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Objectives: A retrospective cohort study was conducted to evaluate the effects of combination oral contraceptives (COCs) on bone mineral density (BMD) and metabolism in perimenopausal Korean women. Methods: The study subjects comprised two groups. The COC group included 55 women who took low-dose COC for at least one year to control vasomotor symptoms. Another 55 women who had annual checkups without history of COC use served as controls. BMD and bone turnover markers were assessed periodically. Results: In the control group, 12-month BMD values at the lumbar spine (LS) and total hip (TH) significantly decreased with a greater magnitude at LS, and bone resorption (BR) and formation (BF) markers increased concurrently with a larger change in BR. COCs increased BMD at LS after 12 months and prevented BMD decline at TH. Multivariable linear regression revealed a significant difference in LS BMD between groups at 12 months. In the COC group, there were significant negative correlations between baseline BMD and Z-score at LS and corresponding changes at 12 months. COCs did not alter BR markers, whereas BF markers were significantly decreased at 3 months. Group comparison at 12 months, as tested with adjusted linear regression, disclosed significant differences in both BR and BF makers. Conclusions: Bone loss associated with activated bone turnover is evident during the menopausal transition, and COCs might prevent BMD decrease and suppress bone turnover markers in perimenopausal Korean women. Significant increase in LS BMD and decreases in BF makers suggest underlying mechanisms of greater impact on BF. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association between oral contraceptive use and cardiovascular risks, including metabolic syndrome and their components in Brazilian adolescents. Method: This study used data from the Study of Cardiovascular Risks in Adolescents (Estudo de Riscos Cardiovasculares em Adolescentes - ERICA), a nationwide, cross-sectional, school-based study with individuals aged 12-17 years. Sociodemographic variables and OC use were assessed by a self-administered questionnaire. International Diabetes Federation criteria were used to define metabolic syndrome. Descriptive statistics were reported as prevalence and their respective confidence interval of 95% of oral contraceptives according to variables. Logistic regression was performed. Crude and adjusted odds ratios were calculated. Results: This subsample was composed of 22,682 female adolescents, of which 12.65% reported using oral contraceptives and their use was associated with hypertension and hypertriglyceridemia. These associations remained statistically significant after adjusting for age, school region, race, and tobacco use with an increase of 2.68 (1.66 - 4.32) and 3.45 (2.56 - 4.65) times, respectively. Conclusion: The present study was the first to examine the association between the use of oral contraceptives and cardiovascular risk factors among the largest number of female Brazilian adolescents. This method was significantly associated with hypertension, hypertriglyceridemia. Teenagers using oral contraceptives should be monitored for side effects, including blood pressure measurements and advised to avoid smoking. [ABSTRACT FROM AUTHOR]

Copyright of Saudi Medical Journal is the property of Saudi Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

While perimenopausal women have low fecundity, they are still capable of becoming pregnant and the majority of pregnancies occurring during perimenopause are unintended pregnancies. Therefore, even during perimenopause, contraception must be used if unintended pregnancies are to be avoided. However, many perimenopausal women and healthcare providers believe that older people should not take combined oral contraceptives (COC) because doing so may be dangerous. However, to date, there is no evidence that taking COC presents an increased risk of cardiovascular events or breast cancer for middle-aged women as compared to other age groups, and in their recommendations, the Centers for Disease Control and Prevention (CDC) also do not list age itself as a contraindication for COC. Perimenopausal women often experience menstrual irregularity, heavy menstrual bleeding, and vasomotor symptoms. Taking COCs can help control these symptoms and significantly reduce the risk of ovarian cancer, endometrial cancer, and colorectal cancer. The objective of the present review is to examine the usage methods of COC among perimenopausal women and the health issues that may arise from taking COC in perimenopausal women. [ABSTRACT FROM AUTHOR]

Introduction: Cervical cancer is the 5th most common cancer in humans, third most common cause of deaths due to cancer in women worldwide and the second most common cancer and cancer related deaths in developing countries like India. Relation between cancer risk and OCP use is complicated by a number of other factors; peak incidence of majority of cancers in old age, use of multiple hormonal formulations, existence of many confounding factors like number of pregnancies, age at first pregnancy, number of sexual partners, etc. Material and methods: This was an Analytical cross section-case control study,conducted in the Oncology department of Pravara Rural Hospital, Loni in a 2 months duration. IEC approval was received for this study from our IEC. This study project was approved by Indian Council for Medical Research (ICMR), Delhi. Type of sampling was simple random and number of subjects were, 50 as cases and 100as controls, both being same in all regards except OCP use. Results: 2 out of 40 cases and the same number out of 98 controls used OCPs for long term (5-10 years). A risk of 2.38 times was calculated for cervical cancer in individuals who had used OCPs for 5-10 years and is significant. It is seen that on long term OCP use cancer was induced earlier than short term use. Time relationship of around 20-25 years was observed with long term use while 31-39 year with short term.100% of the subjects were unaware about any association, only 40% subjects knew about contraceptives. Conclusion: Protection was seen in case of endometrial and ovarian cancer. Long term OCP users are at a risk of developing cervical cancer earlier than short term. They develop cancer after a period of about 20-25 years whereas short term users develop cancer after 31-39 years. [ABSTRACT FROM AUTHOR]

This report describes the case of a 29 year-old female with a history of polycystic ovary syndrome (PCOS) and on combined oral contraceptives who presents with an acute, CT confirmed pulmonary embolus of the right lower lobe, one week following arthroscopic labral repair of the right shoulder. This patient’s relevant risk factors including obesity, oral contraceptive use, PCOS, and surgical positioning are discussed. Literature surrounding venous thromboembolism (VTE) following shoulder arthroscopy is also reviewed. [ABSTRACT FROM PUBLISHER]

