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Revista Brasileira de Enfermagem 2018To identify evidence in the literature of the relationship between the use of different hormonal contraceptive methods and alterations in women's blood pressure values. (Review)
Review
OBJECTIVE
To identify evidence in the literature of the relationship between the use of different hormonal contraceptive methods and alterations in women's blood pressure values.
METHOD
This is an integrative literature review, consisting of ten scientific articles published in PubMed and BVS, between 2012 and 2016, selected by keywords, available fully and free of charge, in English, Portuguese, or Spanish.
RESULTS
The articles showed that exogenous estrogen helps in the activation of the renin-angiotensin-aldosterone system causing hypertensive effects even in small doses; and that combined use with drospirenone reduces these effects. Routes of administration without passage through the liver and use of isolated progestin showed promising results in reducing the effects on blood pressure.
CONCLUSION
There is evidence in the literature of pressure alterations associated with different hormonal contraceptives and that personal history of morbidities are to be considered in an attempt to reduce the effects on the cardiovascular system.
Topics: Adult; Blood Pressure; Contraceptives, Oral, Hormonal; Female; Humans
PubMed: 29972547
DOI: 10.1590/0034-7167-2017-0317 -
The Indian Journal of Medical Research Nov 2014Contraception is a basic human right for its role on health, quality of life and wellbeing of the woman and of the society as a whole. Since the introduction of female... (Review)
Review
Contraception is a basic human right for its role on health, quality of life and wellbeing of the woman and of the society as a whole. Since the introduction of female hormonal contraception the responsibility of family planning has always been with women. Currently there are only a few contraceptive methods available for men, but recently, men have become more interested in supporting their partners actively. Over the last few decades different trials have been performed providing important advances in the development of a safe and effective hormonal contraceptive for men. This paper summarizes some of the most recent trials.
Topics: Contraception; Contraceptives, Oral, Hormonal; Humans; Male; Research; Spermatogenesis
PubMed: 25673544
DOI: No ID Found -
European Journal of Endocrinology Dec 2014For many years, it has been well documented that combined hormonal contraceptives increase the risk of venous thromboembolism (VTE). The third-generation pill use... (Review)
Review
For many years, it has been well documented that combined hormonal contraceptives increase the risk of venous thromboembolism (VTE). The third-generation pill use (desogestrel or gestodene (GSD)) is associated with an increased VTE risk as compared with second-generation (levonorgestrel) pill use. Other progestins such as drospirenone or cyproterone acetate combined with ethinyl-estradiol (EE) have been investigated. Most studies have reported a significant increased VTE risk among users of these combined oral contraceptives (COCs) when compared with users of second-generation pills. Non-oral combined hormonal contraception, such as the transdermal patch and the vaginal ring, is also available. Current data support that these routes of administration are more thrombogenic than second-generation pills. These results are consistent with the biological evidence of coagulation activation. Overall, the estrogenic potency of each hormonal contraceptive depending on both EE doses and progestin molecule explains the level of thrombotic risk. Some studies have shown a similar increased VTE risk among users of COCs containing norgestimate (NGM) as compared with users of second-generation pill. However, for this combination, biological data, based on quantitative assessment of sex hormone-binding globulin or haemostasis parameters, are not in agreement with these epidemiological results. Similarly, the VTE risk associated with low doses of EE and GSD is not biologically plausible. In conclusion, newer generation formulations of hormonal contraceptives as well as non-oral hormonal contraceptives seem to be more thrombogenic than second-generation hormonal contraceptives. Further studies are needed to conclude on the combinations containing NGM or low doses of EE associated with GSD.
