Combined Oral Contraceptives Users Research Articles

Correlation of Forced Vital Capacity and Peak Expiratory Flow Rate with Serum Estrogen and Progesterone Levels in Combined Oral Contraceptive Pill (COCP) User

Background: Combined oral contraceptive pill (COCP) is the most commonly used contraceptive method in Bangladesh. This COCP has some effects on different organs including the lungs. So, there may be a relationship between forced vital capacity (FVC) and peak expiratory flow rate (PEFR) with serum estrogen and progesterone levels in combined oral contraceptive pill (COCP) users.
 Objective: To observe the relationship between FVC and PEFR with serum estrogen and progesterone levels in combined oral contraceptive pill users (COCP-U).
 Methodology: This cross-sectional study was carried out in the Department of Physiology, Sir Salimullah Medical College (SSMC), Dhaka between July 2017 and June 2018. A total of 30 apparently healthy young women, age ranged 20 to 30 years were included in this study, who were combined oral contraceptive pill users (COCP-U) for at least 6 months. Another 30 age and BMI matched combined oral contraceptive pill nonusers (COCP-NU) were also taken as control for comparison. FVC and PEFR of all the subjects were measured by using Digital Auto Spirometer (MINATO AS-507). Moreover, their serum estrogen and progesterone levels were done to observe their levels and also to observe the relationship between them if present. Statistical analysis was done by Independent t-test and Pearson’s Correlation Coefficient test.
 Result: Spirometric parameters like FVC and PEFR were significantly higher in COCP-U women than those of nonuser women. Moreover, the mean serum estrogen and progesterone levels were also significantly higher in COCP users in comparison to those of non-users. Here, FVC showed positive and PEFR showed negative correlation with serum estrogen level and FVC showed negative, PEFR showed positive correlation with serum progesterone level in COCP users, though the relationships were statistically non-significant. 
 Conclusion: The positive correlation of FVC and PEFR with serum estrogen and progesterone indicates, that improvement of pulmonary function occurs in COCP-U due to its estrogen and progesterone contents, which may be by increasing the strength of the muscles along with decreased airway resistance.
 J Shaheed Suhrawardy Med Coll 2022; 14(1): 37-42

The role of sex hormones, oral contraceptive use, and its parameters on visuospatial abilities, verbal fluency, and verbal memory

Sex hormones can cross the blood-brain barrier and access brain regions underlying higher-order cognition. Containing synthetic sex hormones, oral contraceptives (OC) have been found to modulate visuospatial and verbal abilities, though inconsistencies have been found in the literature. Among possible explanations, certain OC use parameters (progestin androgenicity, synthetic hormone levels, duration of use) have not received consistent consideration. Thus, the objectives were to (1) examine group differences between men, combined OC users, and naturally cycling women (NC women; not using OC) in visuospatial abilities, verbal fluency, and verbal memory and (2) investigate the contribution of endogenous and exogenous sex hormones on these effects. We also aimed to (3) identify OC use parameters relevant to cognitive outcomes. In total, 70 combined OC users, 53 early follicular (EF) women, 43 pre-ovulatory (PO) women, and 47 men underwent cognitive tests. Performance was compared based on hormonal milieus (OC, EF, PO, men) and OC users' contraceptive androgenicity (anti, low, high). Correlations between performance, hormone levels and OC use duration were also conducted. OC use dampened the sex difference that typically favors men in 3D visuospatial abilities, whereas its duration of use positively predicted verbal fluency. Androgenicity and hormone levels did not predict performance in any task. These results highlight the importance of considering OC use duration. Results also did not support a role for androgenicity in cognition. Importantly, combined OC use (including prolonged use) does not impair visuospatial, verbal, and memory functions in a healthy young sample.

