Contraceptive Group Research Articles

Associations Between the Use of Contraception and the Psychological Well-being of Women

Introduction Reproductive events have a complex impact on women's lives. The possible effects of endogenous and exogenous gonadal hormones on women's psychological status are matters of debate. Aims This research aims at examining mood and sleep symptoms of women in different reproductive stages and in association to contraceptive use. Methods Data were collected at the Centralized Family Planning of the City of Helsinki (March 2012-February 2013) through a questionnaire regarding participants' reproductive features, psychiatric history and current psychological status at baseline and after 3 months. Results A total of 208 women (18-50 years) accepted to participate: 52 (25.0%) starting contraception, 68 (32.7%) stopping or changing to a different method, 62 (29.8%) continuing with their current method, and 26 (12.5%) breastfeeding women. The response rate at follow-up was 73%. Psychiatric symptoms during the previous month were commonly reported both at baseline and follow-up (sleep symptoms: 86.1% and 80.3%, respectively; anxiety and depressive symptoms: 61.8% and 55.6%; death and suicide thoughts: 10.1% and 5.3%), with no differences between the contraceptive groups. At follow-up, women who continued with their contraception had higher risks of early awakening and tiredness (OR=3.312 and OR=2.942; p p Conclusions Sleep, anxiety and depressive symptoms are common among women; the use of contraception seems to only marginally associate with these symptoms.

Progesterone-based intrauterine device use is associated with a thinner apical layer of the human ectocervical epithelium and a lower ZO-1 mRNA expression.

Currently, whether hormonal contraceptives affect male to female human immunodeficiency virus (HIV) transmission is being debated. In this study, we investigated whether the use of progesterone-based intrauterine devices (pIUDs) is associated with a thinning effect on the ectocervical squamous epithelium, down-regulation of epithelial junction proteins, and/or alteration of HIV target cell distribution in the human ectocervix. Ectocervical tissue biopsies from healthy premenopausal volunteers using pIUDs were collected and compared to biopsies obtained from two control groups, namely women using combined oral contraceptives (COCs) or who do not use hormonal contraceptives. In situ staining and image analysis were used to measure epithelial thickness and the presence of HIV receptors in tissue biopsies. Messenger RNA levels of epithelial junction markers were measured by quantitative PCR. The epithelial thickness displayed by women in the pIUD group was similar to those in the COC group, but significantly thinner as compared to women in the no hormonal contraceptive group. The thinner epithelial layer of the pIUD group was specific to the apical layer of the ectocervix. Furthermore, the pIUD group expressed significantly lower levels of the tight junction marker ZO-1 within the epithelium as compared to the COC group. Similar expression levels of HIV receptors and coreceptors CD4, CCR5, DC-SIGN, and Langerin were observed in the three study groups. Thus, women using pIUD displayed a thinner apical layer of the ectocervical epithelium and reduced ZO-1 expression as compared to control groups. These data suggest that pIUD use may weaken the ectocervical epithelial barrier against invading pathogens, including HIV.

Hormonal fluctuations intensify temporomandibular disorder pain without impairing masticatory function.

The influence of hormonal fluctuations on pain and mastication was evaluated in patients with painful temporomandibular disorder (TMD) symptoms. Fifty women were assigned to menstrual cycle and oral contraceptive groups (n = 25). Their TMD was diagnosed by Research Diagnostic Criteria for Temporomandibular Disorders. Pain levels, maximum oclusal force (MOF), and masticatory performance (MP) were measured in all menstrual cycle phases. A lower pain level was observed in the ovulatory phase when compared to menstrual and luteal phases (P = .02). No differences were found regarding MOF (P = .20) or MP (P = .94). Hormonal fluctuations intensify pain in women with symptomatic TMD without impairing mastication.

