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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]

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Hepatic complications of oral contraceptive pills and exogenous estrogens include intrahepatic canalicular cholestasis, neoplasm formation and vascular pathologies. While it remains controversial as to whether estrogen plays a role in focal nodular hyperplasia, hemangioma or hamartoma, exposure to oral contraceptive pills and estrogen has a strong association with hepatic adenomas. Four different subgroups of adenomas have been described: Inflammatory, HNF-1α-mutated, β-catenin-mutated and unclassified. Vascular complications may include Budd-Chiari syndrome, vascular thrombosis, dilated sinusoids and peliosis. [ABSTRACT FROM AUTHOR]

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]

Objective: This study aims to determine whether emergency contraceptive pills (ECPs) are less safe and effective for women with obesity compared with those without obesity.Study Design: We searched PubMed for articles through November 2015 regarding the safety and effectiveness of ECPs [ulipristal acetate (UPA), levonorgestrel (LNG) and combined estrogen and progestin] among obese users. We assessed study quality using the United States Preventive Services Task Force evidence grading system.Results: We identified four pooled secondary analyses (quality: poor to fair), two of which examined UPA and three examined LNG formulations. Three analyses pooled overlapping data from a total of three primary studies and demonstrated significant associations between obesity and risk of pregnancy after ECP use. One analysis reported a 4-fold increased risk of pregnancy among women with obesity (BMI≥30kg/m2) compared with women within normal/underweight categories (BMI<25kg/m2) after use of LNG ECPs [odds ratio (OR) 4.4; 95% confidence interval (CI) 2.0-9.4]. Further analysis of the same LNG data found that, at an approximate weight of 80 kg, the rate of pregnancy rose above 6%, which is the estimated pregnancy probability without contraception; at weights less than 75 kg, the rate of pregnancy was less than 2%. Two analyses examining UPA suggested an approximate 2-fold increased risk of pregnancy among women with obesity compared with either normal/underweight women or nonobese (BMI<30kg/m2) women (OR 2.6; 95% CI 0.9-7.0 and OR 2.1; 95% CI 1.0-4.3, respectively), but CIs were wide. Finally, the fourth secondary analysis pooled data from three separate randomized controlled trials on LNG ECPs and found no increase in pregnancy risk with increasing weight or BMI and found no consistent association between pregnancy and both factors when adjusted for other covariates.Conclusion: While data are limited and poor to fair quality, findings suggest that women with obesity experience an increased risk of pregnancy after use of LNG ECP compared with those normal/underweight. Women with obesity may also experience an increased risk of pregnancy compared with women without obesity after use of UPA ECP, though differences did not reach statistical significance. Providers should counsel all women at risk for unintended pregnancy, including those with obesity, about the effectiveness of the full range of emergency contraception options in order for them to understand their options, to receive advanced supplies of emergency contraception as needed and to understand how to access an emergency copper intrauterine device if desired. [ABSTRACT FROM AUTHOR]

