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BMJ (Clinical Research Ed.) Sep 2007Long term follow-up of women in the UK shows no increased risk
Long term follow-up of women in the UK shows no increased risk
Topics: Contraceptives, Oral; Female; Humans; Neoplasms; Risk Factors
PubMed: 17855281
DOI: 10.1136/bmj.39336.503067.BE -
Anaesthesia Jul 1991
Topics: Contraceptives, Oral; Estrogen Replacement Therapy; Ethinyl Estradiol; Female; Humans; Postoperative Complications; Thromboembolism
PubMed: 1862887
DOI: 10.1111/j.1365-2044.1991.tb09646.x -
BMJ (Clinical Research Ed.) Apr 1989
Review
Topics: Cardiovascular Diseases; Contraceptives, Oral; Female; Humans; Lipid Metabolism; Risk Factors
PubMed: 2497884
DOI: 10.1136/bmj.298.6680.1049 -
Fertility and Sterility Jan 1990Figure 9 is an attempt to summate the influences of life-style on lipid parameters. Based on the work of Nikkila, it shows the source of the production of HDL and LDL,... (Review)
Review
Figure 9 is an attempt to summate the influences of life-style on lipid parameters. Based on the work of Nikkila, it shows the source of the production of HDL and LDL, the factors that can affect these lipoprotein levels, and where in the cascade of lipoprotein metabolism these factors exert influence. The source of HDL production is the liver and the intestine. At this stage, diet, exercise, hormones, genetics, drugs, and certain disease states can affect HDL levels. Lecithin-cholesterol acyl transferase (LCAT) esterifies HDL-free cholesterol in plasma, and HDL3 is formed that in turn is transformed to HDL2. At the same time, VLDL from the gut and the liver will be converted, under the influence of LPL, to HDL2 and LDL. Thus HDL2 is being formed by the breakdown of VLDL and from the transformation of HDL3 to HDL2. Insulin, exercise, alcohol, fats, drugs, and diet affect lipoprotein lipase and consequently influence levels of LDL and HDL2 indirectly. Progestogens increase and estrogens decrease hepatic endothelial lipase, thus affecting the HDL2 concentration. It is at this point that combination OCs influence HDL2. The balance between estrogen and progestogen in a given contraceptive determines the extent and direction of HDL2 concentration. A separate pathway in the liver also catabolizes HDL2 and HDL3. LDL is generated partly from catabolism of VLDL and is partly secreted from the liver. The removal of LDL is mediated by receptors in both the liver and peripheral tissues. It is here that the Brown-Goldstein theory plays a major role. If LDL receptors are present in an insufficient number or are defective, then the C will accumulate and atherosclerosis may follow. Thus two key enzymes, LCAT and LPL, control the production of HDL2 and LDL, whereas a third enzyme, hepatic endothelial lipase, catabolizes HDL2.
Topics: Cardiovascular Diseases; Contraceptives, Oral; Female; Humans; Lipid Metabolism; Risk Factors
PubMed: 2403935
DOI: 10.1016/s0015-0282(16)53208-7 -
Journal of Neuroscience Research Jan 2017Oral contraceptive (OC) users typically show a blunted or no cortisol response to psychosocial stress. Although most OC regimens include both an inactive (dummy) and...
Oral contraceptive (OC) users typically show a blunted or no cortisol response to psychosocial stress. Although most OC regimens include both an inactive (dummy) and active pill phase, studies have not systematically investigated cortisol responses during these pill phases. Further, high levels of cortisol following a stressor diminish retrieval of emotional material, but the effects of stress on memory among OC users are poorly understood. We examined the effects of a psychosocial stressor, the Trier Social Stress Test, vs. a control condition on cortisol responsivity and emotional memory retrieval in women tested either during their active (n = 18) or inactive pill phase (n = 21). In secondary analyses, we quantitatively compared OC users with normally cycling women and showed a significant lack of cortisol response during both active and inactive pill phase. Emotional recall did not differ between active and inactive pill phases. Stress differentially diminished recall of negative words compared with positive or neutral words, but cortisol levels were unrelated to memory performance. These findings indicate that OC users have distinct cortisol and memory responses to stress that are similar between the active and inactive pill phases. © 2016 Wiley Periodicals, Inc.