Different modalities in the management of functional ovarian cysts

Objective The aim of this work is to compare the different modalities in the management of functional ovarian cysts. Background A functional ovarian cyst is a growth on an ovary that develops during a woman's ovulation cycle. Women who develop a functional ovarian cyst generally remain asymptomatic and only learn of its presence during their annual female examination. Most functional ovarian cysts are small and benign, require no treatment, and dissolve on their own. If the cyst is small to moderate in size and causes no symptoms, a watchful approach will usually be adopted. Materials and methods This study included 80 patients with functional ovarian cysts: 40 patients followed up by transvaginal ultrasound only (expectant group) and 40 patients who received combined oral contraceptive pills (oral contraceptive group) and followed up by transvaginal ultrasound for 3 months. Persistent functional ovarian cysts will be managed by transvaginal ultrasound-guided needle cyst aspiration and then followed up by transvaginal ultrasound for 3 months. Results There was no statistically significances between different modalities of management as regards short-term expectant management (31\40) and combined oral contraceptive management (34\40) for functional ovarian cysts. Persistent functional ovarian cysts were managed by transvaginal-guided ultrasound needle aspiration, which showed a high recurrence rate in both groups, 5\9 and 3\6, respectively, after short-term follow-up. Conclusion The results of the study suggest that optimal management for functional ovarian cysts in reproductive age is expectant management.

Prefrontal GABA concentration changes in women—Influence of menstrual cycle phase, hormonal contraceptive use, and correlation with premenstrual symptoms

Prefrontal regions are involved in processing emotional stimuli and are a topic of interest in clinical and neurological research. Although sex steroids are potent neuromodulators, the influence of menstrual cycle phase and hormonal contraceptive use is rarely taken into account in neuroimaging studies. Our purpose was to evaluate changes in gamma-aminobutyric acid (GABA) in women, as measured by magnetic resonance spectroscopy (MRS), with phases of the menstrual cycle and use of hormonal contraceptives, and to assess correlations with premenstrual symptoms.Three MRI sessions per cycle were obtained in the natural cycle group, and two sessions in the hormonal contraceptives group. In addition to an anatomical scan, single voxel MRS in the prefrontal area was performed. After quality control, 10 women with natural cycle and 21 women taking hormonal contraceptives were included for analysis. Peripheral blood samples were obtained to determine endogenous hormone concentrations. Subjects were asked to complete a daily rating of severity of problems questionnaire, to quantify premenstrual symptoms. In the natural cycle group, we found a significant increase in prefrontal GABA concentration at the time of ovulation. Conversely, in the hormonal contraceptives group, no differences were found between the pill phase and pill-free phase. GABA concentrations did not significantly correlate with endogenous hormone levels, nor with premenstrual symptoms. Our results indicate that spectroscopically measured GABA concentrations are higher during ovulation in women with a natural menstrual cycle. We suggest that neuroimaging studies should take into account this variability.

Safety and acceptability of intrauterine balloon stent used in uterine after hysteroscopic adhesiolysis to prevent adhesion reformation

To evaluate the safety and acceptability of COOK intrauterine balloon stent in uterine for one week after hysteroscopic adhesiolysis. A total of 79 females with moderate-severe Asherman syndrome undergoing hysteroscopic division of intrauterine adhesion were enrolled from June 2012 to December 2013. They were divided into two groups of intrauterine balloon stent (n = 51) and tailed intrauterine contraceptive device (n = 28). The sterile swabs were taken from cervical canals for bacterial culture by the same microbiologist. Each patient in balloon group was requested to answer a questionnaire survey on the acceptability of balloon stent. 82.3% of them could tolerate discomforts during balloon placement and 86.3% desired re-ballooning if necessary. Positive microorganism cultures were seen in 17 patients (33.3%) in balloon group versus 8 (28.6%) in intrauterine contraceptive device group. And the positive rate was not different between two groups. It is relatively safe to maintain the intrauterine balloon stent in uterine for one week. And most patients accept readily the intrauterine balloon stent.

Contraception: Everyone's responsibility.