Mental Health Symptoms in Oral Contraceptive Users During Short-Term Hormone Withdrawal

Hormonal contraception has been linked to mood symptoms and the ability to recognize emotions after short periods of treatment, whereas the mental health of users of long-term hormonal contraceptives has had limited investigation. To evaluate whether short-term hormonal withdrawal, which users of combined oral contraceptives (COCs) undergo once a month (pill pause), was associated with altered mood and emotional recognition in long-term users of COCs. This case-control study included a community sample of individuals assigned female sex at birth who identified as women and used COC for 6 months or longer. The control group included women with natural menstrual cycles who otherwise fulfilled the same inclusion criteria. The study was conducted between April 2021 and June 2022 in Salzburg, Austria. COC users and women with natural menstrual cycles were tested twice within a month, once during their active pill phase or luteal phase and once during their pill pause or menses. Negative affect, anxiety, and mental health problems were assessed during each session. The percentage increase in mental health symptoms was calculated during the pill pause compared with that during the active intake phase in COC users. How this change compared with mood fluctuations along the menstrual cycle in women with natural menstrual cycles was assessed. A total of 181 women aged 18 to 35 years (mean [SD] age, 22.7 [3.5] years) were included in the analysis (61 women with androgenic COC use, 59 with antiandrogenic COC use, 60 women with a menstrual cycle not taking COCs). COC users showed a 12.67% increase in negative affect (95% CI, 6.94%-18.39%), 7.42% increase in anxiety (95% CI, 3.43%-11.40%), and 23.61% increase in mental health symptoms (95% CI, 16.49%-30.73%; P < .001) during the pill pause compared with the active intake phase. The effect size of this change did not differ depending on progestin type (negative affect: F1,117 = 0.30, P = .59; state anxiety: F1,117 = 2.15, P = .15; mental health: F1,117 = .16, P = .69) or ethinylestradiol dose (negative affect: F1,57 = .99, P = .32; state anxiety: F1,57 = 2.30, P = .13; mental health: F1,57 = .14, P = .71) was comparable with mood changes along the menstrual cycle in women with natural cycles (negative affect: F2,175 = 0.13, P = .87; state anxiety: F2,175 = 0.14, P = .32; mental health: F2,175 = 0.65, P = .52). Mood worsening during the pill pause was more pronounced in women with higher baseline depression scores (negative affect increase of 17.95% [95% CI, 7.80%-28.10%] in COC users with higher trait depression [BDI >8]). Emotion recognition performance did not differ between active pill phase and pill pause. In this case-control study of long-term COC users, withdrawal from contraceptive steroids during the pill pause was associated with adverse mental health symptoms similar to those experienced by women during menses with withdrawal from endogenous steroids. These results question the use of the pill pause from a mental health perspective. Long-term COC users may benefit more from the mood-stabilizing effects of COCs in cases of continuous intake.

Effect of Combined Oral Contraceptive on Lipid Profile Level and Cardiovascular Risk

Background: Combined oral contraceptive pills are an effective and widely used method for contraception. Combined oral contraceptives have been shown to alter lipid profiles among various population groups with different patterns of dyslipidemia and cardiovascular risk. Objectives: The study aimed at determining the lipid profile pattern and cardiovascular risk among combined oral contraceptive users. Methods: This cross-sectional analytical study was conducted in the Department of Physiology, Rajshahi Medical College, from January 2018 to December. 2018. The study group was made of 100 women. (mean age 24.1 ± 5 years), who took combined oral contraceptive pills (30 mg ethinyl estradiol, 150 mg Levonorgestrel) for a period ranging from 1-60 months, while 100 age-matched women with regular mentruation with no history of hormonal use within the last six months before the investigation were used as controls. Fasting blood samples from all study subjects were collected and analyzed for lipid profile [ Total cholesterol (TC), High-Density Lipoprotein- cholesterol (HDL-c), Low-Density Lipoprotein- cholesterol (LDL-c) and Triglyceride (TG)] using standard calorimetric Techniques. Results: Combined oral contraceptive use was associated with increased levels of total cholesterol (p ≤ 0.001), Low-density lipoprotein cholesterol (p ≤ 0.001), triglyceride (p ≤ 0.001), as well as decreased high-density lipoprotein cholesterol (HDL-c) (p = .408) in comparison to controls. Conclusion: Combined oral contraceptive use is associated with alteration in lipid profile, particularly increases total cholesterol triglyceride, LDL and decreased HDL-c. These changes carry a potential risk in the development of cardiovascular disease. Evaluating the most effective and safest contraceptive methods is important to avoid the potential risk of developing cardiovascular disease.