Topics: Adult; Analysis of Variance; Association Learning; Contraceptives, Oral; Emotions; Female; Gonadal Steroid Hormones; Humans; Hydrocortisone; Memory; Neuropsychological Tests; Psychiatric Status Rating Scales; Saliva; Stress, Psychological; Young Adult
PubMed: 27870412
DOI: 10.1002/jnr.23904 -
Thrombosis and Haemostasis Jul 1997Studies conducted in the first three decades after discovery of a link between venous thromboembolism and oral contraceptive users showed a relative risk of first... (Review)
Review
Studies conducted in the first three decades after discovery of a link between venous thromboembolism and oral contraceptive users showed a relative risk of first thrombosis during oral contraceptive use of 2.9 (95% CI 0.5-17). In recent studies in which the sub-50 micrograms ethinyl estrodiol containing pills were investigated comparing current users with non-users, the RR is 3.8 for non-fatal deep VTE and 2.7 for superficial VTE, deep VTE and pulmonary embolism (PE) together and 2.1 for fatal VT and PE together. The association is attributed to the estrogenic component and not related to duration of pill use. The risk disappears once the pill has been stopped, and it is not elevated among past users. Smoking does not appear to be risk factor for VTE; obesity and varicose veins are, at the most, weak risk factors. Since a causal relationship between OC use and VTE is tempting, clues for unraveling the mechanism were sought in the hemostatic system. Studies of the coagulation system found changes in the activation of coagulation and fibrinolytic compartments, but within the normal range. An epidemiologic study showed that the risk of VTE among women using OCs is 30-fold increased by the presence of a mutation of factor V, called Factor V Leiden (5% prevalence in the Caucasian population). Selective screening for the mutated factor V should be limited to women with a personal or family history of VTE. Four epidemiologic studies showed a two-fold increase in risk of VTE with the use of OCs containing third-generation progestins (gestodene and desogestrel), relative to second-generations products (levonorgestrel). Biases cannot devaluate the conclusion that the increased risk of VTE in especially first-time and younger users of third-generation OCs is highly likely. The clinical consequence is therefore that second-generation OCs are the first choice in prescription to first-time users.
Topics: Blood Coagulation; Case-Control Studies; Contraceptives, Oral; Female; Humans; Progestins; Reproducibility of Results; Risk Factors; Thromboembolism; Veins
PubMed: 9198174
DOI: No ID Found -
British Medical Journal Jan 1978
Topics: Amenorrhea; Contraceptives, Oral; Female; Humans; Prolactin
PubMed: 620144
DOI: 10.1136/bmj.1.6104.45 -
British Medical Journal Apr 1967
Topics: Contraceptives, Oral; Female; Humans; Pregnancy
PubMed: 6021318
DOI: 10.1136/bmj.2.5545.174 -
The Journal of Headache and Pain Aug 2013A significant number of women with migraine has to face the choice of reliable hormonal contraception during their fertile life. Combined hormonal contraceptives (CHCs)... (Review)
Review
A significant number of women with migraine has to face the choice of reliable hormonal contraception during their fertile life. Combined hormonal contraceptives (CHCs) may be used in the majority of women with headache and migraine. However, they carry a small, but significant vascular risk, especially in migraine with aura (MA) and, eventually in migraine without aura (MO) with additional risk factors for stroke (smoking, hypertension, diabetes, hyperlipidemia and thrombophilia, age over 35 years). Guidelines recommend progestogen-only contraception as an alternative safer option because it does not seem to be associated with an increased risk of venous thromboembolism (VTE) and ischemic stroke. Potentially, the maintenance of stable estrogen level by the administration of progestins in ovulation inhibiting dosages may have a positive influence of nociceptive threshold in women with migraine. Preliminary evidences based on headache diaries in migraineurs suggest that the progestin-only pill containing desogestrel 75μg has a positive effect on the course of both MA and MO in the majority of women, reducing the number of days with migraine, the number of analgesics and the intensity of associated symptoms. Further prospective trials have to be performed to confirm that progestogen-only contraception may be a better option for the management of both migraine and birth control. Differences between MA and MO should also be taken into account in further studies.
Topics: Contraceptives, Oral, Combined; Contraceptives, Oral, Hormonal; Desogestrel; Female; Humans; Migraine Disorders; Progestins
PubMed: 24456509
DOI: 10.1186/1129-2377-14-66 -
The Journal of Family Planning and... Jul 2003
Topics: Contraception; Contraceptives, Oral, Combined; Contraceptives, Oral, Synthetic; Desogestrel; Drug Prescriptions; Female; Humans; Intrauterine Devices; Ovulation; Patient Education as Topic; Practice Patterns, Physicians'; Progesterone Congeners; United Kingdom; Women's Health
PubMed: 12885316
DOI: 10.1783/147118903101197593