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Revista Brasileira de Ginecologia E... Dec 2023Cervical cancer (CC) is caused by persistent infection of human papillomavirus of high oncogenic risk (hr-HPV); however, several cofactors are important in its... (Review)
Review
Cervical cancer (CC) is caused by persistent infection of human papillomavirus of high oncogenic risk (hr-HPV); however, several cofactors are important in its carcinogenesis, such as smoking, multiparity, and prolonged use of oral hormonal contraceptives (COCs). Worldwide, 16% of women use COCs, whereas in Brazil this rate is of ∼ 30%. The safety and adverse effects of COCs are widely discussed in the literature, including the increase in carcinogenic risk. Due to the existence of several drugs, combinations, and dosages of COCs, it is hard to have uniform information in epidemiological studies. Our objective was to perform a narrative review on the role of COCs use in the carcinogenesis of cervical cancer. Several populational studies have suggested an increase in the incidence of cervical cancer for those who have used COCs for > 5 years, but other available studies reach controversial and contradictory results regarding the action of COCs in the development of CC.
Topics: Female; Humans; Uterine Cervical Neoplasms; Contraceptives, Oral, Combined; Risk Factors; Smoking; Carcinogenesis
PubMed: 38141603
DOI: 10.1055/s-0043-1776403 -
The Journal of Dermatological Treatment Dec 2024Dermatomyositis, systemic and cutaneous lupus erythematosus have a significantly higher prevalence in women than men, emphasizing the relevance of exploring the... (Review)
Review
INTRODUCTION
Dermatomyositis, systemic and cutaneous lupus erythematosus have a significantly higher prevalence in women than men, emphasizing the relevance of exploring the relationship between sex hormones and autoimmune skin diseases. This review analyzes the interplay between sex hormones and these two skin diseases.
MATERIALS AND METHODS
We performed an extensive literature search using the PubMed database from July to August 2023. Search terms included 'contraceptives', 'pregnancy', 'hormone replacement', 'tamoxifen', and 'aromatase inhibitors'.
RESULTS AND DISCUSSION
This comprehensive literature review shows that there remains considerable debate regarding the use of hormonal contraceptives and hormonal replacement therapy in individuals with autoimmune skin conditions. Nonetheless, it is well established that their use is contraindicated in patients with antiphospholipid syndrome or when antiphospholipid antibodies are positive. Individuals experiencing disease flares and uncontrolled symptoms should also avoid these interventions. Pregnancy planning should be timed to coincide with well-managed disease states to minimize obstetric and neonatal complications. Hormonal breast cancer treatment requires close skin monitoring.
CONCLUSION
Pregnancy, menopause, contraceptive use, hormone replacement therapy, and breast cancer treatment drugs result in substantial shifts in hormone levels. Additionally, hormone levels are altered by aromatase inhibitors and anti-estrogen medications. These fluctuations can modulate mechanisms influencing autoimmune skin abnormalities.
Topics: Pregnancy; Male; Infant, Newborn; Humans; Female; Hormones; Autoimmune Diseases; Gonadal Steroid Hormones; Menopause; Breast Neoplasms; Lupus Erythematosus, Systemic
PubMed: 38317519
DOI: 10.1080/09546634.2024.2312241 -
Journal of Clinical Medicine Sep 2023Uterine Adenomyosis is a benign condition characterized by the presence of endometrium-like epithelial and stromal tissue in the myometrium. Several medical treatments... (Review)
Review
Uterine Adenomyosis is a benign condition characterized by the presence of endometrium-like epithelial and stromal tissue in the myometrium. Several medical treatments have been proposed, but still, no guidelines directing the management of adenomyosis are available. While a hysterectomy is typically regarded as the definitive treatment for adenomyosis, the scarcity of high-quality data leaves patients desiring fertility with limited conservative options. Based on the available data, the levonorgestrel-IUD appears to offer the most favorable outcomes. Other treatments, including GnRH antagonists, dienogest, prolactin, and oxytocin modulators, show promise; however, further data are required to establish their efficacy definitively. Furthermore, there are many emerging therapies that have been developed that seem worthy of consideration in the near future. The aim of this narrative review was to explore the current medical treatments available for adenomyosis and to provide a glimpse of future therapies under assessment. For this scope, we performed a literature search on PubMed and Medline from incept to September 2022 using the keywords: "medical treatment", "non-steroidal anti-inflammatory", "progesterone intrauterine device", "dienogest", "combined oral contraceptives", "gonadotropin releasing hormone agonist", "gonadotropin releasing hormone antagonist", "danazol", "aromatase inhibitors", "ulipristal acetate", "anti-platelet therapy", "dopamine", "oxytocin antagonists", "STAT3", "KRAS", "MAPK", "micro-RNA", "mifepristone", "valproic acid", "levo-tetrahydropalamatine", and "andrographolide". The search was limited to articles in English, with subsequent screening of abstracts. Abstracts were screened to select relevant studies.