Most women of reproductive age have access to highly effective contraception, and all available methods are associated with side effects. Whether a woman will experience side effects is uncertain, however, which can pose challenges for clinicians who discuss the methods with patients. In this study, we analyze 102 contraceptive counseling visits to understand how clinicians discursively construct knowledge in the context of uncertainty. We find that while some present the uncertainty of side effects in a straightforward, patient-accessible way, others negotiate their predictions by (1) differentially constructing uncertainty, suggesting that positive side effects are likely and negative side effects are unlikely, and (2) contesting uncertainty, presenting the risk of serious side effects as controllable. In the end, these strategies deemphasize consideration of negative side effects in women's contraceptive decision making. Our results demonstrate the importance of elucidating the translation, instantiation, and construction of medical uncertainty both in theory and in practice. [ABSTRACT FROM AUTHOR]

Triple-negative breast cancer (TNBC), a unique subtype of breast cancer, which is resistant to endocrine and targeted therapy, usually relapses early, progresses rapidly and is associated with a poor prognosis. Epidemiological investigations focusing on the association between risk factors and the onset of TNBC demonstrated that the incidence of TNBC exhibits a significant correlation with anthropometric, geographical and demographic parameters. The aim of the present systematic review and meta-analysis was to evaluate the strength of the association between the use of oral contraceptives (OCs) and TNBC. Two databases (PubMed Central/PubMed, Web of Science) and secondary references were searched to identify studies meeting the priorly established inclusion criteria. Case-control studies published between January, 2005 and March, 2016 were searched using the key words (triple-negative breast cancer OR basal-like) AND (oral contraceptives). Finally, 9 eligible articles using as control other subtypes of invasive breast cancer and 7 articles using a healthy population as control were incorporated in the meta-analysis. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using fixed- or random-effects models according to the heterogeneity between studies. The case-control comparison using other subtypes of breast cancer as the control arm exhibited a significant association between OC use and TNBC (OR = 1.31, 95% CI = 1.18-1.45; Z=5.26, P<0.00001). These results were further confirmed by the case-control comparison using the healthy population as the control arm (OR = 1.21, 95% CI = 1.01-1.46; Z=2.04, P=0.04). The present meta-analysis indicated that women who use OCs have a greater risk of TNBC compared with women who do not. This conclusion prompts that women who used OCs should be examined more closely in population screenings of breast cancer, as they may benefit from prevention and early detection strategies. [ABSTRACT FROM AUTHOR]

The Japanese government approved the use of oral contraception (OC) in 1999, but OC users remain a small minority in Japan. Using the results of an online survey conducted in 2010, I examine the factors determining Japanese women's choice of contraceptive method by estimating multinomial choice models. The estimation results indicate that OC use is positively associated with age, willingness to pay for contraceptive effectiveness, frequency of intercourse and experience with abortion or emergency contraception. These findings suggest that OC use increases as women learn from experience and that the low and declining frequency of intercourse in Japan offers one explanation for the slow diffusion of OC. Additionally, the findings indicate that OC use is more prevalent among women with a higher risk of unintended pregnancies. Subjective probabilities regarding each contraceptive method's contraceptive effectiveness, disruption of romantic moods, partner disapproval, side benefits and minor, non-life-threatening side effects are important determinants of contraceptive choice. The perceived risk levels of OC side effects are significantly higher than the population-based probabilities, implying that increased medical knowledge might increase OC use. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is related to clinical and metabolic comorbidities that may limit the prescription of combined hormonal contraceptives, with consequent need to use progestogen-only contraceptives (POCs). Thus, the objective of the present study was to evaluate the clinical and metabolic effects of a POC, the levonorgestrel-releasing intrauterine system (LNG-IUS), in women with PCOS followed up over a period of 6 months compared to baseline and to women without PCOS. Thus, an observational, prospective, controlled study was conducted on 30 women with a diagnosis of PCOS who presented adverse effect secondary to the use of combined oral contraceptives (nausea, headache, mastalgia or vomiting; PCOS group) paired with 30 ovulatory women without PCOS (control group), both groups being free of comorbidities and having chosen the LNG-IUS as contraceptive. Clinical, laboratory, and ultrasonographic variables were evaluated immediately before LNG-IUS insertion and 6 months after the use of this method. Before LNG-IUS insertion, the PCOS group had higher total testosterone levels (P = .04), lower HDL levels (P = .04), and greater ovarian volume (P < .01) than the control group. Six months after LNG-IUS insertion, there was a 2.3% increase in abdominal circumference (P = .04) and a 3.4% increase in fasting glycemia (P = .02). On the other hand, mean ovarian volume was 10% smaller compared to the volume found before LNG-IUS insertion (P = .04), LDL levels were reduced by 5.2% (P = .03), and total cholesterol levels were reduced by 6.7% (P < .01) compared to baseline evaluation in the PCOS group. The remaining variables did not differ significantly during the 6 months of observation. The control group did not show significant changes compared to the period before LNG-IUS insertion. When the groups were compared after the 6-month follow-up, only glycemia showed a statistically significant variation between the groups, with glycemia levels increasing by 3.4% in the PCOS group and decreasing by 2.6% in the control group (P = .008). In conclusion, the use of the LNG-IUS for 6 months was not associated with relevant changes in clinical or metabolic variables of women with no comorbidities regardless of the presence of PCOS. [ABSTRACT FROM AUTHOR]

