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CONTRACEPTIVES HORMONAL [keywords]
- Maximal fat oxidation, but not aerobic capacity, is affected by oral contraceptive use in young healthy women. [JOURNAL ARTICLE]
- Eur J Appl Physiol 2014 Dec 18.
Synthetic ovarian hormones contained in oral contraceptives (OC) may alter the aerobic capacity and lipid metabolism in oral contraceptive users (OC+) compared with non-users (OC-). The aim of this study was thus to investigate the differences between OC- and OC+ (1) in cardiorespiratory parameters at the anaerobic threshold (AT) and at the maximal aerobic capacity and (2) in the exercise intensity (Lipoxmax) at which lipid oxidation rate is maximal (MLOR).Twenty-one healthy untrained women (22.0 ± 0.6 years old) who took OC (OC+; low-dose monophasic OC, n = 11) or not (OC-; n = 10) performed two experimental exercise sessions. In the first one, cardiorespiratory parameters at the AT and at the maximal aerobic capacity were assessed during a maximal incremental exercise session. In the second one, Lipoxmax and MLOR were measured during a submaximal incremental exercise session.No significant difference was observed in cardiorespiratory parameters at the AT and at the maximal aerobic capacity between OC+ and OC- women. OC+ women showed higher MLOR (7.6 ± 1.9 vs 4.6 ± 1.0 mg min(-1) kg FFM(-1); p < 0.01) that was elicited by higher Lipoxmax (45.2 ± 5.2 vs 36.2 ± 4.1 % of VO2max; p < 0.001) compared to OC- women.OC+ and OC- women did not differ in cardiorespiratory parameters at the AT and at the maximal aerobic capacity. However, OC+ women show higher MLOR and Lipoxmax compared with OC- women. The hormonal status appears to be an important MLOR and Lipoxmax determinant in untrained women.
- Aetiology of idiopathic granulomatous mastitis. [Journal Article, Review]
- World J Clin Cases 2014 Dec 16; 2(12):852-8.
Idiopathic granulomatous mastitis is a rare chronic inflammatory lesion of the breast that can clinically and radiographically mimic breast carcinoma. The most common clinical presentation is an unilateral, discrete breast mass, nipple retraction and even a sinus formation often associated with an inflammation of the overlying skin. The etiology of idiopathic granulomatous mastitis is still obscure. Its treatment remains controversial. The cause may be the autoimmune process, infection, a chemical reaction associated with oral contraceptive pills, or even lactation. Various factors, including hormonal imbalance, autoimmunity, unknown microbiological agents, smoking and α 1-antitrypsin deficiency have been suggested to play a role in disease aetiology. In this review, causing factors in the aetiology of idiopathic granulomatous mastitis are reviewed in detail.
- Biology of male fertility control: an overview of various male contraceptives. [JOURNAL ARTICLE]
- Minerva Ginecol 2014 Dec 17.
The population of our planet continues to grow at an alarming rate. If the growth continues at the present rate, the estimated current world population of about seven billion is expected to double in the next forty years. Accumulated data from surveys by the United Nations Population Control Division suggest that a majority of today's young men in many countries are willing to have fewer children than their parents did. However, the contraceptive options available to them have not changed in several decades. In spite of the general agreement that men, like women, must take full responsibility of their fertility, the availability of safe, reversible and affordable contraceptives for men have lagged behind because of the complexity of the science of the male reproductive system. Thus, the contraceptive needs of millions of men/couples go unmet every single day and results in millions of unwanted pregnancies. In this article, we intend to discuss new hormonal and non--hormonal contraceptive approaches that are at various stages of research and development and may someday provide new contraceptives for men. In addition, we intend to discuss many details of three safe, effective, affordable and reversible vas--based approaches that are inching closer to being approved for use by millions of men in multiple countries. Finally, our intention is to discuss the male contraceptive pill that will soon be available to men only in Indonesia. The availability of these male contraceptives will allow both men and women to take full control of their fertility and participate in slowing down the growth of world population.
