Abstract
Oral contraceptive use has been associated with decreased menstrual blood losses; thus, can independently reduce the risk of anemia and iron deficiency in women. Manufacturers have recently started to include supplemental iron in the non-hormonal placebo tablets of some contraceptives. The aims of this narrative review are: (i) to describe the relationship between oral contraceptive use and both anemia and iron status in women; (ii) to describe the current formulations of iron-containing oral contraceptives (ICOC) available on the market; and (iii) to systematically review the existing literature on the effect of ICOC on biomarkers of anemia and iron status in women. We discovered 21 brands of ICOC, most commonly including 25 mg elemental iron as ferrous fumarate, for seven days, per monthly tablet package. Our search identified one randomized trial evaluating the effectiveness of ICOC use compared to two non-ICOC on increasing hemoglobin (Hb) and iron status biomarker concentrations in women; whereafter 12 months of contraception use, there were no significant differences in Hb concentration nor markers of iron status between the groups. ICOC has the potential to be a cost-effective solution to address both family planning needs and iron deficiency anemia. Yet, more rigorous trials evaluating the effectiveness of ICOC on improving markers of anemia and iron deficiency, as well as investigating the safety of its consumption among iron-replete populations, are warranted.
Highlights
Contraceptives are an unparalleled innovation in the public health sector, allowing for family planning and pregnancy prevention [1], with estimates of 922 million users worldwide [2]
As women of reproductive age are at risk for iron deficiency anemia [18,50], combining birth control and iron supplementation together can address both issues of family planning and iron deficiency anemia, with one cost-effective solution
We discovered 21 different brands of ironcontaining oral contraceptives (ICOC) that are currently being manufactured and marketed globally by 12 pharmaceutical companies
Summary
Contraceptives are an unparalleled innovation in the public health sector, allowing for family planning and pregnancy prevention [1], with estimates of 922 million users worldwide [2]. Contraceptives can be categorized into two methods: hormonal and nonhormonal contraception. The former includes contraception methods, such as hormonal intrauterine devices (IUD), oral contraceptive pills, and the vaginal ring [3]. The latter consists of barrier methods (male or female condom, with or without spermicide), copper. Based on the data compiled for the report Contraceptive Use by Method 2019 by the United Nations, approximately 16% of women use oral contraceptives [2]. Reported rates of use among women are approximately 19% in Europe, 17% in Oceania, 15% in North
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