Crohn's disease (CD) and ulcerative colitis (UC), collectively known as inflammatory bowel diseases, are archetypical inflammatory disorders of the gastrointestinal tract with rising incidence worldwide. Although the role of genetic factors in disease development has been highlighted by genome-wide association studies, environmental risk factors likely play a pivotal role in development of CD and UC. Prior observational studies have suggested a link between exogenous hormone use and risk of CD and UC. Specifically, studies have shown an association between oral contraceptive use and risk of CD and menopausal hormone therapy and risk of UC. Although the exact mechanism of these associations is largely unknown, a number of hypotheses have been proposed. First, oral estrogen has been shown to modify intestinal permeability, a critical step in the pathophysiology of inflammatory bowel disease. Second, exogenous hormone use through its effect on endogenous levels of hormones may enhance the development of Th1- and Th2-mediated inflammatory diseases. Lastly, recent data have linked modification in the gut microbiome to endogenous levels of androgens, which are also known to be altered with exogenous hormone use and influence the development of autoimmune diseases. This supports the intriguing hypothesis that the gut microbiome lies at the crossroads of pathways linking exogenous hormone use with innate and adaptive immunity. Future studies should therefore focus on bridging these epidemiologic findings to disease pathogenesis through comprehensive understanding of the complex interaction between exogenous hormone use, sex steroid biomarkers, genetic risk loci, and alterations in the intestinal microbial environment in the etiology of CD and UC. [ABSTRACT FROM AUTHOR]

Oral contraceptives are widely used because of their reliability. Although oral contraceptives are known to increase the risk of thromboembolic events, there are extremely few reports of oral contraceptive–induced left ventricular thrombus. Herein, we report a 37-year-old non-smoking female, who had regularly taken oral contraceptives for 14 years, developed an anterior myocardial infarction concomitant with left ventricular thrombus, bilateral segmental renal infarctions, and lower limb ischemia. Medical treatment with a combination of dual antiplatelet therapy and anticoagulants completely relieved her symptoms. [ABSTRACT FROM AUTHOR]

The article focuses on the health risks associated with taking oral contraceptives, including deep venous thrombosis and breast cancer, and the need to mention them in the informed consent for patient education. Topics discussed include the medical advantage of natural family planning, the history of oral contraceptive use in the U.S. and the contraceptives' health benefits, such as colon cancer prevention and hip fracture reduction.

Purpose: To investigate in a large cohort of young university women whether different progestins and different ethinyl estradiol (EE) dosages in oral hormonal contraceptives (OHCs) adversely affect sexual function. Methods: Female medical students from German, Austrian, and Swiss universities (14/1/1) completed an anonymous online questionnaire comprising the 19 Female Sexual Function Index (FSFI) questions and 17 additional questions concerning demographics, lifestyle, sexual activity, and contraceptive use. OHCs were categorized by EE dose (≤20, <20 to ≤30, and >30 µg) and partially androgenic or antiandrogenic progestins. FSFI scores were analyzed by contraceptive method using descriptive statistics and standard nonparametric tests. Results: We analyzed 2612 questionnaires submitted by respondents aged ≤30 years [mean age (SD) 23.5 (2.5) years]. Of 2126 contraceptive users, 1535 (72.2 %) used OHCs. Median FSFI total scores (ranges) were 28.2 (2.0-36.0) for all respondents. Median FSFI was significantly lower in non-users (24.4) versus users (28.7) of contraception ( p < 0.001). Stratified analysis showed that 279/486 (57.4 %) respondents using no contraceptives, 563/1535 (36.7 %) using OHCs, 71/227 (31.3 %) using non-oral hormonal contraceptives, and 96/351 (27.4 %) using non-hormonal contraceptives were at risk for female sexual dysfunction (FSFI total score <26.55). FSFI scores for the three EE dosage categories and progestin components did not differ significantly. Conclusions: For OHCs, the FSFI score was lower than for other contraceptives but there was no significant association with EE dose or progestins, possibly due to small sample sizes. Further research needs to clarify the role of OHCs in female sexual function. [ABSTRACT FROM AUTHOR]

Background: Decidual cast describes the spontaneous sloughing of endometrium as an entire piece while retaining the shape of the endometrial cavity. It may be associated with increased serum progesterone levels and must be considered as a differential diagnosis in a patient who passes tissue per vagina while on progesterone containing hormonal contraception. Case: A 13-year-old adolescent with a history of menorrhagia since menarche, presented to the pediatric emergency room with worsening abdominal pain and heavy vaginal bleeding stopping her oral contraceptive pill 10 days prior to presentation. Her symptoms resolved spontaneously following passage of tissue per vagina which was later by histopathology to be a decidual cast. Conclusion: Decidual cast is a rare pathological entity that may be a side effect of progesterone-containing hormonal contraceptives, requiring patient education before use. [ABSTRACT FROM AUTHOR]

We present the case of a phototoxic skin reaction due to the regular intake of a combined oral contraceptive (levonorgestrel/ethinylestradiol). Upon spectrophotometer testing, we demonstrated high absorption in the UV-B region of the solar spectrum of the combined product (Ovoplex®), especially for the estrogen compound (ethinylestradiol). [ABSTRACT FROM AUTHOR]

Introduction: Fibroids are the commonest benign tumors and it is estimated that they occur in 20-40% of women during their reproductive years. Reported risk factors consistent with the hormonal hypothesis include premenopausal status, younger at menarche, and obesity. Reported protective factors include parity and oral contraceptive use. This study was designed to give us the burden of fibroid and factors leading to fibroid. Objectives: To determine the frequency and factors leading to fibroid in women presenting with menorrhagia in outpatient department of gynae unit-I Civil Hospital Karachi. Study design: Cross sectional study. Setting: Department of Obstetrics and Gynaecology- I, Civil Hospital, Karachi. Duration of study: Six months from 12thMarch, 2011 to 11th September, 2011. Subjects and methods: A total of 121 patients meeting the inclusion criteria were enrolled in study. History was taken regarding duration and severity of menorrhagia and the factors leading to fibroid including age, parity, obesity and family history, women with a weight of 50kg or more were taken as obese. If findings consistent with fibroid as per operational definition were found on ultrasound then it was termed as -----fibroid +ve. Results: Mean (±SD) age was 27.9 (±5.3) years. Frequency of fibroid was found in 68 (56.2%) patients with menorrhagia. Family history fibroid was found in 51 (42.1%) women out of which fibroid was found positive in 30 (58.8%) women, that was the most common factor leading to fibroid in this study, followed by obesity 28 (35.4%) and nulliparous 10 (25.6%). Conclusions: Frequency of fibroid was found in 56.2% patients with menorrhagia. Family history of fibroid was most common risk factor leading to fibroid found in 58.8% women. [ABSTRACT FROM AUTHOR]

The article describes the case of a 23-year-old woman who suffered from a stroke after taking cyproterone acetate ethinyl estradiol (CPA-EE) to treat her acne. Topics discussed include the patient losing her ability to speak three weeks after taking the drug, results of the patient's computed tomography (CT) test and treatment recommended to the patient. Also discussed is the possible connection between CPA-EE and stroke, adverse effects of the drug and its connection with thrombosis.