Topics: Contraception; Contraceptives, Oral, Combined; Contraceptives, Oral, Hormonal; Drug Administration Routes; Female; France; Humans; Progestins; Risk Factors; Venous Thromboembolism
PubMed: 25012200
DOI: 10.1530/EJE-14-0527 -
Frontiers in Neuroendocrinology Jan 2024Worldwide, over 150 million adolescent and adult women use oral contraceptives (OC). An association between OC-use and the emergence of symptoms of mental disorders has... (Meta-Analysis)
Meta-Analysis Review
Worldwide, over 150 million adolescent and adult women use oral contraceptives (OC). An association between OC-use and the emergence of symptoms of mental disorders has been suggested. This systematic review and meta-analysis provide an overview of published research regarding symptoms of mental disorders in association with OC-use, factoring the influence of OC types, age of first-use, duration of OC-intake, and previous diagnoses of mental disorders. A systematic literature search was conducted between June-July 2022. 22 studies were included. While most found no significant OC-use effects on mental symptoms, some hinted at OCs as a potential risk. The existing evidence regarding the potential link between progestin-only OC-use and an elevated risk of mental symptoms in comparison to combined OC-use remains inconclusive. However, due to emerging indications suggesting that the formulation of OC might play a role in mental health outcomes, this topic warrants further investigation. Moreover, indications of an increased risk for depressive symptoms in adolescent OC-users should be noted. Hence, while general population effects seem unlikely, they cannot be completely disregarded. The decision on OC-use should depend on the patient's medical history and should be re-evaluated regularly.
Topics: Adult; Adolescent; Humans; Female; Contraceptives, Oral; Mental Disorders; Contraception
PubMed: 37967755
DOI: 10.1016/j.yfrne.2023.101111 -
Seminars in Reproductive Medicine May 2016Millions 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... (Review)
Review
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.
Topics: Contraception; Contraceptives, Oral, Hormonal; Female; Humans
PubMed: 26960906
DOI: 10.1055/s-0036-1572546 -
Clinical Obstetrics and Gynecology Dec 2015This chapter reviews the literature on postpartum coital behavior, anovulatory and ovulatory bleeding episodes, and the methodology and efficacy of Lactational... (Review)
Review
This chapter reviews the literature on postpartum coital behavior, anovulatory and ovulatory bleeding episodes, and the methodology and efficacy of Lactational Amenorrhea Method and progesterone-only oral contraceptives. Of interest is the finding that breastfeeding women may resume coital behavior earlier postpartum, but report increased discomfort over time. The high efficacy of the Lactational Amenorrhea Method is confirmed and data illustrating possible relaxation of some criteria are presented. The conflicting guidance of CDC and WHO concerning immediate postpartum use of progestin-only methods is presented. The dearth of recent studies calls for new research on these topics.
Topics: Amenorrhea; Breast Feeding; Coitus; Contraception; Contraceptives, Oral; Female; Humans; Lactation; Ovulation; Postpartum Period; Practice Guidelines as Topic; Progestins; Sexuality
PubMed: 26457855
DOI: 10.1097/GRF.0000000000000154 -
Contraception Apr 2023To examine challenges accessing contraception in the past year and their association with interest in using an over the counter (OTC) oral contraceptive pill (OCP) among...
Challenges accessing contraceptive care and interest in over-the-counter oral contraceptive pill use among Black, Indigenous, and people of color: An online cross-sectional survey.
OBJECTIVE
To examine challenges accessing contraception in the past year and their association with interest in using an over the counter (OTC) oral contraceptive pill (OCP) among Black, Indigenous, and people of color (BIPOC) in the United States.
STUDY DESIGN
From May 2021 to March 2022, a collaborative research team conducted a cross-sectional online survey using convenience sampling to recruit people who identify as Asian American, Native Hawaiian, or Pacific Islander, Black or African American, Indigenous, or Latina/Latinx and used or wanted to use a contraceptive method in the past year. Respondents were recruited through reproductive justice and community-based organizations.