Objectives: The International Active Surveillance study "Safety of Contraceptives: Role of Estrogens" (INAS-SCORE) investigated the cardiovascular risks associated with the use of a combined oral contraceptive (COC) containing dienogest and estradiol valerate (DNG/EV) compared to established COCs in a routine clinical setting.Study Design: Transatlantic, prospective, noninterventional cohort study conducted in the United States and seven European countries with two main exposure groups and one exposure subgroup: new users of DNG/EV and other COC (oCOC), particularly levonorgestrel-containing COCs (LNG). All self-reported clinical outcomes of interest (OoI) were validated via attending physicians and relevant source documents. Main OoI were serious cardiovascular events (SCE), particularly venous thromboembolic (VTEs) events. Comprehensive follow-up procedures were implemented. Statistical analyses were based on Cox regression models.Results: A total of 50,203 new COC users were followed up for up to 5.5years (mean value, 2.1years). Overall 20.3% and 79.7% of these women used DNG/EV and oCOC (including 11.5% LNG users), respectively. A low loss to follow-up of 3.1% was achieved. Based on 47 (VTE) and 233 (SCE) events, the primary analysis (European data set) yielded adjusted hazard ratios for DNG/EV vs. oCOC of 0.4 and 0.5, respectively. The upper bounds of the 95% confidence intervals were 0.98 (VTE) and 0.96 (SCE). The corresponding hazard ratios for DNG/EV vs. LNG showed similar point estimates but the confidence intervals included unity.Conclusion: DNG/EV is associated with similar or even lower cardiovascular risk compared to oCOC and LNG.Implication Statement: A COC containing DNG and EV is associated with similar or even lower cardiovascular risk compared to COCs containing levonorgestrel or other progestogens. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the influence of oral contraceptives on the incidence rate of alveolar osteitis (AO) following the surgical extraction of both impacted mandibular third molars. This retrospective study reviewed the clinical records of patients who presented to the oral surgery clinic of a university school of dentistry for the extraction of impacted mandibular third molars. Using a database search, all patients were categorized by sex, age, occurrence of AO, and whether the females were taking oral contraceptives at the time of surgery. The patient was considered positive for AO if either one or both sockets developed AO. The incidence of AO among women taking oral contraceptives at the time of impacted mandibular third molar extraction differed significantly from that in the other patient groups. AO occurred in 37.9% (11/29) of females taking oral contraceptives, while only 8.9% (16/179) of females who were not taking oral contraceptives at the time of extraction developed AO. The total incidence of AO among females was 13.0% (27/208). The total incidence of AO among the 363 males and females presenting for mandibular third molar extractions was 13.8%. Females who are taking oral contraceptives at the time of impacted mandibular third molar extraction are at a higher risk of developing AO following extraction. [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]

Objective To evaluate the risk of first-ever ischemic stroke associated with current use of oral contraceptive pills (OCPs), and to describe how the risk was influenced by estrogen dose, progestin type, and study characteristics. Methods We obtained relevant articles published between 1970 and March 2014 by conducting a search of Pubmed, Embase and the Cochrane Library. Two investigators independently identified eligible studies based on selection criteria in a two-step method. The quality of studies was assessed with the Newcastle-Ottawa scale. Pooled odds ratios were calculated with a random-effects meta-analysis model. Results A total of 18 independent studies (3 cohort studies and 15 case-control studies) were identified. The overall summary odds ratio for first-ever ischemic stroke risk associated with current OCP use compared with noncurrent OCP use was 2.47 [95% confidence interval (CI), 2.04-2.99]. The risk of ischemic stroke among current OCP users decreased significantly with decreasing estrogen dose: OCPs of ≥ 50 μg ethinyl estradiol (EE), 30-40 ug EE, 20 ug EE and progestin only pills implied odds ratios of 3.28 (95%CI, 2.49-4.32), 1.75 (95%CI, 1.61-1.89), 1.56 (95%CI, 1.36-1.79), and 0.99 (95%CI, 0.71-1.37), respectively. All four generations of progestin were associated with an elevated risk of ischemic stroke, and the risk of ischemic stroke among users of the fourth-generation progestins seemed to be slightly lower than those of other generations of progestins. Conclusions Data from observational studies suggest that current use of modern OCPs is associated with an increased risk of first-ever ischemic stroke. OCPs containing lower estrogen doses incline to contribute to a smaller elevated risk of ischemic stroke. [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]

Previous studies of oral contraceptives and breast cancer indicate that recent use slightly increases risk, but most studies relied on self-reported use and did not examine contemporary oral contraceptive formulations. This nested case-control study was among female enrollees in a large U.S. integrated health care delivery system. Cases were 1,102 women ages 20 to 49 years diagnosed with invasive breast cancer from 1990 to 2009. Controls were randomly sampled from enrollment records (n ¼ 21,952) and matched to cases on age, year, enrollment length, and medical chart availability. Detailed oral contraceptive use information was ascertained from electronic pharmacy records and analyzed using conditional logistic regression, ORs, and 95% confidence intervals (CI). Recent oral contraceptive use (within the prior year) was associated with an increased breast cancer risk (OR, 1.5; 95% CI, 1.3-1.9) relative to never or former OC use. The association was stronger for estrogen receptor-positive (ER+; OR, 1.7; 95% CI, 1.3-2.1) than estrogen receptor-negative (ER-) disease (OR, 1.2, 95% CI, 0.8-1.8), although not statistically significantly different (P ¼ 0.15). Recent use of oral contraceptives involving high-dose estrogen (OR, 2.7; 95% CI, 1.1-6.2), ethynodiol diacetate (OR, 2.6; 95% CI, 1.4-4.7), or triphasic dosing with an average of 0.75 mg of norethindrone (OR, 3.1; 95% CI, 1.9-5.1; Pheterogeneity compared with using other oral contraceptives ¼ 0.004) was associated with particularly elevated risks, whereas other types, including low-dose estrogen oral contraceptives, were not (OR, 1.0; 95% CI, 0.6-1.7). Our results suggest that recent use of contemporary oral contraceptives is associated with an increased breast cancer risk, which may vary by formulation. If confirmed, consideration of the breast cancer risk associated with different oral contraceptive types could impact discussions weighing recognized health benefits and potential risks. [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]

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.

