was 5.5%/82.9% which changed after the recommendations to 70.6%/29.4%. Among the patients who switched from third or fourth to first or second-generation drugs, 83.9% considered that their acne had worsened (p<0.0001). In those patients who received a local acne treatment, 72.1% had additional systemic treatment. This study confirms the important rise in prescriptions of first or second-generation HCP. This switch has resulted in a significant increase in acne, requiring treatment for the large majority of patients, thus confirming the role of a hormonal factor in female acne. PMID:27312707

  2. Hormonal contraception: state of the art and future perspectives.

    PubMed

    Benagiano, G; Bastianelli, C; Farris, M

    2007-06-01

    Attempts at controlling female fertility through the utilisation of hormonal extracts date back to the beginning of the 20th century, however, practical applications in the human species were only possible when Gregory Pincus had the excellent idea of mimicking the effect of progesterone in blocking ovulation and, through this mechanism, inhibit fertility. It is important to notice that, over its 50 years of history, the original method for hormonal contraception (HC), universally known as ''the pill'', developed into a variety of modalities that today utilise a number of new routes of administration. HCs of today are exclusively made up of either oestrogen-progestin combinations or progestins alone. This does not mean that no attempt has been made to use other classes of steroids for contraception. The best known compounds tested are the so-called ''antiprogestins'', more precisely called selective progesterone receptor modulators (SPRM). Hormonal contraceptives, originally administered in the form of daily pills, can be utilised today through seven different routes: intramuscularly, intranasally, intrauterus, intravaginally, orally, subcutaneously, and transdermally. New strategies in the field of oral contraception include further dose reduction, the synthesis of new active molecules and new administration schedules. Newly marketed contraceptive rings to be inserted in the vagina, offer a novel approach by providing a sustained release of steroids and low failure rates. The transdermal route is now well established, as a contraceptive patch, a spray or a gel. The intramuscular route has also seen new products with the marketing of improved monthly injectable preparations, containing an oestrogen and a progestin. A new minipill (progestin-only preparation) containing desogestrel has been recently marketed in a number of countries and is capable of inhibiting ovulation in most women. After the first device capable of delivering progesterone directly into the

  3. Effects of oral contraceptive use on the salivary testosterone and cortisol responses to training sessions and competitions in elite women athletes.

    PubMed

    Crewther, Blair T; Hamilton, Dave; Casto, Kathleen; Kilduff, Liam P; Cook, Christian J

    2015-08-01

    This study examined the salivary testosterone (T) and cortisol (C) responses of elite women hockey players across 4 activities (light and heavy training, club and International competitions). The players formed an oral contraceptive (OC) group (n=10) and a Non-OC (n=19) group for analysis. The Non-OC group had higher T levels (by 31-52%) across all activities, whilst the OC group showed signs of reduced T and C reactivity when data were pooled. As a squad, positive T and C changes occurred with heavy training (45%, 46%), club competitions (62%, 80%) and International competitions (40%, 27%), respectively. Our results confirm that OC use lowers T levels in women athletes whilst reducing the T and C responses to training and competition activities within the sporting environment. Differences in the physical and/or psychological demands of the sporting activity could be contributing factors to the observed hormone responses. These factors require consideration when applying theoretical models in sport, with broader implications for women around exercising behaviours and stress physiology. PMID:25866255

  4. Prospective multicenter randomized intermediate biomarker study of oral contraceptive versus depo-provera for prevention of endometrial cancer in women with Lynch syndrome.

    PubMed

    Lu, Karen H; Loose, David S; Yates, Melinda S; Nogueras-Gonzalez, Graciela M; Munsell, Mark F; Chen, Lee-May; Lynch, Henry; Cornelison, Terri; Boyd-Rogers, Stephanie; Rubin, Mary; Daniels, Molly S; Conrad, Peggy; Milbourne, Andrea; Gershenson, David M; Broaddus, Russell R

    2013-08-01

    Women with Lynch syndrome have a 40% to 60% lifetime risk for developing endometrial cancer, a cancer associated with estrogen imbalance. The molecular basis for endometrial-specific tumorigenesis is unclear. Progestins inhibit estrogen-driven proliferation, and epidemiologic studies have shown that progestin-containing oral contraceptives (OCP) reduce the risk of endometrial cancer by 50% in women at general population risk. It is unknown whether they are effective in women with Lynch syndrome. Asymptomatic women ages 25 to 50 with Lynch syndrome were randomized to receive the progestin compounds Depo-Provera (depo-MPA) or OCP for three months. An endometrial biopsy and transvaginal ultrasound were conducted before and after treatment. Endometrial proliferation was evaluated as the primary endpoint. Histology and a panel of surrogate endpoint biomarkers were evaluated for each endometrial biopsy as secondary endpoints. A total of 51 women were enrolled, and 46 completed treatment. Two of the 51 women had complex hyperplasia with atypia at the baseline endometrial biopsy and were excluded from the study. Overall, both depo-MPA and OCP induced a dramatic decrease in endometrial epithelial proliferation and microscopic changes in the endometrium characteristic of progestin action. Transvaginal ultrasound measurement of endometrial stripe was not a useful measure of endometrial response or baseline hyperplasia. These results show that women with Lynch syndrome do show an endometrial response to short-term exogenous progestins, suggesting that OCP and depo-MPA may be reasonable chemopreventive agents in this high-risk patient population. PMID:23639481

  5. Prospective, Multi-center Randomized Intermediate Biomarker Study of Oral Contraceptive vs. Depo-Provera for Prevention of Endometrial Cancer in Women with Lynch Syndrome

    PubMed Central

    Lu, Karen H.; Loose, David S.; Yates, Melinda S.; Nogueras-Gonzalez, Graciela M.; Munsell, Mark F.; Chen, Lee-may; Lynch, Henry; Cornelison, Terri; Boyd-Rogers, Stephanie; Rubin, Mary; Daniels, Molly S.; Conrad, Peggy; Milbourne, Andrea; Gershenson, David M.; Broaddus, Russell R.

    2013-01-01

    Women with Lynch syndrome have a 40–60% lifetime risk for developing endometrial cancer, a cancer associated with estrogen imbalance. The molecular basis for endometrial-specific tumorigenesis is unclear. Progestins inhibit estrogen-driven proliferation, and epidemiologic studies have demonstrated that progestin-containing oral contraceptives (OCP) reduce the risk of endometrial cancer by 50% in women at general population risk. It is unknown if they are effective in women with Lynch syndrome. Asymptomatic women age 25–50 with Lynch syndrome were randomized to receive the progestin compounds depo-Provera (depoMPA) or OCP for three months. An endometrial biopsy and transvaginal ultrasound were performed before and after treatment. Endometrial proliferation was evaluated as the primary endpoint. Histology and a panel of surrogate endpoint biomarkers were evaluated for each endometrial biopsy as secondary endpoints. A total of 51 women were enrolled, and 46 completed treatment. Two of the 51 women had complex hyperplasia with atypia at the baseline endometrial biopsy and were excluded from the study. Overall, both depoMPA and OCP induced a dramatic decrease in endometrial epithelial proliferation and microscopic changes in the endometrium characteristic of progestin action. Transvaginal ultrasound measurement of endometrial stripe was not a useful measure of endometrial response or baseline hyperplasia. These results demonstrate that women with Lynch syndrome do show an endometrial response to short term exogenous progestins, suggesting that OCP and depoMPA may be reasonable chemopreventive agents in this high-risk patient population. PMID:23639481

  6. WWOX CNV-67048 Functions as a Risk Factor for Epithelial Ovarian Cancer in Chinese Women by Negatively Interacting with Oral Contraceptive Use

    PubMed Central

    Chen, Yongxiu; Tan, Xiaochang; Ding, Yongli; Mai, Bi; Huang, Xiaowen; Hu, Guiying

    2016-01-01

    Copy number variations (CNVs) have attracted increasing evidences to represent their roles as cancer susceptibility regulators. However, little is known about the role of CNV in epithelia ovarian cancer (EOC). Recently, the CNV-67048 of WW domain-containing oxidoreductase (WWOX) was reported to alter cancer risks. Considering that WWOX also plays a role in EOC, we hypothesized that the CNV-67048 was associated with EOC risk. In a case-control study of 549 EOC patients and 571 age (±5 years) matched cancer-free controls, we found that the low copy number of CNV-67048 (1-copy and 0-copy) conferred a significantly increased risk of EOC (OR = 1.346, 95% CI = 1.037–1.747) and it determined the risk by means of copy number-dependent dosage effect (P = 0.009). Data from TCGA also confirmed the abovementioned association as the frequency of low copies in EOC group was 3.68 times more than that in healthy group (P = 0.023). The CNV also negatively interacted with oral contraceptive use on EOC risk (P = 0.042). Functional analyses further showed a lower mRNA level of WWOX in tissues with the 0-copy or 1-copy than that in those with the 2-copy (P = 0.045). Our data suggested the CNV-67048 to be a risk factor of EOC in Chinese women. PMID:27190995

  7. Effect of oral contraceptive use on the incidence of dry socket in females following impacted mandibular third molar extraction: a meta-analysis.

    PubMed

    Xu, J-L; Sun, L; Liu, C; Sun, Z-H; Min, X; Xia, R

    2015-09-01

    The aim of this comprehensive meta-analysis was to provide evidence-based data to test whether oral contraceptive (OC) use can promote the incidence of dry socket (DS) in females following impacted mandibular third molar extraction. PubMed, the Cochrane Library, and Elsevier Science Direct databases were searched. The pooled risk ratio (RR) with 95% confidence interval (CI) was calculated using fixed-effects or random-effects model analysis. Heterogeneity among studies was evaluated with the Cochran test and I(2) statistic. Study quality was assessed with the Newcastle-Ottawa scale. Of 70 articles identified in the search, 12 reporting 16 clinical controlled trials were included in this study. The incidence of DS was significantly greater in the OC groups than in the control groups (RR 1.80, 95% CI 1.33-2.43). Subgroup analyses showed that the unit assessed (tooth or patient), the region in which the study was conducted, and the intervention were not related to the incidence of DS in females taking OC after impacted mandibular third molar extraction. The sensitivity analysis showed no significant change when any one study was excluded. Publication bias was also not detected. This study suggests that OC use may promote the incidence of DS in females following impacted mandibular third molar extraction. PMID:26116066

  8. The 'nonmenstrual woman' in the new millennium? Discourses on menstrual suppression in the first decade of extended cycle oral contraception use in Canada.

    PubMed

    Granzow, Kara

    2014-06-01

    In the early-twenty-first century, extended cycle oral contraception (ECOC) became available by physician prescription in North America. Researchers speculate that this drug, with its capacity to reduce or eliminate menstrual bleeding, may shift not only women's biological processes but also their experiences of menstruation. In this paper, I discuss women's experiences of menstrual suppression drawing on findings from a qualitative study conducted before ECOC was available, and examine these findings against recently published research on menstrual suppression in an ECOC era. Findings suggest that the body as a natural entity figures strongly in women's discourses on suppression. They further suggest that suppression is a contingent, paradoxical and practical achievement, not a securely or fully realised embodied state. This paper reads women's accounts of menstrual suppression prior to ECOC as a challenge to the modern artifice of a mind/body split, and questions whether this challenge is perhaps made less discernible in an ECOC era, where attention may no longer be paid to the daily practices of menstrual suppression. Hence, a case is made for the varied political effects of ongoing non-menstruation versus event-specific practices of non-menstruation. PMID:24735380

  9. Hormonal Contraception and Thrombotic Risk: A Multidisciplinary Approach

    PubMed Central

    Chung, Richard J.; Michelson, Alan D.; Neufeld, Ellis J.; Gordon, Catherine M.; Laufer, Marc R.; Emans, S. Jean

    2011-01-01

    Heightened publicity about hormonal contraception and thrombosis risk and the publication of new guidelines by the World Health Organization in 2009 and the Centers for Disease Control and Prevention in 2010 addressing this complex issue have led to multidisciplinary discussions on the special issues of adolescents cared for at our pediatric hospital. In this review of the literature and new guidelines, we have outlined our approach to the complex patients referred to our center. The relative risk of thrombosis on combined oral contraception is three- to fivefold, whereas the absolute risk for a healthy adolescent on this therapy is only 0.05% per year. This thrombotic risk is affected by estrogen dose, type of progestin, mechanism of delivery, and length of therapy. Oral progestin-only contraceptives and transdermal estradiol used for hormone replacement carry minimal or no thrombotic risk. Transdermal, vaginal, or intrauterine contraceptives and injectable progestins need further study. A personal history of thrombosis, persistent or inherited thrombophilia, and numerous lifestyle choices also influence thrombotic risk. In this summary of one hospital's approach to hormone therapies and thrombosis risk, we review relative-risk data and discuss the application of absolute risk to individual patient counseling. We outline our approach to challenging patients with a history of thrombosis, known thrombophilia, current anticoagulation, or family history of thrombosis or thrombophilia. Our multidisciplinary group has found that knowledge of the guidelines and individualized management plans have been particularly useful for informing discussions about hormonal and nonhormonal options across varied indications. PMID:21199853

  10. Co-existence of a giant splenic hemangioma and multiple hepatic hemangiomas and the potential association with the use of oral contraceptives: a case report

    PubMed Central

    Chatzoulis, George; Kaltsas, Andreas; Daliakopoulos, Stauros; Sallam, Osama; Maria, Kaltsa; Chatzoulis, Kostas; Pachiadakis, Ioannis

    2008-01-01

    Introduction Hepatic and splenic hemangiomas are common benign tumors that mainly affect female patients. Giant splenic hemangiomas are extremely rare, especially when correlated with multiple hepatic hemangiomas. Pathogenetic mechanisms between hemangiomas and oral contraceptives, as well as therapeutic approaches, are analyzed in this case report, in particular for the management of synchronous splenic and hepatic hemangiomas. Case presentation We report here a 42-year-old woman with a giant splenic hemangioma, multiple hepatic hemangiomas and a history of oral estrogen intake for many years. At first it was difficult to determine the organ from which the giant hemangioma originated. Angiography proved extremely helpful in tracing its origin in the spleen. Hematomas in the giant hemangioma posed a significant threat of rupture and catastrophic hemorrhage. We left the small hepatic hemangiomas in place, and removed the spleen along with the giant splenic hemangioma. Conclusion Diagnostic pitfalls in the determination of the origin of this giant hemangioma, attribution of its origin to the spleen angiographically, the unusual co-existence of the giant splenic hemangioma with multiple hepatic ones, and the potential threat of rupture of the giant hemangioma are some of the highlights of this case report. Estrogen administration represents a pathogenic factor that has been associated with hemangiomas in solid organs of the abdominal cavity. The therapeutic dilemma between resection and embolization of giant hemangiomas is another point of discussion in this case report. Splenectomy for the giant splenic hemangioma eliminates the risk of rupture and malignant degeneration, whereas observation for the small hepatic ones (<4 cm) was the preferable therapeutic strategy in our patient. PMID:18462497

  11. Reversible contraception for the woman over 35 years of age.

    PubMed

    Archer, D F

    1992-12-01

    Methods of reversible contraception, oral contraceptives, intrauterine devices, and Norplant (systemic progestin-only contraceptive; Wyeth-Ayerst, Radnor, PA), can be used for women over 35 years of age. Oral contraceptive formulations are safe and effective for healthy women up to the age of menopause. Oral contraceptives in women who do not smoke cigarettes do not result in a significant increased risk for cardiovascular disease. The incidence of breast cancer is not increased in women who have used oral contraceptives. A slight increase was found in younger women who had been on oral contraceptives based on a reanalysis of the contraceptive and steroid hormone study of the Centers for Disease Control. A reduction in the incidence of ovarian epithelial neoplasia by 40% was found in three European case-control studies. Two intrauterine devices are currently available on the US market: Paragard (GynoPharma, Somerville, NJ) and Progestasert (Alza Corp., Palo Alto, CA). Both of these provide highly effective contraception. A World Health Organization prospective randomized study found that there was an increase in pelvic inflammatory disease rates in the first 20 days after intrauterine device insertion. The intrauterine device itself did not increase the pelvic inflammatory disease incidence rates. The Norplant system exerts its contraceptive action through ovulation inhibition and alteration of cervical mucus. The major consumer complaint is irregular or prolonged uterine bleeding, which can be controlled by oral estrogen. PMID:1450355

  12. Male contraception.

    PubMed

    Chao, Jing; Page, Stephanie T; Anderson, Richard A

    2014-08-01

    Clear evidence shows that many men and women would welcome new male methods of contraception, but none have become available. The hormonal approach is based on suppression of gonadotropins and thus of testicular function and spermatogenesis, and has been investigated for several decades. This approach can achieve sufficient suppression of spermatogenesis for effective contraception in most men, but not all; the basis for these men responding insufficiently is unclear. Alternatively, the non-hormonal approach is based on identifying specific processes in sperm development, maturation and function. A range of targets has been identified in animal models, and targeted effectively. This approach, however, remains in the pre-clinical domain at present. There are, therefore, grounds for considering that safe, effective and reversible methods of contraception for men can be developed. PMID:24947599

  13. Male contraception

    PubMed Central

    Chao, Jing; Page, Stephanie T.; Anderson, Richard A.