RESULTS
Among 727 respondents, 45% reported experiencing at least one challenge accessing contraception in the past year of which 37% reported a logistical challenge, and 20% reported an interpersonal challenge. Sixty-seven percent of respondents said they were likely to use an OTC OCP. Respondents who reported experiencing at least one challenge accessing contraception in the past year were more likely to say they would use an OTC OCP. Fifty-seven percent of respondents who were not using a contraceptive method in the past year reported they were likely to use an OTC OCP.
CONCLUSION
Among people in this study, interest in an OTC OCP is high, particularly among those who have faced challenges accessing contraception, and among those who are not currently using a contraceptive method.
IMPLICATIONS
Availability of an OCP OTC has the potential to address challenges accessing contraceptive care among BIPOC in the United States, who are often impacted by structural inequities and racism. Findings from this study can inform future OTC implementation strategies to ensure OTC access addresses logistical and interpersonal challenges.
Topics: Female; Humans; Contraception; Contraceptive Devices; Contraceptives, Oral; Cross-Sectional Studies; United States; Black or African American; Indigenous Peoples; Health Services Accessibility; Ethnic and Racial Minorities
PubMed: 36641098
DOI: 10.1016/j.contraception.2023.109950 -
Experimental Physiology Jan 2020What is the central question of this study? What are the effects of the menstrual (early follicular and mid-luteal) or monophasic oral contraceptive (inactive- and...
NEW FINDINGS
What is the central question of this study? What are the effects of the menstrual (early follicular and mid-luteal) or monophasic oral contraceptive (inactive- and active-pill) cycle phases on vascular reperfusion of lower limb microvasculature in healthy, active women using the near-infrared spectroscopy (NIRS) vascular occlusion test (VOT) technique? What is the main finding and its importance? We demonstrated that vascular responsiveness in the lower limb microvasculature remained unchanged between the early follicular and mid-luteal phases of the menstrual cycle and inactive- and active-pill phases of the oral contraceptive cycle. These data support that controlling for the cycle phases, within the specific times evaluated in this study, might not be necessary when assessing NIRS-VOT reperfusion rates.
ABSTRACT
The objective was to examine whether the menstrual or monophasic oral contraceptive cycle phases affect microvascular responsiveness of the lower limb in healthy, active women. During the follicular or inactive-pill phase and the luteal or active-pill phase of the menstrual or oral contraceptive cycle, respectively, 15 non-oral contraceptive users (mean ± SD; 27 ± 6 years of age) and 15 monophasic oral contraceptive users (24 ± 4 years of age) underwent a lower-limb vascular occlusion test (5 min baseline, 5 min occlusion and 8 min post cuff release). Menstrual cycle phases were verified using an ovulation test. Vascular responsiveness was assessed by calculating the near-infrared spectroscopy-derived muscle oxygen saturation (StO ) reperfusion slope (slope 2 StO ) and the post occlusion StO area under the curve (StO ) of the tibialis anterior muscle. There were no differences in the reperfusion slope (as a percentage per second; follicular, 1.18 ± 0.48; luteal, 1.05 ± 0.48, inactive-pill, 0.95 ± 0.23; and active-pill, 0.87 ± 0.36; P = 0.09) and area under the curve (as a product of the percentage and seconds; follicular, 1067 ± 562; luteal, 918 ± 414, inactive-pill, 945 ± 702; and active-pill, 750 ± 519; P = 0.09) between the phases of the menstrual or oral contraceptive cycle, regardless of pill generation. The duration of oral contraceptive use was not associated with changes in slope 2 StO (r = 0.02, P = 0.94) or StO (r = -0.34, P = 0.22) between cycle phases. In conclusion, vascular responsiveness remained unchanged between the early follicular and mid-luteal phases of the menstrual cycle and the inactive-pill and active-pill phases of the oral contraceptive cycle.
