A rat model of oral hormonal contraception: Effects on drug preference and gonadal function.

Contraceptive Conundrum: Use of Hormonal Contraceptives Is Associated With an Increased Risk of Suicide Attempt and Suicide.

HIV and Reproduction: Fertility, Contraception, and Preconception Issues and Interventions

Contraception

Hormonal contraceptives during adolescence impact the female brain and behavior in a rat model.

Canadian Contraception Consensus (Part 2 of 4).

Canadian Contraception Consensus (Part 1 of 4).

ObjectiveResearchers traditionally rely on participant self-report for contraceptive use. We hypothesized that self-reported contraceptive use by clinical research participants may disagree with objectively measured hormonal status. Study designWe enrolled women in Harare, Zimbabwe, aged 18–34, who by self-report had not used hormonal or intrauterine contraception for >30 days, or depot medroxyprogesterone acetate for >10 months, into a study designed to assess biologic changes with contraceptive initiation and use. Blood samples obtained at enrollment and each follow-up visit (N=1630 from 447 participants) were evaluated by mass spectrometry for exogenous hormones. We individually interviewed a subset of participants (n=20) with discrepant self-reported and measured serum hormones to better understand nondisclosure of contraceptive use. ResultsDiscrepant with self-reported nonuse of hormonal contraception, synthetic progestogens were detectable in 120/447 (27%, 95% confidence interval 23%–31%) enrolled women. Measured exogenous hormones consistent with use of contraceptive pills (n=102), injectables (n=20) and implants (n=3) were detected at enrollment, with 7 women likely using >1 contraceptive. In-depth interviews revealed that participants understood the requirement to be hormone free at enrollment (100%). Most (85%) cited partner noncooperation with condoms/withdrawal and/or pregnancy concerns as major reasons for nondisclosed contraceptive use. All interviewed women (100%) cited access to health care as a primary motivation for study participation. Of participants who accurately reported nonuse of hormonal contraception at enrollment, 41/327 (12.5%) had objective evidence of nonstudy progestin use at follow-up that disagreed with self-reported nonuse. ConclusionsWomen joining contraceptive research studies may misrepresent their use of nonstudy contraceptive hormones at baseline and follow-up. Objective measures of hormone use are needed to ensure that study population exposures are accurately categorized. Implications statementAmong Zimbabwean women participating in a contraceptive research study, 27% had objective evidence of use of nonstudy contraceptives at enrollment that disagreed with self-report. Studies that rely on self-report to identify contraceptive hormone exposure could suffer from significant misclassification.

Anemia is a significant health concern for women in low- and middle-income countries. Hormonal contraceptives, which can reduce heavy menstrual bleeding and prevent pregnancy and its resulting blood loss, are an underexplored opportunity for anemia reduction. Using Demographic and Health Survey data from 46 countries across four global regions, we examined country prevalence of anemia (i.e., hemoglobin below 12 g/dl via HemoCue testing) among women aged 15-49 years who were not pregnant. For each country, we used multivariable logistic regression to compare odds of anemia between women using hormonal contraceptive (users) to women using non-hormonal contraception or not using any contraception (nonusers). We merged data across countries to examine this effect stratified by contraceptive method and length of use and conducted a quantitative bias analysis of the anemia test. Anemia prevalence ranged from 12% in Rwanda to 63% in Gabon. In the merged sample, the crude odds ratio comparing anemia in users of hormonal contraception to nonusers was 0.57 (95% confidence interval: 0.56-0.58); the adjusted odds ratio was 0.55 (0.39-0.79) when controlling for age, education, wealth, and rurality. In the stratified analysis of merged data, we found that users of all hormonal contraception had lower adjusted odds of anemia compared to nonusers (AOR: 0.51, 95% CI: 0.46-0.57), and that the protective effect was strongest among users of contraceptive injections (AOR:0.37, 95% CI 0.30-0.45). In our bias analysis, the crude odds of anemia for users ranged from 0.29 to 0.57 when varying anemia test sensitivity and specificity between 75% and 100%. Future research should directly examine the causal link between hormonal contraceptive use and anemia as a high impact non-contraceptive benefit of hormonal contraception, especially with understudied methods such as injectable contraception and contraceptive implants.

