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CONTRACEPTIVES HORMONAL [keywords]
- The effect of chronic estrogen application on bile and gallstone composition in women with cholelithiasis. [JOURNAL ARTICLE]
- Minerva Endocrinol 2014 Nov 21.
Chronic application of third generation progestagens as contraceptives or hormone replacement therapy (HRT) could influence the serum lipid profile, and consequently the bile and gallstone composition.To determinate components of serum, bile and gallstones in women of reproductive age or postmenopausal women using hormonal third generation for at least two years.We enrolled 101 Caucasian women with cholelithiasis. The study included 45 women of reproductive age and 56 postmenopausal women who were divided into subgroups receiving or not exogenous female hormones. In patients we determined serum levels of 17β--estradiol, triglycerides, HDL and LDL cholesterol as well as composition of gallstones and bile.The postmenopausal women showed a significant reduction in the concentration of bile acids in serum while the application of HRT caused an increase in their contents. Serum total and LDL cholesterol in postmenopausal women was higher than in women without hormonal contraception and postmenopausal patients with HRT. Moreover, women taking the exogenous hormones showed a reduced content of calcium ions in both serum, bile and gallstones.Our observations confirm that the chronic use of oral contraceptives and hormone replacement therapy cause an increase in bile lithogenity.
- Examination of cortisol and state anxiety at an academic setting with and without oral presentation. [JOURNAL ARTICLE]
- Stress 2014 Nov 19.:1-20.
Abstract Holding oral presentations in a university course is perceived as stressful and can increase stress hormone concentrations and state anxiety. In such a naturalistic setting, further attention should be paid to the relationship between psychological and hormonal measures of acute stress, as well as women's intake of hormonal contraceptives as a potential moderating variable. In the present study, 76 healthy students gave saliva samples before and after their oral presentations in a university course as well as on a second, control day in the same course without giving an oral presentation. Anticipatory state anxiety was rated on both days. Cortisol concentrations as well as state anxiety were substantially higher on the presentation relative to the control day. During the oral presentation, an increase in cortisol concentrations was observed, whereas a decrease occurred on the control day. Nearly the same picture emerged for both variables when looking at men, women taking hormonal contraceptives and free-cycling women separately. A positive correlation was found between the change in anticipatory state anxiety in the presentation compared to the control day and cortisol concentrations before and after the oral presentation. Concluding, oral presentations constitute a potent stressor and do not seem to be substantially different between men, free-cycling women and women taking hormonal contraceptives. Future studies may want to explore changes associated with specific menstrual cycle phases and with specific hormonal contraceptives.
- The association between discontinuing hormonal contraceptives and wives' marital satisfaction depends on husbands' facial attractiveness. [JOURNAL ARTICLE]
- Proc Natl Acad Sci U S A 2014 Nov 17.
How are hormonal contraceptives (HCs) related to marital well-being? Some work suggests HCs suppress biological processes associated with women's preferences for partner qualities reflective of genetic fitness, qualities that may be summarized by facial attractiveness. Given that realizing such interpersonal preferences positively predicts relationship satisfaction, any changes in women's preferences associated with changes in their HC use may interact with partner facial attractiveness to predict women's relationship satisfaction. We tested this possibility using two longitudinal studies of 118 newlywed couples. Trained observers objectively rated husbands' facial attractiveness in both studies. In study 1, wives reported their marital satisfaction every 6 mo for 4 y and then reported the history of their HC use for their relationship. In study 2, wives reported whether they were using HCs when they met their husbands and then their marital satisfaction and HC use every 4 mo for up to three waves. In both studies, and in an analysis that combined the data from both studies, wives who were using HCs when they formed their relationship with their husband were less satisfied with their marriage when they discontinued HCs if their husband had a relatively less attractive face, but more satisfied if their husband had a relatively more attractive face. Beginning HCs demonstrated no consistent associations with marital satisfaction. Incongruency between HC use at relationship formation and current HC use was negatively associated with sexual satisfaction, regardless of husbands' facial attractiveness. These findings suggest that HC use may have unintended implications for women's close relationships.
- Trends and patterns of hormonal contraceptive prescribing for adolescents in primary care in the UK. [JOURNAL ARTICLE]
- J Fam Plann Reprod Health Care 2014 Nov 14.