- Barriers to and Enablers of Contraceptive Use among Adolescent Females and their Interest in an Emergency Department-based Intervention. [JOURNAL ARTICLE]
- Contraception 2014 Dec 11.
Over 15 million adolescents, many at high risk for pregnancy, use emergency departments (ED) in the United States annually, but little is known regarding reasons for failure to use contraceptives in this population. The purpose of this study was to identify the barriers to and enablers of contraceptive use among adolescent females using the ED and determine their interest in an ED-based pregnancy prevention intervention. Study Design We conducted semi-structured, open-ended interviews with females in an urban ED. Eligible females were 14-19 years old, sexually active, presenting for reproductive health complaints, and at risk for pregnancy, defined as non-use of effective (per the World Health Organization) contraception. Interviews were recorded, transcribed, and coded based on thematic analysis. Enrollment continued until no new themes emerged. A modified Health Belief Model guided the organization of the data.Participants (n=14) were predominantly Hispanic (93%), insured (93%), and in a sexual relationship (86%). The primary barrier to contraceptive use was perceived health risk, including effects on menstruation, weight, and future fertility. Other barriers consisted of mistrust in contraceptives, ambivalent pregnancy intentions, uncertainty about the future, partner's desire for pregnancy, and limited access to contraceptives. Enablers of past contraceptive use included the presence of a school-based health clinic and clear plans for the future. All participants were receptive to ED-based pregnancy prevention interventions.The identified barriers and enablers influencing hormonal contraceptive use can be used to inform the design of future ED-based adolescent pregnancy prevention interventions. Implications Adolescents who visit the emergency department (ED) identify contraceptive side effects, mistrust in contraceptives, limited access, pregnancy ambivalence, and partner pregnancy desires as barriers to hormonal contraception use. They expressed interest in an ED-based intervention to prevent adolescent pregnancy; such an intervention could target these themes to maximize effectiveness.
- Mineralocorticoid receptor haplotype, oral contraceptives and emotional information processing. [JOURNAL ARTICLE]
- Neuroscience 2014 Dec 10.
Oral contraceptives (OCs) affect mood in some women and may have more subtle effects on emotional information processing in many more users. Female carriers of mineralocorticoid receptor (MR) haplotype 2 have been shown to be more optimistic and less vulnerable to depression.To investigate the effects of oral contraceptives on emotional information processing and a possible moderating effect of MR haplotype.Cross-sectional study in 85 healthy premenopausal women of West-European descent.We found significant main effects of oral contraceptives on facial expression recognition, emotional memory and decision-making. Furthermore, carriers of MR haplotype 1 or 3 were sensitive to the impact of OCs on the recognition of sad and fearful faces and on emotional memory, whereas MR haplotype 2 carriers were not.Different compounds of OCs were included. No hormonal measures were taken. Most naturally cycling participants were assessed in the luteal phase of their menstrual cycle.Carriers of MR haplotype 2 may be less sensitive to depressogenic side-effects of OCs.
- Prefrontal GABA concentration changes in women-Influence of menstrual cycle phase, hormonal contraceptive use, and correlation with premenstrual symptoms. [JOURNAL ARTICLE]
- Brain Res 2014 Dec 3.
Prefrontal regions are involved in processing emotional stimuli and are a topic of interest in clinical and neurological research. Although sex steroids are potent neuromodulators, the influence of menstrual cycle phase and hormonal contraceptive use is rarely taken into account in neuroimaging studies. Our purpose was to evaluate changes in gamma-aminobutyric acid (GABA) in women, as measured by magnetic resonance spectroscopy (MRS), with phases of the menstrual cycle and use of hormonal contraceptives, and to assess correlations with premenstrual symptoms. Three MRI sessions per cycle were obtained in the natural cycle group, and two sessions in the hormonal contraceptives group. In addition to an anatomical scan, single voxel MRS in the prefrontal area was performed. After quality control, 10 women with natural cycle and 21 women taking hormonal contraceptives were included for analysis. Peripheral blood samples were obtained to determine endogenous hormone concentrations. Subjects were asked to complete a daily rating of severity of problems questionnaire, to quantify premenstrual symptoms. In the natural cycle group, we found a significant increase in prefrontal GABA concentration at the time of ovulation. Conversely, in the hormonal contraceptives group, no differences were found between the pill phase and pill-free phase. GABA concentrations did not significantly correlate with endogenous hormone levels, nor with premenstrual symptoms. Our results indicate that spectroscopically measured GABA concentrations are higher during ovulation in women with a natural menstrual cycle. We suggest that neuroimaging studies should take into account this variability.