Contraception and fertility planning should form part of every consultation, as it is key to reducing maternal mortality and morbidity associated with unplanned pregnancy. It also prevents pregnancy in women who are medically unfit for pregnancy until their condition has been optimised. This is only the tip of the iceberg compared with the social and economic burden of unintended pregnancy. The South African (SA) National Department of Health has recognised the importance of contraception and fertility planning. A national policy and guideline have been formulated that promote this agenda. In the past, the commonest contraceptives used in SA were the combined oral contraceptive and the injectable contraceptive. Long-acting reversible contraceptives (LARCs) offer the most benefit, and have efficacy comparable to permanent contraception. Their failure rates are the same for typical and perfect use. In addition, continuation rates after one year of use remain high. The intrauterine contraceptive device, the levonorgestrel intrauterine system and the injectable progestogen contraceptives form part of this group of contraceptives. The most recently launched LARC is Implanon NXT. A comprehensive guideline to assess suitability of the various contraceptive methods in various medical conditions is the World Health Organization Medical Eligibility Criteria for contraceptive use. Counselling is key to choice and suitability of contraceptive methods. Compliance, in part, is dependent on adequate discussion of side-effects, availability and acceptance of the method.

A comparison of second and third generations combined oral contraceptive pills' effect on mood.

Background:Most women taking combined oral contraceptives (COCs) are satisfied with their contraceptive method. However, one of the most common reasons reported for discontinuation of combined oral contraceptives (COCs) is mood deterioration.Objectives:This study aimed to compare effects of the second and third generation oral contraceptive pills on the mood of reproductive women.Materials and Methods:This randomized, double-blind, controlled clinical trial was conducted in reproductive women at health centers in Tehran, Iran. Participants were randomized into the second and third generation oral contraceptive groups. Positive and negative moods were recorded using positive affect, negative affect scale (PANAS) tools at the end the second and fourth months of the study. Data analysis was carried out using ANOVA and P Values < 0.05 was considered significant.Results:Statistically significant difference was seen in positive and negative mood changes in women receiving contraceptive pills. The second generation oral contraceptive pills resulted in a decrease in positive mood (95% CI: 43.39 to 38.32 in second month and 43.39 to 26.05 in four month) and increase in negative mood (95% CI: 14.23 to 22.04 in second month and 14.23 to 32.26 in four month - P < 0.001), but the third generation led to an increase in positive mood (95% CI: 22.42 to 25.60 in second month and 22.42 to 33.87 in four month) and decrease in negative mood (95% CI: 36.78 to 31.97 in second month and 36.78 to 22.65 in four month - P < 0.001).Conclusions:Third generation combined oral contraceptive pills have a better effect on mood in women in reproductive ages than the second generation pills. It can be recommended as a proper combined oral contraceptive in Iran.

The application of capillary electrophoresis in the determination of glutathione in healthy women's blood.

The purpose of this work was to compare glutathione status in the blood of women taking oral contraceptives, female smokers and pregnant women using both the capillary electrophoresis (CE) and alloxan methods. The studies were performed on the whole blood prepared by deproteinization by 25% metaphosphoric acid. The reduced glutathione (GSH) was measured by alloxan and CE methods. Oxidized glutathione (GSSG) was measured by CE and the GSH/GSSG ratio was calculated. In pregnant women (Group A), women taking oral contraceptives (Group B) and female smokers (Group C), lower concentrations of GSH were observed compared with the control group (Group D) as measured by CE and alloxan methods, suggesting the presence of oxidative stress. The level of GSSG in Group C was higher than in Group D, indicating glutathione oxidation. In Groups A and B, reduced levels of GSSG were observed, which indicates that other processes besides oxidation affect glutathione status. In Groups A and C, a lower GSH/GSSG ratio was observed than in Group D, while in Group B no statistical change was observed. In conclusion, the advantage of CE is the possibility of measuring GSSG, which could allow for a more accurate interpretation of the status of GSH in the human body. Oxidation of glutathione in female smokers was indicated, while in pregnant women and women taking oral contraceptives processes other than oxidation can be associated with a decrease in glutathione levels.