    2015-01-01

    Clear evidence shows that many men and women would welcome new male methods of contraception, but none have become available. The hormonal approach is based on suppression of gonadotropins and thus of testicular function and spermatogenesis, and has been investigated for several decades. This approach can achieve sufficient suppression of spermatogenesis for effective contraception in most men, but not all; the basis for these men responding insufficiently is unclear. Alternatively, the nonhormonal approach is based on identifying specific processes in sperm development, maturation and function. A range of targets has been identified in animal models, and targeted effectively. This approach, however, remains in the pre-clinical domain at present. There are, therefore, grounds for considering that safe, effective and reversible methods of contraception for men can be developed. PMID:24947599

  14. Introduction of postabortion contraception, prioritizing long-acting reversible contraceptives, in the principal maternity hospital of Gabon.

    PubMed

    Mayi-Tsonga, Sosthène; Obiang, Pamphile Assoumou; Minkobame, Ulysse; Ngouafo, Doris; Ambounda, Nathalie; de Souza, Maria Helena

    2014-07-01

    A prospective, descriptive, analytic study was conducted at the Centre Hospitalier de Libreville in Gabon between February and September 2013 to evaluate acceptance of long-acting reversible contraceptives (LARC) and depot-medroxyprogesterone acetate (DMPA) following abortion. Women received counseling on the combined oral pill, DMPA, copper intrauterine devices (IUDs), and implants. The association between sociodemographic and clinical characteristics, knowledge of contraceptives, and acceptance was analyzed. Of the 383 women admitted with abortion complications, 206 (53.7%) knew of no systemic contraceptives. The best-known method was the oral pill (42.0%). Only 14 women (3.6%) knew of a LARC method (IUD or implants) and only 2 (0.5%) said the injectable was their best-known method. Over 90% accepted a modern contraceptive method after abortion. Two-thirds (66.8%) chose the pill, 14.6% DMPA, and 9.3% a LARC method. Only 9.1% of the women refused to initiate use of any method. PMID:24745694

  15. Pharmacodynamic effects of oral contraceptive steroids on biochemical markers for arterial thrombosis. Studies in non-diabetic women and in women with insulin-dependent diabetes mellitus.

    PubMed

    Petersen, Kresten Rubeck

    2002-02-01

    Even small increases in the frequency of thrombotic disease in users of OCs have general health impact because of their widespread use, which is currently expanding to potential risk groups. The present investigations were launched to study the effects of OCs containing 20-40 micrograms of EE combined with the latest developed gonane progestogens on biochemical risk markers within metabolic systems involved in the development of arterial thrombotic disease. The studies included evaluation of carbohydrate and lipid metabolism as well as the haemostatic system and were performed in non-diabetic women and in women with IDDM, who are prone to the development of arterial thrombosis. In the evaluation of the carbohydrate metabolism in non-diabetic women, we found no effect on fasting glucose or insulin and no effect on the insulin response to oral glucose in women using monophasic OCs containing EE combined with DSG or GST. This contrasts the evaluation of triphasic OCs containing EE combined with GST or NGT, which increased fasting insulin and reduced insulin sensitivity without affecting the glucose-effectiveness or the beta-cell function. Impaired glucose tolerance developed in 10% of the women after 6 months. These finding suggest that OCs are able to induce a state of insulin resistance, which should be considered in the prescription for women with potential disturbed insulin sensitivity or reduced beta-cell secretory capacity e.g. women with ovarian hyperandrogenism, obesity, previous GDM or perimenopausal women. We found no change in glycaemic control in 22 women with well-regulated IDDM treated with a monophasic combination of EE and GST for one year and none of the women developed microalbuminuria during treatment. In the women with diabetes we observed an increase in fasting levels of triglycerides, a decrease in LDL-cholesterol, and unchanged concentrations of total cholesterol and HDL-cholesterol during treatment. In non-diabetic women treated with the same

  16. Intrauterine Contraception.

    PubMed

    Hsia, Jennifer K; Creinin, Mitchell D

    2016-05-01

    Currently, there are only two basic types of intrauterine devices (IUDs): copper and hormonal. However, other types of IUDs are under development, some of which are in clinical trials around the world. Continued development has focused on increasing efficacy, longer duration of use, and noncontraceptive benefits. This review discusses currently available intrauterine contraceptives, such as the Cu380A IUD and levonorgestrel-releasing intrauterine systems; novel intrauterine contraceptives that are available in select parts of the world including the intrauterine ball, low-dose copper products, frameless devices, and intrauterine delivery systems impregnated with noncontraceptive medication; and novel products currently in development. PMID:26947701

  17. Emergency contraception - Potential for women's health

    PubMed Central

    Mittal, Suneeta

    2014-01-01

    Emergency contraception (EC) is a safe and effective method which is used to prevent unwanted pregnancy after unprotected sexual intercourse. Many of the unwanted pregnancies end in unsafe abortions. The search for an ideal contraceptive, which does not interfere with spontaneity or pleasure of the sexual act, yet effectively controls the fertility, is still continuing. Numerous contraceptive techniques are available, yet contraceptive coverage continues to be poor in India. Thus, even when not planning for a pregnancy, exposure to unprotected sex takes place often, necessitating the use of emergency contraception. This need may also arise due to failure of contraceptive method being used (condom rupture, diaphragm slippage, forgotten oral pills) or following sexual assault. Emergency contraception is an intervention that can prevent a large number of unwanted pregnancies resulting from failure of regular contraception or unplanned sexual activity, which in turn helps in reducing the maternal mortality and morbidity due to unsafe abortions. However, a concern has been expressed regarding repeated and indiscriminate usage of e-pill, currently the rational use of emergency contraception is being promoted as it is expected to make a significant dent in reducing the number of unwanted pregnancies and unsafe abortions. In fact, since the introduction of emergency contraception, the contribution of unsafe abortion towards maternal mortality has declined from 13 to 8 per cent. PMID:25673542

  18. Combined Use of Self-Efficacy Scale for Oral Health Behaviour and Oral Health Questionnaire: A Pilot Study

    ERIC Educational Resources Information Center

    Soutome, Sakiko; Kajiwara, Kazumi; Oho, Takahiko

    2012-01-01

    Objective: To examine whether the combined use of a task-specific self-efficacy scale for oral health behaviour (SEOH) and an oral health questionnaire (OHQ) would be useful for evaluating subjects' behaviours and cognitions. Design: Questionnaires. Methods: One hundred and eighty-five students completed the SEOH and OHQ. The 30-item OHQ uses a…

  19. [Post-abortion contraception: effects of contraception services and reproductive intention].

    PubMed

    Borges, Ana Luiza Vilela

    2016-02-01

    Contraceptive counseling and the supply of contraceptive methods are part of post-abortion care and positively influence the subsequent use of contraceptive methods. Studies showing such evidence have been conducted predominantly in countries with no legal restrictions on abortion and with adequate care for women that terminate a pregnancy. However, little is known about contraceptive practices in contexts where abortion is illegal, as in Brazil, in which post-abortion contraceptive care is inadequate. The objective of this study was to analyze the effect of contraceptive care on male condom use and oral and injectable contraceptives in the six months post-abortion, considering reproductive intention. The results showed that contraceptive care only has a positive effect on the use of oral contraceptives in the first six months post-abortion, as long as the woman had a medical consultation in the same month in which she received information on contraception. One or the other intervention alone had no significant impact. PMID:26910252

  20. [Pregnancy contraception (Current Care Guideline)].

    PubMed

    Halttunen-Nieminen, Mervi; Piltonen, Terhi; Alenius, Heidi; Apukka, Laura; Kosunen, Elise; Pietilä, Kirsi; Sihvo, Sinikka; Vuorela, Piia; Väänänen, Eija; Yli-Kivistö, Tiina

    2016-01-01

    There are no age limits for the start or use of contraception. Prior gynecological examination or cervical smear is not needed. Condom is the only method that protects from sexually transmitted diseases. An increase in the risk of venous thromboembolism (VTE) is associated only with combined contraceptives. However, the risk is remarkably higher with pregnancy, puerperium or with smoking. The most effective reversible methods are intrauterine devices (IUD) and implants, as these do not depend on daily memory. Natural family planning methods are not reliable, and effective contraception should be easily available for all at all times. PMID:27382829

  1. [Progestational contraception].

    PubMed

    Bercovici, J P

    1987-09-21

    Synthetic progestins derived from nortestosterone provide a promising contraceptive alternative for women with contraindications for estrogens. Progesterone and synthetic progestins reduce vasodilatation and edema induced by estrogens and stop estrogen-dependent cellular multiplication in target tissue. Progestins have 2 kinds of contraceptive affect: antigonadotropic action at sufficient doses, and peripheral action at lower doses. The cervical mucus is modified in composition and volume, becoming hostile to sperm; the endometrial mucus atrophies; and tubal motility is slowed. High dose progestins are administered from the 5th or 10th to the 25th cycle day, with the earlier date preferred for women with shorter cycles. They are an ideal method for women with endometrial hyperplasia or benign breast disease or histories of breast or uterine cancer, as well as for women over 40 with dysovulatory cycles. Contraindications to high dose progestins include obesity, hypertension, lipid metabolic anomalies, and diabetes. Low dose progestin-only pills are administered at the exact same time each day including during menstruation. They are attractive for some women because they contain no estrogen, a reduced progestin dose causing fewer headaches and less somnolence, and fewer metabolic effects. Low dose progestins are indicated for lactating women, those with contraindications to estrogens such as obesity, hypertension, hyperlipidemia, and diabetes, and those with renal or cardiac insufficiency with valvulopathy. Low dose progestins are also indicated for nulliparas and other women for whom IUDS are contraindicated. Women using low dose progestins should never take drugs that act as enzymatic inductors, which speed hepatic degradation of steroids and reduce their efficiency. A resulting pregnancy is likely to be extrauterine because of slowed tubal transport. The failure rate of low dose progestins ranges from .9-3%, with higher failure rates among younger women. About 30

  2. Biological variability and impact of oral contraceptives on vitamins B(6), B(12) and folate status in women of reproductive age.

    PubMed

    McArthur, Jennifer O; Tang, HoMan; Petocz, Peter; Samman, Samir

    2013-09-01

    Vitamins B(6), B(12) and folate play crucial metabolic roles especially during the reproductive years for women. There is limited reporting of within-subject variability of these vitamins. This study aimed to determine the within and between subject variability in serum vitamins B(6), B(12), folate and erythrocyte folate concentrations in young women; identify factors that contribute to variability; and determine dietary intakes and sources of these vitamins. Data were obtained from the control group of a trial aimed at investigating the effect of iron on the nutritional status of young women (age 25.2 ± 4.2 year; BMI 21.9 ± 2.2 kg/m2). The coefficients of variability within-subject (CVI) and between-subject (CVG) for serum vitamins B(6), B(12)and folate, and erythrocyte folate were calculated. Food frequency questionnaires provided dietary data. CVI and CVG were in the range 16.1%-25.7% and 31.7%-62.2%, respectively. Oral contraceptive pill (OCP) use was associated (P = 0.042) with lower serum vitamin B12 concentrations. Initial values were 172 ± 16 pmol/L and 318 ± 51 pmol/L for OCP and non-OCP users, respectively; with differences maintained at four time points over 12 weeks. BMI, age, physical activity, alcohol intake and haematological variables did not affect serum or erythrocyte vitamin concentrations. Vitamin B12 intakes were derived from traditional and unexpected sources including commercial energy drinks. Young women using OCP had significantly lower serum vitamin B12 concentrations. This should be considered in clinical decision making and requires further investigation. PMID:24067390

  3. Oral administration of an anti-inflammatory does not compromise the efficacy of intra-testicular injection of zinc gluconate as a contraceptive for dogs.

    PubMed

    Oliveira, Erika C S; Muller, Patricia M; Silva, Fernanda L M; Nery, Lorena T B; de Sá, Marcelo J C; Guerra, Maria Madalena P; Oliveira-Esquerre, Karla P; Kastelic, John P; Douglas, Robert H

    2012-06-01

    The objective was to determine whether the efficacy of zinc gluconate (Testoblock(®)) as a chemical contraceptive in male dogs was compromised in the presence of metamizole sodium (a nonsteroidal antiinflammatory/analgesic agent). Ten sexually mature mongrel dogs were assigned to two groups, a control group (n = 5) and a treated group (n = 5). Testoblock(®), a proprietary zinc-gluconate (13.1 mg zinc/ml) solution in a physiological vehicle, was injected into each testis (0.2-1.0 ml/testis, based on testis width). Half of the dogs (treated group) were also given metamizole sodium (also known as sodium dipyrone) orally (25mg/kg three times a day for 2 days), starting 2-3 h after testis injection. A physical examination and assessment of testis width, hematology, clinical chemistry (hepatic and renal function) and semen characteristics, were done immediately after treatment and then every 2 months for 180 days. There was no post-treatment scrotal biting or licking, although there was transient testicular swelling in both control and treated dogs during the first 3 days after injection. At 60 days after injection, all dogs were azoospermic. At 120 and 180 days, seven dogs had azoospermia and the remaining three (two control and one treated) had apparent aspermia (no ejaculate could be collected). There were no significant differences between groups for clinical findings or any aspect of hematology, renal, or hepatic function. In conclusion, giving metamizole sodium concurrent with an intra-testicular injection of a zinc-based solution did not interfere with chemical sterilization and it improved animal welfare. PMID:22682769

  4. Oral Contraceptive Use, Micronutrient Deficiency, and Obesity among Premenopausal Females in Korea: The Necessity of Dietary Supplements and Food Intake Improvement

    PubMed Central

    Park, Boyoung; Kim, Jeongseon

    2016-01-01

    This study addressed the associations between oral contraceptive (OC) use and obesity as measured by recording the body mass index (BMI) of premenopausal females, and possible interactions with micronutrient intake were considered. A group of 39,189 premenopausal females aged 35–59 were included in the analysis; they were in the Health Examinee cohort. Participant BMIs were calculated from anthropometric measurements, and females with a BMI≥25kg/m2 were considered obese. Individual OC use, age at first OC use, duration of OC use, nutrient intake, and other covariates were measured with a structured questionnaire. A multivariate logistic regression with an interaction term was applied to identify the odds ratio (OR) and 95% confidence intervals (CI) between OC use and obesity along with consideration of micronutrient intake interactions. OC use is associated with an increased risk of obesity (OR = 1.12, 95% CI = 1.04–1.20), and females who used OCs for more than 6 months over their lifetimes were more likely to be obese (OR = 1.15, 95% CI = 1.01–1.32) compared with those who used OCs for <6 months. There were interaction effects between phosphorus, potassium, vitamin A, vitamin B1, vitamin B2, niacin, vitamin C intake and total duration of OC use on being obesity (P-value<0.05). When stratified by micronutrient intake, the associations between total OC use duration and obesity were present only among those with calcium, phosphorus, potassium, vitamin A, B1, B2, C, niacin, and folate intakes below the recommended levels. Efforts to estimate nutrient intake and prevent micronutrient depletion with supplements or food should be considered by clinicians for females who take OC for a long period. PMID:27348598

  5. Methylprednisolone Oral

    MedlinePlus

    ... Nizoral), oral contraceptives, phenobarbital, phenytoin (Dilantin), rifampin (Rifadin), theophylline (Theo-Dur), and vitamins.if you have a ... stomach irritation vomiting headache dizziness insomnia restlessness depression anxiety acne increased hair growth easy bruising irregular or ...

  6. Dexamethasone Oral

    MedlinePlus

    ... Nizoral), oral contraceptives, phenobarbital, phenytoin (Dilantin), rifampin (Rifadin), theophylline (Theo-Dur), and vitamins.if you have a ... stomach irritation vomiting headache dizziness insomnia restlessness depression anxiety acne increased hair growth easy bruising irregular or ...

  7. Hydrocortisone Oral

    MedlinePlus

    ... Nizoral), oral contraceptives, phenobarbital, phenytoin (Dilantin), rifampin (Rifadin), theophylline (Theo-Dur), and vitamins.if you have a ... stomach irritation vomiting headache dizziness insomnia restlessness depression anxiety acne increased hair growth easy bruising irregular or ...