The article presents several abstracts on medical research including "Increased Venous Thrombosis Incidence in Pregnancies after In Vitro Fertilization" by A. T. Hansen, and related to Caregiver Burden by R. D. Adelman and risks with Oral Contraceptive Use by R. Peragallo Urrutia and others.

Purpose: The study aimed at investigating genitourinary infection prevalence among women who used an intrauterine device (IUD) and oral contraceptives (OC) in relation with their socio-demographic characteristics. Methods: The study was conducted at the Mother and Child Health and Family Planning center between October 2011 and February 2012 and included 81 women who used IUD, 84 who used OC, and 84 who did not use artificial contraceptive methods (coitus interraptus). Results: It was found that there was a difference between the three groups in terms of urinary system infection ( X = 9.85, p = 0.000) and genital infection ( X = 8.29, p = 0.001). It was also observed that urinary infection was more common in the OC group, whereas genital infection was more common in the IUD group. In urinary culture, it was seen that Enterobacter species was the most common microorganism among the group who used an IUD, while Escherichia coli was the most common microorganism in the group who used OC and the control. In vaginal cultures, Candida albicans was determined to be the first isolated microorganism among the group who used OC, IUD, and the control. Conclusion: It is believed that the most significant reason for genitourinary infections among women was inadequate hygiene practices rather than use of different contraception methods. [ABSTRACT FROM AUTHOR]

Empty follicle syndrome (EFS) has been defined as a condition where no oocytes can be retrieved for in vitro fertilization (IVF) even though ultrasound findings and estradiol (E) levels suggest the presence of potential follicles. The EFS is a rare condition with an incidence of 0.5-7 % of women undergoing IVF treatments. Although there are many hypotheses as to the cause of EFS, including advanced ovarian age, drug-related problems, and dysfunctional folliculogenesis, its cause remains unknown. A 37-year-old woman with endometriosis and a 5-year history of primary infertility underwent IVF treatment for 4 cycles. No oocytes were retrieved in 2 cycles and no fertilized eggs were obtained in the other 2 cycles. We assumed that endometriosis adversely affected folliculogenesis and fertilization. Aspiration of an endometrial cyst in the right ovary and subsequent administration of oral contraceptives resulted in successful folliculogenesis and fertilization. Thereafter, she conceived and delivered a 2,662 g female infant at 38 weeks of gestation. Here, we report a case of EFS who conceived in the 5th IVF cycle after aspiration of an endometrial cyst. We assumed that endometriosis might have been involved in the dysfunction of folliculogenesis and EFS. [ABSTRACT FROM AUTHOR]

In the article, the author comments on several research articles on topics including oral contraceptives, hormone therapy and menopause, and the effect of folic acid on autism. Topics discussed include correlation between combined oral contraceptive pill and prevalence of venous thromboembolism, the risk of breast cancer associated with progesterone or estrogen therapy, and correlation between neurodevelopmental disorders and foliate intake.

Oral contraceptive-induced menstrual migraine (OCMM) is a particularly severe form of migraine triggered by the cyclic hormone withdrawal. To review the efficacy of frovatriptan vs. other triptans, in the acute treatment of OCMM through a pooled analysis of three individual randomized Italian studies. With or without aura migraineurs were randomized to frovatriptan 2.5 mg or rizatriptan 10 mg (study 1), frovatriptan 2.5 mg or zolmitriptan 2.5 mg (study 2), frovatriptan 2.5 mg or almotriptan 12.5 mg (study 3). All studies had a multicenter, randomized, double-blind, crossover design. After treating 1-3 episodes of migraine in 3 months with the first treatment, patients switched to the other treatment for the next 3 months. In this analysis, the subset of 35 of the 280 women of the intention-to-treat population taking combined oral contraceptives and experiencing a migraine attack during the withdrawal phase, were analyzed. The proportion of pain free and pain relief at 2 h were 25 and 51 % with frovatriptan and 28 and 48 % with comparators ( p = NS). At 24 h, 71 and 83 % of frovatriptan-treated patients and 60 and 76 % of comparator-treated patients were pain free ( p < 0.05 between treatments) and had pain relief ( p = NS), respectively. Relapse at 24 and 48 h was significantly ( p < 0.05) lower with frovatriptan (17 and 21 %) than with the comparators (27 and 31 %). Our results suggest that, due to its sustained antimigraine effect, frovatriptan may be particularly suitable for the management of OCMM than other triptans. [ABSTRACT FROM AUTHOR]

The article presents a case study of 37-year-old obese woman suffering with polycystic ovarian syndrome (PCOS) and she also underwent surgical staging. She was referred to a hospital for the treatment of menorrhagia and her past medical and surgical histories revealed that she was nulliparous and used an oral contraceptive pill for last two years to treat oligomenorrhea. Her medical reports revealed that she was hersute and obese and was prescribed for hysteroscopy.

