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Human Reproduction Update Sep 2016In recent years, several new oral contraceptives have become available. In some ways, they represent an evolution in terms of individualization and compliance on the... (Review)
Review
BACKGROUND
In recent years, several new oral contraceptives have become available. In some ways, they represent an evolution in terms of individualization and compliance on the part of women. The new formulations make it increasingly possible to prescribe a specific hormonal contraceptive on an individual basis.
METHODS
A systematic literature search of PubMed was performed using the following combination of terms: 'oral contraceptives', 'estroprogestins' and 'combined oral contraceptive'. Only English-language papers published between January 2000 and July 2014 were included in our analysis. The present review analyzes all aspects of the choice of oral contraceptives in the different phases of a woman's life in detail.
RESULTS
Regarding the estrogen component, lowering the dose of ethinylestradiol (EE) helped reduce associated side effects. Natural estradiol is now available and represents a valid alternative to EE. And regarding progestins, the dose has changed over time, as well as the endocrine and metabolic characteristics. These are the fruit of much research into improvement of old products (19-nor-progesterone-derived progestins) with androgenic effects and testing of new molecules with improved metabolic neutrality in terms of insulin sensitivity and lipid parameters. New progestins were a genuine turning point because they greatly reduced major side effects, such as water retention, and their anti-androgenic properties made them indicated for all forms of hyperandrogenism associated with acne and mild hirsutism. The associations of estradiol/dienogest and estradiol/nomegestrol acetate are the most suitable contraceptives for women with abundant menstrual bleeding and can increase the number of potential users of hormonal contraception.
CONCLUSION
Progress in the provision of new oral contraceptives has improved the risk/benefit ratio, by increasing benefits and reducing risks. The present challenge is to tailor contraceptives to individual needs in terms of efficacy and protection of reproductive health.
Topics: Chemistry, Pharmaceutical; Contraception; Contraceptives, Oral, Combined; Contraceptives, Oral, Hormonal; Drug Combinations; Ethinyl Estradiol; Female; Humans; Menstruation; Norpregnenes; Progestins; Risk Assessment; Women's Health
PubMed: 27307386
DOI: 10.1093/humupd/dmw016 -
Journal of Women's Health (2002) Jul 2020
Topics: Contraceptives, Oral; Female; Humans; Parturition; Pregnancy
PubMed: 32379995
DOI: 10.1089/jwh.2020.8404 -
The European Journal of Contraception &... Apr 2024This review presents an update of the non-contraceptive health benefits of the combined oral contraceptive pill. (Review)
Review
PURPOSE
This review presents an update of the non-contraceptive health benefits of the combined oral contraceptive pill.
METHODS
We conducted a literature search for (review) articles that discussed the health benefits of combined oral contraceptives (COCs), in the period from 1980 to 2023.
RESULTS
We identified 21 subjective and/or objective health benefits of COCs related to (i) the reproductive tract, (ii) non-gynaecological benign disorders and (iii) malignancies. Reproductive tract benefits are related to menstrual bleeding(including anaemia and toxic shock syndrome), dysmenorrhoea, migraine, premenstrual syndrome (PMS), ovarian cysts, Polycystic Ovary Syndrome (PCOS), androgen related symptoms, ectopic pregnancy, hypoestrogenism, endometriosis and adenomyosis, uterine fibroids and pelvic inflammatory disease (PID). Non-gynaecological benefits are related to benign breast disease, osteoporosis, rheumatoid arthritis, multiple sclerosis, asthma and porphyria. Health benefits of COCs related to cancer are lower risks of endometrial cancer, ovarian cancer and colorectal cancer.
CONCLUSIONS
The use of combined oral contraceptives is accompanied with a range of health benefits, to be balanced against its side-effects and risks. Several health benefits of COCs are a reason for non-contraceptive COC prescription.
Topics: Humans; Female; Contraceptives, Oral, Combined; Neoplasms
PubMed: 38426312
DOI: 10.1080/13625187.2024.2317295 -
Expert Opinion on Pharmacotherapy Oct 2016Treatment of ovarian endometriomas is commonly achieved through laparoscopic surgery and this can be effective in eliminating the disease, although a majority of recent... (Review)
Review
INTRODUCTION
Treatment of ovarian endometriomas is commonly achieved through laparoscopic surgery and this can be effective in eliminating the disease, although a majority of recent trials documented an adverse effect of surgery on ovarian reserve markers. With the advancement in imaging techniques, ovarian endometriomas are increasingly diagnosed at an earlier stage when the endometrioma may be smaller, less fibrotic and more responsive to medical treatment, making an evaluation of medical options critically important.