  8. Emergency contraception

    PubMed Central

    Langille, Donald B.; Allen, Michael; Whelan, Anne Marie

    2012-01-01

    Abstract Objective To determine the extent to which Nova Scotian FPs prescribe and provide emergency contraceptive pills (ECPs) and to explore their knowledge of and attitudes toward ECPs. Design Survey of Nova Scotian FPs using a modified Dillman method. Setting All regions of Nova Scotia. Participants Family physicians registered with Dalhousie University’s Division of Continuing Medical Education. Main outcome measures Sex differences in the provision of ECPs and knowledge and attitudes about the ECP Plan B. Results Of 913 eligible FPs, 155 (17.0%) participated in the survey. Respondents resembled the sampling frame closely. Most physicians (64.0%) had prescribed ECPs in the previous year (mean number of prescriptions, 4.92); only 12.9% provided ECPs in advance of need. Knowledge about Plan B was quite good, except for knowledge of the time frame for potential effectiveness; only 29.2% of respondents answered that question correctly. Respondents generally supported nonprescription availability of ECPs, but 25.0% of FPs were concerned that this could lead to less use of more effective methods of contraception, and 39.2% believed that it would encourage repeat use. Younger FPs provided ECPs more often than their older colleagues, while female respondents had better knowledge about Plan B. In multivariate analysis being younger than 40 years was marginally associated with prescribing Plan B and with prescribing any form of ECP. Conclusion Most Nova Scotian FPs provided ECPs and had generally good knowledge about and attitudes toward providing such contraception without prescription. However, FPs were poorly informed about the length of time that Plan B can be effective, which could potentially affect use when patients consult several days after unprotected sex. There were some concerns about nonprescription availability of ECPs, which could have implications for recommending it to patients. Rarely were ECPs prescribed for advance use, which might represent a lost

  9. Knowledge and Beliefs about Reproductive Anatomy and Physiology among Mexican-Origin Women in the U.S.A: Implications for Effective Oral Contraceptive Use

    PubMed Central

    Amastae, Jon; Potter, Joseph E.; Hopkins, Kristine; Grossman, Daniel

    2013-01-01

    Inherent in many reproductive health and family planning programmes is the problematic assumption that the body, its processes, and modifications to it are universally experienced in the same way. This paper addresses contraceptive knowledge and beliefs among Mexican-origin women, based upon data gathered by the qualitative component of the Border Contraceptive Access Study. Open-ended interviews explored the perceived mechanism of action of the pill, side effects, non-contraceptive benefits, and general knowledge of contraception. Findings revealed complex connections between traditional and scientific information. Use of medical terms (“hormone”) illustrated attempts to integrate new information with existing knowledge and belief systems. Conclusions address concerns that existing information and services may not be sufficient if population-specific knowledge and beliefs are not assessed and addressed. Findings can contribute to the development of effective education, screening, and reproductive health services. PMID:23464742

  10. "Pregnancy and labour cause more deaths than oral contraceptives": The debate on the pill in the Spanish press in the 1960s and 1970s.

    PubMed

    Ortiz-Gómez, Teresa; Ignaciuk, Agata

    2015-08-01

    From 1941 to 1978, Franco's regime in Spain banned all contraceptive methods. The pill started circulating in Spain from the 1960s, officially as a drug used in gynaecological therapy. However, in the following decade it was also increasingly used and prescribed as a contraceptive. This paper analyses debates about the contraceptive pill in the Spanish daily newspaper ABC and in two magazines, Blanco y Negro and Triunfo, in the 1960s and 1970s. It concludes that the debate on this contraceptive method was much more heterogeneous than might be expected given the Catholic-conservative character of the dictatorship. The daily press focused on the adverse effects of the drug and magazines concentrated on the ethical and religious aspects of the pill and discussed it in a generally positive light. Male doctors and Catholic authors dominated the debate. PMID:24259515

  11. [Historical survey of modern reversible contraceptive methods].

    PubMed

    Mbabajende, V

    1986-04-01

    Because of contraception, pregnancy need not be viewed by women as punishment for sexual activity but as a planned and desired event. Most of the contraceptive methods used in developing countries at present were introduced during the 1960s, but use of contraception has a long history and some methods date back to antiquity. Contraceptive pills were already used around 2000 BC in the form of mercury and arsenic tablets. Their effectiveness was questionable. The role of hormones in human reproduction began to be understood only in the early 1900s. The discovery of progesterone in a Mexican iguana in the 1940s permitted production of progesterone on a large scale. Estrogens had been identified around 1930. Human trials of a contraceptive pill beginning in 1956 in Puerto Rico demonstrated that progestins could prevent pregnancy by suppressing ovulation. Later on, estrogen was added to reduce menstrual irregularities. The 1st generation of combined oral contraceptives contained very high levels of hormones associated with high rates of side effects. Numerous formulations with lower hormonal contents became available beginning around 1970 and constitute the principal formulations in use today. A number of long acting hormonal methods based on progestins have been developed, including injectables, some IUDs and vaginal rings, and implants. The 1st commercially available injectable, norethisterone enanthate, did not acquire the wide distribution of medroxyprogesterone acetate, sold as Depo Provera and used to treat various pathological conditions as well as for contraception. The 1st true IUDs were small stones placed within the uteri of camels by nomads to prevent pregnancy during long caravans. An IUD was developed in 1909 by Richter, and the 2 most widely used models before 1960 were the Grafenberg and Ota silver rings. Use of the 2 rings became rare for medical reasons after 1935 despite their efficacy. Safe plastic IUDs which appeared beginning in the early 1960s

  12. Contraceptive practices.

    PubMed

    Morgenthau, J E; Rao, P S

    1976-08-01

    A family life education program (FLEP) providing contraceptive services within a comprehensive health care organization for low-income, inner-city adolescents is described. Each female patient attending in the July 1-September 30, 1974, period was included in a study undertaken to identify and serve the unmet needs of the teen-age population in the community of East Harlem. Of the 334 females interviewed, almost 1/2 were black, 37% were Hispanic, 12% were white, and 2% were Oriental, totals representative of the surrounding community. The questionnaire included information on demographic and social background, sexual history, reproductive history, and contraceptive experience. Comparisons are made on the answers between groups. Personal contacts and school outreach were the 2 main sources of referral to the clinic. Sexual history was found to be associated with social background rather than physiological factors. More than 1/2 the teen-agers had never used contraception prior to their 1st clinic visit and another 1/4 of the girls were using unreliable methods. The study indicated that teen-agers will use good programs which are designed to meet their needs. For teen-agers, a free-standing clinic offering comprehensive health care is the ideal situation. PMID:1066531

  13. Emergency Contraception Website

    MedlinePlus

    Text Only Full media Version Get Emergency Contraception NOW INFO about Emergency Contraception Q&A about Emergency Contraception Español | Arabic Find a Morning After Pill Provider Near You This website is ...

  14. [Family planning with different contraceptive methods].

    PubMed

    Dumitrache, F; Gheorghiţă, E

    1991-01-01

    Female hormonal contraceptives, introduced commercially in 1959, contained 10 mg of norethynodrel and .15 mg of mestranol. The estrogen and progesterone doses were progressively reduced over time. In 1989, approximately 60 million couples used oral contraceptives (OCs) ranging from 1% in Japan to 40% in the Netherlands. The monophasic pill contains .01 - .04 mg of ethinyl estradiol (EE), and the biphasic pill contains increasing doses of progesterone and estroprogesterone in the course of the menstrual cycle. Triphasic combined pills contain an initially dominant estrogen dose. In oral sequential pills, estrogen is given on days 14-16 followed by a estroprogesterone for 5-7 days. Micropills with progesterone, injectables with medroxyprogesterone, and 3rd-generation OCs such as gestoden with a low progesterone dose of .04 mg/day and reduced androgenic activity are among other OCs. The OCs are administered in 21-22 day packets. Absolute contraindications include history of venous thrombosis, atherogenic lipid profile, hormone-dependent cancer, and allergy. Relative contraindications include arterial ailments, smoking, hypertension, older age, obesity, and familial history of cardiovascular and cerebrovascular accidents. Interactions with antibiotics (ampicillin and tetracycline) occur as the modified intestinal flora reduces the level of deconjugated EE. Most frequent side effects are depression, modification of libido, ocular disorders, headache, and urinary infection. Benefits include favorable modification of menstrual cycle, and reduction of endometriosis and endometrial and ovarian cancer. Systemic risks such as cardiovascular and blood coagulation effects occur mainly with high-dose OCs. Further topics addressed are the cancer risk and protective effect of OCs, postcoital OCs, traditional contraception, the IUD, RU-486, implants, vaccination with the human antigonadotropine, and the vaginal ring. PMID:1823414

  15. Sterilization and contraceptive services in Catholic hospitals.

    PubMed

    O'Lane, J M

    1979-02-15

    Sterilization and contraceptive practices in United States Catholic hospitals were surveyed by anonymous mail questionnaires, obtaining a 57% response rate (340 of 598). Twenty per cent of the hospitals permitted medically indicated sterilization operations. Forty-seven per cent of those hospitals not allowing sterilization procedures reported that their medical staffs were interested in performing medically indicated sterilizations. The types of contraceptive services offered varied widely. The rhythm method was most frequently available, with oral contraceptives in second place; many hospitals did not provide any family-planning services; 13% utilized all types of contraception. The thesis is advanced that improvement in availability of sterilization and contraceptive services is a duty of hospital medical staffs. PMID:433994

  16. [A beam of dawn light of study on gossypol as a safe, effective, and reversible male antifertility contraceptive--evaluation of the studies by using low dose gossypol combined with steroid hormone for male contraception].

    PubMed

    Xue, S

    2000-06-01

    The present paper is an evaluation of the studies of two articles published in this issue of the journal which adopted a new regimen of low dose gossypol(12 mg.kg-1.d-1) combined with steroid hormones (methyltestosterone 20 mg.kg-1.d-1 and ethinyl estradiol 100 micrograms.kg-1.d-1) for 6 weeks as initial dose, and a similar low dose gossypol alone for 12 weeks as maintenance dose. Results showed that the dosage regimen could damage the epididymal sperms and onset of antifertility within 6 weeks in male rats, and prevent the incidence of the side effect of irreversible azoospermia. There was no adverse effect in viscera tissues, and the infertility could be reversible in about 6 weeks following withdrawal of gossypol. Male volunteers taking low dose gossypol (15 mg/d) could induce antifertility within 12 weeks, then followed by a maintenance dose of gossypol(10 mg/d) for 44 weeks. All of them remained infertile, and without developing hypokalemia and irreversible azoospermia. The fertility and the inducing abnormal histone-to-protamine replacement reaction as well as alteration of nuclear basic proteins could be recovered 10 weeks after withdrawal of drug treatment. These results provide a new approach for using the new regimen in clinical trial and a new prospect of gossypol as a potential male contraceptive. PMID:12903461

  17. Immaculate contraception.

    PubMed

    Smith, K

    The city of Dundee has the highest teen pregnancy and abortion rate in Scotland. In the heart of the city, The Corner is a health and information drop-in center for people aged 12-25 years which has provided a range of health promotion activities, contraception services, and general information and advice since April 1996. 8000 inquiries were posed from young people in Dundee and the surrounding areas in The Corner's first full year of operation, one-third on sexual health. A survey conducted last December found that 55% of the center's clients were aged 12-15. Young people helped to design the center, creating a cafe atmosphere in the main drop-in area with tables, chairs, and loungers. Reference literature is on display, music plays, and a series of computers is linked to health information databases. In this environment, clients can hang out, ask questions, and receive condoms or other contraceptive services without the embarrassment of attending a local family planning clinic. The examination and counseling rooms are also relaxed and warmly-appointed. The Corner has also offered emergency contraception since January, one of the few places in Scotland where nurses can provide it. While The Corner has received some local criticism, it is operating within the laws and codes of professional practices. The center is jointly funded by Tayside Health Board, Dundee City Council, and the Scottish Office. Finally, the center has a travel program which offers a package of activities based upon a different foreign country each week. PMID:9326014

  18. Oral contraceptives modify the effect of GATA3 polymorphisms on the risk of asthma at the age of 18 years via DNA methylation

    PubMed Central

    2014-01-01

    Background The prevalence of asthma in girls increases after puberty. Previous studies have detected associations between sex hormones and asthma, as well as between sex hormones and T helper 2 (Th2) asthma-typical immune responses. Therefore, we hypothesized that exogenous or endogenous sex hormone exposure (represented by oral contraceptive pill (OCP) use and early menarche, respectively) are associated with DNA methylation (DNA-M) of the Th2 transcription factor gene, GATA3, in turn affecting the risk of asthma in girls, possibly in interaction with genetic variants. Blood samples were collected from 245 female participants aged 18 years randomly selected for methylation analysis from the Isle of Wight birth cohort, UK. Information on use of OCPs, age at menarche, and concurrent asthma were assessed by questionnaire. Genome-wide DNA-M was determined using the Illumina Infinium HumanMethylation450 beadchip. In a first stage, we tested the interaction between sex hormone exposure and genetic variants on DNA-M of specific cytosine-phosphate-guanine (CpG) sites. In a second stage, we determined whether these CpG sites interact with genetic variants in GATA3 to explain the risk of asthma. Results Interactions between OCP use and seven single nucleotide polymorphisms (SNPs) of GATA3 were analyzed for 14 CpG sites (stage 1). The interaction between OCP use and SNP rs1269486 was found to be associated with the methylation level of cg17124583 (P = 0.002, false discovery rate (FDR) adjusted P = 0.04). DNA-M of this same CpG site was also influenced by the interaction between age at menarche and rs1269486 (P = 0.0017). In stage 2, we found that cg17124583 modified the association of SNP rs422628 with asthma risk at the age of 18 years (P = 0.006, FDR adjusted P = 0.04). Subjects with genotype AG showed an increase in average risk ratio (RR) from 0.31 (95% CI: 0.10 to 0.8) to 11.65 (95% CI: 1.71 to 79.5) when methylation level increased from 0.02 to 0

  19. The effect of past use of oral contraceptive on bone mineral density, bone biochemical markers and muscle strength in healthy pre and post menopausal women

    PubMed Central

    Allali, Fadoua; El Mansouri, Laila; Abourazzak, Fatima zohra; Ichchou, Linda; Khazzani, Hamza; Bennani, Loubna; Abouqal, Redouane; Hajjaj-Hassouni, Najia

    2009-01-01

    Background during adulthood, most studies have reported that oral contraceptive (OC) pills had neutral, or possibly beneficial effect on bone health. We proposed this study of pre and post menopausal women assessing BMD, bone biochemical markers and physical performance among OC past users and comparable women who have never use Ocs. Methods A cross-sectional study comparing the bone density, bone biochemical markers (osteocalcin, CTX) and three measures to assess physical performance: timed get-up-and-go test "TGUG", five-times-sit-to-stand test "5 TSTS" and 8-feet speed walk "8 FSW" of users and never users OC. We were recruited 210 women who used OC for at least 2 years with that of 200 nonusers was carried out in pre and postmenopausal women (24-86 years). Results when analysing the whole population, BMD and biochemical markers values were similar for Ocs past users and control subjects. However when analysing the subgroup of premenopausal women, there was a statistically significant difference between users and never-users in osteocalcin (15,5 ± 7 ng/ml vs 21,6 ± 9 ng/ml; p = 0,003) and CTX (0,30 ± 0,1 ng/ml vs 0,41 ± 0,2 ng/ml; p = 0,025). This difference persisted after adjustment for age, BMI, age at menarche and number of pregnancies. In contrast, in post menopausal women, there was no difference in bone biochemical markers between OC users and the control. On the other hand OC past users had a significant greater performance than did the never users group. And when analysing the physical performance tests by quartile OC duration we found a significant negative association between the three tests and the use of OC more than 10 years. Conclusion the funding show no evidence of a significant difference in BMD between Ocs users and never user control groups, a decrease in bone turn over in OC pre menopausal users and a greater physical performances in patients who used OC up than 10 years. PMID:19887010

  20. Intrauterine contraception.

    PubMed

    Reinprayoon, D

    1992-08-01

    Currently 85 million women use an intrauterine device (IUD), making it the most widely used, reliable, reversible contraceptive method worldwide. Although the exact mechanisms by which copper-bearing IUDs produce contraceptive action are not completely defined, recent evidence indicates that they act primarily to prevent sperm from fertilizing ova. The future of the IUD is brighter than it has been for the past 20 years. The latest generation of IUDs, such as the TCu 380A (Paragard, GynoPharma, Somerville, NJ), are safer and more effective than ever. In World Health Organization large, multicenter trials, pregnancy rates for the TCu 380A are 1.0, 1.4, 1.6, and 1.8 at 3, 5, 7, and 9 years of use, respectively. The ectopic pregnancy rates and removal for pelvic inflammatory disease are very low. The device may soon be the major IUD available in most countries. The acceptability of IUD use can be increased by good clinical management, sympathetic counseling, careful client selection, proper device selection, careful insertion, timing of insertion, and regular follow-up with quick access to medical care. PMID:1324024

  1. Combined hysteroscopy-laparoscopy approach for excision of pelvic nitinol fragment from Essure contraceptive device: Role of intraoperative fluoroscopy for uterine conservation.