This study was designed to determine the effect of oral contraceptive treatment (estrogen and progestin), alone or in combination, on LDL composition and atherogenic potential in cynomolgus monkeys fed an atherogenic diet. Groups (n = 8 each) of monkeys were untreated (control) or treated with ethinyl estradiol (EE), levonorgestrel (LNG); or triphasic oral contraceptive (EE+LNG) for 1.5 years before plasma LDLs were isolated for characterization. Total plasma cholesterol concentrations were unaffected by the treatments. LDL particle size (measured as LDL molecular weight, g/mumol) was significantly smaller, in the EE (4.61 +/- 0.09) and EE+LNG (4.43 +/- 0.09) treatment groups compared with the control (4.99 +/- 0.09) or LNG (5.29 +/- 0.17) groups and contained fewer molecules of free and esterified cholesterol. Both the EE and EE+LNG groups had significantly less cholesterol and apolipoprotein B distributed in the d = 1.015 to 1.025 g/mL subfraction and correspondingly more in the d = 1.025 to 1.035 g/mL subfraction of LDL compared with the control and LNG groups. The apolipoprotein E content (molecules/particle) of LDL was significantly less in the EE (0.35 +/- 0.1) and EE+LNG (0.28 +/- 0.1) groups compared with the control (0.86 +/- 0.2) and LNG (0.99 +/- 0.2) groups, and this trend was apparent in all three LDL subfractions. The atherogenic potential of LDL was tested using an in vitro binding assay to arterial proteoglycans. Twice as much LDL bound to arterial proteoglycans in the LNG group (11.3 +/- 1.8% of total LDL cholesterol in the incubation) compared with the control (6.4 +/- 1.9%), EE (5.5 +/- 1.5%), or EE+LNG (5.2 +/- 1.2%) groups. We conclude that EE and EE+LNG treatment alters the composition of LDL toward a less atherogenic particle that is smaller and more dense, contains less cholesterol and less apolipoprotein E, and is less reactive with arterial proteoglycans compared with LNG treatment. The inclusion of EE in the triphasic oral contraceptive treatment was sufficient to negate the potentially atherogenic effects of LNG on LDL composition.

Studies using high dose testosterone (T) administration in normal men as a male contraceptive have resulted in azoospermia rates of only 50-70%. Previous studies of T and progestogen combinations have shown comparable rates of azoospermia, but have been uncontrolled or used T in doses less than that associated with maximal suppression of sperm production. We conducted a randomized, placebo-controlled, single blind trial comparing 6 months of T enanthate administration (100 mg, im, weekly) with the same dose of T enanthate in conjunction with the progestogen levonorgestrel (LNG; 500 micrograms, orally, daily) in 36 normal men, aged 20-42 yr (n = 18 in each group). The primary end points were induction of azoospermia or severe oligospermia (< 3 million sperm/mL). The combination of T plus LNG was much more effective in suppressing sperm production than T alone. Sixty-seven percent of the T plus LNG group (12 of 18) and 33% of the T alone group (6 of 18) achieved azoospermia by 6 months (P = 0.06). Severe oligospermia or azoospermia developed in 94% of the T plus LNG (17 of 18) group compared to 61% of the T alone group (11 of 18; P < 0.05). T plus LNG also suppressed sperm production more rapidly than T alone. Time to azoospermia was 9.9 +/- 1.0 vs. 15.3 +/- 1.9 weeks in the T plus LNG and T alone groups, respectively (mean +/- SEM; P < 0.05). Serum high density lipoprotein cholesterol decreased 21.7 +/- 3.6% in men given T plus LNG (P < 0.05), compared to only a 1.8 +/- 3.8% decrease in men in the T alone group. Average weight gain was 5.3 +/- 0.8 kg in the T plus LNG group and 2.3 +/- 0.9 kg in the T alone group (P < 0.05). Acne and increase in hemoglobin were similar in the two groups. We conclude that combination hormonal therapy with T plus a progestogen might offer a reversible male contraceptive approach with a more rapid onset of action and more reliable induction of both azoospermia and severe oligospermia than T alone.