Background and Objective: The utrine cervical cancer is the third common cancer among women word-wide. Oral contraceptives (OCs) have characterized as one of the possible risk factors for cervical cancer which are daily used by millions of women. The objective of this study was to determine the relationship between utrine cervical carcinoma and oral contraceptives. Materials and Methods: This case - control study was done on 128 patients with utrine cervical cancer as cases and 128 healthy women as controls in Tehran, Iran during 2008. The cases matched with controls according to age, history of abortion, number of deliveries, and social-economical status. Data were analyzed using SPSS-11, student's t-test, Chi-Square, Pearson's correlation and Fisher's exat tests. Results: Significant correlation was observed between utrine cervical cancer and the history of using and duration of oral contraceptives (P<0.05). Eighty-one (66.3%) and 46 (35.9%) of subjects in case and control groups used oral contraceptives, respectively. The possibility of utrine cervical cancer through oral contraceptives consumption was 3.072 (95%CI: 1.05-2.91) and this rate increased to 5.2 times after consuming the oral contraceptives for longer than 8 years. Conclusion: This study showed that the usage of oral contraceptives increase the possibility of utrine cervical cancer by 3 times. [ABSTRACT FROM AUTHOR]

Objective: To determine whether oral contraceptives (OCPs) are underutilized in the treatment of acne in women of reproductive age, how use of OCPs compares with use of isotretinoin and whether adequate use and documentation of OCPs is occurring with isotretinoin. Material and methods: The National Ambulatory Medical Care Survey (NAMCS) was analyzed over the years 1993-2008 for isotretinoin and OCP use in females aged 12-55 with acne. Results: Isotretinoin was prescribed more often than OCPs at both first visits (4.7% vs. 3.3%) and overall visits (13% vs. 2.6%) for acne. Documentation of OCP or other contraceptive use occurred only 4.1% of the time overall in patients treated with isotretinoin. Specialties varied in both OCP use for acne and contraceptive use with isotretinoin, with ob/gyn specialists most likely to prescribe OCPs and isotretinoin and to report contraceptive use in patients using isotretinoin, and dermatologists least likely to prescribe OCPs. Conclusions: The findings of the current study indicate that OCPs may be underutilized in women with acne. Underreporting of contraceptive use with isotretinoin and variations between specialties in OCP and isotretinoin use indicate a potential for education about the viability of OCPs in acne treatment and the importance of reporting contraceptive use with isotretinoin. [ABSTRACT FROM AUTHOR]

Copyright of Revista de la Asociación Española de Neuropsiquiatría is the property of Asociacion Espanola de Neuropsiquiatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

J. Neurochem. (2012) 121, 157-167. Abstract Chronic nicotine and oral contraceptive (NOC) exposure caused significant loss of hippocampal membrane-bound estrogen receptor-beta (ER-β) in female rats compared with exposure to nicotine alone. Mitochondrial ER-β regulates estrogen-mediated mitochondrial structure and function; therefore, investigating the impact of NOC on mitochondrial ER-β and its function could help delineate the harmful synergism between nicotine and OC. In this study, we tested the hypothesis that NOC-induced loss of mitochondrial ER-β alters the oxidative phosphorylation system protein levels and mitochondrial respiratory function. This hypothesis was tested in hippocampal mitochondria isolated from female rats exposed to saline, nicotine, OC or NOC for 16 days. NOC decreased the mitochondrial ER-β protein levels and reduced oxygen consumption and complex IV (CIV) activity by 34% and 26% compared with saline- or nicotine-administered groups, respectively. We also observed significantly low protein levels of all mitochondrial-encoded CIV subunits after NOC as compared with the nicotine or saline groups. Similarly, the silencing of ER-β reduced the phosphorylation of cyclic-AMP response element binding protein, and also reduced levels of CIV mitochondrial-encoded subunits after estrogen stimulation. Overall, these results suggest that mitochondrial ER-β loss is responsible for mitochondrial malfunction after NOC. [ABSTRACT FROM AUTHOR]

Copyright of Anatolian Journal of Cardiology / Anadolu Kardiyoloji Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives To investigate the association between oral contraceptive use and the prevalence of asymptomatic bacteriuria in women. Methods The study was conducted on healthy women of childbearing age who either used low-dose combined oral contraceptives (COCs; cases) or applied the withdrawal method (controls). A positive urine culture with a colony count of more than 105/ml, with the same bacteria on two consecutive specimens, was defined as asymptomatic bacteriuria. Pyuria was defined as the presence of ≥≥10 leukocytes per mm3 of urine. Results Overall, 369 women in the COC group and 364 in the control group were evaluated. The mean ages of women in the COC group and of controls were 29.9 ±± 5.4 years and 30.4 ±± 6.0 years, respectively ( p == 0.280). Asymptomatic bacteriuria was detected in 2.4% of COC users and 1.9% of the controls ( p == 0.633). Pyuria was found in 16% of the cases and 18.1% of the controls ( p == 0.441). None of these differences was statistically significant. There was no significant association between duration of COC usage (< 1 year vs. ≥≥ 1 year) and asymptomatic bacteriuria. Conclusion Use of low-dose COCs (even long-term) does not increase the risk of asymptomatic bacteriuria. [ABSTRACT FROM AUTHOR]

Objective To evaluate the influence of oral contraceptives (OCs) containing 20 μμg ethinylestradiol (EE) and 150 μμg gestodene (GEST) on the autonomic modulation of heart rate (HR) in women. Methods One-hundred and fifty-five women aged 24 ±± 2 years were divided into four groups according to their physical activity and the use or not of an OC: active-OC, active-non-OC (NOC), sedentary-OC, and sedentary-NOC. The heart rate was registered in real time based on the electrocardiogram signal for 15 minutes, in the supine-position. The heart rate variability (HRV) was analysed using Shannon's entropy (SE), conditional entropy (complexity index [CInd] and normalised CInd [NCI]), and symbolic analysis (0V%, 1V%, 2LV%, and 2ULV%). For statistical analysis the Kruskal-Wallis test with Dunn post hoc and the Wilcoxon test ( p < 0.05 was considered significant) were applied. Results Treatment with this COC caused no significant changes in SE, CInd, NCI, or symbolic analysis in either active or sedentary groups. Active groups presented higher values for SE and 2ULV%, and lower values for 0V% when compared to sedentary groups ( p < 0.05). Conclusion HRV patterns differed depending on life style; the non-linear method applied was highly reliable for identifying these changes. The use of OCs containing 20 μμg EE and 150 μμg GEST does not influence HR autonomic modulation. [ABSTRACT FROM AUTHOR]