- Different health behaviors and clinical factors associated with bone mineral density and bone turnover in premenopausal women with and without type 1 diabetes. [JOURNAL ARTICLE]
- Diabetes Metab Res Rev 2014 Dec 2.
Women with type 1 diabetes (T1DM) have an elevated fracture risk. We therefore compared the associations of health behaviors and clinical factors with bone mineral density (BMD) and bone remodeling between premenopausal women with and without T1DM to inform potential interventions.Participants included women with T1DM (n = 89) from the Wisconsin Diabetes Registry Study and age- and race-matched controls without diabetes (n = 76). Peripheral (heel, forearm) and central (hip, spine) BMD, markers of bone resorption and formation, bone cell signaling, glycemic control, and kidney function were assessed. Health behaviors and medical history were self-reported.In controls, but not in women with T1DM, older age was associated with lower bone resorption (p < 0.006) and formation (p = 0.0007). Body mass index (BMI) was positively associated with heel and forearm BMD in both controls and T1DM women (all p < 0.0001), but with hip and spine BMD only in controls (p < 0.005). Worse glycemic control during the previous 10 years, greater alcohol intake, history of smoking, and lack of physical activity were associated with poorer bone outcomes only in women with T1DM (all p < 0.002); whereas use of hormonal contraceptives was related to low bone formation in both women with and without T1DM (all p < 0.006). Diabetes duration, insulin dose, residual C-peptide, and kidney function were not associated with bone in T1DM.Age and BMI may not predict bone health in T1DM women. However modifiable behaviors such as optimizing glycemic control, limiting substance and hormonal contraceptive use, and increasing physical activity may improve bone health in T1DM women. This article is protected by copyright. All rights reserved.
- Plasma levels of soluble fibroblast activation protein in arterial thrombosis; determinants and cleavage of its substrate alpha-2-antiplasmin. [JOURNAL ARTICLE]
- Int J Cardiol 2014 Oct 22.:105-110.
Fibroblast activation protein (FAP) is a transmembrane glycoprotein with dipeptidyl-peptidase and endopeptidase activities and circulates in blood in a truncated, soluble form (sFAP). Fibrinolysis inhibitor α2-antiplasmin (α2AP) has been described as a potential in vivo substrate of sFAP. We aimed to investigate sFAP levels and α2AP cleavage in young arterial thrombosis patients and in control individuals, study the correlation between sFAP levels and α2AP cleavage and investigate determinants of these variables.sFAP levels and α2AP cleavage were determined by ELISA in the plasma samples of 391 coronary heart disease (CHD) patients, 221 ischemic stroke patients, 51 peripheral arterial disease patients and 501 control individuals.Median sFAP levels were similar in arterial thrombotic patients and in control individuals, but in CHD patients sFAP levels significantly increased with time (number of months) between the event and study inclusion (Spearman's rho: 0.209, p<0.001), indicating reduced sFAP levels at time of event. sFAP levels and percentage α2AP cleavage significantly correlated in controls and in patients. Furthermore, sex, use of oral contraceptives and hyperlipidemia were significant determinants of sFAP levels.sFAP levels were reduced in the CHD patient population, but only in the first months after the event, indicating that over time sFAP levels may normalize. The significant correlation between sFAP level and α2AP cleavage indicates that in vivo sFAP (at least partly) regulates cleavage of α2AP, irrespective of disease status. Differences in sFAP level due to sex, use of oral contraceptives and hyperlipidemia might suggest hormonal control of sFAP levels.