PubMed: 37834773
DOI: 10.3390/jcm12196130 -
Expert Opinion on Pharmacotherapy 2023Estetrol (E4) is a native estrogen produced only by the fetal liver during pregnancy. E4 is the first new estrogen to be used in hormonal contraception since the... (Review)
Review
INTRODUCTION
Estetrol (E4) is a native estrogen produced only by the fetal liver during pregnancy. E4 is the first new estrogen to be used in hormonal contraception since the introduction of oral contraceptives in 1960. Ethinyl estradiol, the most commonly used estrogen in oral contraceptives today, increases the risks of thromboembolism and has other significant hepatic impacts, which induce important drug-drug interactions. On the other hand, Phase 2 E4 characterization studies demonstrated that E4 has negligible impacts on liver, breast, and vascular endothelium due to its distinct tissue selectivity. Combined with drospirenone (DRSP), E4 offers an improved safety profile for oral contraception.
AREAS COVERED
This paper briefly highlights the unique pharmacokinetic and pharmacodynamic features of E4. The efficacy, safety, and tolerability results from the Phase 2 and 3 studies of the E4/DRSP pill are discussed to provide the reader with a thorough understanding of E4 and information to use when counseling potential users.
EXPERT OPINION
The estetrol/drospirenone oral contraceptive is effective and well tolerated and provides good cycle control. In the future, estetrol may be the estrogen of choice if subsequent evidence verifies that it reduces the risks associated with current estrogens, such as venous thromboembolism and drug-drug interactions.
Topics: Pregnancy; Female; Humans; Contraceptives, Oral; Estetrol; Estrogens; Contraception; Contraceptives, Oral, Combined
PubMed: 37691580
DOI: 10.1080/14656566.2023.2247979 -
Exploratory Research in Clinical and... Sep 2023Fentanyl has garnered significant focus from governments, academics, and the media due to the unparalleled increase in overdose fatalities it has triggered in North... (Review)
Review
BACKGROUND
Fentanyl has garnered significant focus from governments, academics, and the media due to the unparalleled increase in overdose fatalities it has triggered in North America. However, the pill presses, dies, and molds used to tablet counterfeit fentanyl-laced pills in Mexico and the United States (U.S.) have gone largely unstudied despite their substantial influence on fentanyl production. The Biden-Harris administration's recent initiative to intensify the prosecution of illicit fentanyl supply chains and the U.S. Treasury Department's decision to impose sanctions on numerous Chinese entities for illicit pill press production and distribution highlights the need to increase controls on pill-press proliferation.
OBJECTIVE
Review the existing legislative frameworks and enforcement in the U.S., China, and Mexico that pertain to pill press control and provide recommendations for improvement.
METHODS
A literature review was conducted to gather information on counterfeit fentanyl-laced pill production, pill press control, and related legislative frameworks and enforcement in the U.S., China, and Mexico. Federal and state laws, policies, and enforcement mechanisms were reviewed to identify gaps, limitations, and potential for improvement. A comparative study was then performed to determine the strengths and weaknesses of these states' prevailing legislative structures and enforcement mechanisms.
RESULTS
In the U.S., pill press laws at the federal level are limited, and state laws are generally weak or nonexistent. The U.S. Controlled Substances Act should be amended to include harsher penalties for the unregistered possession of pill presses with or without the intent to tablet illicit substances. China, the primary source of illicitly distributed pill presses, does not have laws regulating pill presses and should enact strong pill press legislation and engage in rigorous enforcement.
CONCLUSIONS
As pill presses are integral to the final and crucial step in counterfeit fentanyl-laced pill production, pill press control should receive more legislative and law enforcement attention in the U.S., China, and Mexico.
PubMed: 37694167
DOI: 10.1016/j.rcsop.2023.100321 -
Human Reproduction (Oxford, England) Nov 2023What are the associations between female-specific reproductive factors and leukocyte telomere length (LTL)?
STUDY QUESTION
What are the associations between female-specific reproductive factors and leukocyte telomere length (LTL)?
SUMMARY ANSWER
Early menarche, early menopause, short reproductive lifespan, early age at first birth, multiparity, and use of oral contraceptives (OCs) and hormone replacement therapy (HRT) were associated with shorter LTL.