Hormonal contraceptives are the most common method used worldwide by teenagers to prevent unwanted pregnancies. To date there are limited data about such use by teenagers in the UK. This study investigated trends and patterns of hormonal contraceptive prescribing to adolescents aged 12-18 years in UK primary care between 2002 and 2011.A retrospective cohort study using the IMS Disease Analyzer database was conducted. All females aged 12-18 years with ≥1 prescription for a contraceptive drug between 1 January 2002 and 31 December 2011 were included. Annual prevalence of contraceptive drug prescribing was calculated, and indications for prescribing, and types of contraceptive drug prescribed, were examined.In 2002, 13.7% (6135/44 532) of female adolescents received prescriptions for hormonal contraceptives, compared to 19.0% (6597/34 676) in 2011. The majority of female adolescents [2002: 76.2% (4676/6135); 2011: 65.7% (4334/6597)] received a contraceptive drug for 'contraceptive management'. The combined oral contraceptive (COC), 'progestogen+estrogen', was the most commonly prescribed. Although use of progestogen-only contraceptives was lower than COCs, the number of patients who received desogestrel pills and etonogestrel implants increased during the study period; levonorgestrel pill use declined. Only one injectable progestogen, long-acting depot medroxyprogesterone acetate, was prescribed.Use of hormonal contraceptives among adolescents increased between 2002 and 2011, and COC usage was dominant. The increasing use of hormonal contraceptives in adolescents, especially in younger adolescents, warrants further investigation, including research into the long-term safety of these medicines in this age group.
- Reproductive behaviour among women on antiretroviral therapy in Botswana: mismatched pregnancy plans and contraceptive use. [Journal Article]
- Afr J AIDS Res 2014 Sep; 13(3):305-11.
Understanding pregnancy planning and contraceptive use is important in preventing unplanned/unwanted pregnancies among women on antiretroviral therapy (ART). Through a cross-sectional survey of 155 women living with HIV on ART in Botswana (mean age = 36), bivariate/multivariate analyses were used to identify and understand pregnancy planning and contraceptive use. Women who did not plan to have a child (n = 85) were older, less educated, had more children and worried about stigmatisation from family and healthcare workers (HCWs). Multivariate analyses found age (OR:3.41; CI:1.57-7.45; p = 0.002); perceived stigmatisation from family and healthcare workers (OR:3.62; CI:1.47-8.96; p = 0.005); and believing it is irresponsible for women living with HIV to want a child (OR:2.40; CI:1.10-5.24; p = 0.028) to be significantly associated with not planning to have a child. Although reported condom use among 85 women who did not plan to have a child was nearly 90%, a total of 26 of these women (34%) believed they did not have control over condom use. Lack of contraception was reported by 6 women who did not plan a child; this, coupled with the lack of control over condom use, puts unmet need for contraception at 38%. Most women reported feeling comfortable talking with HCWs about contraceptives. However, almost a quarter of the women indicated they were infrequently advised about contraceptives at ART clinics. This study found discordance between pregnancy planning and contraceptive use among women on ART. Lack of control over condom use coupled with low hormonal contraceptive use creates unmet need for contraception and increases the risk of unwanted pregnancies. Regular clinic visits for women on ART present excellent opportunities to address contraceptive needs in a considerate and comprehensive manner.
- European Society of Contraception Statement on Contraception in Obese Women. [JOURNAL ARTICLE]
- Eur J Contracept Reprod Health Care 2014 Nov 7.:1-10.
The obesity 'epidemic' continues to increase, mostly but not only in developed countries. As overweight and obese women are at an increased risk for venous thromboembolism (VTE) at baseline and at a much higher risk during pregnancy, it is essential to help these women to plan pregnancies carefully and to use contraceptives with a positive ratio of benefits versus risks. The Expert Group on hormonal and molecular contraception of the European Society of Contraception convened to review the existing evidence and propose recommendations to the prescribers in line with most recent studies and with the Medical Eligibility Criteria of the World Health Organisation.
- Iron Status and Reproduction in US Women: National Health and Nutrition Examination Survey, 1999-2006. [Journal Article]
- PLoS One 2014; 9(11):e112216.
Women experience significant changes in iron status throughout their reproductive lifespans. While this is evident in regions with high rates of malnutrition and infectious disease, the extent of reproductive-related changes is less well known in countries with low rates of iron deficiency anemia, such as the United States. The goal of this study is determine the relationship between women's reproductive variables (pregnancy, parity, currently breastfeeding, regular menstruation, hormonal contraceptive use, and age at menarche) and iron status (hemoglobin, ferritin, transferrin receptor, and % transferrin saturation) using an anthropological framework for interpreting the results. Data from women aged 18-49 were taken from the 1999-2006 US NHANES, a nationally representative cross-sectional sample of US women. Using multiple imputation and complex survey statistics, women's reproductive variables were regressed against indicators of iron status. Pregnant women had significantly poorer iron status, by most indicators, than non-pregnant women. All biomarkers demonstrated significantly lower iron levels with increasing parity. Women who were having regular periods had iron indicators that suggested decreased iron levels, while women who used hormonal contraceptives had iron indicators that suggested increased iron levels. Despite relatively good iron status and widespread availability of iron-rich foods in the US, women still exhibit patterns of iron depletion across several reproductive variables of interest. These results contribute to an ecological approach to iron status that seeks to understand variation in iron status, with the hopes that appropriate, population-specific recommendations can be developed to improve women's health.
- Clinical course of illness in women with early onset puerperal psychosis: a 12-year follow-up study. [Journal Article]
- J Clin Psychiatry 2014 Oct; 75(10):1096-104.