Hormonal contraception & face processing: Examining face gender, androgenicity & treatment duration

Previous cross-sectional studies observed differences between users and non-users of combined oral contraceptives (COCs) in both the structure and function of the fusiform face area (FFA) related to face processing. For the present study 120 female participants performed high-resolution structural, as well as functional scans at rest, during face encoding and face recognition. Participants were either never-users of COCs (26), current first-time users of androgenic (29) or anti-androgenic COCs (23) or previous users of androgenic (21) or anti-androgenic COCs (21). Results suggest that associations between COC-use and face processing are modulated by androgenicity, but do not persist beyond the duration of COC use. The majority of findings concern the connectivity of the left FFA to the left supramarginal gyrus (SMG), which is a key region in cognitive empathy. While connectivity in anti-androgenic COC users differs from never users irrespective of the duration of COC use already at rest, connectivity in androgenic COC users decreases with longer duration of use during face recognition. Furthermore, longer duration of androgenic COC use was related to reduced identification accuracy, as well as increased connectivity of the left FFA to the right orbitofrontal cortex. Accordingly, the FFA and SMG emerge as promising ROIs for future randomized controlled trials on the effects of COC use on face processing.

Medication Adherence and Contraceptive Counseling.

Combined oral contraceptives (COC) are a very popular form of birth control. Incorrect use and lack of adherence to treatment reduce the effectiveness of this method. Having a standard tool to identify poor-adherence profiles quickly and objectively can be helpful for midwives and potentially for COC users. The MMAS-4 adherence scale has been used in various medical fields, but there is little evidence of its potential in contraceptive consultation. This paper presents a piece of multicenter observational research based on a sample of 327 women who had attended contraceptive counselling in Spain and were COC users or had informed the midwife that they want to start to use this method. Two interviews were conducted: at the time of consultation and after one year. In our research, the MMAS-4 identified high-risk behaviors: during the 1-year follow-up period, COC users classified as poorly adherent had a significantly higher risk of missed contraceptive pills, more incidents and problems related to the method of contraception, as well as a lower degree of satisfaction with the contraceptive method. One case of unplanned pregnancy and two cases of emergency contraception were identified, all of them corresponding to poorly adherent women. The use of MMAS-4 in consultation can improve midwives' contraceptive counselling.

Fasting blood glucose, blood pressure and body mass index among combined oral contraceptive users in Chencha town Southern Ethiopia, 2019.

The use of contraceptives has become prevalent among women in Ethiopia. Oral contraceptive use has been suggested to trigger changes in glucose metabolism, energy expenditure, blood pressure, and body weight, among various populations and ethnic groups. To elucidate the pattern of fasting blood glucose, blood pressure, and body mass index among combined oral contraceptive pills users compared to controls. An institution-based cross-sectional study design was employed. A total of 110 healthy women using combined oral contraceptive pills were recruited as cases. Another 110 healthy age and sex-matched women not using any hormonal contraceptives were recruited as controls. A study was conducted between October 2018 and January 2019. Data obtained was entered and analyzed using IBM SPSS version 23 software packages. One-way ANOVA was used to identify the variation of variables in relation to the duration of use of the drug. The P-value of < 0.05 at the 95% confidence level was statistically significant. Fasting blood glucose level among oral contraceptive users (88.55 ± 7.89 mg/dl) was higher than fasting blood glucose level among oral contraceptive non-users (86.00 ± 9.85 mg/dl) with a p-value of 0.025. The mean arterial pressure of oral contraceptive users (88.2 ± 8.48 mmHg) was relatively higher than their counterparts (86.0 ± 6.74 mmHg), with a p-value of 0.04. Comparatively the body weight and body mass index among oral contraceptive users were 2.5% and 3.9% higher than non-users with a p-value of 0.03 and 0.003, respectively(5). Utilization of oral contraceptive pills for prolonged period of time seemed to be a significant predictive factor for higher mean arterial pressure and body mass index with p < 0.001and p < 0.05 respectively. Use of combined oral contraceptives was associated with higher fasting blood glucose (+2.9%), mean arterial pressure (+2.5%), and body mass index (3.9%) compared to controls.