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]

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]

Abstract: Background: Studies have suggested that estrogen is protective against Parkinson''s disease; however, the results have been inconsistent. Methods: Our cohort comprised 27,466 women from the prospective Diet, Cancer and Health study. At inclusion, all the cohort members filled in questionnaires on diet and lifestyle, including reproductive factors, use of hormone products, and smoking habits. The cohort was followed up for Parkinson''s disease in the Danish Hospital Register, and risks associated with indicators of exposure to estrogen were estimated in a Cox proportional hazards model. Results: No significant association was found between reproductive factors and risk for Parkinson''s disease. Use of oral contraceptives was associated with a nonsignificantly increased risk (hazard ratio, 1.30; 95% confidence interval, 0.81–2.09), as was use of hormone replacement therapy (1.41; 0.90–2.21). Conclusions: Our data do not support the hypothesis of a protective effect of estrogen on the risk for Parkinson''s disease in women. [Copyright &y& Elsevier]

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.

Abstract: Background: Combined hormonal contraceptives (CHCs) place women at increased risk of venous thromboembolic events (VTEs) and arterial thrombotic events (ATEs), including acute myocardial infarction and ischemic stroke. There is concern that three recent CHC preparations [drospirenone-containing pills (DRSPs), the norelgestromin-containing transdermal patch (NGMN) and the etonogestrel vaginal ring (ETON)] may place women at even higher risk of thrombosis than other older low-dose CHCs with a known safety profile. Study Design: All VTEs and all hospitalized ATEs were identified in women, ages 10–55 years, from two integrated health care programs and two state Medicaid programs during the time period covering their new use of DRSP, NGMN, ETON or one of four low-dose estrogen comparator CHCs. The relative risk of thrombotic and thromboembolic outcomes associated with the newer CHCs in relation to the comparators was assessed with Cox proportional hazards regression models adjusting for age, site and year of entry into the study. Results: The hazards ratio for DRSP in relation to low-dose estrogen comparators among new users was 1.77 (95% confidence interval 1.33–2.35) for VTE and 2.01 (1.06–3.81) for ATE. The increased risk of DRSP was limited to the 10–34-year age group for VTE and the 35–55-year group for ATE. Use of the NGMN patch and ETON vaginal ring was not associated with increased risk of either thromboembolic or thrombotic outcomes. Conclusions: In new users, DRSP was associated with higher risk of thrombotic events (VTE and ATE) relative to low-dose estrogen comparator CHCs, while the use of the NGMN patch and ETON vaginal ring was not. [Copyright &y& Elsevier]

Abstract: Background: We examined the influence of depressed mood and psychological stress on oral contraceptive (OC) side effects and discontinuation. Study Design: We administered standard psychological instruments to 354 young women (13–24 years old) beginning a 6-month OC continuation intervention trial and questions on OC side effects and use at 6 months. Logisitic regression determined the relationships between psychological conditions, perceived OC side effects and continuation rates. Results: Baseline depressed mood (21%) and stress (19%) and 6-month mood (25%) and weight changes (57%) were relatively common. Only 38% continued OCs at 6 months. Depressed mood [odds ratio (OR) 2.27, confidence interval (CI) 1.25–4.15, p=.007] and stress (OR 2.07, CI 1.12–3.82, p=.02) were associated with perceived OC-related moodiness; depressed mood was associated with perceived weight loss (OR 1.89, CI 1.01–3.55, p=.05). Depressed mood (OR 0.54, CI 0.29–0.99, p=.04), stress (OR 0.48, CI 0.25–0.91, p=.03) and perceived weight change (OR 0.60, CI 0.38–0.94, p=.03) all reduced the likelihood of OC continuation. Conclusion: Young women with adverse psychological symptoms are at risk for perceived OC side effects and discontinuation. [Copyright &y& Elsevier]