Behavioral characterization of co-exposure to cannabinoids and hormonal contraceptives in female rats

Background:This study was designed to evaluate the comparison of insertion of levonorgestrel (LNG)-releasing intrauterine system versus oral medroxyprogesterone acetate on endometrial hyperplasia in a randomized controlled trial.Materials and Methods:A total of 60 women with the initial histopathological diagnosis of endometrial hyperplasia in two groups received LNG or medroxyprogesterone (10 mg/d orally) for 12 days a month for 3 months). Endometrial biopsy was obtained for all patients after 3 months of treatment. Response to treatment was defined based on the histopathology of the post treatment pipelle endometrial specimens in three categories of resolution, persistence and progression.Results:Treatment response rate in patients in the LNG group was 89.3% (25 of 28 patients), versus 70.4% (19 of 27 patients) in patients in the medroxyprogesterone group. The rate of persistence was 10.7% (3 of 28 patients) and 22.2% (6 of 27 patients) in LNG and medroxyprogesterone groups respectively. No progression of endometrial hyperplasia observed in any of the patients in LNG group, but progression of endometrial hyperplasia was observed in 7.4% (2 of 27 patients) in the medroxyprogesterone group. There was no statistically significant difference between groups regarding the response to treatment (P = 0.15). Side effects such as bloating, weight gain, fatigue and hair loss were comparable between the groups (P > 0.05). Hirsutism was significantly more in the medroxyprogesterone group than LNG group (P = 0.013).Conclusion:Results showed that the use of LNG for treating endometrial hyperplasia for 3 months was associated with high-treatment response rate and the low proportion of patients with progression compared to the use of medroxyprogesterone.

BackgroundSerbian women use contraception in general sporadically and numerous women still undergo induced abortions in case of unwanted pregnancy. This study aimed to investigate the frequency and factors associated with the use of hormonal and emergency contraception among women from Belgrade (Serbia) who had induced abortions.MethodsThis cross-sectional study investigated 433 women aged 15 to 55 years who were having induced abortions at the Clinic for Ob/Gyn, University Clinical Center of Serbia from 2022 to 2024. They filled-in an anonymous questionnaire about their socio-demographic data, general medical and gynecological history. They were specifically asked about the use of hormonal and emergency contraception.ResultsJust 17.6% of the investigated women used hormonal contraception, while 29.8% had used the emergency contraception at least once. Use of hormonal contraception was associated with Serbian nationality and being an atheist, having gynecological illnesses, engaging in regular recreation and drinking alcohol. The use of emergency contraception correlated with younger age, being nulliparous, having higher education, not being in a relationship, engaging in regular recreation and drinking alcohol.ConclusionsOur study confirms that Serbian women rarely use hormonal contraception and if they do, it is mostly as therapy for different gynecological illnesses. Younger women with higher education, who are not in committed relationship and who drink alcoholic beverages, are more likely to use emergency contraception even though it is not recommended for regular use. Global strategies and individualized programs for contraception counseling are necessary to increase the use of contraception in Serbia.Key messages• Few women who underwent induced abortion used either hormonal or emergency contraception.• Emergency is more often used than hormonal contraception, particularly among younger, educated and single women.

Influence of trans fat and omega-3 on the preference of psychostimulant drugs in the first generation of young rats

Birth controlling your fears: The long-term effects of adolescent exposure to hormonal contraceptives on fear extinction in long-evans female rats.