Changes in Visual Long-Term Potentiation Show Preserved Cyclicity in Human Females Taking Combined Oral Contraceptives

Introduction: The combined oral contraceptive (COC) pill is often employed to address physical and neurological symptoms in menstrual cycle-related disorders by suppressing shifts in endogenous gonadal hormone fluctuations. Symptom persistence, especially in the lead up to the hormone-free interval (HFI), suggests an underlying neurobiological mechanism of preserved cycling. Our study utilised a non-invasive method of visually inducing long-term potentiation (LTP) to index changes in neural plasticity in the absence of hormonal fluctuations. Methods: Visually induced LTP was recorded using electroencephalography in 24 healthy female COC users across three sessions: days 3 and 21 during active hormone pills, and day 24 during the HFI. The Daily Record of the Severity of Problems (DRSP) questionnaire tracked premenstrual symptoms. Dynamic causal modelling (DCM) was used to elucidate the neural connectivity and receptor activity changes associated with LTP across different days of COC. Results: Visually induced LTP was greater on day 21 than day 3 (p = 0.011) and was localised to the P2 visually evoked potential. There was no effect of the HFI (day 24) on LTP. DCM of differences between days 3 and 21 showed changes to inhibitory interneuronal gating of LTP in cortical layer VI. The DRSP only showed a significant increase in symptoms in the HFI, meaning the LTP result appeared more sensitive to cyclicity. Conclusions: This study provides objective evidence of preserved cyclicity in COC users through enhanced LTP on day 21 compared to day 3 of a 28-day COC regimen, indicating that relatively higher excitation in the brain despite peripheral gonadal suppression may underlie and exacerbate menstrual cycle-related disorders.

Disparities in utilisation of combined oral contraceptives in Aotearoa New Zealand: A cross-sectional whole-of-population study.

The combined oral contraceptive (COC) is the most commonly used hormonal contraceptive in Aotearoa New Zealand (Aotearoa/NZ). Currently there is limited data available on who uses COC in Aotearoa/NZ. The aims were to (i) define the population of reproductive-aged females in Aotearoa/NZ in 2018 and identify the rate of COC use among this group and (ii) describe the sociodemographic and geographic characteristics of the population of COC users compared to the general population of reproductive-aged females in 2018. This whole-of-population cross-sectional study used the Integrated Data Infrastructure, a large research database managed by Statistics New Zealand. Females aged 16-50 years with complete sociodemographic and geographic information in 2018 from Aotearoa/NZ's estimated resident population were included. COC dispensing records to this cohort were identified from the national Pharmaceutical Collection. This paper reports descriptive counts of COC use and employs generalised linear regression with a binomial distribution and a log link to estimate adjusted risk ratios (aRR) of COC use for key sociodemographic and geographic subgroups. Of 1 113 750 individuals in the study, 159 789 (14.3%) were dispensed as COC in 2018. European/other individuals were most likely to use COC (aRR: 2.72, 2.67-2.78), and Pacific Peoples were least likely (aRR: 0.56, 0.55-0.58) to use COC. Individuals residing in the most deprived quintile had less COC use than individuals in the least deprived quintile (aRR: 0.73, 0.72-0.74). Our study is able to highlight significant disparities in use by ethnicity, area-level deprivation, and geographic factors.

Perception of oral contraception – do women think differently from gynaecologists?