Synthetic progestins and estrogens have been reported to be toxic in various experimental models. Their prolonged use has been reported to induce cancer in humans. In the present study the effects of oral contraceptives were studied among users using chromosomal aberrations, sister chromatid exchanges and DNA damage as a parameter, in cultured human peripheral blood lymphocytes. The study was performed on 25 women (users) and 25 age match controls. No significant difference was observed in chromosomal aberrations and DNA damage. A significant increase was observed in sister chromatid exchanges (SCEs) Cell among users. The results obtained and the risk of oral contraceptives (OCs) genotoxicity have been discussed [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction. Hormonal contraceptives can influence female sexual function. Aim. The goal of this article was to provide a comprehensive review of the effects that various hormonal contraceptives may have on female sexual function. Methods. A Medline search was conducted using several terms related to and including the terms contraception, oral contraceptive, female sexual function, dyspareunia, libido, and sexual desire. Results. A thorough review of the effects of hormonal contraceptives on female sexual function. Conclusions. The sexual side effects of hormonal contraceptives are not well studied, particularly with regard to impact on libido. There appears to be mixed effects on libido, with a small percentage of women experiencing an increase or a decrease, and the majority being unaffected. Healthcare providers must be aware that hormonal contraceptive can have negative effects on female sexuality so they can counsel and care for their patients appropriately. Burrows LJ, Basha M, and Goldstein AT. The effects of hormonal contraceptives on female sexuality: A review. J Sex Med 2012;9:2213-2223. [ABSTRACT FROM AUTHOR]

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]

Introduction. The role of oral contraceptives (OC) in psychiatry illness has been object of little attention. In particular, there is scarce scientific literature regarding its influence in the pathogenesis and treatment of eating psychopathology. Clinical Case. We describe the case of a 16 years-old woman, who developed an anorexia nervosa after the administration of an OC for the treatment of a mild hyperandrogenic hirsutism. After the implementation of cognitive-behavioral and psychopharmacological (SSRI) interventions, weight restoration was attained, disappearing anorectic cognitions and dysfunctional eating behaviors. Conclusions. The study of OC in eating psycho- pathology is in an early stage, being androgenic regulation postulated as main factor mediating this association. In patients with anorexia nervosa, is mandatory carrying out longitudinal research, given preliminary evidence suggesting the involvement of OC as a risk factor, either through decreased levels of testosterone or greater fear of gaining weight among those users with weight gain after its administration. [ABSTRACT FROM AUTHOR]

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]

Summary: Background: Endometriosis is a risk factor for epithelial ovarian cancer; however, whether this risk extends to all invasive histological subtypes or borderline tumours is not clear. We undertook an international collaborative study to assess the association between endometriosis and histological subtypes of ovarian cancer. Methods: Data from 13 ovarian cancer case–control studies, which were part of the Ovarian Cancer Association Consortium, were pooled and logistic regression analyses were undertaken to assess the association between self-reported endometriosis and risk of ovarian cancer. Analyses of invasive cases were done with respect to histological subtypes, grade, and stage, and analyses of borderline tumours by histological subtype. Age, ethnic origin, study site, parity, and duration of oral contraceptive use were included in all analytical models. Findings: 13 226 controls and 7911 women with invasive ovarian cancer were included in this analysis. 818 and 738, respectively, reported a history of endometriosis. 1907 women with borderline ovarian cancer were also included in the analysis, and 168 of these reported a history of endometriosis. Self-reported endometriosis was associated with a significantly increased risk of clear-cell (136 [20·2%] of 674 cases vs 818 [6·2%] of 13 226 controls, odds ratio 3·05, 95% CI 2·43–3·84, p<0·0001), low-grade serous (31 [9·2%] of 336 cases, 2·11, 1·39–3·20, p<0·0001), and endometrioid invasive ovarian cancers (169 [13·9%] of 1220 cases, 2·04, 1·67–2·48, p<0·0001). No association was noted between endometriosis and risk of mucinous (31 [6·0%] of 516 cases, 1·02, 0·69–1·50, p=0·93) or high-grade serous invasive ovarian cancer (261 [7·1%] of 3659 cases, 1·13, 0·97–1·32, p=0·13), or borderline tumours of either subtype (serous 103 [9·0%] of 1140 cases, 1·20, 0·95–1·52, p=0·12, and mucinous 65 [8·5%] of 767 cases, 1·12, 0·84–1·48, p=0·45). Interpretation: Clinicians should be aware of the increased risk of specific subtypes of ovarian cancer in women with endometriosis. Future efforts should focus on understanding the mechanisms that might lead to malignant transformation of endometriosis so as to help identify subsets of women at increased risk of ovarian cancer. Funding: Ovarian Cancer Research Fund, National Institutes of Health, California Cancer Research Program, California Department of Health Services, Lon V Smith Foundation, European Community''s Seventh Framework Programme, German Federal Ministry of Education and Research of Germany, Programme of Clinical Biomedical Research, German Cancer Research Centre, Eve Appeal, Oak Foundation, UK National Institute of Health Research, National Health and Medical Research Council of Australia, US Army Medical Research and Materiel Command, Cancer Council Tasmania, Cancer Foundation of Western Australia, Mermaid 1, Danish Cancer Society, and Roswell Park Alliance Foundation. [Copyright &y& Elsevier]