To complete a follow-up analysis at a mean of 12 years after patients had presented with an early onset puerperal psychotic index episode.A retrospective design was used. Patients with puerperal psychosis and onset within 4 weeks after childbirth who had been referred to the Psychiatric Department of the Ludwig Maximilian University of Munich, Munich, Germany, between 1975 and 1995 (maximum: 24 years, minimum: 7 years) were followed up after a mean of 12 years post index episode. Ninety patients were included in the study. Before the index episode, 35 of the patients had previous nonpuerperal psychoses, while 55 patients presented their index episode as the first manifestation of a psychotic illness. Diagnostic evaluation at follow-up was performed by the Structured Clinical Interview for DSM-IV Axis I Disorders according to DSM-IV-TR. Differential rates of risk of psychotic relapse were calculated. Data on some gynecologic variables (postpartum blues, premenstrual tension, psychiatric symptoms triggered perimenstrually, mood symptoms while taking oral contraceptives) were collected. Clinical and psychosocial outcomes were measured by the Global Assessment Scale and Disability Assessment Scale.Patients who presented with major depression and bipolar affective disorder with psychotic features at the initial index episode showed overall diagnostic stability. Many patients with initial brief psychosis (cycloid psychosis) shifted to a clear bipolar affective disorder. The general risk of a psychotic relapse was high (previous psychosis = 0.77 vs first psychotic manifestation = 0.56; not significant). The risk after further pregnancies was 0.57 versus 0.48, respectively (not significant), and the risk regarding at least 1 other psychotic nonindex episode was 0.71 versus 0.44, respectively (P = .015). Gynecologic variables did not significantly discriminate between the groups. In some patients, a possible link to a hormonal susceptibility was discussed. Patients who remained without any further psychotic relapse (n = 24) had a favorable outcome.Puerperal psychosis of an early onset seemed to be of a prevailing affective nature. Brief psychosis (cycloid psychosis) during a puerperal index episode showed a strong link to bipolar affective disorder in the further course of illness. Outcome was excellent in patients without a further psychotic relapse.
- Use of contraception by women with induced abortion in Italy. [Journal Article]
- Minerva Ginecol 2014 Dec; 66(6):521-6.
Aim of the present study was to investigate type of contraception, if any, used by women with induced abortion.Retrospective analysis on the medical records of 1782 women with induced abortion performed at the University Hospital of Modena (Italy) between 2009 and 2011.Some kind of contraception was used by 81.1% of women with induced abortion. At time of conception most of these women (39%) had used withdrawal, 19% natural methods, 15.2% condom, 7% hormonal contraception (95% estrogen plus progestin for any route) and 0.4% copper-IUD. None was using implants or levonorgestrel-IUD. Figures of past use of hormonal contraception were much higher than those present at the time of the unwanted pregnancy (50.3% vs. 7%; P<0.0001). A higher prevalence of condom use (19.7% vs. 10.9%; P<0.0001), and a lower prevalence of natural methods (14.5% vs. 21.6%; P<0.001) were found in single vs. married women. Use of no contraception was more prevalent among low vs. highly educated women with induced abortion (22.2% vs. 14.2%; P<0.02), but was not related to marital status. Prevalence of use of the different contraceptives is different from the one described in the general population, suggesting differences in contraceptive efficacy among the different methods.Women with induced abortion infrequently use long term or hormonal contraception. In half of the cases the latter has been used at least once in life, but then it has been abandoned. Appropriate education and contraceptive counselling, personalization and follow-up may reduce induced abortion.
- Comparing the satisfaction and efficacy of Cyclofem and contraceptive pills among females in Northern Iran: A randomized controlled trial study. [Journal Article]
- J Adv Pharm Technol Res 2014 Oct; 5(4):152-7.
Hormonal contraceptives are the most effective method for birth control, though they may have some default or complications. This research aimed to comparison of the efficacy and satisfaction of Cyclofem with oral contraceptives (OCs) among females. A descriptive-comparative method was conducted on 80 women who were selected through cluster sampling during November 2011-December 2012. The selected subjects start using OCs or Cyclofem for the 1(st) time in their life. They evaluated in 2 times frames, at the beginning of the study and then 3 and 6 months after the contraceptive precautions. The data were collected by questionnaire. The data were analysed using parametric and nonparametric test in SPSS 16 software. The reasons for discontinuation of the methods were varied, in which 50% of the sample group were Cyclofem users who discontinued because of menstrual changes and the desire to use other methods, and 50% were the OC users whose reason was medical problems, and absent-mindedness was the last reason for 35.7% of the cases. The efficacy of the both (OCs and Cyclofem) was high and only one unwanted pregnancy occurred at the end of the 6(th) month among OC users. There was no significant difference in term of satisfaction of two groups at the end of 3-6 months (PV = 0.433). The results indicated that Cyclofem can be well used by those women who desire for an easy and effective method which is not disturbing the sexual activity and does not also need to be used daily, but the users should be consulted before using the method.