    PubMed

    Sills, E Scott; Palermo, Gianpiero D

    2016-07-01

    We describe the successful removal of a pelvic contraceptive coil in a symptomatic 46-year-old patient who had Essure devices for four years, using a combined hysteroscopy-laparoscopy-fluoroscopy approach. Following normal hysteroscopy, at laparoscopy the right Essure implant was disrupted and its outer nitinol coil had perforated the fallopian tube. However, the inner rod (containing polyethylene terephthalate) had migrated to an extrapelvic location, near the proximal colon. In contrast, the left implant was situated within the corresponding tube. Intraoperative fluoroscopy was used to confirm complete removal of the device, which was further verified by postoperative computed tomography. The patient's condition improved after surgery and she continues to do well. This is the first report to describe this technique in managing Essure complications remote from time of insertion. Our case highlights the value and limitations of preoperative and intraoperative imaging to map Essure fragment location before surgery. PMID:27462605

  2. Combined hysteroscopy-laparoscopy approach for excision of pelvic nitinol fragment from Essure contraceptive device: Role of intraoperative fluoroscopy for uterine conservation

    PubMed Central

    Palermo, Gianpiero D.

    2016-01-01

    We describe the successful removal of a pelvic contraceptive coil in a symptomatic 46-year-old patient who had Essure devices for four years, using a combined hysteroscopy-laparoscopy-fluoroscopy approach. Following normal hysteroscopy, at laparoscopy the right Essure implant was disrupted and its outer nitinol coil had perforated the fallopian tube. However, the inner rod (containing polyethylene terephthalate) had migrated to an extrapelvic location, near the proximal colon. In contrast, the left implant was situated within the corresponding tube. Intraoperative fluoroscopy was used to confirm complete removal of the device, which was further verified by postoperative computed tomography. The patient's condition improved after surgery and she continues to do well. This is the first report to describe this technique in managing Essure complications remote from time of insertion. Our case highlights the value and limitations of preoperative and intraoperative imaging to map Essure fragment location before surgery. PMID:27462605

  3. Emergency contraception: a second chance at preventing adolescent unintended pregnancy.

    PubMed

    Gold, M A

    1997-08-01

    Adolescent pregnancy challenges the United States and Europe. For most sexually active adolescents, pregnancy is unintended. Emergency contraception, also called the "morning-after treatment" or postcoital contraception is a way to prevent pregnancy after unprotected intercourse. In February 1997, the Food and Drug Administration (FDA) approved the use of certain oral contraceptive pills for emergency contraception. There are currently six brands of pills marketed in the United States that can be prescribed to, conform to the FDA-approved regimen. When emergency contraceptive pills are initiated within 72 hours of unprotected intercourse, they reduce the risk of pregnancy by 75%. Contraindications are the same as those used for ongoing contraceptive pills. The most common side effects are nausea, vomiting, menstrual disturbances, breast tenderness, abdominal cramping, dizziness, headache, and mood changes. Routinely counseling all adolescents about emergency contraceptive pills and increasing access to them can give adolescents a second chance at preventing pregnancy. PMID:9300185

  4. Status of Contraceptive Vaccines

    PubMed Central

    Naz, Rajesh K.

    2008-01-01

    Problem This is a review of antisperm contraceptive vaccines (CV), and synthesis of human scFv antibodies that can be used as immunocontraceptives. Method of study Various methods of proteomics and genomics, peptide synthesis, phage display technology, and antibody engineering were used to obtain multi-epitope vaccines and human scFv antibodies from immunoinfertile and vasectomized men. The present review primarily focuses on the effect of multi-epitope vaccines and Izumo on fertility and synthesis and characterization of sperm specific human scFv antibodies. Results The immunization with Izumo peptides causes a contraceptive effect in female mice. The efficacy is enhanced by combination vaccination, including peptides based on other sperm antigens. Using phage display technology, we were able to synthesize at least four novel scFv antibodies with unique complimentarity determining regions (CDRs) that reacted with specific fertility-related sperm antigens. These antibodies inhibited human sperm function in vitro, and their immunocontraceptive effect in vivo is currently being investigated. Conclusions The multi-epitope vaccines may provide an efficacious and viable approach to contraception. The human scFv antibodies, if they block fertility in vivo, may provide unique and novel immunocontraceptives, the first of its kind for human use. The multi-epitope CV and preformed engineered antibodies of defined specificity may obliterate the concern related to inter-individual variability of the immune response. PMID:19086987

  5. Estrogen and Progestin (Oral Contraceptives)

    MedlinePlus

    ... of appetite extreme tiredness, weakness, or lack of energy fever dark-colored urine light-colored stool swelling ... you also have trouble sleeping, tiredness, loss of energy, or other mood changes unusual bleeding rash menstrual ...

  6. [Topical contraceptives].

    PubMed

    Alipov, V I; Korkhov, V V

    1982-02-01

    Recently there has been little interest in topical contraceptives. The most popular are the cervical cap and the diaphragm. Other types of mechanical contraceptive devices are being investigated. Standley and Kessler have developed a device for introduction into the cervical canal with a reservoir of spermatocide, it does not block the flow of blood during menstruation. New models of vaginal rings are also being developed which are simple enough for self-insertion and also contain a reservoir of spermatocide. Work is being done on spermatocide-containing sponges in many countries. Another project being investigated is the possibility of using natural proteins, collagens, and other substances which absorb spermatozoids. The ancients used various vaginal suppositories to kill spermatozoids; in the late 19th century quinine sulfate was used for this, and a variety of substances have been used recently. These spermicidal creams also have the advantage of acting as anti-infectious agents in many cases. But they do have some negative effects. They are about 85% effective, are local irritants, and some cause discomfort during intercourse. And it is possible that some are resorbed by the body and act on the liver and other organs. Vaginal globules and suppositories are also popular. The "Kontraceptin-T" brand contains quinosol, boric acid, and tannin. There are also foaming tablets which are mixed with water and then introduced. New locally-active chemical substances are being developed in Japan, West Germany, and the USSR. Kontraceptin-E contains paranonyl-phenoxypolyethylene glycol and sodium dioctylsulfosuccinate. The "Norforks" and other preparations contain mercurial compounds which may turn out to be harmful. The future promises the development of products which will act to prevent fertilization by acting on the hyaluronidase and the acrosine of the spermatozoid, thus preventing it from penetrating the ovum. It would be best to find enzyme inhibitors which are

  7. Evaluating steroidal contraceptives: pre-clinical and clinical approaches.

    PubMed

    Berry, C L

    1988-05-01

    The Special Program of Research, Development and Research Training in Human Reproduction of the World Health Organization held a meeting in Geneva in February of 1987 to review the results of animal and human studies analyzing contraceptive steroids. In reviewing this data, assessment of pre-clinical toxicology and human risk would be possible. The studies reviewed included: studies on steroid exposure and breast disease, the protective factor of combined oral contraceptives (OC) (against ovarian cancer), hormonal contraceptives and cervical cancer, the relationship of gall bladder disease to OC use, congenital malformations and steroid hormone, OC use and its effect on breast milk and other topics. Basic principles on pre-clinical testing were adopted. These included: 1) the establishment of safety is a joint responsibility of experimental toxicology and clinical pharmacology. 2) Testing should include detailed analysis of the hormonal effect of new types in several animal species. 3) Species specific data should be collected. 4) Studies to detect cumulative toxicity should be performed. 5) Reproductive toxicity should concentrate on exposure throughout the embryonic period. 6) In vivo and in vitro tests should be conducted to investigate the mutagenic potential of new contraceptive steroids. 7) Long-term carcinogenicity study should be performed, preferably on the rat. 8) When new delivery systems are used to administer established steroidal contraceptives, experimental safety studies should assess potential interactions with the system and on the possibility of adverse effects of the delivery system. 9) Post-registration surveillance is on integral part of the risk assessment process. PMID:3391619

  8. [Contraception in women suffering from systemic lupus ethymatosus].

    PubMed

    Musson, P; Serfaty, D; Puissant, A

    1985-10-01

    Systemic lupus erythematosus usually affects young women of reproductive age and may be brought on or worsened by pregnancy or use of some oral contraceptives (OCs). At certain stages of the disease pregnancies are possible, but effective and reversible contraception permitting careful pregnancy planning is required. Amenorrhea is frequent in acute stages of the disease, but most authors have observed fertility levels in lupic women comparable to those of the population at large. Pregnancy complications and aggravations of lupus are much more rare when conception occurs during a stable remission of at least 6 months. Risks of lupus that must be considered in choosing a contraceptive method include vascular accidents such as venous thrombosis and inflammatory lesions of the arteries, hypertension usually secondary to nephropathy or corticotherapy, metabolic disturbances, anomalies of hemostasis, initiation or exacerbation of the disease with use of combined OCs, and predisposition to infection. Pills containing estrogen, even at low doses, are contraindicated because of the already high vascular risk of lupus patients and because estrogens may aggravate the condition. Progestins derived from 19 norsteroids are inadvisable because of the still imperfectly understood secondary effects which may include disturbances of metabolism or blood pressure. Low dose progestins or those derived from 17 hydroxyprogesterone appear to be a contraceptive of choice for lupus patients because of their lack of effects on metabolism or blood pressure. Their contraceptive efficacy is not quite as high as that of other OCs and they may entail a relative hyperestrogenic climate. They are not advisable in case of luteal insufficiency. IUDs are contraindicated because of the risk of infection, although they may be used in periods of remission for mild cases of lupus not treated with immunosuppressive drugs. Progestin-releasing IUDs may reduce risk of infection. Local methods have the

  9. Intrauterine steroid contraceptives.

    PubMed

    Scholten, P C; Christaens, G C; Haspels, A A

    1987-11-15

    Progestagen releasing IUDs were specially developed to diminish the problems of bleeding and pain with inert and copper containing IUDs. The intrauterine release of the progestagen causes endometrial atrophy, resulting in impairment of nidation, and interferes with transport of the ovum and the spermatozoa. Two available types, Progestasert, Biograviplan (Alza Corporation, California; Grünenthal) and Levonorgestrel Nova-T (Leiras Pharmaceuticals, Finland), have been sufficiently tested in multinational trials. Compared with Progestasert, LNG Nova-T showed lower pregnancy rates (Pearl Index 0.30), less risk for ectopic pregnancy and a longer effective lifetime (7 years). With both IUDs the amount and duration of menstrual blood loss is decreased. Amenorrhea is a frequent occurring side effect of LNG Nova-T, caused by endometrial atrophy. Intermenstrual blood loss and spotting incidences are not uniformly reduced and are still a frequent reason for removal. Preinsertion counselling may improve the acceptance of these non-health-threatening side effects. With both IUDs a decrease of menstrual cramps during periods is percepted and a low incidence of PID is found. Basically, the progestagen releasing IUD can be recommended to all women who wish an IUD for contraception and to women with contraindications for oral contraceptives, especially to those with menorrhagia, anaemia or risk for anaemia. PMID:3131966

  10. Unintended Pregnancies Observed With Combined Use of the Levonorgestrel Contraceptive Implant and Efavirenz-based Antiretroviral Therapy: A Three-Arm Pharmacokinetic Evaluation Over 48 Weeks

    PubMed Central

    Scarsi, Kimberly K.; Darin, Kristin M.; Nakalema, Shadia; Back, David J.; Byakika-Kibwika, Pauline; Else, Laura J.; Dilly Penchala, Sujan; Buzibye, Allan; Cohn, Susan E.; Merry, Concepta; Lamorde, Mohammed

    2016-01-01

    Background. Levonorgestrel subdermal implants are preferred contraceptives with an expected failure rate of <1% over 5 years. We assessed the effect of efavirenz- or nevirapine-based antiretroviral therapy (ART) coadministration on levonorgestrel pharmacokinetics. Methods. This nonrandomized, parallel group, pharmacokinetic evaluation was conducted in three groups of human immunodeficiency virus–infected Ugandan women: ART-naive (n = 17), efavirenz-based ART (n = 20), and nevirapine-based ART (n = 20). Levonorgestrel implants were inserted at baseline in all women. Blood was collected at 1, 4, 12, 24, 36, and 48 weeks. The primary endpoint was week 24 levonorgestrel concentrations, compared between the ART-naive group and each ART group by geometric mean ratio (GMR) with 90% confidence interval (CI). Secondary endpoints included week 48 levonorgestrel concentrations and unintended pregnancies. Results. Week 24 geometric mean levonorgestrel concentrations were 528, 280, and 710 pg/mL in the ART-naive, efavirenz, and nevirapine groups, respectively (efavirenz: ART-naive GMR, 0.53; 90% CI, .50, .55 and nevirapine: ART-naive GMR, 1.35; 90% CI, 1.29, 1.43). Week 48 levonorgestrel concentrations were 580, 247, and 664 pg/mL in the ART-naive, efavirenz, and nevirapine groups, respectively (efavirenz: ART-naive GMR, 0.43; 90% CI, .42, .44 and nevirapine: ART-naive GMR, 1.14; 90% CI, 1.14, 1.16). Three pregnancies (3/20, 15%) occurred in the efavirenz group between weeks 36 and 48. No pregnancies occurred in the ART-naive or nevirapine groups. Conclusions. Within 1 year of combined use, levonorgestrel exposure was markedly reduced in participants who received efavirenz-based ART, accompanied by contraceptive failures. In contrast, nevirapine-based ART did not adversely affect levonorgestrel exposure or efficacy. Clinical Trials Registration. NCT01789879. PMID:26646680

  11. Effect of contraceptives on the skin.

    PubMed

    1988-10-01

    Combined oral contraceptives (COCs) affect the skin 3 different ways. They decrease the amount of androgenic hormones produced in the ovaries and adrenal gland. They also limit the quantity of biologically active circulating testosterone. Finally, estrogen markedly decreases oil production in the sebaceous glands. Physicians should prescribe to women with acne a COC that is low in progestogen and high in estrogen. A biphasic pill with no more than 500 mcg norethisterone/day meets these requirements. If a woman is taking systemic antibiotics to treat acne, however, the physician should prescribe a biphasic pill containing 50 mcg ethinyl estradiol. Even though many believe that using COCs causes hair loss, there is little evidence to support it. Nevertheless, if a woman has indeed experienced hair loss, she should take a COC with a high estrogen to progestogen ratio. As in some pregnant women, cholasma may occur in women taking COCs when not protected from sunlight. Physicians need to prescribe the lowest possible dose of hormones in these women and counsel them to shield their face from sunlight. To err on the side of safety, women who have had a malignant melanoma should not use a hormonal contraceptive. In addition, women who have experienced many bouts of skin candidiasis should use an alternative contraceptive. Other skin disorders that they have been found to be more prevalent in women taking COCs include erythema nodosum, accelerated systemic lupus erythematosus, porphyria cutanea tarda, herpes gestationis, spider naevus, and telangiectasia. There also exists an association between dermatitis and barrier methods and spermicides. Some articles have suggested that copper containing IUDs have also cause a variety of skin disorders. PMID:3240155

  12. Approach to the patient: contraception in women with polycystic ovary syndrome.

    PubMed

    Yildiz, Bulent O

    2015-03-01

    Polycystic ovary syndrome (PCOS) is a common reproductive and metabolic disorder. Patients with PCOS present with clinical signs of androgen excess (ie, hirsutism and acne), menstrual irregularities, and infertility. Combined oral contraceptive (OC) pills are the first-line medical therapy for the long-term management of PCOS. Containing a combination of estrogen and progestin, OCs restore regular menses, improve androgen excess, and provide effective contraception and protection from endometrial cancer. The benefits of hormonal contraception outweigh the risks in the vast majority of women with PCOS. However, concerns have been raised about potential adverse cardiovascular and metabolic effects of OCs. Currently available evidence indicates an increased relative risk of venous thrombosis associated with OCs varying among different formulations. Arterial thrombosis risk attributable to OCs does not appear to be significantly increased in young nonsmoking women. OC use might be associated with increased risk of diabetes in morbidly obese women with PCOS with severe insulin resistance. A tailored clinical approach to oral contraception in women with PCOS requires individualized risk stratification and management by determination of each PCOS patient's personal cardiometabolic risk profile at baseline and during follow-up. Before prescribing an OC, clinicians should document individual risk factors including age, smoking, obesity, any degree of glucose intolerance including prediabetes and diabetes, hypertension, dyslipidemia, thrombophilia, and personal or family history of a venous thromboembolic event. PMID:25701301

  13. Knowledge about missed contraceptive pills among married women at King Abdulaziz University Hospital

    PubMed Central

    Iftikhar, Rahila; Aba Al Khail, Bahaa Abdulrahman

    2015-01-01

    Background Oral contraceptive pills (OCPs) are one of the most reliable methods of contraception. However, lack of knowledge about oral contraceptive use and inconsistent pill-taking might result in decreased efficacy. The study reported here aimed to explore women’s knowledge about oral contraceptive use and assess the factors associated with knowledge about OCPs among users. Methods This cross-sectional survey was conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia between April and June 2014. We included married, non-pregnant women >18 years old who had used a combined 21-day OCP for at least 3 months prior to recruitment. A questionnaire was used to collect the participants’ demographic information. It also assessed their knowledge about OCPs. Data were entered into and analyzed using SPSS software. Results A total of 357 women were recruited. Of these, 57.7% reported they knew what to do after missing one or two pills, but only 18.3% knew exactly what to do after missing more than two pills consecutively. Postgraduate women had a significantly higher knowledge score than illiterate women (P=0.002) and those who had completed at least primary education (P=0.001). Conversely, there was no difference in knowledge scores between Saudi and expatriate women (P=0.2). Monthly incomes (P=0.2) and mode of OCP selection (P=0.2) were also not significantly associated with knowledge scores. Conclusion Women had poor knowledge about OCP use. Appropriate measures should be taken to educate women about proper oral contraceptive use. PMID:25792813

  14. The use of newer progestins for contraception.

    PubMed

    Sitruk-Ware, Regine; Nath, Anita

    2010-11-01

    The synthetic progestins used for contraception so far are structurally related either to testosterone (estranes and gonanes) or to progesterone (pregnanes and 19-norpregnanes). Several new progestins have been designed to minimize side-effects related to androgenic, estrogenic or glucocorticoid receptor (GR) interactions. Dienogest (DNG) and drospirenone (DRSP) exhibit a partial antiandrogenic action, and DRSP has predominant anti-mineralocorticoid properties. The 19-norpregnanes include Nestorone (NES), nomegestrol acetate (NOMAc) and trimegestone (TMG), and possess a high specificity for binding to the progesterone receptor (PR) with no or little interaction with other steroid receptors. DRSP has been developed as combination oral pills with ethinyl estradiol (EE); DNG has been combined both with EE and, more recently, with estradiol valerate (E2V). NOMAc has been used as a progestin-only method and more recently combined with estradiol (E2). Nestorone is not active orally but proved to be the most active antiovulatory progestin when used parenterally. It has been developed in various formulations such as implants, vaginal rings or transdermal gel or spray. Risks and benefits of the new progestins depend upon the type of molecular structure, the type of estrogen associated in a combination and the route of administration. PMID:20933114

  15. Oral azithromycin versus its combination with miltefosine for the treatment of experimental Old World cutaneous leishmaniasis.