Topics: Adult; Constriction; Contraceptives, Oral; Female; Follicular Phase; Humans; Lower Extremity; Luteal Phase; Menstrual Cycle; Microvessels; Muscle, Skeletal; Reperfusion; Spectroscopy, Near-Infrared; Young Adult
PubMed: 31625647
DOI: 10.1113/EP088135 -
BMJ Sexual & Reproductive Health Apr 2022Online contraception services increasingly provide information, clinical assessment and home-delivered oral contraceptives (OCs). Evidence is lacking on the effects of...
BACKGROUND
Online contraception services increasingly provide information, clinical assessment and home-delivered oral contraceptives (OCs). Evidence is lacking on the effects of online contraceptive service use on short-term contraceptive continuation.
METHODS
Cohort study comparing contraceptive continuation between new users of a free-to-access online OC service in South East London with those from other, face-to-face services in the same area. Online questionnaires collected data on participants' sociodemographic characteristics, motivations for OC access, service ratings, OC knowledge and contraceptive use. Contraceptive use in the 4-month study period was measured using health service records. Unadjusted and multivariable logistic regression models compared outcomes between the online service group and those using other services.
RESULTS
Online service-users (n=138) were more likely to experience short-term continuation of OCs compared with participants using other services (n=98) after adjusting for sociodemographic and other characteristics (adjusted OR 2.94, 95% CI 1.52 to 5.70). Online service-users rated their service more highly (mean 25.22, SD 3.77) than the other services group (mean 22.70, SD 4.35; p<0.001), valuing convenience and speed of access. Among progestogen-only pill users, knowledge scores were higher for the online group (mean 4.83, SD 1.90) than the other services group (mean 3.87, SD 1.73; p=0.007). Among combined oral contraceptive users, knowledge scores were similar between groups.
CONCLUSIONS
Free-to-access, online contraception has the potential to improve short-term continuation of OCs. Further research using a larger study population and analysis of longer-term outcomes are required to understand the impact of online services on unintended pregnancy.
Topics: Cohort Studies; Contraception; Contraceptives, Oral, Combined; Female; Humans; Pregnancy; Pregnancy, Unplanned; Surveys and Questionnaires
PubMed: 34452936
DOI: 10.1136/bmjsrh-2021-201168 -
International Journal of Molecular... Dec 2020Polycystic ovary syndrome (PCOS) is characterized by elevated androgen production and subclinical changes in cardiovascular and metabolic risk markers. Total... (Review)
Review
Polycystic ovary syndrome (PCOS) is characterized by elevated androgen production and subclinical changes in cardiovascular and metabolic risk markers. Total cholesterol, high-density lipoprotein (HDL) cholesterol, fasting glucose, and fasting insulin appear to increase specifically in PCOS compared with fertile women. PCOS also confers an increased risk of cardiometabolic disease in later life. Novel biomarkers such as serum's cholesterol efflux capacity and blood-derived macrophage activation profile may assist in more accurately defining the cardiometabolic risk profile in these women. Aldosterone antagonists, androgen receptor antagonists, 5α-reductase inhibitors, and synthetic progestogens are used to reduce hyperandrogenism. Because increased insulin secretion enhances ovarian androgen production, short-term treatment with metformin and other hypoglycemic agents results in significant weight loss, favorable metabolic changes, and testosterone reduction. The naturally occurring inositols display insulin-sensitizing effects and may be also used in this context because of their safety profile. Combined oral contraceptives represent the drug of choice for correction of androgen-related symptoms. Overall, PCOS management remains focused on specific targets including assessment and treatment of cardiometabolic risk, according to disease phenotypes. While new options are adding to established therapeutic approaches, a sometimes difficult balance between efficacy and safety of available medications has to be found in individual women.
Topics: Adult; Androgen Antagonists; Biomarkers; Cardiovascular Diseases; Chemoprevention; Contraceptives, Oral; Disease Susceptibility; Female; Humans; Outcome Assessment, Health Care; Polycystic Ovary Syndrome; Risk Assessment; Risk Factors
PubMed: 33334002
DOI: 10.3390/ijms21249554