Purpose This study aimed to assess the experience and satisfaction with contraceptives and use of Combined Oral Contraceptives (COC) by women and compare their perceptions with those of gynaecologists. Methods This was a multicentre survey study conducted in Portugal, during April and May, 2021 with women using contraceptives and gynaecologists. Online quantitative questionnaires were carried out. Results A total of 1508 women and 100 gynaecologists were included. Cycle control was the pill non-contraceptive benefit most valued by gynaecologists and women. For gynaecologists, the main pill concern was the risk of thromboembolic events, but they believed that weight gain was the main concern for their patients. The pill was the most used contraceptive (70%) and women were largely (92%) satisfied. The pill was associated with health risks for 85% of users, mainly thrombosis (83%), weight gain (47%), and cancer (37%). The attributes of the pill most valued by women are contraceptive efficacy (82%), followed by low risk of thromboembolic events (68%), good cycle control (60%), non-interference with libido and mood (59%) and weight (53%). Conclusion Most women use contraceptive pills and are generally satisfied with their contraceptive. Cycle control was the most valued non-contraceptive benefit for gynaecologists and women, agreeing with physicians’ beliefs about women. On the other hand, contrary to physicians’ beliefs, that women’s main concern is weight gain, women are mainly concerned with risks associated with contraceptives. Thromboembolic events are women’s and gynaecologists most valued risk. Finally, this study indicates the need for physicians to better understand what COC users really fear.

Combined oral contraceptives may activate the contact system in healthy women

BackgroundThe contact system (CAS) is part of the coagulation system, consisting of a group of plasma proteins stimulating inflammation, coagulation, and fibrinolysis when activated. CAS can be triggered by several activating surfaces, and CAS may play a potential role in thrombus formation. Combined oral contraceptives (COCs) are known to increase the risk of venous thromboembolism, and COCs induce various prothrombotic changes in the coagulation system, whereas the effect of COC on CAS has not been thoroughly investigated. ObjectivesTo investigate CAS in COC users compared with nonusers. MethodsBlood samples from 62 study subjects, 30 COC users, and 32 nonusers, were analyzed. Coagulation factor XII (FXII), prekallikrein (PK), H-Kininogen (HK), cleaved HK (cHK), C1-esterase inhibitor (C1-inh), and the endogenous kallikrein potential (EKP) were measured. ResultsCOC users had significantly higher FXII (median, 38.4 vs 28.9 mg/L) and lower C1-inh levels (0.20 vs 0.23 g/L) than nonusers. The levels of PK and HK were not significantly different. Measurement of EKP indicated an increased capacity of CAS in COC users (1860 vs 1500 nmol/L × min), and increased plasma levels of cHK (2.02 vs 1.07 μg/L) indicated an increased activity in vivo. ConclusionThis study demonstrates an increased CAS capacity in women using COC compared with nonusers and also an increased activity in vivo. The results indicate that increased contact activation may contribute to the increased thrombotic risk caused by COC.

New approaches for developing biomarkers of hormonal contraceptive use

To identify biomarkers of hormonal contraceptive (HC) use in urine and saliva, we conducted a pilot study with 30 women initiating levonorgestrel (LNG) containing combined oral contraceptives (COCs) or depot medroxyprogesterone acetate (DMPA) (15/group). Based on established COC pharmacokinetics, we collected serum and urine samples before COC ingestion and during Days one and three of use, or before DMPA injection and on Days 21 and 60 post-injection. We used liquid chromatography-tandem mass spectrometry (LC–MS/MS) to measure serum/urine LNG and MPA. LNG was undetectable at baseline (specificity 100%); post ingestion, most urine samples had detectable LNG levels (sensitivity: 80% 6 h post Dose one, 93% 6 h post Dose three). We used a DetectX LNG immunoassay kit and showed 100% sensitivity measuring urine LNG. Urine MPA levels were undetectable in 14/15 women at baseline (specificity 91%); post-injection all urine samples had detectable MPA levels (sensitivity: 100% days 21 and 60). Results suggest urine sampling can be used to identify a biomarker of LNG and MPA use. Based on evidence from other steroidal hormonal studies showing changes affecting the transcriptome profile of saliva at 24 h, we used the same (COC, DMPA) timepoints to collect saliva. We performed transcriptome analysis and detected several differentially expressed genes in DMPA users’ saliva on Days 21 and 60 compared to baseline; none among COC users. We plan further research of differential gene expression in saliva as a HC biomarker of DMPA use, and will explore longer periods of COC use and saliva collection times, and application of microRNA sequencing to support using saliva as a COC biomarker.

