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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 -
American Family Physician Dec 2022Breastfeeding is universally recognized as the preferred method of infant nutrition, but is sometimes abbreviated because of fear of harm to the infant from maternal...
Breastfeeding is universally recognized as the preferred method of infant nutrition, but is sometimes abbreviated because of fear of harm to the infant from maternal medication. The amount of medication that enters breast milk varies based on the maternal serum concentration and the pharmacologic properties of the medication. When prescribing medications for a breastfeeding patient, those with the lowest risk to the infant should be selected, and dosing should be before the infant's longest sleep interval. Prescribers should use current, accurate resources. LactMed is a convenient, government-sponsored, authoritative resource that lists safety information for many medications and is available free online. When mental health conditions occur during lactation, priority should be given to effectively treating the mother, often with medications that were effective during pregnancy. Most antidepressants are compatible with breastfeeding. Stimulant medications may decrease milk supply. Insulin, metformin, and second-generation sulfonylureas are generally preferred to treat diabetes mellitus during breastfeeding, but newer agents require caution because they have not been studied in lactation. Inhaled and nasal treatments for asthma and allergic rhinitis are unlikely to affect breastfed infants. Acetaminophen and ibuprofen are preferred analgesics during lactation. Maternal opioid use can cause infant sedation. Herbal supplements are concerning for risk of impurities and lack of study of effects on breastfed infants. Nonhormonal and progestin-only contraceptives are preferred over combination oral contraceptives. Contrast for computed tomography or magnetic resonance imaging is not concerning during lactation, but use of radiopharmaceuticals, such as iodine 131, can accumulate in the lactating breast and increase risk to the infant.
Topics: Infant; Pregnancy; Female; Humans; Breast Feeding; Lactation; Milk, Human; Progestins; Contraceptives, Oral
PubMed: 36521462
DOI: No ID Found -
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 -
The European Journal of Contraception &... Feb 2023Progestins used in contraception are either components of combined hormonal contraceptives or are used as a single active ingredient. Progestins are highly effective in... (Review)
Review
OBJECTIVES
Progestins used in contraception are either components of combined hormonal contraceptives or are used as a single active ingredient. Progestins are highly effective in long-term contraception and have a very good safety profile with very few contraindications.
METHODS
An oestrogen-free ovulation inhibitor POP has been authorised in the USA and the EU. It contains 4 mg of drospirenone (DRSP). The hormone administration regimen of 24 days followed by a 4-day hormone-free period was chosen to improve bleeding control and to maintain oestradiol concentrations at early follicular- phase levels, preventing oestrogen deficiency.
RESULTS
Clinical trials have demonstrated high contraceptive effectiveness, a very low risk of cardiovascular risk events and a favourable bleeding pattern. Due to the long half-life of DRSP (30-34 h), the effectiveness is maintained even in case of a forgotten pill on a single occasion. Studies involving deliberate 4 days in one cycle 24-hour delays in taking a pill have demonstrated that ovulation inhibition is maintained if a single pill is missed.
CONCLUSIONS
This review article will describe the clinical impact in the daily use of the 4 mg DRSP only pill and the resulting data on the effectiveness and safety of this hormonal contraceptive.
Topics: Female; Humans; Progestins; Androstenes; Contraception; Estradiol; Contraceptive Agents; Contraceptives, Oral, Combined
PubMed: 36724207
DOI: 10.1080/13625187.2022.2164186 -
Nederlands Tijdschrift Voor Geneeskunde Oct 2022All current hormonal contraceptives have side effects and contraindications related to estrogens and progestins. Users are often dissatisfied with this. There is a great...
All current hormonal contraceptives have side effects and contraindications related to estrogens and progestins. Users are often dissatisfied with this. There is a great need for a new contraceptive drug without these hormones with the associated side effects and contraindications; with also a favorable bleeding profile; that can be used orally and not daily; that can serve as a contraceptive and after-care and can also be used on demand. Mifepristone 50 mg seems to provide the answer to all these wishes but is not (yet) registered in the Netherlands.
Topics: Female; Humans; Mifepristone; Progestins; Contraceptives, Oral, Hormonal; Estrogens; Netherlands
PubMed: 36300464
DOI: No ID Found -
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 -
Journal of Pediatric and Adolescent... Jun 2020Peak bone mass acquisition during adolescence is an important determinant of adult bone health. Knowledge about the effects of different contraceptives on peak bone mass... (Review)
Review
Peak bone mass acquisition during adolescence is an important determinant of adult bone health. Knowledge about the effects of different contraceptives on peak bone mass acquisition could influence choice of method recommended. This review summarizes normal bone acquisition during adolescence, discusses methods of assessing bone health in this age group, and reviews the effects of different contraceptive options on bone health, both in adults and in adolescents. Based on the evidence, long-acting reversible contraceptives do not appear to affect peak bone mass acquisition or future fracture risk and remain the first-line contraceptive choice for adolescents. Oral contraceptives with doses of ethinyl estradiol greater than 30 μg should be used in preference to lower-dose preparations, and the adverse effects of depo medroxyprogesterone acetate (DMPA) on bone health are reversible on discontinuation of the medication. Concerns about bone health should not prevent use of DMPA in an adolescent who prefers this method.
Topics: Adolescent; Bone Density; Contraception; Contraceptive Agents, Female; Contraceptives, Oral; Ethinyl Estradiol; Female; Humans; Long-Acting Reversible Contraception; Medroxyprogesterone Acetate
PubMed: 31972296
DOI: 10.1016/j.jpag.2020.01.003 -
Expert Review of Clinical Pharmacology Oct 2020The contraceptive activity of synthetic progestins is mediated through three basic mechanisms: (a) An anti-gonadotrophic action leading to the inhibition of ovulation;... (Review)
Review
INTRODUCTION
The contraceptive activity of synthetic progestins is mediated through three basic mechanisms: (a) An anti-gonadotrophic action leading to the inhibition of ovulation; (b) Changes in cervical mucus characteristics that inhibit sperm penetration and (c) desynchronization of the endometrial picture necessary for implantation.
AREAS COVERED
Mechanisms involved in the progestin-induced endometrium desynchronization are individually reviewed for each of the routes of administration and, whenever possible, by individual members of the various families of synthetic progestin derivatives.
EXPERT OPINION
For contraceptive purposes, progestins are today administered through several routes: orally, as injections, subdermally and via the vagina or the uterine cavity. Given this variety of modalities, their effects may differ, depending on the route of administration, concentration reached at the level of the endometrium and the duration of use. These are characterized by inactivation of the endometrium. Progestin-only contraception provides a safe and effective control of fertility regulation, although, they are associated with the problem of endometrial break through bleeding that may lead to discontinuation. Unfortunately, in spite of a major research effort over two decades, there is not, as yet, an established long-term intervention available to manage bleeding irregularities, making mandatory a deeper understanding of the mechanisms involved is required.
Topics: Animals; Contraceptive Agents, Female; Contraceptives, Oral, Hormonal; Endometrium; Female; Humans; Metrorrhagia; Progestins
PubMed: 32903118
DOI: 10.1080/17512433.2020.1821649 -
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