- Hormonal Contraceptives and Migraine With Aura-Is There Still a Risk? [Review]
- HHeadache 2016 Oct 24
- Unnecessary confusion still surrounds the use of combined hormonal contraceptives (CHCs) in the setting of migraine with aura (MwA). Clearing this confusion is a key issue for headache specialists, s...
Unnecessary confusion still surrounds the use of combined hormonal contraceptives (CHCs) in the setting of migraine with aura (MwA). Clearing this confusion is a key issue for headache specialists, since most women with migraine have menstrual-related migraine (MRM), and some CHCs can prevent this particularly severe migraine. Their use, however, is still restricted by current guidelines due to concerns of increased stroke risk - concerns that originated over half a century ago in the era of high dose contraceptives. Yet studies consistently show that stroke risk is not increased with today's very low dose CHCs containing 20-25 µg ethinyl estradiol (EE), and continuous ultra low-dose formulations (10-15 µg EE) may even reduce aura frequency, thereby potentially decreasing stroke risk. This article clarifies the stroke risk of CHCs and examines their impact on migraine. It also examines how stroke risk is altered by the estrogen content of the CHC, by contributing factors such as smoking, age and hypertension, and by aura frequency. And finally, it puts these risks into a meaningful context with a risk/benefit assessment.
- Non-oral combined hormonal contraceptives and thromboembolism: a systematic review. [Journal Article]
- CContraception 2016 Oct 19
- CONCLUSIONS: Limited Level II-2 good to fair evidence demonstrated conflicting results on whether women using the patch or the ring have a higher risk of VTE than women using COCs. Evidence did not demonstrate an increased risk of ATE among women using the patch. Overall, any potential elevated risk likely represents a small number of events on a population level. Additional studies with standard methodology are needed to further clarify any associations and better understand mechanisms of hormone-induced thrombosis among users of non-oral combined hormonal contraception.
- Urinary steroid profile in females -the impact of menstrual cycle and emergency contraceptives. [Journal Article]
- DTDrug Test Anal 2016 Oct 18
- Today's doping tests involving longitudinal monitoring of steroid profiles are difficult in women. Women have more complex hormonal fluctuations than men and commonly take drugs such as hormonal cont...
Today's doping tests involving longitudinal monitoring of steroid profiles are difficult in women. Women have more complex hormonal fluctuations than men and commonly take drugs such as hormonal contraceptives that are shown to affect biomarkers used in these doping tests. In this study we followed six women's urinary steroid profile during one menstrual cycle, including both glucuronides and sulfate conjugated fractions. Additionally, we studied what happens to the steroidal module of the athlete biological passport (ABP) after administration of an emergency contraceptive (levonorgestrel, NorLevo®). The study shows that there are large individual variation in all metabolites included in the ABP and that the administration of emergency contraceptives may lead to suspicious steroid profile findings in the ABP. Urinary epitestosterone concentration increased during the menstrual cycle, leading to a decrease in the testosterone/epitestosterone ratio. The ratios followed in the ABP varied widely throughout the menstrual cycle, the coefficient of variation (CV) ranging from 4 to 99%. There was a 3-fold decrease in epitestosterone 24 hours post administration of the emergency contraceptive pill and also androsterone, etiocholanolone, and 5β- androstan-3α,17β-diol concentrations decreased about 2-fold. When analyzed with the ABP software, one of the six women had an atypical profile after taking the emergency contraceptive. Furthermore, we could not find any alterations in excretion routes (i.e. if the metabolites are excreted as glucuronide or sulfate conjugates) during the menstrual cycle or after administration of emergency contraceptive, indicating no direct effect on phase II enzymes. This article is protected by copyright. All rights reserved.
- Use pattern for contraceptive implants in Norway. [Journal Article]
- AOActa Obstet Gynecol Scand 2016; 95(11):1244-1250
- CONCLUSIONS: Implants play a minor role in the overall use of hormonal contraception in Norway. One in five starters continue as long-term users.
- Impact of combined hormonal contraceptives on vessels functionality. [Journal Article]
- AGArch Gynecol Obstet 2016; 294(6):1317-1322
- CONCLUSIONS: CHC may affect vessel reactivity to flicker light by increasing arteries constriction. This may reflect systemic changes in vascular functionality in subjects using CHC. Moreover, CHC should be considered as a confounding bias in studies involving DVA.
- Oxidative Stress in Female Athletes Using Combined Oral Contraceptives. [Journal Article]
- SMSports Med Open 2016; 2(1):40
- CONCLUSIONS: The markedly elevated oxidative stress we revealed in OC-user athletes could be detrimental to physical activity and elevate cardiovascular risk (as thromboembolism). Further research is needed to extend our results, to clarify the biochemical pathways leading to increased hydroperoxides (mainly lipid peroxides) and reduced antioxidant defense, and to elucidate the potential effects on athletic performance. OC use should be considered when developing gender-focused strategies against oxidative stress.