AREAS COVERED
The review focuses on currently utilized pharmacologic therapies for endometrioma (oral contraceptives, the levonorgestrel-releasing IUS, the hormone-releasing subdermal implant, Implanon); experimental and future treatments are also mentioned (GnRH antagonists, progesterone receptor modulators, antioestrogens, newer subdermal implants and intracystic administration of pharmacologic agents). Finally, the usefulness of post-operative adjuvant medical treatments is discussed Expert opinion: Today, reliable, non-invasive diagnostic procedures of an ovarian endometrioma are available and should be utilized to identify its presence and type of pathology. In a young patient, classic medical therapies such as oral contraceptives and synthetic progestins should be tried first to alleviate symptoms. Only when these regimens fail, should a minimally invasive surgery be envisaged. Following endoscopic surgery, adjuvant medical treatment may reduce recurrence of both symptoms and the lesion.
Topics: Contraceptives, Oral; Desogestrel; Endometriosis; Female; Humans; Levonorgestrel
PubMed: 27615386
DOI: 10.1080/14656566.2016.1229305 -
Journal of the National Cancer Institute Apr 2022
Topics: Contraceptives, Oral; Female; Genes, BRCA1; Genes, BRCA2; Humans; Neoplasms
PubMed: 35048983
DOI: 10.1093/jnci/djac006 -
Contraception Oct 2016The introduction of the birth control pill (the Pill) in 1960 revolutionized the options for contraception, sparking vibrant discussion in the scientific and social... (Review)
Review
The introduction of the birth control pill (the Pill) in 1960 revolutionized the options for contraception, sparking vibrant discussion in the scientific and social science literature and in the media. Much attention focused on issues of women's rights, including ethics and personal choice. But the Pill also introduced new questions about risk. Shortly after its introduction, the risk of thromboembolic disease was recognized [1]. After more than half a century, controversies about the relationship between the Pill and thromboembolic disease have persisted. The scientific and media communities have been active in the discussion, debate and delivery of information about this risk. Scientific and public attention to thromboembolism and the Pill has had dramatic consequences, both good and bad. The spotlight on risk has helped to change norms regarding the public's right to know and assess dangers; it has sparked Pill scares linked to increased unplanned pregnancy, birth and abortion rates; and it has led to a change in federally mandated policies regarding how new contraceptive products are studied and brought to market. This paper charts the narrative of the thromboembolic risk of the Pill from its introduction in 1960 until today and reviews the corresponding media response to this history. How does the story of the thromboembolic risk of the Pill - explored through the lens of science, media and contemporary social dynamics - frame contemporary understanding of risk for researchers, clinicians, individuals and the public?
Topics: Biomedical Research; Contraception; Contraceptives, Oral; Female; History, 20th Century; History, 21st Century; Humans; Mass Media; Risk Assessment; Thromboembolism; Women's Health; Women's Rights
PubMed: 27343747
DOI: 10.1016/j.contraception.2016.06.009 -
Current Opinion in Hematology Sep 2020Hormonal therapy is administered for multiple indications including contraception, alleviation of menopausal symptoms, hypogonadism, and more recently, gender-affirming... (Review)
Review
PURPOSE OF REVIEW
Hormonal therapy is administered for multiple indications including contraception, alleviation of menopausal symptoms, hypogonadism, and more recently, gender-affirming care. Data suggest varying degrees of increased risk for venous thromboembolism (VTE).
RECENT FINDINGS
While oral progestin only methods do not appear to increase the risk of VTE, an association was seen with injection progestin contraception. Combined oral contraception with low-dose ethinyl estradiol and most types of progestin increased the risk of VTE compared with levonorgestrel-containing oral therapies. While transdermal hormonal contraception has been previously associated with increased VTE, a recently approved levonorgestrel and ethinyl estradiol transdermal patch reported low rates (<0.2%) in a large single-arm open-label study. Women receiving postmenopausal HRT experienced an increased risk of VTE in a dose-dependent manner when using oral hormonal therapy while nonoral methods, such as topical estrogen, did not appear to increase the risk of VTE. Some studies suggest no increased risk of VTE with testosterone therapy, however, a recent case-crossover study suggested higher VTE risk in men on testosterone, particularly men less than age 65 without hypogonadism. Route of administration had no effect on VTE rates. The estimated incidence rate of VTE risk in transgender women receiving estrogen therapy is 2.3 per 1000 person years, but may be imprecise due to heterogeneity in studies included in published meta-analyses. Surgical risk estimates are primarily indirect data drawn from cisgender patients receiving hormone therapy in the perioperative setting.