    PubMed

    Amer, Eglal I; Eissa, Maha M; Mossallam, Shereen F

    2016-06-01

    Leishmaniasis is one of the neglected infectious diseases included in the World Health Organization's list of the top guns of antimicrobial resistance. Miltefosine is the first and the only available oral effective therapy for leishmaniasis. For fear of its potential resistance, identification of alternative, effective and safe drugs is urgently needed. Therefore, in view of azithromycin promising activity against a number of Leishmania species, this work was carried out to evaluate the efficacy of oral azithromycin alone versus its combination with miltefosine against experimental Old World Cutaneous leishmaniasis thus, can provide another alternative oral therapy or for the first time an oral combination therapy for leishmaniasis. The experiment were carried out on Swiss strain albino mice which were treated either with miltefosine for 20 days, Azithromycin for 20 days or both drugs in combination therapy for shorter duration of 10 days. Efficacy of azithromycin mono and combination therapy with miltefosine was evaluated clinically, parasitologically and by examination of the cutaneous lesions by Transmission Electron Microscopy. The current work demonstrated superior activity of oral azithromycin over oral miltefosine in the treatment of experimentally infected mice with Leishmania major (MHOM/IL/81/FEBNI). Unfortunately, oral combination therapy of azithromycin and miltefosine for short duration though, induced dramatic clinical improvement yet, relapse rapidly developed after cessation of therapy. Oral azithromycin could be a promising oral antileishmanial agent. Further research is recommended to investigate its leishmanicidal activity against other Leishmania species thus; another alternative oral therapy for leishmaniasis can be rapidly available. PMID:27413324

  16. [An implantable contraceptive: Norplant].

    PubMed

    Munyakazi, A

    1989-08-01

    The Norplant contraceptive system consists of 6 silastic capsules 34 mm long by 2.4 mm in diameter each containing 36 mg of levonorgestrel. Norplant provides a constant daily dose of 30 mcg of levonorgestrel beginning 24 hours after insertion and lasting for 5 years. 3 contraceptive effects are provided: the cervical mucus becomes less permeable for sperm, the endometrium atrophies, and ovulation is inhibited in about 50% of cycles. The failure rate is lower than those of pills and IUDs. It is somewhat higher for women weighing over 70 kg than for those weighing less. The safety of Norplant is due to the absence of estrogen. It has no effect on blood pressure, and the risks of ectopic pregnancies or infection at the insertion site are minor. The principal side effect is disturbance of the menstrual cycle, which usually decreases after 3-6 months of use. Other minor effects should not cause termination of the method if the user has been forewarned. Women using Norplant should be followed regularly. Norplant is particularly indicated for women desiring longterm contraception or a very effective method for spacing, postpartum women, and women with contraindications to oral contraceptives and IUDs. Contraindications include pregnancy or suspicion of pregnancy, unexplained vaginal bleeding, liver or cardiovascular disorders, jaundice or pruritus during the last pregnancy, thrombophlebitis or pulmonary embolism, falciform anemia, and breast cancer. Studies are underway to verify that Norplant does not affect lactation. Norplant should be removed immediately if the woman develops migraine headaches or visual problems, signs of thrombophlebitis or hepatic disorders, increased blood pressure, or if she becomes pregnant or must undergo a surgical procedure requiring lengthy bed rest. Norplant should be inserted under scrupulously aseptic conditions during the 1st 7 cycle days under local anesthesia. Large studies in Egypt, Indonesia, Chile and elsewhere have confirmed

  17. [Young men's contraceptive habits].

    PubMed

    Kaiser, A H; Nielsen, B B; Hansen, K; Johansen, J B; Nielsen, M B

    1992-10-01

    A total of 379 men from the greater Copenhagen area were invited to fill out a questionnaire about sexual habits and use of contraception in connection with conscription for military duty. A total of 334 (88%) answered the questionnaire. In the autumn of 1988, a total of 27 men answered the test questionnaire, while in the spring of 1989, when the real study was conducted, 307 men answered it. The median age of 334 participants was 18 years (range of 17-29 years). 33% of the group stated that they had used condoms during first intercourse, while 47% had not. 1 person reported to be exclusively attracted sexually to men, 5 persons were attracted both to men and women, but 97% were exclusively attracted to women. 82% had had intercourse or other sexual experience with women. 1.8% had had intercourse or other sexual experience with men. 8% had no sexual experience, and 8% did not answer the question. Oral contraceptives were used by 60% and the condom by 56%. 10% had used coitus interruptus at one time or another; 15% had used no contraception; 5% used the IUD; and 5% used the diaphragm. Some gave several answers. 1% used spermicidal lotion. 60% thought that it was the responsibility of both men and women to be concerned about contraception, 12% opined that it was exclusively men's duty, and 2% that it was exclusively women's, while 26% did not answer. 68% wanted to use the condom in the future for protection, 24% did not know, but 8% did not want to use it more extensively. 64% did not think that the fear of AIDS would affect their sexual life, but 36% thought it would. Several of the subjects indicated that they would be more careful about choosing a partner, and every 10th suggested that they would use the condom with a new partner. One person (0.3%) was a drug addict, 89% had never injected drugs, but about 11% did not answer about drugs. 97% and 95%, respectively, indicated that the condom provided good protection against pregnancy and venereal diseases. PMID

  18. Evaluation of a Computerized Contraceptive Decision Aid for Adolescent Patients.

    ERIC Educational Resources Information Center

    Chewning, Betty; Mosena, Pat; Wilson, Dale; Erdman, Harold; Potthoff, Sandra; Murphy, Anita; Kuhnen, Kathleen Kennedy

    1999-01-01

    Discusses a computer-based contraceptive decision aid used with adolescent female family planning clinic patients (N=949). Results show improved short-term knowledge of and confidence in oral contraceptive (OC) efficacy. Higher OC knowledge after one year and fewer pregnancies were seen in one group. Findings suggest the usefulness of informatics…

  19. [Specific changes of the uterine cervix due to contraceptives].

    PubMed

    Werner, R; Dinges, H P

    1976-01-01

    A group of 344 cervices, produced by conisation within a period of 5 1/2 years, were examined for specific effects of contraceptives. In half of all women, who used oral contraceptives, specific lesions such as "siebartige polypoide Hyperplasie" (cribriform polypoid hyperplasia) were found. The findings and their etiology and importance are discussed. PMID:970001

  20. Providing Contraception to Adolescents.

    PubMed

    Raidoo, Shandhini; Kaneshiro, Bliss

    2015-12-01

    Adolescents have high rates of unintended pregnancy and face unique reproductive health challenges. Providing confidential contraceptive services to adolescents is important in reducing the rate of unintended pregnancy. Long-acting contraception such as the intrauterine device and contraceptive implant are recommended as first-line contraceptives for adolescents because they are highly effective with few side effects. The use of barrier methods to prevent sexually transmitted infections should be encouraged. Adolescents have limited knowledge of reproductive health and contraceptive options, and their sources of information are often unreliable. Access to contraception is available through a variety of resources that continue to expand. PMID:26598305

  1. Bacterial flora of the cervix in women using different methods of contraception.

    PubMed

    Haukkamaa, M; Stranden, P; Jousimies-Somer, H; Siitonen, A

    1986-03-01

    Bacteriologic culture samples were taken from the cervix in three groups of 10 healthy, sexually active women using barrier contraception, oral contraceptives, or a levonorgestrel-releasing intrauterine contraceptive device. Culture samples for Candida albicans and Trichomonas vaginalis were taken, a cytologic vaginal smear was obtained, and an amine sniff test was performed; these were in addition to a routine gynecologic examination. Multiple bacteria were isolated from the cervix in women using oral contraceptives or an intrauterine contraceptive device, whereas lactobacilli alone dominated the flora of women using barrier contraception. Significantly more anaerobic bacteria were isolated from the cervix in oral contraceptive and intrauterine contraceptive device users when compared with the barrier method users. Symptoms and findings evident of anaerobic vaginosis were associated with the occurrence of anaerobic bacteria in the cervix of three patients using the intrauterine contraceptive device. The results showed that the cervical bacterial flora in sexually active healthy women is rich in anaerobes that can be regarded as a normal finding in women using oral contraceptives or intrauterine contraceptive devices. Barrier contraception with a condom prevents this anaerobic shift and maintains a lactobacilli-dominated flora in the cervix. PMID:3953700

  2. A new contraceptive pill containing 17β-estradiol and nomegestrol acetate.

    PubMed

    Christin-Maitre, Sophie; Laroche, Emmanuelle; Bricaire, Léopoldine

    2013-01-01

    Most combined oral contraceptive pills contain ethinyl estradiol (EE) with progestins. In order to minimize the pill's cardiovascular risks, the concept of using 17β-estradiol (E2), the endogenous estradiol, arose in the 1970s. Many attempts to develop a pill containing 17β-E2 have failed as cycle control was low. The first pill containing 17β-E2 was launched in 2011. This monophasic pill contains 24 pills with 1.5 mg 17β-E2 and 2.5 mg nomegestrol acetate, and four placebo pills. Studies conducted in Europe and the USA demonstrate that its Pearl index is 0.38 and 1.13, respectively. It has less influence on hemostasis, fibrinolysis markers, lipids and carbohydrate metabolism than the combined oral contraceptive levonorgestrel/EE (150 g/30 g and 100 µg/20 µg). Withdrawal bleedings are shorter and lighter as compared with women using drospirenone/EE (3 mg/ 30 µg). The number of women without withdrawal bleeding is approximately 30% after 12 months. Even though its contraindications are identical to other combined oral contraceptives, this nomegestrol acetate/E2 pill should be considered to be of interest for many women. PMID:23241152

  3. Adherence to a flexible extended regimen for oral hormonal contraception provided in blister packaging compared with an adherence-supporting digital tablet dispenser: historical comparison of data from two clinical studies

    PubMed Central

    Elliesen, Jörg; Trummer, Dietmar

    2016-01-01

    Background The Clyk™ digital pill dispenser helps ensure correct and consistent administration of a flexible extended regimen of the combined oral contraceptive, ethinylestradiol (EE) 20 μg/drospirenone 3 mg (EE/drospirenone ; YAZ® Flex Flex), guiding users through the intake cycle and 4-day pill break and providing visible and acoustic daily reminders when pill intake is due. A study showed that the audible alarm function of the dispenser could help reduce the number of missed pills, but it lacked an appropriate “non-dispenser” group for a meaningful assessment of the impact of the dispenser on adherence. This study indirectly assessed the overall effect of the digital dispenser on adherence by comparing data from a treatment with standard blister packaging. Materials and methods One-year adherence data were compared from two similarly designed, Phase III, open-label, randomized trials of EE/drospirenoneFlex. In study 1, women used diary cards to record adherence with EE/drospirenoneFlex dispensed in blister packs (n=640), and in study 2 the dispenser was used with the alarm activated (n=250) or deactivated (n=248) in addition to using diary cards. Results A mean (±SD) of 4.3 (±4.24) missed pills over 1 year were recorded in diary cards among women who dispensed their pills from the blister packages (study 1) compared with 1.0 (±2.4) recorded by the alarm-activated dispenser (study 2). In study 2, a mean of 1.9 (±4.2) missed pills were reported in the diaries over 1 year compared with 4.4 (±9.1) from automatic recording by the dispenser (both arms of study 2), indicating underreporting of missed pills in diary cards vs the digital dispenser. Adjusting for this rate of underreporting, an estimated mean of ten pills were missed over 1 year by women using EE/drospirenoneFlex in blister packs, or ten times more than with the digital dispenser with activated acoustic alarm. Conclusion The digital dispenser helps reduce the number of missed pills and

  4. Associations of hormone replacement therapy and oral contraceptives with risk of colorectal cancer defined by clinicopathological factors, beta-catenin alterations, expression of cyclin D1, p53, and microsatellite-instability

    PubMed Central

    2014-01-01

    Background Postmenopausal hormone therapy (HRT) and oral contraceptive (OC) use have in several studies been reported to be associated with a decreased colorectal cancer (CRC) risk. However, data on the association between HRT and OC and risk of different clinicopathological and molecular subsets of CRC are lacking. The aim of this molecular pathological epidemiology study was therefore to evaluate the associations between HRT and OC use and risk of specific CRC subgroups, overall and by tumour site. Method In the population-based prospective cohort study Mamö Diet and Cancer, including 17035 women, 304 cases of CRC were diagnosed up until 31 December 2008. Immunohistochemical expression of beta-catenin, cyclin D1, p53 and MSI-screening status had previously been assessed in tissue microarrays with tumours from 280 cases. HRT was assessed as current use of combined HRT (CHRT) or unopposed oestrogen (ERT), and analysed among 12583 peri-and postmenopausal women. OC use was assessed as ever vs never use among all women in the cohort. A multivariate Cox regression model was applied to determine hazard ratios for risk of CRC, overall and according to molecular subgroups, in relation to HRT and OC use. Results There was no significantly reduced risk of CRC by CHRT or ERT use, however a reduced risk of T-stage 1–2 tumours was seen among CHRT users (HR: 0.24; 95% CI: 0.09-0.77). Analysis stratified by tumour location revealed a reduced overall risk of rectal, but not colon, cancer among CHRT and ERT users, including T stage 1–2, lymph node negative, distant metastasis-free, cyclin D1 - and p53 negative tumours. In unadjusted analysis, OC use was significantly associated with a reduced overall risk of CRC (HR: 0.56; 95% CI: 0.44-0.71), but this significance was not retained in adjusted analysis (HR: 1.05: 95% CI: 0.80-1.37). A similar risk reduction was seen for the majority of clinicopathological and molecular subgroups. Conclusion Our findings provide information on

  5. [Attitude to be taken with the adolescent requesting contraception].