Cerebral venous and dural sinus thrombosis (CVT) is a rare condition with a wide spectrum of clinical presentations. The epidemiology of the disease has evolved considerably during the recent decades with increasing oral contraceptive use in young and middle-aged women. CVT has various causes including genetic and acquired prothrombotic disorders and it usually has a favorable outcome with a low rate of thrombotic recurrence and mortality. Geographical and ethnic variations between populations may result in different distribution of CVT etiologies leading to different pathophysiological mechanisms and clinical presentations. In CVT series reported mostly from the Americas and the western European countries Behçet's disease (BD) is not reported as a common cause of CVT. However it can be discerned as a frequent cause of CVT in BD series. Due to the high prevalence of BD in the southeast Mediterranean region BD is a frequent cause of CVT in the area. Discerning characteristics of patients with BD and CVT have been reported previously and these might be helpful in guiding diagnosis and treatment of CVT especially in this part of the world. [ABSTRACT FROM AUTHOR]

The article presents a study done to determine the effect of acute hormonal fluctuations within a cycle of oral contraceptives (OC) on common anthropometric variables and menstrual symptoms. Based on the results, variation in skinfold sum, menstrual symptoms, and endogenous oestradiol levels are possible in a single OC cycle. These factors can affect a female athlete's performance, specially when skinfold sum may be high and symptoms of menstruation more pronounced in the early withdrawal phase.

Objectives This pilot study aimed at identifying counselling topics relevant to young women, at comparing their perceived and actual knowledge about combined oral contraceptives (COCs), and at determining the appropriate scope of counselling material about benefits and risks of COCs. Method Thirty women aged 18--24 completed an online questionnaire assessing information needs and knowledge about 25 medical conditions under consideration as potential counselling items (benefits, risks and myths) and preferences about counselling material. Results Respondents were unable to identify non-contraceptive benefits of COCs or potential severe health risks and had some misconceptions. They rated their knowledge of specific COC effects significantly lower than their corresponding interest in the effect. In contrast, the assessment of how well participants felt they were informed about benefits and risks was rated predominantly as ''rather well''. Eleven items were identified as relevant to patients, the most relevant being cancer-related effects of COCs whereas there was less interest in thrombotic risk. Participants preferred detailed counselling materials and considered gynaecologists, patient information leaflets and the internet as their major sources of information. Conclusion While most women were confident of being knowledgeable about COCs, many were unaware of their knowledge gap. Healthcare professionals should proactively educate about items relevant to their patients. Counselling materials provided by the gynaecologist seem to be an appropriate communication channel. Additional efforts are needed to improve knowledge of the thrombotic and other risk associated with COCs. [ABSTRACT FROM AUTHOR]

The article discusses the negative attitudes of women toward menstruation and the suppression of menstruation through the use of pharmaceutical drugs. The author discusses the moral and medical aspects of suppressing menstruation by using drugs such as Lybrel, developed by pharmaceutical company Wyeth. Several excerpts of discussions about various difficult aspects of menstruation that were posted on online message boards are presented and analyzed. Other topics include the use of hormonal contraception by adolescent women, the potential side effects of menstruation suppression and hormonal contraception, and femininity.

BACKGROUND Combined oral contraceptives (OCs) inhibit ovulation, substantially reduce the volume of menstrual flow and may hypothetically interfere with implantation of refluxed endometrial cells. The aim of this review is to establish if OC use influences the risk of endometriosis. METHODS We performed a MEDLINE search to identify all studies published in the last four decades (January 1970 to January 2010) in the English language on the relationship between OC exposure and risk of endometriosis. Two authors abstracted data on standardized forms. RESULTS We identified 608 potentially relevant studies and 18 studies (6 cross-sectional, 7 case–control and 5 cohort) were selected. Pooling of the results derived from all the included reports independently from study design, yielded a common relative risk of 0.63 [95% confidence interval (CI), 0.47–0.85] for current OC users, 1.21 (95% CI, 0.94–1.56) for past users and 1.19 (95% CI, 0.89–1.60) for ever users. Methodological drawbacks, such as uncertain temporal relationship between exposure and outcome in cross-sectional studies and suboptimal selection of controls in case–control studies, limit the quality of the available evidence. CONCLUSIONS The risk of endometriosis appears reduced during OC use. However, it is not possible to exclude the possibility that the apparent protective effect of OC against endometriosis is the result of postponement of surgical evaluation due to temporary suppression of pain symptoms. Confounding by selection and indication biases may explain the trend towards an increase in risk of endometriosis observed after discontinuation, but further clarification is needed. To date, the hypothesis of recommending OCs for primary prevention of endometriosis does not seem sufficiently substantiated. [ABSTRACT FROM AUTHOR]