Correlation between Serum Sialic Acid, Serum Lipids, Cardiac Troponin I and Myoglobin among Women on Combined Oral Contraceptives

Background: Women using combined oral contraceptives have an increased risk of developing cardiovascular disease. While the utility of biomarkers such as serum lipids have been well evaluated, serum sialic acid, which has shown some promise as a marker of cardiovascular disease progression has been poorly studied. This study aimed to determine the correlation between sialic acid and lipid profile as risk factors of cardiovascular disease in women on combined oral contraceptives. Materials and Methods: This was a cross-sectional study involving 143 women on combined oral contraceptive pill as the study group and 100 age and sex matched healthy controls. Serum levels of Total Sialic Acid (TSA), lipids, and some cardiac biomarkers (Myoglobin, Creatine Kinase-MB and Troponin-I) were measured, summarized as mean (±SD) and compared. Correlation between serum level of sialic acid and each of the measured serum lipid component was subsequently determined using correlation analysis. Results: Sialic acid (1.070±0.117 vs 0.837±0.272), Total cholesterol (3.944±0.918 vs 3.106±0.635), Low density lipoprotein cholesterol (2.408±1.085 vs 1.088±0.392), High density lipoprotein cholesterol (1.049±0.421 vs 0.902±0.542) &amp; Triglycerides (1.620±0.703 vs 1.052±0.514) were all significantly (P&lt;0.05) higher in the combined oral contraceptive group than controls respectively. Sialic acid demonstrated a weak but positive correlation with Myoglobin (r= +0.403), Creatine kinase-MB (r= +0.441) and Troponin-I (r= +0.424). While TGs and sialic acid were shown to have a very weakly positive association (r= +0.089), TC, LDL-C, and HDL-C all had very weakly negative correlations (r= -0.136, -0.146, and -0.006, respectively). Conclusion: Combined oral contraceptives use confers an artherogenic lipid profile imparting a positive cardiovascular disease risk. Although sialic acid is significantly higher among combined oral contraceptive users and shows a positive relationship with cardiac biomarkers, it correlates poorly with serum lipids suggesting its limited utility as a CVD marker.

Smoking and combined oral contraceptives should be considered as an independent variable in sex and gender-oriented studies

The influence of sex combined with smoking and combined oral contraceptives (COC) use on atherogenic indexes is scarcely studied. Thus, traditional lipid parameters were measured, and non-traditional atherogenic indexes were calculated in a young and healthy population of men, COC-free women, and COC users.Total cholesterol (TChol), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and HDL/LDL ratio were lower in men, while triglycerides (TG)/HDL ratio, atherogenic index of plasma (AIP), Castelli's Risk Index I (CRII) and CRI-II, atherogenic coefficient (AC), creatinine, creatinine clearance, and estimated glomerular filtration rate (eGFR) were higher in men. The use of COC modified TChol, HDL, TG, TG/HDL, and AIP which had significantly higher values in COC users. In addition, TG were also increased in COC users in comparison with men.Smoking reduced sexually divergent parameters: BMI, TG, HDL/LDL, TG/HDL, AIP, CRII, CRI-II, and AC became similar among the three cohorts, losing the reported sex differences.Smoking also reduced differences in TChol, HDL, TG, and AIP between COC-free women and COC users, but it does not affect CRII, CRI-II, creatinine, creatinine clearance, and eGFR, underlining that COC users and COC-free women have to be considered two different populations.Our results represent a complex landscape suggesting that for both sexes smoking should be an independent variable in medical studies. Moreover, in women, the use of COC evidenced two different cohorts. Thus, more variables should be considered during a single study indicating that sex, smoking, and COC should be studied together to get a picture of the real-life context.