WHAT IS KNOWN ALREADY
Reproductive factors have been associated with age-related diseases, but their associations with cellular aging, as indicated by LTL, are unclear.
STUDY DESIGN, SIZE, DURATION
This population-based study included 224 965 women aged 40-69 years from the UK Biobank between 2006 and 2010.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Women aged 40-69 were included. Female-specific reproductive factors, including age at menarche, age at natural menopause, reproductive lifespan, number of live births, age at first live birth, history of stillbirth, history of miscarriage, and use of OCs and HRT were self-reported. LTL was measured using a validated polymerase chain reaction method. Multiple linear regression and restricted cubic spline models were applied to explore the association between each reproductive factor and LTL.
MAIN RESULTS AND THE ROLE OF CHANCE
After adjustment for potential confounders, early menarche (<12 years; percent change, per unit change in LTL Z score: -1.29%, 95% CI: -2.32%, -0.26%), early menopause (<45 years; percent change: -7.18%, 95% CI: -8.87%, -5.45%), short reproductive lifespan (<30 years; percent change: -6.10%, 95% CI: -8.14%, -4.01%), multiparity (percent change: -3.38%, 95% CI: -4.38%, -2.37%), early age at first live birth (<20 years; percent change: -4.46%, 95% CI: -6.00%, -2.90%), and use of OCs (percent change: -1.10%, 95% CI: -2.18%, -0.02%) and HRT (percent change: -3.72%, 95% CI: -4.63%, -2.80%) were all significantly associated with shorter LTL. However, no significant association was found for history of miscarriage and stillbirth. We observed nonlinear relationships of age at menarche, age at natural menopause, reproductive lifespan, and age at first live birth with LTL (Pnonlinear < 0.05).
LIMITATIONS, REASONS FOR CAUTION
Considering that the participants were predominantly of European ethnicity, the findings may not be generalizable to women of other ethnic backgrounds.
WIDER IMPLICATIONS OF THE FINDINGS
Our findings suggest that early menarche, early menopause, short reproductive lifespan, early age at first birth, multiparity, and use of OCs and HRT were associated with shorter LTL, which has been linked to various chronic diseases. The accelerated shortening of telomeres may potentially contribute to the development of chronic diseases related to reproductive factors.
STUDY FUNDING/COMPETING INTEREST(S)
This study was funded by the National Natural Science Foundation of China (82003479, 82073660), Hubei Provincial Natural Science Foundation of China (2023AFB663), and the China Postdoctoral Science Foundation (2019M662646, 2020T130220). The authors have no competing interests to disclose.
TRIAL REGISTRATION NUMBER
N/A.
Topics: Pregnancy; Female; Humans; Abortion, Spontaneous; Stillbirth; Leukocytes; Menopause, Premature; Live Birth; Contraceptives, Oral; Menstruation Disturbances; Telomere; Chronic Disease
PubMed: 37671590
DOI: 10.1093/humrep/dead176 -
PloS One 2024Women living in high-quality healthcare systems are more likely to use oral contraceptives at some point in their lives. Research findings have sparked controversial...
BACKGROUND
Women living in high-quality healthcare systems are more likely to use oral contraceptives at some point in their lives. Research findings have sparked controversial discussions about contraception in the scientific community and the media, potentially leading to higher rates of method discontinuation. Understanding the underlying motives for method discontinuation is crucial for reproductive health equity and future programming interventions. To address this question, this study aims to explore women's experiences of oral contraceptive use and discontinuation on YouTube.
METHODS
A concurrent explanatory mixed-methods design was used to conduct content analysis of German YouTube videos. The information from 175 videos of 158 individuals was extracted through quantitative descriptive content analysis. Twenty-one individuals were included in the qualitative content analysis.
FINDINGS
The body was a recurring theme in the pill biographies. Women described, for example, bodily sensations as reasons for taking and stopping the pill. They also described positive and negative side effects while taking the pill and after stopping. The most common side effects of taking the pill mentioned by YouTubers were mood swings (76/158), weight gain (45/158), headaches (33/158), and depressed mood (45/158). The symptoms after discontinuation reported most were facial skin impurities (108/158), decreased mood swings (47/158), hair loss (42/158), and weight loss (36/158). Overall, women overwhelmingly rated their discontinuation experience as positive (87/91).
CONCLUSIONS
The study identified key symptoms of oral contraceptive initiation and discontinuation by portraying the experiences of female YouTubers, adding valuable insights to the understanding of method initiation and discontinuation. Further research is needed to explore women's personal experiences with method discontinuation beyond the YouTube platform.