- Lack of a Pharmacokinetic Interaction Between SYM-1219 Granules Containing 2 Grams of Secnidazole and a Combined Oral Contraceptive in a Phase 1, Randomized, Open-Label Study in Healthy Female Volunteers. [Journal Article]
- ATAdv Ther 2016 Oct 15
- CONCLUSIONS: SYM-1219 is a valuable single-dose treatment option for women with BV that will not interfere with combined oral contraceptive methods.
- Hormone Phase Influences Sympathetic Responses to High Levels of Lower Body Negative Pressure in Young Healthy Women. [Journal Article]
- AJAm J Physiol Regul Integr Comp Physiol 2016 Oct 12; :ajpregu.00190.2016
- We tested the hypothesis that sympathetic responses to baroreceptor unloading may be affected by circulating sex hormones. During lower body negative pressure at -30, -60, and -80 mmHg, muscle sympat...
We tested the hypothesis that sympathetic responses to baroreceptor unloading may be affected by circulating sex hormones. During lower body negative pressure at -30, -60, and -80 mmHg, muscle sympathetic nerve activity (MSNA), heart rate and blood pressure were recorded in women taking (n=8) and not taking (n=9) hormonal contraceptives. All women were tested twice, once during the low hormone phase (i.e. the early follicular phase of the menstrual cycle and the placebo phase of hormonal contraceptive use), and again during the high hormone phase (i.e. the midluteal phase of the menstrual cycle and active phase of contraceptive use). During baroreceptor unloading the reductions in stroke volume and resultant increases in MSNA and total peripheral resistance were greater in high hormone than low hormone phases in both groups. When normalized to the fall in stroke volume, increases in MSNA were no longer different between hormone phases. While stroke volume and sympathetic responses were similar between women taking and not taking hormonal contraceptives, mean arterial pressure was maintained during baroreceptor unloading in women not taking hormonal contraceptives but not in women using hormonal contraceptives. These data suggest that differences in sympathetic activation between hormone phases as elicited by lower body negative pressure are the result of hormonally-mediated changes in the hemodynamic consequences of negative pressure, rather than centrally-driven alterations to sympathetic regulation.
- Stress fractures: concepts and therapeutics. [Journal Article]
- JCJ Clin Endocrinol Metab 2016 Oct 12; :jc20162720
- Stress fractures are repetitive use injuries in which recurrent strains lead to material fatigue and microarchitectural discontinuities. Stress fractures account for up to 20% of athletic injuries, m...
Stress fractures are repetitive use injuries in which recurrent strains lead to material fatigue and microarchitectural discontinuities. Stress fractures account for up to 20% of athletic injuries, more commonly sustained by women and in those who engage in track-and-field events. The pathogenesis of stress fractures is multifactorial. Although most stress fracture are reported among women who may experience menstrual disturbances, low body mass index, low energy intake and sometimes low bone mass, these individuals do not regularly seek endocrinological attention. Most published reports, moreover, are not found in Endocrinology journals. There are no standard protocols for evaluation or management of stress fractures.
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- Relationships between Common and Novel Interleukin-6 Gene Polymorphisms and Risk of Cervical Cancer: a Case-Control Study. [Journal Article]
- POPathol Oncol Res 2016 Oct 8
- We investigated the association between six common and novel interleukin-6 (IL-6) polymorphisms with the risk of cervical cancer (CC) among Tunisians. Study subjects comprised 112 CC cases and 164 co...
We investigated the association between six common and novel interleukin-6 (IL-6) polymorphisms with the risk of cervical cancer (CC) among Tunisians. Study subjects comprised 112 CC cases and 164 control women. Genotyping of IL-6 rs2069845, rs2069840, rs1474348, rs1800795, rs1800797, rs2069827 variants was done by real-time PCR, with defined clusters. The allelic and genotypic distributions of the tested IL-6 SNPs were comparable between CC patients and control women. Stratification according to FIGO staging revealed that rs1800795 homozygous major allele genotype (P = 0.033; OR =0.49(0.25-0.95)) and major allele (P = 0.037; OR = 0.57 (0.33-0.97)) were protective of CC. Moreover, carriage of rs1474348 major allele was also protective of CC (P = 0.014; OR = 0.53(0.32-0.88)), while higher rs1474348 minor allele frequency was seen in CC patients with early FIGO stage (P = 0.044; OR = 0.39 (0.15-1.00)), thus implicating rs1474348 in CC evolution and progression of angiogenesis. Haploview analysis demonstrated high linkage disequilibrium (LD) between rs2069845, rs2069840, rs1474348 and rs1800795, and 6-locus haplotype analysis identified GACCCA haplotype to be positively associated with increased CC, while GAGGGG haplotype was negatively associated with CC, thus suggesting a protective role for this haplotype in CC. Furthermore, there was a significant association between the incidence of CC and the use hormonal contraception (P = 0.047; OR = 1.97 (0.94-4.13)) and smoking (P < 0.001; OR = 7.12 (2.97-17.04)). The IL-6 variants rs1800795 and rs1474348, and haplotypes GACCCA and GAGGGG, along with use of hormonal contraceptives and smoking, are major risk factors of CC susceptibility and evolution among Tunisian women.