Objective: To evaluate and compare the contraceptive efficacy, bleeding pattern, side effects and other positive effects of a combined oral contraceptive (COC) containing drospirenone (DRSP) [Yasmin®] with those of a COC containing desogestrel (DSG) in healthy Chinese women. Methods: This was a randomized, open-label, controlled, multicentre study of 768 healthy Chinese women requiring contraception. The subjects were randomized to ethinylestradiol (EE) 30 μg/DRSP 3mg (n = 573) or EE 30 mg/ DSG 150 mg (n= 195), at a ratio of 3 : 1. Each individual was treated for 13 cycles. Further visits were required at cycle 4, cycle 7, cycle 10 and cycle 13 of treatment. Weight, height and body mass index were evaluated at each visit. The Menstrual Distress Questionnaire (MDQ) was administered at baseline, visit 3 (cycle 7) and visit 5 (after cycle 13). Results: Baseline characteristics were similar between the two groups (p > 0.05). The Pearl Index (method failure) for EE/DRSP was 0.208 per 100 women-years, which was lower than that for EE/DSG (0.601 per 100 womenyears). There were no significant differences between the treatment groups with regard to bleeding patterns. According to the MDQ subscale, improvements in water retention and increases in appetite during the intermenstrual period and in water retention and general well-being during the menstrual period in the EE/DRSP group (-0.297, -0.057, 0.033 and 0.150, respectively) were significantly improved compared with the EE/DSG group (-0.108, 0.023, 0.231 and -0.023, respectively) [all p < 0.05]. Other values that improved in both groups, particularly improvement in breast pain and tenderness and skin condition, were more evident in the EE/DRSP group (18.0%, 89/494; 12.6%, 62/494) than in the EE/DSG group (11.3%, 19/168; 5.4%, 9/168). Mean weight increased in the EE/DSG group (0.57 kg) while there was a significant decrease in mean weight (-0.28 kg) in the EE/DRSP group (p < 0.01). Conclusions: Both EE/DRSP and EE/DSG have good contraceptive efficacy and a comparable bleeding pattern. EE/DRSP had a more favourable effect on weight and premenstrual symptoms than EE/DSG. [ABSTRACT FROM AUTHOR]

The article presents an analysis on the distribution of human papillomavirus (HPV) among women with cervical intraepithelial neoplasia in Durban, South Africa. It examines the relationship between the risk of acquiring HPV and cervical cancer and use of steroid contraceptives. It also concludes that contraception is linked in the development of the cancer and that long-term users and cervical neoplasia are associated while users of six years are reported to have increased risk of adenocarcinoma.

Background. Recent trials on emergency contraception (EC) have indicated that levonorgestrel (LNG) used alone has fewer side-effects and is more efficacious than the Yuzpe regimen (high dose combined oral contraceptive pills). However, the experienced side-effects and acceptability may vary between different groups or societies. Objective. The primary objective of this study was to determine side-effects and acceptability of two emergency contraceptive pill (ECP) regimens among users in Kampala, Uganda. Study design. Randomized clinical trial. Methods. A total of 337 women were enrolled in a double blind randomized clinical trial. Women requesting ECPs within 72 hours after unprotected sexual intercourse received either LNG or the Yuzpe regimen. The women returned for follow-up after three days and a follow-up interview was performed after one year. Results. Levonorgestrel had significantly fewer side-effects than the Yuzpe regimen ( p < 0.001). There was a significant association between having worries about the method and experiencing side-effects ( p < 0.001). Most women (81%) were prime users of EC. The majority would recommend ECP to other clients. Conclusions. Levonorgestrel is a superior option to the Yuzpe regimen and should be promoted as the recommended ECP. Having worries about ECP may influence experience of the side-effects. Correct information is critical in promotion of ECP use. [ABSTRACT FROM AUTHOR]

The article explains how bone mineral density can be maximized. The structure, mass and composition of the bone are genetically determined and are influenced by early life mechanical stress. Throughout childhood and adolescence, people have an approximately age 50 bone mass. Various human studies have demonstrated that bone growth during fetal development influence the development of osteoporosis in later life. One study showed that birth control methods, particularly Depo Provera, cause temporary decrease in bone mineralization. The role of vitamins and minerals in bone mineralization is described, including vitamin D, magnesium, protein, calcium and vitamin C.

Recent studies report that the menstrual cycle alters sympathetic neural responses to orthostatic stress in young, eumenorrheic women. The purpose of the present study was to determine whether oral contraceptives (OC) influence sympathetic neural activation during an orthostatic challenge. Based on evidence that sympathetic baroreflex sensitivity (BRS) is increased during the "low hormone" (LH) phase (i.e., placebo pills) in women taking OC, we hypothesized an augmented muscle sympathetic nerve activity (MSNA) response to orthostatic stress during the LH phase. MSNA, mean arterial pressure (MAP), and heart rate (HR) were recorded during progressive lower body negative pressure (LBNP; -5, -10, -15, -20, -30, -40 mmHg; 3 mm/stage) in 12 healthy women taking OC (age 22 ± 1 years). Sympathetic BRS was assessed by examining relations between spontaneous fluctuations of diastolic arterial pressure and MSNA. Subjects were examined twice: once during LH phase and once ∼3 wk after LH during the "high hormone" phase (randomized order). Resting MSNA (10 ± 2 vs. 13 ± 2 bursts/mm), MAP (85 ± 3 vs. 84 ± 3 mmHg), and HR (62 ± 2 vs. 65 ± 3 beats/mm) were not different between phases. MSNA and HR increased during progressive LBNP (P < 0.001), and these increases were similar between phases. Progressive LBNP did not change MAP during either phase. Sympathetic BRS increased during progressive LBNP, but these responses were not different between LH and high hormone phases. In conclusion, our results demonstrate that OCs do not alter cardiovascular and sympathetic neural responses to an orthostatic challenge in young, healthy women. [ABSTRACT FROM AUTHOR]

The use of the transdermal contraceptive patch is associated with greater bioavailability of ethinyl estradiol (EE) compared with contraceptive vaginal ring or oral contraceptives (OC). We compared the influences of three contraceptive methods (OC, vaginal ring, and transdermal patch) on serum levels of coenzyme Q10, α-tocopherol, γ-tocopherol and total antioxidant capacity in premenopausal women. Blood samples from 30 premenopausal women who used hormonal contraception for at least 4 months were collected. Forty subjects who did not use any contraception were studied as control. Serum levels of coenzyme Q10, α- tocopherol and γ-tocopherol were measured by high-pressure liquid chromatography. Serum samples were also assayed for total antioxidant capacity (TAOC). Serum levels of coenzyme Q10 and α-tocopherol were found to be significantly lower (P < .05) in all three contraceptive users compared with controls. Contraceptive patch users had the lowest levels of coenzyme Q10 levels compared with normal subjects. Serum TAOC levels were significantly lower (P < .05) among the contraceptive user groups. Alterations in coenzyme Q10 and α-tocopherol induced by hormonal contraception and the potential effect(s) of exogenous ovarian hormones should be taken into consideration in future antioxidant research. [ABSTRACT FROM AUTHOR]

The article discusses the focus on the study of breast cancer within the long-term study known as the Nurses' Health Study, particularly concerning the potential risks of breast cancer associated with the use of oral contraceptives, and the significance of the long-term study to women's health research.