The article presents a study which examines the effect of progestin-only contraceptive pills compared with combined hormonal pills on lactation continuation rates in postpartum women. It shows that lactation continuation rates at eight weeks with progestin-only and combined pills were 63.5% and 64.1%, respectively, and suggests that inadequate milk supply is associated with low breastfeeding rates. It notes that choice of progestin-only and combined pills did not affect lactation continuation.

Objective: Increased levels of homocysteine and C-reactive protein (CRP) are considered as independent risk factors for atherosclerosis. As the level of these factors is affected by sex hormones, a population-based assessment of their changes following oral contraceptive therapy is needed to avoid the side effects that might arise of these variations. To this aim, the present study was to investigate the effect of combined oral contraceptive (OCP) on CRP and homocysteine levels among young healthy women. Methods: We conducted an observational cross-sectional analysis of 90 healthy, non-obese women (mean age 25 years and body-mass index 22 kg/m²). Forty-five healthy women on OCP and 45 healthy controls were studied for CRP and homocysteine levels by enzyme-linked immunosorbent assay (ELISA). Unpaired t test and Chi-square test were used for comparison of variables between oral contraceptive users and non-oral contraceptive users. Results: The results showed that the homocysteine (13.268±3.475 vs. 7.288±2.621 µmol/L) and CRP (5863.0±1349.5 vs. 1138.3±691.12 ng/ml) levels were significantly higher in women receiving OCP in comparison with the control group (p=0.027 and p<0.001, respectively). Conclusion: The alteration in homocysteine and CRP levels could be attributed to the OCP suggesting that use of these pills should be reviewed in women with increased risk of atherosclerosis and other cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

Abstract: Background: The study was conducted to determine whether geographic location, primary specialty, attitudes and knowledge influence the prescribing habits of physicians regarding extended-use oral contraceptives (OC) and medically induced amenorrhea. Study Design: Practice characteristics, contraceptive prescription habits, menstrual cycle physiology knowledge and attitudes about medically induced amenorrhea of Oregon obstetrics and gynecology (OBGYN) and family medicine physicians were assessed using either a cross-sectional postal or electronic mail survey. Attitudes were assessed using a series of Likert-style questions; multiple-choice responses were used to evaluate knowledge and prescribing habits. Results: Of the 713 physicians in the sample (email 575, paper 138), 233 returned the survey, for an overall response rate of 32.7%. Over 90% (211/233) of respondents prescribed OCs; of these, 73.9% (155/211) stated that they prescribed extended-use OCs either often (23.5%) or sometimes (50.5%). Without adjusting for other factors, physicians reporting an OBGYN specialty (odds ratio [OR] 8.02, 95% confidence interval [CI]: 3.40–18.91) or an urban practice location (OR 2.75, 95% CI: 1.42–5.30) were more likely to report prescribing extended-use OCs. However, after adjusting for other factors, attitude was the only factor which remained significantly associated with prescribing (OR 1.85, 95% CI 1.41–2.42). Conclusion: Physicians'' attitudes regarding medically induced amenorrhea influence the use of extended-cycle OC more than any other characteristic. [Copyright &y& Elsevier]

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]

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]

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.