Hematological parameters of reproductive-age women using hormonal contraceptives at University of Gondar Comprehensive Specialized Referral Hospital, Northwest Ethiopia: A comparative cross-sectional study.

More than one-third of reproductive aged women in Ethiopia use hormonal contraceptives to prevent conception. The present study aimed to compare the hematological parameters of reproductive-age women taking hormonal contraceptives at the University of Gondar Comprehensive Specialized Referral Hospital, Northwest Ethiopia in 2021. A comparative cross-sectional study was conducted from April to June 2021. A total of 240 study participants were recruited by using a consecutive sampling technique. Data on socio-demographic variables and clinical data were collected through face-to-face interviews using a structured questionnaire and medical record reviews, respectively. Three milliliter venous blood was collected for complete blood count analysis using Unicel DxH 800 coulter hematology analyzer. Data was entered into Epi-data 4.4.3.1 version then exported to IBM SPSS v25 for analysis. Kruskal-Wallis H, Dunn-Bonferroni pairwise comparison test, and Spearman's correlation analysis were used for inferential statistics. P&lt;0.05 were considered statistically significant. The median and interquartile range of platelet count among combined oral contraceptive users was 285(238-332) which is significantly higher than that of depot medroxyprogesterone acetate users 246(220-226) (p = 0.010), implant user 247(221-297) (p = 0.034), and controls 256(224-278) (p = 0.015). The result also showed long-term use of implant negatively correlated with red blood cell count (p = 0.033). This finding concludes that combined oral contraceptive users had a higher platelet counts than controls while long-term use of implants can result in low red blood cells count. Therefore, a baseline evaluation of complete blood count in women desiring contraceptive methods would also be recommended.

Combined oral contraceptive use and risk for binge eating in women: Potential gene × hormone interactions

Extant animal and human data suggest endogenous ovarian hormones increase risk for binge eating in females, possibly via gene × hormone interactions and hormonally induced increases in genetic influences. Approximately 85 % of women will take combined oral contraceptives (COCs) that mimic the riskiest hormonal milieu for binge eating (i.e., post-ovulation when both estrogen and progesterone are present). The purpose of this narrative review is to synthesize findings of binge eating risk in COC users. Few studies have been conducted, but results suggest that COCs may increase risk for binge eating and related phenotypes (e.g., craving for sweets), particularly in genetically vulnerable women. Larger, more systematic human and animal studies of COCs and binge eating are needed. The goal of this work should be to advance personalized medicine by identifying the extent of COC risk as well as the role of gene × hormone interactions in susceptibility.

Analysis of Adverse Events and Medical Errors in Long-Term Hormone Treatments for Endometriosis: A Study Based on the US Food and Drug Administration Event Reporting System

PurposeTo investigate adverse events and medical errors, as well as their possible risk factors, of combined oral contraceptives and progestins used in patients with endometriosis.Patients and MethodsReports between January 1, 2014 and September 30, 2021 about patients with endometriosis in US Food and Drug Administration Adverse Event Reporting System were analyzed. Disproportional analysis was performed with the Gamma-Poisson Shrinker model to detect overreported drug-event pairs. Logistic regression analysis was utilized to explore potential risk factors.ResultsThere were 823 reports on long-term hormone treatments and 6247 reports on other drugs after removing duplicates, most of which were reported by consumers and were from the United States. Procedural complications and product issues were common among long-term hormone treatment users, while some other new adverse events emerged in subgroup analysis of different dosage forms of progestin. Polytherapy was negatively associated with off label use (adjusted OR = 0.47, 95% CI 0.22–0.94) and product use in unapproved indication (adjusted OR = 0.36, 95% CI 0.15–0.76) for combined oral contraceptive users. Combined oral contraceptive users aged greater than or equal to 30 were less likely to have product use issue (adjusted OR = 0.33, 95% CI 0.12–0.82) but were at higher risk of pulmonary embolism (adjusted OR = 4.04, 95% CI 1.35–17.43).ConclusionLong-term hormone treatment products in this study are generally safe for endometriosis, while newly detected signals need to be validated by further exploration. Patients’ tolerance and fertility desire should be considered when preparing treatment plans.

