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CONTRACEPTIVES HORMONAL [keywords]
- Oxytocin levels are lower in premenopausal women with type 1 diabetes mellitus compared to matched controls. [JOURNAL ARTICLE]
- Diabetes Metab Res Rev 2014 Jul 7.
Oxytocin (OT), a hormone most commonly associated with parturition and lactation, may have additional roles in diabetes complications. We determined OT levels in premenopausal women with type 1 diabetes mellitus (T1DM) compared to nondiabetic controls; and examined associations of OT with health behaviors, clinical factors, biomarkers, kidney function, and bone health. Lower OT was hypothesized for T1DM.Cross-sectional study of premenopausal women with T1DM (n = 88) from the Wisconsin Diabetes Registry Study, a population-based cohort of incident T1DM cases, and matched nondiabetic controls (n = 74).Women with T1DM had lower OT levels than controls adjusting for caffeine and alcohol use (p = 0.03). Health behaviors associated with OT differed between women with and without T1DM: OT was negatively associated with hormonal contraceptive use (quantified as lifetime contraceptive estrogen exposure) in women with T1DM (p = 0.003) while positively related to hormonal contraceptive use (quantified as never/former/current) in controls (p < 0.001). OT had a positive association with adiposity (waist-to-hip ratio and leptin) in women with T1DM and a negative relationship with adiposity (weight gain) in controls. In T1DM only, OT was positively associated with caffeine intake (p = 0.01) and negatively associated with alcohol use (p = 0.01). OT was not related to glycemic control, kidney function, or bone health in T1DM.OT levels are lower in women with T1DM than matched controls. OT also has opposing associations with hormonal contraceptives and adiposity in women with and without T1DM. Research is needed to determine if the altered OT milieu in T1DM is associated with other health outcomes. This article is protected by copyright. All rights reserved.
- Acute mesenteric venous thrombosis with a vaginal contraceptive ring. [Journal Article]
- West J Emerg Med 2014 Jul; 15(4):395-7.
Mesenteric venous thrombosis is a rare cause of abdominal pain, which if left untreated may result in bowel infarction, peritonitis and death. The majority of patients with this illness have a recognizable, predisposing prothrombotic condition. Oral contraceptives have been identified as a predisposing factor for mesenteric venous thrombosis in reproductive-aged women. In the last fifteen years new methods of hormonal birth control have been introduced, including a transdermal patch and an intravaginal ring. In this report, we describe a case of mesenteric venous thrombosis in a young woman caused by a vaginal contraceptive ring.
- Oral contraceptive use, parity, and constitutional characteristics in soft tissue sarcoma: a Swedish population-based case-control study 1988-2009. [JOURNAL ARTICLE]
- Cancer Causes Control 2014 Jul 18.
The study was designed to investigate the influence of surrogate factors associated with sex (SH) and growth hormones (GH) on the risk of developing soft tissue sarcomas (STS).The etiology of soft tissue sarcoma is largely unknown. We have studied the effect of hormone related factors on STS in the Swedish population between 1988 and 2009 using a population-based matched case-control design.Our study is the largest on this topic to date, including 634 cases in a primary matched analysis and 855 cases in an unmatched sensitivity analysis. We identified protective effects connected to constitutional characteristics, hormonal and reproductive factors. Being shorter than your peers at age 11 was associated with an odds ratio (OR) of 0.51 (0.36-0.74). Having used oral contraceptives (OC), OR 0.75 (0.49-1.15), and high parity, OR 0.16 (0.04-0.63), comparing three or more children to two or less, also appeared to reduce the risk of STS. The risk was further reduced with the duration of OC use (p = 0.01), comparing use for 11 years or more to use for 3 years or less yielded an OR of 0.10 (0.02-0.41). No effect was observed for ever having had perimenopausal hormone therapy OR 1.02 (0.70-1.47). The effect of BMI varied significantly with subtype (p = 0.03) and tumor location (p < 0.001).We observed surrogates of SH, GH, and insulin-like growth factor 1 to be associated with STS development. These findings are important as they may connect STSs to the group of hormone-dependent tumors, potentially revealing common treatment and prevention targets.
- Association Between Contraceptive Use and Gestational Diabetes: Missouri Pregnancy Risk Assessment Monitoring System, 2007-2008. [JOURNAL ARTICLE]
- Prev Chronic Dis 2014.:E121.