- Obesity and its relation to depressive symptoms and sedentary lifestyle in middle-aged women. [Journal Article]
- Maturitas 2015 Jan; 80(1):100-5.
The prevalence of obesity increases during female mid-life and although many factors have been identified, data from Latin America is lacking.To assess factors related to obesity among middle-aged women and determine the association with depressive symptoms, sedentary lifestyle and other factors.A total of 6079 women aged 40-59 years of 11 Latin American countries were asked to fill out the Goldberg Anxiety and Depression Scale, the Menopause Rating Scale, the Athens Insomnia Scale, the Pittsburgh Sleep Quality Index and a general questionnaire containing personal socio-demographic data, anthropometric measures and lifestyle information. Obesity was defined as a body mass index (BMI) ≥30kg/m(2).Obesity was observed in 18.5% and sedentary lifestyle in 63.9%. A 55.5% presented vasomotor symptoms, 12.2% had severe menopausal symptoms and 13.2% used hormone therapy for the menopause. Prevalence of depressive symptoms was 46.5% and anxiety 59.7%. Our logistic regression model found that significant factors associated to obesity included: arterial hypertension (OR: 1.87), depressive symptoms (OR: 1.57), sedentary lifestyle (OR: 1.50) diabetes mellitus (OR: 1.34), higher number of individuals living at home (OR: 1.31), sleep problems (OR:1.22), anxiety (OR: 1.21), having a stable partner (OR: 1.20), parity (OR: 1.16) and vasomotor symptoms (OR:1.14). A lower risk for obesity was found among women using hormonal contraceptives (OR: 0.69).Obesity in middle-aged women is the consequence of the interaction of multiple factors. It was associated to hypertension, depressive symptoms, sedentary lifestyle, climacteric symptoms and other factors.
- The link between oral contraceptive use and prevalence in autism spectrum disorder. [JOURNAL ARTICLE]
- Med Hypotheses 2014 Oct 12; 83(6):718-725.
Autism spectrum disorder (ASD) is a group of developmental disabilities that include full syndrome autism, Asperger's syndrome, and other pervasive developmental disorders. The identified prevalence of ASD has increased in a short time period across multiple studies causing some to conclude that it has reached epidemic proportions in the U.S. Many possible explanations for the rise in numbers of individuals diagnosed with ASD have been offered and yet, causes and contributing factors for ASD are inadequately understood. Current evidence suggests that both genetics and environment play a part in causing ASD. One possible risk factor for the increase in prevalence has been profoundly overlooked in the existing biomedical and epidemiologic literature. As the prevalence of ASD has risen in the last sixty years, so has the prevalence of the usage of the oral contraceptives and other modern hormonal delivery methods. In 1960 about one million American women were using oral contraceptives, today close to 11million women in the U.S. use oral contraceptives. Eighty-two percent of sexually active women in the U.S. have used oral contraceptives at some point during their reproductive years. Thus, the growth in use of progesterone/estrogen-based contraceptives in the United State has reached near-ubiquitous levels among women in the child-bearing age range. The suppression of ovulation produced by estrogen-progesterone is an indisputable abnormality. It is logical to consider the outcome of the ovum that would have been normally released from the ovary during ovulation. To date there is no comprehensive research into the potential neurodevelopmental effects of oral contraceptive use on progeny. The issue has been only sparsely considered in the biomedical literature. This article hypothesizes that the compounds, estrogen and progesterone, used in oral contraceptives modify the condition of the oocyte and give rise to a potent risk factor that helps explain the recent increase in the prevalence of ASD's. This hypothesis does not propose to delineate the cause of autism. Rather, it attempts to explain the recent dramatic increase in prevalence and point the way for further study that will lead to causal examination.