    PubMed

    Wermelinger, R

    1983-05-01

    A combination of biological factors such as earlier age at puberty and fecundity, and social factors such as the disappearance of the extended family and of rites of passage and the development of a youth culture have encouraged adolescent sexuality at the same time that length of schooling is increasing and adolescents have not yet become socially autonomous. Adolescents employ contraception relatively infrequently and tend to choose less reliable methods. Reasons for this include ignorance of the biology of reproduction and of contraception methods; the fear of secondary effects, encouraged by the mass media; lack of access to family planning facilities or fear that parents will be informed; and the cost of contraceptives. An adolescent requesting contraception should be treated as a adult, taking into account the degree of maturity; the attitude of the medial practitioner will influence motivation and success in using the method. The medical history will indicate cases in which a hormonal contraceptive is contraindicated. The gynecological examination reveals the gynecological age of the patient, which is more important than chronological age. The frequency of sexual realtions should also be considered in the choice. Because motivation of adolescents is less reliable than that of adults, such methods as rhythm and withdrawal are not appropriate. Condoms or diaphragms are disliked because of the necessity of repeated manipulation before each act of intercourse, but may be acceptable to highly motivated individuals. Condoms are indicated when relations are unexpected and infrequent. IUDs are indicated only when hormonal contraceptives cannot be used and when forgetting of pills is likely to occur. Nevertheless, IUD use in adolescents can entail serious problems of expulsion or of infection that may lead to later infertility. Little is known of the effects of oral contraceptive use on sexual maturation and growth of very young adolescents, but because of the growth

  6. Combination therapy for portopulmonary hypertension with intravenous iloprost and oral bosentan.

    PubMed

    Halank, Michael; Kolditz, Martin; Miehlke, Stephan; Schiemanck, Steffen; Schmeisser, Alexander; Hoeffken, Gert

    2005-08-01

    Severe portopulmonary hypertension (PPHTN) is a rare complication of liver cirrhosis and carries a poor prognosis. In the last years, intravenous (IV) epoprostenol has been suggested to be the optimal medical treatment for PPHTN, and recently oral bosentan has been shown to be efficacious and safe in selected patients with PPHTN. We report a case of PPHTN suffering from recurrent right heart failure while on treatment with IV iloprost, which was successfully managed by combination therapy with IV iloprost plus oral bosentan, providing sustained cardiopulmonary stabilization for at least two years. This report documents the first case of a patient with PPHTN successfully treated with the combination of IV iloprost and oral bosentan over an extended period. Thus, combination therapy with IV iloprost and oral bosentan might be a promising new option for selected patients suffering from PPHTN and recurrent right heart failure. PMID:16160926

  7. Transdermal contraception and the renin-angiotensin-aldosterone system in premenopausal women.

    PubMed

    Odutayo, Ayodele; Cherney, David; Miller, Judith; Ahmed, Sofia B; Lai, Vesta; Dunn, Sheila; Pun, Nicole; Moineddin, Rahim; Hladunewich, Michelle A

    2015-03-15

    The oral contraceptive pill (OCP) activates the renin-angiotensin-aldosterone system (RAAS) through first-pass hepatic metabolism. Although usually benign, RAAS activation may have detrimental effects on renal and hemodynamic function in some women. Since combined hormonal contraception with the transdermal patch (EVRA) does not undergo first-pass hepatic metabolism, we hypothesized that the RAAS response would be different from that of OCP subjects. Thirty-five nonsmoking, premenopausal women (15 control subjects, 10 OCP subjects, and 10 contraceptive patch subjects) without evidence of cardiovascular disease, renal disease, or diabetes were studied. Baseline angiotensinogen, renin, angiotensin II, aldosterone, and plasma renin activity were assessed along with hormonal and hemodynamic responses to simulated orthostatic stress using incremental lower body negative pressure (LBNP; -15, -25, and -40 mmHg). Baseline levels of angiotensinogen, angiotensin II, and plasma renin activity were significantly higher in OCP subjects compared with normotensive control and contraceptive patch subjects (P < 0.05), whereas aldosterone was significantly higher in OCP versus control subjects only (P < 0.05). Plasma renin levels were significantly lower at baseline in contraceptive patch subjects compared with normotensive control and OCP subjects (P < 0.05). In response to LBNP, increases in renin, angiotensin II, and aldosterone were attenuated in contraceptive patch subjects in conjunction with an exaggerated decline in mean arterial pressure (P < 0.05 vs. control and OCP subjects). The contraceptive patch in healthy premenopausal women is associated with an impaired ability to maintain blood pressure in response to LBNP, possibly due to insensitivity of the endogenous RAAS. Further evaluation may be beneficial in women with kidney disease. PMID:25587124

  8. Knowledge and attitudes of Latin American obstetricians and gynecologists regarding intrauterine contraceptives

    PubMed Central

    Bahamondes, Luis; Makuch, Maria Y; Monteiro, Ilza; Marin, Victor; Lynen, Richard

    2015-01-01

    Background Intrauterine contraceptives (IUCs), including the copper intrauterine device and the levonorgestrel-releasing intrauterine system (LNG-IUS), are among the reversible contraceptive methods with high effectiveness. However, use is low in many settings, including some Latin American countries, mainly due to the influences of myths, fears, and negative attitudes, not only of users and potential users, but also of different cadres of health care professionals. The purpose of this study was to assess the knowledge and attitudes of a group of Latin American obstetricians and gynecologists regarding IUCs. Methods A survey was conducted during a scientific meeting organized in Chile in 2014 to present and discuss updated information about contraception. Obstetricians and gynecologists from 12 Latin American countries, who reported that they provide daily contraception services in both the public and private sectors, participated in the meeting. Participants who agreed to take part in the survey responded to a multiple-choice questionnaire on issues regarding knowledge, use, and attitudes about IUCs. Results Of the 210 obstetricians and gynecologists participating in the meeting, the respondents to each question varied from 168 (80.0%) to 205 (97.6%). Almost 50% recognized that the failure rate of combined oral contraceptives, patches, and vaginal rings is 8%–10%. Furthermore, 10% of the participants did not recognize the high contraceptive effectiveness of long-acting reversible contraceptive methods. Additionally, almost 80% of the respondents answered that they did not offer IUCs to nulligravidas and almost 10% did not offer IUCs to adolescents, albeit almost 90% of the respondents reported that nulligravidas are candidates for an LNG-IUS. Conclusion Some deficiencies and contradictions in terms of knowledge and attitudes were identified from the answers of the Latin American obstetricians and gynecologists who participated in the survey. The knowledge and

  9. Contraception for adolescents.

    PubMed

    Ott, Mary A; Sucato, Gina S

    2014-10-01

    A working knowledge of contraception will assist the pediatrician in both sexual health promotion as well as treatment of common adolescent gynecologic problems. Best practices in adolescent anticipatory guidance and screening include a sexual health history, screening for pregnancy and sexually transmitted infections, counseling, and if indicated, providing access to contraceptives. Pediatricians' long-term relationships with adolescents and families allow them to help promote healthy sexual decision-making, including abstinence and contraceptive use. Additionally, medical indications for contraception, such as acne, dysmenorrhea, and heavy menstrual bleeding, are frequently uncovered during adolescent visits. This technical report provides an evidence base for the accompanying policy statement and addresses key aspects of adolescent contraceptive use, including the following: (1) sexual history taking, confidentiality, and counseling; (2) adolescent data on the use and side effects of newer contraceptive methods; (3) new data on older contraceptive methods; and (4) evidence supporting the use of contraceptives in adolescent patients with complex medical conditions. PMID:25266435

  10. Contraception for adolescents.

    PubMed

    2014-10-01

    Contraception is a pillar in reducing adolescent pregnancy rates. The American Academy of Pediatrics recommends that pediatricians develop a working knowledge of contraception to help adolescents reduce risks of and negative health consequences related to unintended pregnancy. Over the past 10 years, a number of new contraceptive methods have become available to adolescents, newer guidance has been issued on existing contraceptive methods, and the evidence base for contraception for special populations (adolescents who have disabilities, are obese, are recipients of solid organ transplants, or are HIV infected) has expanded. The Academy has addressed contraception since 1980, and this policy statement updates the 2007 statement on contraception and adolescents. It provides the pediatrician with a description and rationale for best practices in counseling and prescribing contraception for adolescents. It is supported by an accompanying technical report. PMID:25266430

  11. Contraception--the morning after.

    PubMed

    Johnson, J H

    1984-01-01

    Although no postcoital method has been developed for safe and effective regular use, postcoital contraception is being offered in Canada and Western Europe on an emergency basis to people who experience such problems as a burst condom. It is little known in the US, however. The 1st commercial version of a postcoital method recently became available to women in England. A former postcoital contraceptive was diethylstilbestrol (DES) which has been linked to cancer in the daughters of women who had taken the drug to prevent miscarriage. A new postcoital contraceptive regime was developed by Albert Yuzpe and consists of 4 ordinary contraceptive pills combining estrogen and progestin to be taken over a 12-hour period. In the US, this is the formulaion of birth control pill marketed under the trade name Ovral by Wyeth Laboratories. England and Germany are the only countries in which the Yuzpe method is officially approved for use as an emergency postocital contraceptive, but the method is used to some degree in most European countries, being well-known in France and Denmark. The most frequent side-effect reported by Yuzpe is vomiting experienced by 29% of women; another 22% felt nauseated. Other side effects, e.g. headache, were infrequent. The findings of the Pregnancy Advisory Service and the Brook Advisory Centre in Britain are reported. Overall very few side effects were found. Postcoital contraceptive treatment may cause the length of the cycle in which it occurs to be irregular. Treatment before day 15 has been found to shorten the cycle, whereas treatment after day 15 lengthens it. The majority of women who become pregnant due to treatment failure tend to seek an abortion. Ectopic pregnancy incidence may also be a result of treatment failure. In 1981, the International Planned Parenthood Federation (IPPF) issued a statement endorsing the use of postcoital contraceptives. Reasons for using them include rape, problems with barrier methods, ineffective use of the

  12. Vaccination of cattle with Mycobacterium bovis BCG by a combination of systemic and oral routes.

    PubMed

    Buddle, Bryce M; Denis, Michel; Aldwell, Frank E; Martin Vordermeier, H; Glyn Hewinson, R; Neil Wedlock, D

    2008-11-01

    Mycobacterium bovis bacille Calmette-Guérin (BCG) vaccine delivered to calves by the subcutaneous (s.c.) or by the oral route in a formulated lipid matrix has been previously shown to induce similar levels of protection against bovine tuberculosis. The current study was aimed at determining whether a combination of delivering BCG by s.c. and oral routes would enhance levels of protection, compared to only one route of vaccination. Forty calves were randomly divided into four groups (10/group). Calves were vaccinated with 10(6)colony forming units (CFU) of BCG Pasteur by the s.c. route or orally with 10(9)CFU BCG incorporated into a lipid formulation. One group received a combination of BCG administered by both the s.c. and oral routes and a non-vaccinated group served as a control. The two groups of calves that received s.c. BCG produced strong IFN-gamma responses in whole blood cultures stimulated with bovine purified protein derivative (PPD) 3 weeks after vaccination. Cattle vaccinated just with oral BCG in a lipid matrix produced a strong IFN-gamma response 8 weeks after vaccination, and peaking at 11 weeks after vaccination. All calves were challenged by the intratracheal route with M. bovis 15 weeks after vaccination and were euthanized and necropsied to assess protection at 17 weeks following challenge. BCG given s.c. or orally induced significant and comparable levels of protection against the virulent challenge. Vaccination of cattle by a combination of s.c./oral routes did not enhance protection beyond that achieved by s.c. or oral vaccination alone. We conclude that vaccination of cattle with BCG by a combination of routes has no beneficial additive effects, compared to a single s.c. administration of BCG or BCG given orally in a lipid formulation. PMID:18439875

  13. A prospective, open-label, single arm, multicentre study to evaluate efficacy, safety and acceptability of pericoital oral contraception using levonorgestrel 1.5 mg

    PubMed Central

    Festin, Mario P.R.; Bahamondes, Luis; Nguyen, Thi My Huong; Habib, Ndema; Thamkhantho, Manopchai; Singh, Kuldip; Gosavi, Arundhati; Bartfai, Gyorgy; Bito, Tamas; Bahamondes, M. Valeria; Kapp, Nathalie

    2016-01-01

    STUDY QUESTION Will the use of levonorgestrel (LNG) 1.5 mg taken at each day of coitus by women who have relatively infrequent sex be an efficacious, safe and acceptable contraceptive method? SUMMARY ANSWER Typical use of LNG 1.5 mg taken pericoitally, before or within 24 h of sexual intercourse, provides contraceptive efficacy of up to 11.0 pregnancies per 100 women-years (W-Y) in the primary evaluable population and 7.1 pregnancies per 100 W-Y in the evaluable population. WHAT IS KNOWN ALREADY LNG 1.5 mg is an effective emergency contraception following unprotected intercourse. Some users take it repeatedly, as their means of regular contraception. STUDY DESIGN, SIZE, DURATION This was a prospective, open-label, single-arm, multicentre Phase III trial study with women who have infrequent coitus (on up to 6 days a month). Each woman had a follow-up visit at 2.5, 4.5 and 6.5 months after admission or until pregnancy occurs if sooner, or she decided to interrupt participation. The study was conducted between 10 January 2012 and 15 November 2014. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 330 healthy fertile women aged 18–45 years at risk of pregnancy who reported sexual intercourse on up to 6 days a month, were recruited from four university centres located in Bangkok, Thailand; Campinas, Brazil; Singapore and Szeged, Hungary to use LNG 1.5 mg pericoitally (24 h before or after coitus) as their primary method of contraception. The participants were instructed to take one tablet every day she had sex, without taking more than one tablet in any 24-h period, and to maintain a paper diary for recording date and time for every coital act and ingestion of the study tablet, use of other contraceptive methods and vaginal bleeding patterns. Anaemia was assessed by haemoglobin evaluation. Pregnancy tests were performed monthly and pregnancies occurring during product use were assessed by ultrasound. At the 2.5-month and final visit at 6.5 months, acceptability

  14. Permanent contraception for women.

    PubMed

    Micks, Elizabeth A; Jensen, Jeffrey T

    2015-11-01

    Permanent methods of contraception are used by an estimated 220 million couples worldwide, and are often selected due to convenience, ease of use and lack of side effects. A variety of tubal occlusion techniques are available for female permanent contraception, and procedures can be performed using a transcervical or transabdominal approach. This article reviews currently available techniques for female permanent contraception and discusses considerations when helping patients choose a contraceptive method and tubal occlusion technique. PMID:26626698

  15. Lunelle monthly contraceptive injection (medroxyprogesterone acetate and estradiol cypionate injectable suspension): a contraceptive method for women in the US and worldwide.

    PubMed

    Kaunitz, A M; Mishell, D R

    1999-10-01

    This paper presents data from the first large US clinical trial of Lunelle monthly contraceptive injection, which is a combination of 25 mg of medroxyprogesterone acetate (MPA) and 5 mg of estradiol cypionate (E2C). The lead article reports that there was no occurrence of unintended pregnancies and no contraceptive discontinuation among more than 700 women using the MPA/E2C in a 60-week clinical trial. Most women experienced regular monthly cycles the same as those women using the nonhormonal method. The second article reports the results of a separate trial that studied return ovulation after three monthly injections of MPA/E2C in surgically sterile women. Serum progesterone determinations found that return of ovulation was documented as early as 63 days after the third (final) intramuscular injection of MPA/E2C. Two articles in this issue assess the pharmacokinetics of MPA/E2C injections. Findings indicate that MPA/E2C represents a contraceptive option that combines the advantages of oral contraceptives with the convenience and effectiveness of monthly administration. Accordingly, a US Food and Drug Administration approval should play an important role in helping women achieve effective birth control in the US and worldwide. PMID:10640163

  16. Steatocystoma multiplex suppurativum: oral isotretinoin treatment combined with cryotherapy.

    PubMed

    Apaydin, R; Bilen, N; Bayramgürler, D; Başdaş, F; Harova, G; Dökmeci, S

    2000-05-01

    A 30-year-old man presented with numerous papules, nodules and inflamed cysts. The lesions were located all over the body, including the scalp, except the palms and soles. His mother and one sister had had similar but less extensive lesions. Histopathology of the biopsy specimens obtained from the anterior chest wall, axillae and the back region was consistent with steatocystoma multiplex (SM). A diagnosis of steatocystoma multiplex suppurativum was made. The inflamed lesions were treated with oral isotretinoin (1 mg/kg per daily) for 6 months. At the same time, cryotherapy was used for non-suppurating lesions smaller than 2 cm. When the patient was evaluated 6 months later, cosmetic results were good. No new lesions have appeared in the subsequent 12-month follow up. PMID:10812703

  17. Contraceptive revolution.

    PubMed

    Segal, S J

    1994-06-01

    Global population will increase by almost 1 billion people in the 1990s, the largest 10-year increase ever recorded. In 1994 alone, population will surpass 5.7 billion. The prospect of double-digit billions of people is worrisome, especially since these numbers may affect global warming, supplies of fresh water, destruction of rain forests, industrial pollution, and sustainable development. Yet, many indicators of quality of life show that people enjoy a better quality of life today than they did 100 years ago. Between India's independence and now, life expectancy increased by 20 years, infant mortality decreased 2-fold, literacy increased, and the food supply stabilized. Even though India's population has almost tripled since 1947, its economy increased rapidly and is 1 of the world's top 10 economies. University enrollment stands at 4.5 million. Agricultural production has exceeded demand. India represents the potential for human achievement through technological advancement and social organization. If the world's first national family planning program had been more successful when it began in 1952 in an India of 350 million people, India's population would be around 500 million instead of the expected 1 billion in 2000. All countries need to achieve a sustainable balance between human numbers and needs and natural resources. Family planning is an essential, cost-effective part of any development strategy. Family planning use has reduced fertility from 6 to 3.6 in developing countries. In 1965, only 8% used contraception, while more than 50% use it now. The most remarkable family planning/fertility reduction successes are Bangladesh, Brazil, Colombia, Indonesia, Mexico, and Thailand. Sufficient investment in family planning is needed if significant declines in fertility are to occur. More than 90% of the developing world's people are in countries with official family planning programs. Cost-effective assistance by donors and developing countries implementing

  18. Plasma levels of 25-hydroxyvitamin D3 and in vivo markers of cytochrome P450 3A activity in Swedes and Koreans: effects of a genetic polymorphism and oral contraceptives.