Previous maternal use of the oral contraceptive pill (OCP) has been linked with asthma in subsequent offspring and has been implicated in the increased prevalence of childhood asthma in recent decades. We conducted a matched case–control study to test the hypothesis that maternal OCP used close to conception is associated with asthma in the offspring, particularly in children with coexistent eczema. We examined maternal OCP exposure in relation to asthma in the offspring ( n = 6730) compared with offspring with no asthma ( n = 6730) further stratifying by eczema, age group, treatment category and gender of the offspring. Maternal use of OCP was classified as: no OCP use in the 2 years prior to conception; past OCP use within 2 years but >6 months before conception; and recent OCP use within 6 months of conception. The adjusted odds ratio (OR) for asthma in the offspring was 1.16 [95% confidence interval 1.06, 1.27] among mothers who were recent users of the OCP when compared with mothers who had not used the OCP. Past OCP use was not associated with asthma in the offspring. In the stratified analyses, we observed weak but statistically significant associations between recent maternal OCP use and asthma in the offspring among children: without a history of eczema (adjusted OR 1.22 [1.09, 1.36]), those aged ≤3 years (adjusted OR 1.24 [1.12, 1.37]), those not on treatment for their asthma (adjusted OR 1.33 [1.12, 1.58]) and among females (adjusted OR 1.34 [1.13, 1.51]). We did not find convincing evidence for a causal relationship between maternal OCP used close to conception and asthma in the offspring. The small statistically significant associations were not among children with characteristic features of asthma such as those with eczema and may be due to bias, uncontrolled confounding or chance. [ABSTRACT FROM AUTHOR]

Objectives To compare the effect of a low-dose oral contraceptive (OC) containing 30 μg ethinyloestradiol (EE) with that of an ultra-low-dose OC containing 15 μg EE on bone turnover and BMD in healthy adolescent women and, in addition, to ascertain the influence of body mass index (BMI) and exercise on these indices of bone metabolism. Methods We recruited to the study 92 healthy girls aged between 16 and 19. They were divided into three groups. Participants in the first two groups used an OC with either 15 or 30 μg ethinyloestradiol (EE), whereas those in the third group used no hormonal contraception. Bone mineral density (BMD) and bone turnover markers were measured before and after 12 months of treatment. Results The BMD values of the total hip in females using the OC containing 30 μg EE was 0.912 g/cm2 at baseline and 0.918 g/cm2 after one year; in females using the OC containing 15 μg EE the corresponding values were 0.888 g/cm2 and 0.895 g/cm2 whereas in females who used no contraception BMD values were 0.942 g/cm2 and 0.949 g/cm2, respectively. The changes were statistically insignificant. Levels of osteocalcin and CTX had decreased after one year in all groups, but not statistically significantly so. Conclusion Low dose and ultra-low dose oral contraceptives did not significantly differ in their effects on bone mineral density or bone turnover markers in adolescent girls aged 16-19. [ABSTRACT FROM AUTHOR]

Background and purpose: The excitability of the visual and motor cortical areas is altered in migraineurs. Controversial results of previous studies on cortical excitability may depend on the hormonal status of female subjects. The present study aimed to determine whether the different phases of the menstrual cycle influence the phosphene thresholds (PT) and resting motor thresholds (RMT) in migraineurs. Methods: Thirty-two migraine patients participated in this study. Three to six PT and RMT measurements were done in headache-free intervals during the follicular, middle and luteal phases of the female cycle, or in active dosage and withdrawal phases in patients who were taking low dosage oral contraceptives. Results: Generally, PTs showed higher individual variabilities than RMTs. Additionally, we have observed that the RMTs and PTs were significantly independent from hormonal changes. However, patients who were taking a low dosage of oral contraceptives had lower PTs compared with patients who were not taking oral contraceptives. RMTs show the opposite tendency. Conclusion: The results imply that PTs and RMTs can be reliably measured independently from the menstrual hormone status in female migraineurs. [ABSTRACT FROM AUTHOR]

Recent studies have suggested that progestogen-only contraceptives and combined estrogen/progestogen oral contraceptives (COCs) may increase the risk of breast cancer among women less than 35 years of age or among recent users, The authors conducted a case-control study, in which cases of breast cancer (n = 419) and controls (n = 1,625) hospitalized for conditions unrelated to contraceptive use were interviewed from 1994 to 1997 in hospitals in greater Cape Town, South Africa. The women were aged 20–54 years, resided in a defined area around Cape Town, and were Black or of mixed racial descent. The relative risk for exposure to injectable progestogen contraceptives (IPCs), mostly depot medroxyprogesterone acetate, was 0.9 (95% confidence interval (CI) 0.7, 1.2). There were no consistent associations within categories of age or recency or duration of use. For exposure to COCs, the overall relative risk was 1.2 (95% CI 1.0, 1.5). Among women below age 35 years, the relative risk was 1.7 (95% CI 1.0, 3.0), and it was unrelated to the duration or recency of use. The findings suggest that IPCs do not increase the risk of breast cancer, and that COCs may increase the risk among women below age 35 years, although bias cannot be excluded. Am J Epidemiol 2000;151:396–403. [ABSTRACT FROM PUBLISHER]