The efficacy and safety of contraceptives have been questioned for decades; however, whether a relationship exists between hormonal contraceptives and gestational diabetes (GDM) is undetermined. The aim of this study was to investigate whether maternal risk for GDM was influenced by type of contraceptive method used before pregnancy.Data collected in 2007 and 2008 by the Missouri Pregnancy Risk Assessment Monitoring System (PRAMS) were analyzed to determine if type of contraception before pregnancy influenced maternal risk for GDM. We used a logistic regression model to determine the adjusted odds for GDM given exposure to hormonal forms of contraception.Of the 2,741 women who completed the 2007-2008 PRAMS survey, 8.3% were diagnosed with gestational diabetes, and 17.9% of the respondents had used hormonal contraceptive methods. Women who used hormonal methods of birth control had higher odds for gestational diabetes (adjusted odds ratio [AOR] = 1.43; 95% confidence interval [CI], 1.32-1.55) than did women who used no contraception. A protective effect was also observed for women who had used barrier methods of contraception (AOR = 0.79; 95% CI, 0.72-0.86).Findings suggest there may be a relationship between type of contraceptive method and GDM. More research is needed to verify contraception as a potential risk factor for GDM.
- Impact of having a high-risk pregnancy on future postpartum contraceptive method choice. [JOURNAL ARTICLE]
- Women Birth 2014 Jul 11.
To compare the knowledge and preference of preconceptional contraception to future postpartum contraceptive method choice in high-risk pregnancies.Does a high-risk pregnancy condition affect future postpartum contraceptive method choice?Women hospitalised at the High Risk Pregnancy unit of a tertiary research and training hospital were asked to complete a self-reported questionnaire that included demographic characteristics, presence of unintended pregnancy, contraceptive method of choice before the current pregnancy, plans for contraceptive use following delivery and requests for any contraceptive counselling in the postpartum period.A total of 655 pregnant women were recruited. The mean age, gravidity and parity of the women were 27.48±6.25 years, 2.81±2.15 and 1.40±1.77, respectively. High-risk pregnancy indications included 207 (31.6%) maternal, 396 (60.5%) foetal and 52 (7.9%) uterine factors. All postpartum contraceptive choices except for combined oral contraceptives (COCs) usage were significantly different from preconceptional contraceptive preferences (p<0.001). High-risk pregnancy indications, future child bearing, ideal number of children, income and education levels were the most important factors influencing postpartum contraceptive choices. While the leading contraceptive method in the postpartum period was long-acting reversible contraceptive methods (non-hormonal copper intrauterine device Cu-IUD, the levonorgestrel-releasing intrauterine system (LNG-IUS) (40%), the least preferred method was COCs use (5.2%) and preference of COCs use showed no difference between the preconceptional and postpartum periods (p=0.202). Overall 73.7% of the women wanted to receive contraceptive counselling before their discharge.A high-risk pregnancy condition may change the opinion and preference of contraceptive use, and also seems to affect the awareness of family planning methods.
- Menstrual suppression: current perspectives. [Journal Article, Review]
- Int J Womens Health 2014.:631-7.
Menstrual suppression to provide relief of menstrual-related symptoms or to manage medical conditions associated with menstrual morbidity or menstrual exacerbation has been used clinically since the development of steroid hormonal therapies. Options range from the extended or continuous use of combined hormonal oral contraceptives, to the use of combined hormonal patches and rings, progestins given in a variety of formulations from intramuscular injection to oral therapies to intrauterine devices, and other agents such as gonadotropin-releasing hormone (GnRH) antagonists. The agents used for menstrual suppression have variable rates of success in inducing amenorrhea, but typically have increasing rates of amenorrhea over time. Therapy may be limited by side effects, most commonly irregular, unscheduled bleeding. These therapies can benefit women's quality of life, and by stabilizing the hormonal milieu, potentially improve the course of underlying medical conditions such as diabetes or a seizure disorder. This review addresses situations in which menstrual suppression may be of benefit, and lists options which have been successful in inducing medical amenorrhea.
- Contraceptive use in acne. [Journal Article]
- Clin Dermatol 2014 Jul-Aug; 32(4):502-15.