    PubMed

    Nylén, Hanna; Björkhem-Bergman, Linda; Ekström, Lena; Roh, Hyung-Keun; Bertilsson, Leif; Eliasson, Erik; Lindh, Jonatan D; Diczfalusy, Ulf

    2014-10-01

    In vitro studies have shown that vitamin D may induce several cytochrome P450 (CYP) enzymes in general and CYP3A4 in particular. The primary aim of this study was to investigate the relationship between plasma levels of 25-hydroxyvitamin D3 and suggested in vivo markers of CYP3A activity in healthy volunteers from Sweden and Korea. Plasma concentrations of 25-hydroxyvitamin D3 were analysed in samples from three previously performed studies, and the correlation between these levels and suggested in vivo markers of CYP3A activity was investigated by means of nonparametric correlation. In addition, we studied the modulating effects of three vitamin D receptor promoter polymorphisms on the association between 25-hydroxyvitamin D3 and CYP3A enzyme activity in Swedish subjects. The plasma levels of 25-hydroxyvitamin D3 were not significantly associated with CYP3A phenotypes in any of the three studies, but after accounting for the vitamin D receptor polymorphism rs4516035, there was a significant positive association between 25-hydroxyvitamin D3 and CYP3A activity (p = 0.004). Swedes (n = 65) had significantly higher 25-hydroxyvitamin D3 levels than Koreans (n = 67), 75 nM compared with 31 nM (p < 0.001). Swedish women taking oral contraceptives (OC) (n = 19) had somewhat higher plasma levels of 25-hydroxyvitamin D3 compared with Swedish women not taking oral contraceptives (n = 21), 89 and 72 nM, respectively (p = 0.02). In conclusion, our results suggest that the overall influence on the CYP3A activity by 25-hydroxyvitamin D3 is of marginal importance. PMID:24655660

  19. [Chronic illness and contraception].

    PubMed

    Saarikoski, S

    1987-01-01

    In recent years sterilization that can cause problems of the psyche and marital life has been recommended much less frequently with respect to chronic diseases. As regards heart and hypertensive diseases pregnancy is always contraindicated in case of 3rd and 4th disease categories and sterilization is recommended according to the New York Heart Association. As far as 1st and 2nd category patients are concerned if the load carrying capacity is normal pregnancy could be undertaken. Combination pills are not recommended for contraception because they can cause fluid retention or increase the risk of thrombosis. If the patient has a higher-than-normal risk of developing thrombosis or infection, for instance, those who wear pacemakers only tablets containing progesterone or subdermal capsule implants can be used. In those with blood pressure problems the additional use of the IUD is also advised. Among diseases of neurological and psychic origin the effect of hormonal contraceptives is weakened by antiepileptics, but even in such cases older combination pills of larger doses of active ingredients can be employed. Migraine is exacerbated in 1/3 of patients; here IUDs can be used. Even the contraceptive tablets themselves can induce depression. In psychosis methods requiring regular attention can be easily forgotten, therefore the IUD is the most suitable device. In diabetes progesterone and other progestogens reduce insulin response, harm carbohydrate metabolism; therefore in young people the IUD is preferred an in older women with children even sterilization can be employed. Hormonal tablets must not be used in hyperlipidemia and liver diseases. Caution must be exercised in hyperthyroidism and in endocrine disorders (e.g., Cushing's syndrome); if it is accompanied by blood pressure disorders appropriate treatment is required. In kidney diseases pregnancy is contraindicated if it is accompanied by blood pressure increase or a higher level of creatine. On the other hand

  20. Searching for Ideal Contraceptives.

    ERIC Educational Resources Information Center

    Djerassi, Carl

    1985-01-01

    Discusses the problem of adolescent pregnancy and focuses on improving contraception as a practical solution. Describes the advantages and disadvantages of existing methods (the condom, the pill, and the contraceptive sponge). Predicts that the development of a fundamentally new contraceptive, such as a monthly menses-inducer pill, will not occur…

  1. [Drug interactions with contraceptive methods].

    PubMed

    Simon, P; Hakkou, F; Warot, D

    1984-03-01

    3 possible types of drug interactions with contraceptives involve oral contraceptives (OCs), IUDs, and spermicides. The interaction of combined OCs with various drugs is frequently discussed in the literature, but the reported facts are sometimes contradictory. Case studies have indicated failure of OCs in patients taking ampicillin, but comparative studies using ampicillin and placebos have shown no difference in rates of estrogen, progestogens, follicle stimulating hormone, or luteinizing hormone in the 2 groups. Individual differences and predispositions among some women appear to play a role in drug interactions. The clinician should be wary of modifying accepted prescription practices too readily in the face of findings that may be explained by other as yet undisclosed factors. Interactions are difficult to establish, as are their mechanisms. They may perhaps be explained by the estrogen or progestogen components of the pills, the timing of the antibiotic dose, the duration of treatment and the dosage used, resistance of the intestinal flora, self-medication, or other factors. The drug troleandomycin is a special case; it appears to favor the already existing tendency of OCs to provoke cholestatic jaundice. A table of drug interactions with OCs can be divided into 2 parts, those that have been confirmed and whose mechanisms of action are known, including antiepileptics such as phenobarbital, butobarbital, phenytoin, and primidone, and the drug rifampicin, which are enzyme inductors; and those that are suspected but as yet unconfirmed and whose mechanism of action is not established. The unconfirmed interactions involve a variety of effects in addition to pregnancy. It is not yet established whether enzyme inductors are a greater problem for users of low-dose pills, but the probable existence of individual variations in sensitivity causes problems in setting recommendations applicable to all patients. Interactions between progestogen-only OCs and other drugs

  2. Study of norethindrone in contraception.

    PubMed

    Goldzieher, J W; Moses, L E; Ellis, L T

    1962-05-01

    The contraceptive effectiveness of 10 mg norethindrone plus .06 mg ethinyl estradiol, administered orally for 20 days of the menstrual cycle, was evaluated in 210 women over 6232 cycles at the Planned Parenthood Center of San Antonio, Texas. There were no unplanned pregnancies during the study period, and not a single patient discontinued use because of side effects. Dysmenorrhea and premenstrual tension diminshed considerably. The incidence of menstrual irregularities, was low. 99 of the women reported an increase in libido. Of 18 patients who discontinued use to become pregnant, 16 became pregnant within the first 3 cycles. The contraceptive effect of norethindrone is thought to be due to the inhibition of ovulation, reinforced by additional protective mechanisms. PMID:12305165

  3. Update on the metabolic effects of steroidal contraceptives and their relationship to cardiovascular disease risk.

    PubMed

    Godsland, I F; Crook, D

    1994-05-01

    Evaluation of metabolic disturbances has had an important role in the modification of oral contraceptive formulations toward estrogen-progestin combinations with reduced adverse metabolic impact. An increasing number of interrelationships between metabolic risk factors for cardiovascular disease are being recognized, and a metabolic syndrome of disturbances has been identified with insulin resistance as a potential underlying factor. The insulin resistance syndrome includes hyperinsulinemia and impaired glucose tolerance, hypertriglyceridemia, reduced high-density lipoprotein concentrations, and hypertension. Increased concentration of a small, dense, low-density lipoprotein subtype may also be important. Depending on steroid type and dose, combined oral contraceptives may induce all the features of the insulin resistance syndrome. Reduction in estrogen dose and modification of progestin content have resulted in formulations with no adverse effect on high-density lipoprotein and blood pressure, but insulin resistance and hypertriglyceridemia remain. These are caused primarily by the estrogen component. Therefore modification of the estrogen content of oral contraceptives might result in "metabolically transparent" formulations that could conceivably afford a degree of cardiovascular protection. PMID:8178902

  4. A Comparative Efficacy of Low-Dose Combined Oral Contraceptives Containing Desogestrel and Drospirenone in Premenstrual Symptoms

    PubMed Central

    Wichianpitaya, Jirath; Taneepanichskul, Surasak

    2013-01-01

    Objective. To compare the efficacy of low-dose COC containing desogestrel (DSG) with drospirenone (DRSP) in the changes of premenstrual symptoms. Methods. In an open-label randomized controlled trial, 90 women with premenstrual syndrome who required COC were randomly recruited and allocated equally to receive either 6 cycles of 20 micrograms ethinyl estradiol (EE)/150 micrograms DSG (DSG group) or 20 micrograms EE/3 mg DRSP (DRSP group) in 24/4 extended regimen. Analysis of covariance and repeated analysis of variance were used to determine the difference of mean Women's Health Assessment Questionnaire (WHAQ) scores changes between groups, within group, and in premenstrual, menstrual, and postmenstrual phases. Results. Baseline characteristics and WHAQ scores were comparable. At the ends of the 3rd and the 6th cycles, mean WHAQ scores of all the 3 phases in DRSP group showed significant reduction and were significantly lower than those in DSG group. DSG group showed significant reduction in both premenstrual and menstrual phases after the 6th cycle. Adverse effects were comparable in both groups. In conclusion, low-dose COC containing either DSG or DRSP reduced premenstrual symptoms, but the latter showed greater efficacy and earlier reduction. PMID:23577032

  5. Combined compared to dissociated oral and intestinal sucrose stimuli induce different brain hedonic processes

    PubMed Central

    Clouard, Caroline; Meunier-Salaün, Marie-Christine; Meurice, Paul; Malbert, Charles-Henri; Val-Laillet, David

    2014-01-01

    The characterization of brain networks contributing to the processing of oral and/or intestinal sugar signals in a relevant animal model might help to understand the neural mechanisms related to the control of food intake in humans and suggest potential causes for impaired eating behaviors. This study aimed at comparing the brain responses triggered by oral and/or intestinal sucrose sensing in pigs. Seven animals underwent brain single photon emission computed tomography (99mTc-HMPAO) further to oral stimulation with neutral or sucrose artificial saliva paired with saline or sucrose infusion in the duodenum, the proximal part of the intestine. Oral and/or duodenal sucrose sensing induced differential cerebral blood flow changes in brain regions known to be involved in memory, reward processes and hedonic (i.e., pleasure) evaluation of sensory stimuli, including the dorsal striatum, prefrontal cortex, cingulate cortex, insular cortex, hippocampus, and parahippocampal cortex. Sucrose duodenal infusion only and combined sucrose stimulation induced similar activity patterns in the putamen, ventral anterior cingulate cortex and hippocampus. Some brain deactivations in the prefrontal and insular cortices were only detected in the presence of oral sucrose stimulation. Finally, activation of the right insular cortex was only induced by combined oral and duodenal sucrose stimulation, while specific activity patterns were detected in the hippocampus and parahippocampal cortex with oral sucrose dissociated from caloric load. This study sheds new light on the brain hedonic responses to sugar and has potential implications to unravel the neuropsychological mechanisms underlying food pleasure and motivation. PMID:25147536

  6. Transdermal delivery of contraceptives.

    PubMed

    Friend, D R

    1990-01-01

    Contraceptive agents are administered to the body through a variety of routes. Research has recently been directed at examining the transdermal route for systemic delivery of contraceptive agents, including estrogens and progestins. The transdermal route has several potential advantages over the other routes of administration: (1) improved compliance, (2) once-weekly administration, (3) delivery is easily terminated, and (4) some side effects can be alleviated based on more constant delivery rates. This article reviews the permeability of skin toward contraceptive steroids and how skin permeability is evaluated. The metabolism of contraceptive steroids is also considered. Transdermal delivery systems used to deliver contraceptives are presented, followed by a detailed discussion of several delivery systems for specific contraceptive agents such as levonorgestrel and estradiol. The potential problem of skin irritation is presented as it relates to transdermal contraceptive delivery systems, all of which will be worn chronically. PMID:2272099

  7. The quest for a herbal contraceptive.

    PubMed

    Chaudhury, R R

    1993-01-01

    An oral herbal contraceptive would allow couples control their fertility without consulting a health worker, which in turn would likely markedly increase the number of couples practicing family planning. Other advantages of such a contraceptive would include the familiarity rural people have with herbal medicines, the fewer side effects associated with herbal preparations, their ready availability from local sources, and protection of privacy. There are many references to plants in India with antifertility properties. Since 1966, the Indian Council of Medical Research (ICMR) has been conducting research to identify a herbal contraceptive, as have other organizations. Plants that have exhibited antifertility activity in clinical trials include Hibiscus rosasinensis (benzene extract of the flower petals suppresses implantation); Rudrapushpaka (extract of the flower petals prevents pregnancy); Embelia ribes (pregnancy prevention); Davcus carota, Butea monosperma, and Sapindus trifoliatis (seeds have an anti-implantation effect); and Mentha arvensis (leaves have anti-implantation effect). The Central Drug Research Institute in Lucknow, India, in collaboration with the US National Institutes of Health, the World Health Organization, and the ICMR confirm anti-implantation activity in Ferula jaeschkeana, Bupleurum marginatum, Lepidium capitatum, Caesalpinia sepiaria, Lonicera japonica, Juniperus communis, Lotus corniculatus, Lamium allum, and Acacia farnesiana. In China, scientists have evaluated the cotton-seed extract gossypol as a male contraceptive. They are now studying the possible antifertility effect on men of the plant Tripterygium wilfordii. From all the aforementioned plants as well as others under investigation, three possible types of contraceptives could be developed: an anti-ovulatory contraceptive; a postcoital contraceptive; and a male contraceptive. Some obstacles to their development include difficulties in obtaining adequate quantities of the herbs, a

  8. [Do's and don'ts in post-partum contraception].

    PubMed

    Buhler, M

    1985-10-01

    It is sometimes difficult to plan contraception with a woman who has just delivered a baby, because she is sometime not motivated in the week following delivery, feeling unable to contemplate intercourse because of perineal pain and other discomforts. Effective contraception should be used beginning with the 25th postpartum day because of the subsequent strong possibility of ovulation before the return of menstruation. The woman should be provided with as much information on contraception as possible during this period, and possible contraindications to specific methods should be sought, such as thromboembolic accidents, hyperlipidemia, hypertension, diabetes, infection, ectopic pregnancy, abortion, and desire for subsequent pregnancy. No request for contraception should be ignored and the same method should not be imposed on all women. The topic of contraception should not be deferred until the postpartum check-up in the 2nd month, because 50% of women will have had intercourse by the end of the 2nd month, often unprotected. Local methods such as spermicides and condoms are effective when the couple is motivated and they are well accepted. The thromboembolic risk appears minimal when oral contraceptives (OCs) are begun on the 15th postpartum day for non-breastfeeding women. OCs should not be prescribed for women after prolonged bedrest, and women who previously used pills should have lipid and glucose tests before the 2nd month postpartum consultation. The low dose progestin pill should be preferred to the low dose combined pill if a potential thromboembolic risk exists. Infants of breastfeeding women using pills receive 1/500 of the estrogen dose administered to the mother and 1/1000 of the progestin dose. No effects of these doses have been found on the growth or genital development of infants, and modifications of milk composition are not constant. A low dose progestin pill beginning on postpartum day 20 may however be preferred. It is better to await the

  9. The current state of male hormonal contraception.

    PubMed

    Chao, Jing H; Page, Stephanie T

    2016-07-01

    World population continues to grow at an unprecedented rate, doubling in a mere 50years to surpass the 7-billion milestone in 2011. This steep population growth exerts enormous pressure on the global environment. Despite the availability of numerous contraceptive choices for women, approximately half of all pregnancies are unintended and at least half of those are unwanted. Such statistics suggest that there is still a gap in contraceptive options for couples, particularly effective reversible contraceptives for men, who have few contraceptive choices. Male hormonal contraception has been an active area of research for almost 50years. The fundamental concept involves the use of exogenous hormones to suppress endogenous production of gonadotropins, testosterone, and downstream spermatogenesis. Testosterone-alone regimens are effective in many men but high dosing requirements and sub-optimal gonadotropin suppression in 10-30% of men limit their use. A number of novel combinations of testosterone and progestins have been shown to be more efficacious but still require further refinement in delivery systems and a clearer understanding of the potential short- and long-term side effects. Recently, synthetic androgens with both androgenic and progestogenic activity have been developed. These agents have the potential to be single-agent male hormonal contraceptives. Early studies of these compounds are encouraging and there is reason for optimism that these may provide safe, reversible, and reliable contraception for men in the near future. PMID:27016468

  10. Contraception and toxic-shock syndrome: a reanalysis.

    PubMed

    Shelton, J D; Higgins, J E

    1981-12-01

    A nonstratified reanalysis of data from 2 recent studies of toxic-shock syndrome (TSS) from Wisconsin and from the Center for Disease Control (CDC) was done to confirm the studies' claim of a protective effect of contraception against TSS. The analysis lumped together all spermicide-containing contraceptive methods and made reference comparisons of risks for users of various methods of contraception vs. the risk for women using no contraceptive method. Despite the small number involved, the spermicide-containing contraceptive methods exhibited a significant protective effect in the Wisconsin study and a borderline significant protective effect in the CDC study. The Mantel-Haenszel odds ratio across both studies was 0.23 (Taylor-series 95% confidence interval 0.09-0.61) for spermicide-containing methods. The Wisconsin study exhibited a significant protective effect for oral contraceptives. Although the CDC study showed a similar protective effect (odds ratio 0.38), pill use in this population was very low and the effect was not statistically significant. The Mantel-Haenszel odds ratio across the 2 studies was 0.27 (95% confidence interval 0.12-0.63). The protective effect of spermicides against TSS was related to an antimicrobial action of spermicidal ingredients in vaginal contraceptives against Staph. aureus. Possible protective mechanisms for oral contraceptive against TSS included reduced menstrual flow and duration, alterations to the cervical mucus, and the effects of contraceptive steroids on the vaginal flora. The studies suggest that women using vaginal methods of contraceptives can allay their fears that the increased risk of TSS associated with vaginal tampons extends to vaginal contraceptives. PMID:7326935