SUMMARY
Hormonal therapy affects VTE risk to varying degrees dependent on specific type of hormone, formulation, and occasionally route of delivery.
Topics: Contraceptives, Oral, Hormonal; Female; Humans; Pregnancy; Risk Factors; Venous Thromboembolism
PubMed: 32740039
DOI: 10.1097/MOH.0000000000000599 -
Tidsskrift For Den Norske Laegeforening... Oct 2017
Topics: Contraceptives, Oral; Female; History, 20th Century; Humans; Norway; Pregnancy
PubMed: 29094558
DOI: 10.4045/tidsskr.17.0665 -
Sports Medicine (Auckland, N.Z.) May 2017Despite a rapidly growing body of research, a systematic evidence compilation of the risk and protective factors for middle- and long-distance running-related injury... (Review)
Review
BACKGROUND
Despite a rapidly growing body of research, a systematic evidence compilation of the risk and protective factors for middle- and long-distance running-related injury (RRI) was lacking.
OBJECTIVES
Our objective was to compile the evidence about modifiable and non-modifiable training-related and behavioral risk and protective factors for middle- and long-distance RRI.
METHODS
We searched five databases (PubMed, CINAHL, MEDLINE, SPORTDiscus, and PsycINFO) for the dates 1 January 1970 to 31 December 2015, inclusive, for original peer-reviewed articles. The eligible designs were cross-sectional, case-control, longitudinal observational studies, and randomized controlled trials involving runners competing at distances from ≥800 m to ≤42.2 km. Outcomes were any specific and/or general RRI, and exposures included training-related and behavioral factors. We extracted authors and date, study design, injury type(s), descriptors and comparators for each exposure, and results and measures of association from the selected studies. Methodological quality was independently appraised using two separate checklists: a modified checklist for observational study designs and the Physiotherapy Evidence Database (PEDro) scale for randomized controlled trials.
RESULTS
Among 73 articles eligible for inclusion, 19 (26.0%) and 30 (41.0%) were of high or satisfactory methodological quality, respectively. As a non-modifiable exposure, a history of previous injury was found to be associated with an increased risk of both general and specific RRI. In terms of modifiable exposures, irregular and/or absent menstruation was found to be associated with an increased risk of stress fracture development, whereas the use of oral contraceptives was found to be associated with a decreased risk. High clinical, methodological, and statistical heterogeneity meant it was not feasible to estimate a pooled effect size across similar studies.
CONCLUSIONS
A history of previous injury was associated with an increased risk of both general and specific RRI. The use of oral contraceptives was found to be associated with a decreased risk of skeletal stress fracture. Conversely, irregular and/or absent menstruation was associated with an increased risk. The varied effect directions and/or a number of statistically insignificant results associated with the majority of factors hindered our ability to draw any definitive conclusions about their relationship to RRI risk.
Topics: Contraceptives, Oral; Female; Fractures, Bone; Humans; Menstruation; Musculoskeletal System; Protective Factors; Running
PubMed: 27785775
DOI: 10.1007/s40279-016-0636-4 -
Frontiers in Neuroendocrinology Apr 2023Oral contraceptives (OCs) are widely used. While the physical impacts of OCs have been well researched, there is increasing interest on potential impacts of OCs on...
Oral contraceptives (OCs) are widely used. While the physical impacts of OCs have been well researched, there is increasing interest on potential impacts of OCs on brain, behaviour and cognition. We systematically reviewed the literature to determine the influence of OCs on cognition, including neurocognition, social cognition and emotional processing. Inclusionary criteria were: (a) premenopausal females taking OCs; (b) a control group of naturally cycling women or OCs users in their inactive (i.e. 'sugar pill') phase; and (c) at least one measure of performance on a neurocognitive or social cognitive task. The systematic review found that OC use was associated with some differences in performance on all cognitive domains examined (with the exception of basic auditory attention and psychomotor performance). Several factors were identified that are likely to modulate the way OCs influence cognition, including task related factors, OC type and control group characteristics. Directions for future research are highlighted.
Topics: Female; Humans; Contraceptives, Oral; Emotions; Cognition; Brain
PubMed: 36581228
DOI: 10.1016/j.yfrne.2022.101052