Effect of prolonged use of hormonal contraception on ovarian reserve

Background and Objective: Contraception is widely used throughout the world, with 62% of reproductive-aged women. This trial was established to assess the effect of prolonged use of hormonal contraception (HC) on ovarian reserve. Methods: This retrospective randomized controlled trial was performed on 150 healthy females aged (20-35) years with normal menstrual history had at least one offspring after spontaneous pregnancy. Participants were subdivided into equal three groups: first group (study group): used the injectable progesterone for more than four years continuously, second group (study group): used combined oral contraceptive (COC) for more than four years continuously, control group: didn’t use HC (as intrauterine device, natural and non-users of any contraception). Results: Ovarian volume (OV) and antral follicle count (AFC) were significantly decreased in COC group than control group. There was a significant negative correlation between body mass index and OV was found. There was an insignificant correlation between age, gravidity, parity, BMI, usage duration and both AFC, AMH among group 3 controls. Conclusion: The prolonged use of HC in COC group had a significant negative effect on volume of ovary and AFC with no effect on AMH. A significant negative correlation between age and AMH was found among COC users.

Effects of Combined Oral Contraceptives on Women’s Sexual Function, Eje Cafetero, Colombia, 2016-2020

Introduction: The sexual function of women could be affected by the use of combined oral contraceptives. Objective: To evaluate the sexual function of women users of combined oral contraceptives and to know the adverse events. Materials and methods: Cross-sectional study in 224 women over 18 years of age, sexually active, users of combined oral contraceptives (Estradiol Valerate/ Dienogest: VE₂/DNG, ethinylestradiol/levonorgestrel: EE₂/LNG and ethinylestradiol/drospirenone: EE₂/DSP), who attended three university clinics in the Coffee Region (Colombia); between 2016 and 2020. The Female Sexual Function Index (IFSF) instrument was used. Descriptive statistics were applied.

Endogenous oestradiol and progesterone as predictors of oncogenic human papillomavirus (HPV) persistence

BackgroundHigh-risk human papillomavirus (HR-HPV) is the main aetiological factor for the development of cervical cancer. While nearly 70% of HR-HPV infections are cleared within 12 months, in the remainder of women they persist and can progress into cervical cancer. Oestradiol and progesterone have been shown to be involved in the development and progression of cervical cancer. The objective of this study was to investigate, for the first time, whether diurnal oestradiol and progesterone are also involved in HR-HPV persistence – before cervical cancer develops.MethodsA total of N = 39 women between 18 and 31 years of age were investigated. All were nulliparous and regular users of combined oral contraceptives. Presence of HR-HPV was determined by cervical swabs. Salivary oestradiol and progesterone were measured upon awakening and at 11 am, 2 pm, and 5 pm. All HR-HPV positive women were re-tested in terms of HR-HPV status 12 months later.ResultsHR-HPV positive women had significantly higher morning (p = .007, partial eta2 = .221) and daily oestradiol levels (p < .001, partial eta2 = .442) when compared to HR-HPV negative women. In addition, those with persistent HR-HPV 12 months later had significantly elevated morning (p = .005, partial eta2 = .534) and daily (p = .027, partial eta2 = .346) oestradiol. Progesterone was found to be unrelated to HR-HPV.ConclusionsOestradiol was positively linked to HR-HPV presence and persistence. Provided that these findings are replicated, regular monitoring of oestradiol levels may prove useful in identifying women who are at risk of developing cervical cancer.