  11. Hormonal contraceptives and travel to high altitude.

    PubMed

    Keyes, Linda E

    2015-03-01

    Women frequently ask about the safety and efficacy of using hormonal contraception (HC), either oral contraceptive pills (OC) or other forms, when traveling to high altitude locales. What are the risks and benefits of using HC at high altitude? Does HC affect acclimatization, exercise performance, or occurrence of acute mountain sickness? This article reviews current data regarding the risks and benefits of HC at high altitude, both demonstrated and theoretical, with the aim of helping health care providers to advise women traveling above 2500 meters. Most healthy women can safely use HC when traveling to high altitude, but should be aware of the potential risks and inconveniences. PMID:25759908

  12. The economic value of contraception: a comparison of 15 methods.

    PubMed Central

    Trussell, J; Leveque, J A; Koenig, J D; London, R; Borden, S; Henneberry, J; LaGuardia, K D; Stewart, F; Wilson, T G; Wysocki, S

    1995-01-01

    OBJECTIVES. The purpose of the study was to determine the clinical and economic impact of alternative contraceptive methods. METHODS. Direct medical costs (method use, side effects, and unintended pregnancies) associated with 15 contraceptive methods were modeled from the perspectives of a private payer and a publicly funded program. Cost data were drawn from a national claims database and MediCal. The main outcome measures included 1-year and 5-year costs and number of pregnancies avoided compared with use of no contraceptive method. RESULTS. All 15 contraceptives were more effective and less costly than no method. Over 5 years, the copper-T IUD, vasectomy, the contraceptive implant, and the injectable contraceptive were the most cost-effective, saving $14,122, $13,899, $13,813, and $13,373, respectively, and preventing approximately the same number of pregnancies (4.2) per person. Because of their high failure rates, barrier methods, spermicides, withdrawal, and periodic abstinence were costly but still saved from $8933 to $12,239 over 5 years. Oral contraceptives fell between these groups, costing $1784 over 5 years, saving $12,879, and preventing 4.1 pregnancies. CONCLUSIONS. Contraceptives save health care resources by preventing unintended pregnancies. Up-front acquisition costs are inaccurate predictors of the total economic costs of competing contraceptive methods. Images FIGURE 1 FIGURE 2 PMID:7702112

  13. Topical Tacrolimus and Oral Dapsone Combination Regimen in Lichen Planus Pigmentosus.

    PubMed

    Verma, Prashant; Pandhi, Deepika

    2015-01-01

    Lichen planus pigmentosus is a well-recognized variant of lichen planus; however, its etiopathogenesis is still unclear. An effective and safe treatment for lichen planus pigmentosus is needed; therefore, the authors examined a series of five patients with lichen planus pigmentosus with successful response to a combination of topical tacrolimus and oral dapsone. PMID:26790504

  14. New frontiers in nonhormonal male contraception

    PubMed Central

    Cheng, C. Yan; Mruk, Dolores D.

    2015-01-01

    The world’s population is nearing 6.8 billion, and we are in need of a male contraceptive that is safe, effective, reversible and affordable. Hormonal approaches, which employ different formulations of testosterone administered in combination with other hormones, have shown considerable promise in clinical trials, and they are currently at the forefront of research and development. However, the long-term effects of using hormones throughout a male’s reproductive life for contraception are unknown, and it may take decades before this information becomes available. Because of this, many investigators are aiming to bring a nonhormonal male contraceptive to the consumer market. Indeed, there are several distinct but feasible avenues in which fertility can be regulated without affecting the hypothalamus-pituitary-testis axis. In this review, we discuss several approaches for fertility control involving the testis that one day may lead to the development of a nonhormonal male contraceptive. PMID:20933122

  15. Contraception: Efficacy, Risks, Continuation Rates, and Use in High-Risk Women.

    PubMed

    Batur, Pelin; Bowersox, Natalie; McNamara, Megan

    2016-08-01

    The clinical update serves as a brief review of recently published, high-impact, and potentially practice-changing journal articles summarized for our readers. Topics include menopause, sexual dysfunction, breast health, contraception, osteoporosis, and cardiovascular disease. In this clinical update, we selected recent publications relevant to the use of contraceptive methods. We highlight articles on continuation rates of long-acting reversible contraception versus nonlong-acting methods, updated risks of intrauterine devices, use of estrogen-containing contraceptives during anticoagulation for venous thromboembolic events, and the efficacy of oral and emergency contraception in women with elevated body mass index. PMID:27438879

  16. Effect of hormonal contraception on the function of plasmacytoid dendritic cells and distribution of immune cell populations in the female reproductive tract

    PubMed Central

    Michel, Katherine G.; Huijbregts, Richard P.H.; Gleason, Jonathan L.; Richter, Holly E.; Hel, Zdenek

    2016-01-01

    Objective Epidemiological evidence suggests an association between the use of hormonal contraception and an increased risk of acquiring sexually transmitted diseases including HIV-1. We sought to elucidate the biological mechanisms underlying the effect of hormonal contraception on the immune system. Design Cross-sectional study. Methods To delineate the biological mechanisms underlying the effect of hormonal contraceptives on the immune system, we analyzed the functional capacity of circulating plasmacytoid dendritic cells (pDCs), the distribution of vaginal immune cell populations, and the systemic and genital levels of immune mediators in women using depot medroxyprogesterone acetate (DMPA), NuvaRing, or combined oral contraceptives (COC). Results The use of DMPA or NuvaRing was associated with reduced capacity of circulating pDCs to produce IFNα and TNFα in response to TLR-9 stimulation. Systemic levels of IFNα and cervicovaginal fluid levels of IFNα, CXCL10, MCP-1, and G-CSF were significantly lower in DMPA users compared to control volunteers not using hormonal contraception. The density of CD207+ Langerhans cells in the vaginal epithelium was reduced in NuvaRing and COC users but not in DMPA users. Conclusions The presented evidence suggests that the use of some types of hormonal contraception is associated with reduced functional capacity of circulating pDCs and altered immune environment in the female reproductive tract. PMID:25763784

  17. Drospirenone/ethinylestradiol 3mg/20microg (24/4 day regimen): a review of its use in contraception, premenstrual dysphoric disorder and moderate acne vulgaris.

    PubMed

    Fenton, Caroline; Wellington, Keri; Moen, Marit D; Robinson, Dean M

    2007-01-01

    Drospirenone 3mg with ethinylestradiol 20microg (Yaz) is a low-dose combined oral contraceptive (COC) administered in a regimen of 24 days of active tablets followed by a short hormone-free interval (4 days; 24/4 regimen). Drospirenone, unlike other synthetic progestogens used in COCs, is a 17alpha-spirolactone derivative and a 17alpha-spironolactone analogue with antimineralocorticoid and antiandrogenic properties. Drospirenone/ethinylestradiol 3mg/20microg (24/4) is approved in the US for the prevention of pregnancy in women, for the treatment of the symptoms of premenstrual dysphoric disorder (PMDD) and for the treatment of moderate acne vulgaris in women who wish to use an oral contraceptive for contraception.Drospirenone/ethinylestradiol 3mg/20microg (24/4) provided 99% contraceptive protection over 1 year of treatment in two large studies. The same treatment regimen over three treatment cycles also significantly improved the emotional and physical symptoms associated with PMDD, and improved moderate acne vulgaris over six treatment cycles in double-blind trials. It was generally well tolerated, with adverse events generally typical of those experienced with other COCs and which were most likely to occur in the first few cycles. Clinical trials indicate that drospirenone/ethinylestradiol 3mg/20microg (24/4) is a good long-term contraceptive option, and additionally offers relief of symptoms that characterise PMDD and has a favourable effect on moderate acne vulgaris. PMID:17683173

  18. Contraceptive methods used and preferred by men and women.

    PubMed

    Kirkkola, A L; Virjo, I; Isokoski, M; Mattila, K

    1999-01-01

    In 1997, a random sample of Finnish men (n = 395) and women (n = 393) aged 18-50 years received a postal questionnaire concerning family planning, in which they were asked which contraceptive methods they had ever used and which three methods they considered to be best. Men's contraceptive preferences were compared to those of women. The response rate for men was 45% and for women 56%. The majority of both men and women had used, together with their partners, condom, oral contraceptives (OCs) and intrauterine devices (IUDs). The use of diaphragm, Norplant, Depo Provera and postcoital IUDs was not common. Among the men, 2-11% did not know whether their partner/partners had used the contraceptives in question. Concerning the three best contraceptive methods, men placed the condom first and women OCs. No male or female respondents rated postcoital emergency pills a superior method. Both men and women appreciated the most reliable means. PMID:11145377

  19. Out from behind the contraceptive Iron Curtain.

    PubMed

    Jacobson, J L

    1990-01-01

    In the early 1950s, the Soviet Union and several of its Eastern European satellites completed their transition from high to low fertility before the US and Western Europe. They did this even though there were not enough modern contraceptives available to meet the needs of its citizens. As late as 1990, the Soviet Union had no factories manufacturing modern contraceptives. A gynecologist in Poland described domestically produced oral contraceptives (OCs) as being good for horses, but not for humans. The Romanian government under Ceaucescu banned all contraceptives and safe abortion services. Therefore, women relied on abortion as their principal means of birth control, even in Catholic Poland. The legal abortion rates in the Soviet Union and Romania stood at 100/1000 (1985) and 91/1000 (1987) as compared to 18/1000 in Denmark and 13/1000 in France. All too often these abortion were prohibited and occurred under unsafe conditions giving rise to complications and death. Further, the lack of contraceptives in the region precipitated and increase in AIDS and other sexually transmitted diseases. On the other hand, abortion rates were minimalized in Czechoslovakia, East Germany, and Hungary due to the availability of modern contraceptives and reproductive health services. Hungary and East Germany even manufactured OCs. OC use in these 2 nations rated as among the world's highest. East Germany also treated infertility and sexually transmitted diseases. The region experienced a political opening in latecomer 1989. In 1989, IPPF gave approximately 15 million condoms and 3000 monthly OC packets to the Soviet Union to ease the transition. More international assistance for contraceptive supplies and equipment and training to modernize abortion practices is necessary. PMID:12283401

  20. Television and contraception.

    PubMed

    Klein, L

    1986-01-01

    This article consists of excerpts from a speach made on October 19th at the 1986 annual meeting of the Association of Planned Parenthood Professionals by Dr. Luella Klein, President of the American College of Obstetricians and Gynecologists (ACOG) between 1984-85. The speaker described the reaction of US television network to the ACOG's request that the networks air a public service announcement encouraging responsible sexual behavior among the nation's young people. In 1984 the ACOG initiated a public information program aimed at reducing the high number of unwanted births among young people. The ACOG with the help of an advertising agency developed a 27-second public service announcement stressing responsible parenthood and informing young people that they could write or call for further information. A booklet, entitled "Facts," was prepared for distribution to those who inquired. It advised young people to consider postponing sexual intercourse but to use the most effective methods of contraception if they decided to be sexually active. Oral contraceptives for females and condoms for males were recommended as the most effective methods. When the 3 major television networks, i.e., the American Broadcasting Company (ABC), the National Broadcasting Company (NBC), and the Columbia Broadcasting System (CBS), were requested to carry the announcement, all 3 networks claimed the announcement was too controversial to air. These same networks do not hesitate to show blatant, irresponsible sexual behavior repeatedly during their entertainment programming, and commercials with sexual innuendos are routinely accepted for airing by the networks. In July, 1986, the ACOG called a news conference in New York City to inform the news media about the rejection of the announcement by the networks. The conference stimulated considerable interest, and the story was carried by many newspapers and by radio and television news programs. Many of the news accounts of the story contained

  1. Social marketing of contraceptives.

    PubMed

    Schellstede, W P; Derr, B B

    1986-12-01

    Application of commercial marketing techniques has not only increased awareness, acceptability, and use of modern contraceptives in developing countries, but also overcome logistic problems in service delivery. The ability of contraceptive social marketing to reach large numbers and to treat contraceptives as common consumer products has helped to diminish social and religious constraints associated with family planning. Each contraceptive social marketing program is built around a theme tailored to meet specific cultural, social, and management requirements. The primary target populations are those who cannot afford regular commercial products and those who are not adequately reached by government programs. In countries such as Sri Lanka and Jamaica, profit is not a primary sales objective and retail prices are highly subsidized to make products affordable to low-income people. In contrast, the Colombian and Thai programs use contraceptive social marketing to help offset the operating costs of rural community-based programs and seek profits. The most impressive contraceptive social marketing sales performances have been recorded in Bangladesh, Colombia, Egypt, and Jamaica. The main reason contraceptive social marketing is more cost-efficient than other modes of contraceptive distribution is that the cost of product delivery is assumed by the commercial system. Although there has been some interest in making these programs self-sufficient financially, this step has tended to undermine the purpose of serving lower income groups. PMID:12341233

  2. Male Adolescent Contraceptive Utilization.

    ERIC Educational Resources Information Center

    Finkel, Madelon Lubin; Finkel, David J.

    1978-01-01

    The contraceptive utilization of a sample of sexually active, urban, high school males (Black, Hispanic, and White) was examined by anonymous questionnaire. Contraceptive use was haphazard, but White males tended to be more effective contraceptors than the other two groups. Reasons for nonuse were also studied. (Author/SJL)

  3. A Randomised Controlled Trial Comparing the Efficacy and Side-Effects of Intravaginal Ring (Nuvaring®) With Combined Oral Hormonal Preparation in Dysfunctional Uterine Bleeding

    PubMed Central

    Vaid, Neelam B.; Narang, Yam; Suneja, Amita; Guleria, Kiran

    2016-01-01

    Introduction Combined Oral Contraceptive (COC) pills are being used in patients of abnormal uterine bleeding, especially adolescents and reproductive age women considering their need for contraception. It decreases the blood loss due to haemostatic effect of estrogen and also regularizes the cycle. Intravaginal route has been found to be effective and acceptable; Gastrointestinal absorption and hepatic first-pass metabolism is avoided and steady, uniform blood concentration is achieved. Bioavailability of estrogen and progestogen through oral and vaginal route are same. The convenience of once-a-month administration is another major advantage. Materials and Mathods Sixty women fulfilling inclusion criteria were randomised into 2 groups in 1:1 ratio. In one group (n=30), monthly insertion of Nuvaring®) was done for three consecutive months. Nuvaring® releases 15μg ethinyl estradiol and 120 μg etonogesterol daily. The other group (n=30) received COC pill containing 30μg EE and 150 μg levonorgestrel for three consecutive months. Primary outcome measures were change in menstrual cycle pattern and pictorial Blood Loss Assessment chart (PBAC) score. Other Parameters included side effects, change in haemoglobin and weight. Data was analyzed by statistical software SPSS 20. Results Both Nuvaring® and COC were found to significantly decrease blood loss in each cycle. Decrease in PBAC score was more in Nuvaring® group compared to COC, however difference was not significant. Ideal bleed (IB) was frequently higher for Nuvaring® group than COC in all 3 cycles, although no statistically significant difference was observed between groups (p-value=0.286). Late withdrawl, intermenstural spotting was higher in COC group. Compliance was better and women were more satisfied in Nuvaring® group compared to COC group. Minor side effects like headache, mastalgia, nausea and mood changes were seen in both groups, which were not significant. Continuation rate was significantly

  4. Hormonal contraception and lactation.

    PubMed

    Kelsey, J J

    1996-12-01

    Hormonal contraceptive measures can be used immediately postpartum if the patient so desires. Progestin-only contraceptives are preferable to estrogen-containing methods if initiated during the first six months after delivery. Progestin only contraceptives do not appear to affect milk volume, composition, or to cause deleterious effects in the infant. Ideally for women who desire a form of contraception in addition to lactation-induced amenorrhea, progestin-only methods should be started at six weeks postpartum if the woman is fully breastfeeding. Since contraception protection is provided by lactation amenorrhea, the six week delay will decrease infant exposure to exogenous hormones and decrease the incidence of irregular postpartum bleeding. Milk volume may decrease with the use of estrogen; however, no detrimental effects have been shown on infant growth or development. For women who are planning to gradually wean their infant, use of COCs may provide an easier transition to bottle-feeding. COCs should be used with caution by women who are not able to obtain supplemental milk. A decrease in milk volume can lead to earlier discontinuation of the hormonal contraceptive in an attempt to increase milk quantity. Supplementation is often needed, and then the woman ovulates again, possibly resulting in an unintended pregnancy. Many women are motivated immediately postpartum to accept contraception. For other women, lack of access to health care may provide barriers in obtaining adequate contraception later. In either case, there are adequate data to show no detriments of starting progestin-only