Acne vulgaris is an inflammatory disorder of the pilosebaceous follicle. It is well established that androgen hormones play a major role in sebum production and excretion, and are vital in the pathogenesis of acne. Isotretinoin notwithstanding, hormonal therapies such as combined oral contraceptives (COCs) and spironolactone are the only treatments that can affect sebum production and the androgen component of acne. Contraceptives are also used during isotretinoin therapy for pregnancy prevention. It is important for a dermatologist to be familiar with all the available methods of contraception to provide essential counseling to patients. The aim of this paper is to review the role of hormones in acne pathogenesis, discuss the use of hormonal therapies for acne, and detail various alternative contraceptive methods in relation to isotretinoin treatment and pregnancy prevention.
- MECHANISMS IN ENDOCRINOLOGY: Epidemiology of hormonal contraceptives related thromboembolism. [JOURNAL ARTICLE]
- Eur J Endocrinol 2014 Jul 10.
For many years, it has been well documented that combined hormonal contraceptives increase the risk of venous thromboembolism (VTE). Third generation pill use (desogestrel or gestodene) is associated with an increased VTE risk as compared to 2nd generation (levonorgestrel) pill use. Other progestins such as drospirenone or cyproterone acetate combined with ethinyl-estradiol (EE) have been investigated. Most studies have reported a significant increased VTE risk among users of these combined oral contraceptives (COC) when compared with users of 2nd generation pills. Non oral CHC such as the transdermal patch and the vaginal ring are also available. Current data support than these routes of administration are more thrombogenic than 2nd generation pill. These results are consistent with the biological evidence of coagulation activation. Overall, the estrogenic potency of each hormonal contraceptive depending on both EE doses and progestin molecule explains the level of thrombotic risk. Some studies have shown a similar increased VTE risk among users of COC containing norgestimate as compared to users of 2nd generation pill use. However, for this combination, biological data, based on quantitative assessment of SHBG or haemostasis parameters, are not in agreement with these epidemiological results. Similarly, the VTE risk associated with low doses of EE and GSD is not biologically plausible. In conclusion, newer generation formulations of hormonal contraceptives as well as non-oral hormonal contraceptives seem to be more thrombogenic than 2nd generation hormonal contraceptives. Further studies are needed to conclude on combinations containing norgestimate or low doses of EE associated with GSD.
- The Impact of Oral Contraceptive Initiation on Young Women's Condom Use in 3 American Cities: Missed Opportunities for Intervention. [JOURNAL ARTICLE]
- PLoS One 2014; 9(7):e101804.
To describe women's condom use and assess predictors of consistent condom use and dual method use in the 6 months after the initiation of oral contraception (OC).We conducted a planned secondary cohort analysis among women less than 25 years of age initiating oral contraceptives at public family planning clinics in Atlanta, Dallas and New York City, USA, as part of a randomized trial. These clinics provide care to predominantly African American or Hispanic women of low socioeconomic status. Participants completed interviews at enrollment and at 6 months after OC start. We used multivariate logistic regression to assess factors associated with consistent condom and dual method use at 6 months.1281 participants met the inclusion criteria for this analysis. At enrollment prior to OC start, 28% were consistent condom users. In the six months after initiation of oral contraception, only 14% always used a condom and 4% always used dual methods. In multivariate analysis, receiving basic advice to always use a condom after OC initiation from a provider during the baseline clinic consultation was associated with a 50% increase in the odds of using condoms consistently. Only 28% of participants were given this condom use advice.This study documents a decline in women's condom consistent use subsequent to initiation of the oral contraceptive and suggests that opportunities for positive intervention around condom use among women starting hormonal methods are being missed. Basic condom use advice, which is neither time consuming nor resource dependent, was associated with increased consistent use and should be immediately implemented in all family planning services.
- Polycystic ovary syndrome as a rare association with inflammatory hepatocellular adenoma: A case report. [JOURNAL ARTICLE]
- Clin Res Hepatol Gastroenterol 2014 Jun 30.
Hormonal factors, like oral contraceptives, create a predisposition to hepatocellular adenoma. We present the case of a young woman with an inflammatory hepatocellular adenoma occurring in the context of a polycystic ovary syndrome. In view of this possible relationship, it would be recommended to follow up patients with hyperandrogenism with repeated liver tests and ultrasonographics. Furthermore, this observation illustrated some difficulties to differentiate remodelled inflammatory hepatocellular adenoma and focal nodular hyperplasia and underlined the interest of immunohistochemical markers for the right diagnosis.