Topics: Humans; Female; Contraceptives, Oral; Adult; Social Media; Young Adult; Video Recording; Adolescent; Contraception Behavior; Middle Aged
PubMed: 38787833
DOI: 10.1371/journal.pone.0302316 -
Phytomedicine : International Journal... Nov 2023The complex bidirectional communication between the gastrointestinal tract and the brain is associated with mental disorders such as depression; serotonin, as a crucial...
BACKGROUND
The complex bidirectional communication between the gastrointestinal tract and the brain is associated with mental disorders such as depression; serotonin, as a crucial neurotransmitter in the communication system between the central nervous system and the gastrointestinal tract, has effects on regulating gastrointestinal motility and sensation and improving psychosomatic status. Zuojin pill is used as a traditional Chinese medicine formula for the treatment of gastrointestinal disorders. This study explored the effects of Zuojin pill on the improvement of depression and gastrointestinal function in CUMS mice via TPH2 and its mechanism.
PURPOSE
The aim of this study was to investigate whether Zuojin pill could improve depression and concomitant gastrointestinal dysfunction, and to reveal whether Zuojin pill could work through the regulation of the tryptophan hydroxylase 2 (TPH2) pathway.
METHODS
The CUMS model was established to observe the effects of Zuojin pill on depression-like behavior and gastrointestinal function in mice. Nissler staining and HE staining were used to observe the structure of hippocampal neurons and intestinal mucosa respectively. 5-HT levels in serum, hippocampus, and intestinal tissues were measured by ELISA, and TPH2 expression in hippocampus and intestinal nerves was observed by WB and immunofluorescence. In order to investigate the protective effect and mechanism of Zuojin pill on PC12 cells, CORT used an in vitro model to produce PC12 cell damage.
RESULTS
Our study showed that Zuojin pill ameliorated depression-like behavior and gastrointestinal dysfunction in CUMS mice, elevated BDNF, 5-HT, and TPH2 expression in the hippocampus, and restored the ratio of dopaminergic and GABAergic neurons between intestinal muscles. In vitro experiments showed that Zuojin pill exerted a protective effect on neurons by regulating TPH2 ubiquitination and thus inhibiting CORT-induced apoptosis of PC12 cells.
CONCLUSION
Zuojin pill improves chronic unpredictable stress-induced depression-like behavior and gastrointestinal dysfunction in mice via the TPH2/5-HT pathway. Therefore, TPH2 may be a potential therapeutic target for depression with gastrointestinal dysfunction.
Topics: Humans; Rats; Animals; Mice; Serotonin; Depression; Gastrointestinal Diseases; Drugs, Chinese Herbal
PubMed: 37716030
DOI: 10.1016/j.phymed.2023.155067 -
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 -
Journal of Affective Disorders Jan 2024The link between oral contraceptive pill (OCP) and depression is still unclear. This work analyses the prevalence and correlates of major depression in US women using...
BACKGROUND
The link between oral contraceptive pill (OCP) and depression is still unclear. This work analyses the prevalence and correlates of major depression in US women using OCP.
METHODS
This study used the National Health and Nutrition Examination Survey (NHANES) 2005-2012 data to provide the prevalence and correlates of major depression in women using OCP. Major depression was defined as a score of ≥10 using the Patient Health Questionnaire-9 (PHQ-9).
RESULTS
A total of 6239 women aged 18-55 years were included in the present analysis. Current OCP users had a lower prevalence of major depression (4.6 %; 95 % CI, 3.2 to 6.6) compared to former users of OCP (11.4 %; 95 % CI, 10.1 to 12.9) and never users of OCP (10 %; 95 % CI, 8.3 to 12.1). Current users of OCP were significantly less likely to report major depression compared to former users of OCP (OR 0.59; 95CI%, 0.39 to 0.90) after adjusting for potential confounders. The prevalence of major depression was higher in women who were: black or Hispanic, widowed/divorced/separated, those with a low and middle income, current smokers, current users of antidepressants, and with history of cancer and thyroid problems.
LIMITATIONS
This is a cross-sectional study.
CONCLUSION
The prevalence of major depression among women using OCP may be lower than in former users of OCP, however, the burden of depression remains high. Further research with longitudinal follow-up for depression in women using OCP is needed to understand real world effect of the OCP on depression.
Topics: Humans; Female; Contraceptives, Oral; Nutrition Surveys; Depression; Cross-Sectional Studies; Depressive Disorder, Major
PubMed: 37832730
DOI: 10.1016/j.jad.2023.10.041