Thyroid function, activated protein C resistance and the risk of venous thrombosis in users of hormonal contraceptives

Use of combined hormonal contraceptives is associated with a three- to eight-fold increased risk of venous thrombosis compared with non-use. The thrombotic risk depends on the estrogen dose as well as the progestogen type. Use of hormonal contraceptives leads to resistance to activated protein C (APC), which may serve as marker for the risk of venous thrombosis. Hyperthyroidism is also associated with an increased risk of venous thrombosis, due to increased free Thyroxine (FT4) levels which cause a hypercoagulable state. The objective of this study was to evaluate the effects of hormonal contraceptives on levels of FT4, thyroid stimulating hormone (TSH) and thyroxine binding globulin (TBG), and to investigate the effects on APC resistance per contraceptive group. We measured FT4, TBG and TSH levels and APC resistance in 231 users of oral contraceptives. Users of the most thrombogenic hormonal contraceptives, i.e. containing desogestrel, cyproterone acetate or drospirenone, had higher TBG levels than users of less thrombogenic hormonal contraceptives, i.e. the levonorgestrel-containing intrauterine device. TSH levels were not significantly elevated and FT4 levels did not change. TBG levels were also associated with APC resistance. Use of hormonal contraceptives lead to elevated TBG levels, slightly elevated TSH levels and unchanged FT4 levels without causing a hyperthyroid state. Thus, the increased thrombotic risk during the use of hormonal contraceptives cannot be explained by a hyperthyroid state caused by use of these hormonal contraceptives.

Assessment of Some Coagulation Parameters among Clients on Hormonal Contraceptive in a Tertiary Health Facility in Sokoto, North Western, Nigeria

Background: Hormonal contraceptives are widely used, and contain different doses of estrogen and types of progestogen. However, these hormonal contraceptives may potentially be associated with some side effects of coagulopathy. Objective: The aim of this study was to evaluate the Prothrombin Time (PT) and Partial Thromboplastin Time with Kaolin (PTTK) among clients on hormonal contraceptives. Method: This descriptive case-control study was conducted among clients on hormonal contraceptives. A total of 43 clients on hormonal contraceptives constituted the subjects. Twenty non-hormonal contraceptives users were monitored as controls. PTTK and PT was carried out on citrated samples from subjects and control participants using the Diagen kit for PTTK and PT. Results: The mean values for PT and PTTK of the contraceptive users was 15.6 ± 1.5 s and 36.4 ± 2.7 s respectively, while the mean value for the control group was 16.0 ± 1.2 s and 38.6 ± 3.9 s respectively. The PT and PTTK mean values of the contraceptives users although marginally lower among subjects compared to the control group (0.4 and 2.2 seconds) respectively. The bivariate analysis did not demonstrate any significant difference between the coagulation parameters of contraceptive users and control group (t = 0.702, p = 0.491 for PT; t = 1.732, p = 0.100 for PTTK). There was significant differences in the in the PT and PTTK values of hormonal contraceptive users based on age. There was a negative correlation between PT and duration of contraceptive use. Conclusion: There was no clinically significant differences between the values of coagulation parameters of contraceptives users and non-users. However, it is not conclusive whether long term use of modern hormonal contraceptives increases the risk of thrombosis. There is need for more studies to investigate the effect of long-term hormonal contraceptive use on the PT and PTTK.

Two Low-Dose Levonorgestrel Intrauterine Contraceptive Systems

To evaluate the efficacy and safety of two low-dose levonorgestrel intrauterine contraceptive systems. Nulliparous and parous women aged 18-35 years with regular menstrual cycles (21-35 days) requesting contraception were randomized to 3 years of treatment with one of two levonorgestrel intrauterine contraceptive systems: 13.5 mg total content or 19.5 mg total content. The primary outcome was the pregnancy rate, calculated as the Pearl Index. Overall, 1,432 and 1,452 women in the 13.5 mg intrauterine contraceptive system and 19.5 mg intrauterine contraceptive system groups, respectively, had a placement attempted and were included in the full analysis set to evaluate efficacy and safety. Mean (standard deviation) age was 27.1 (4.8) years; 39.2% were nulliparous. Over the 3-year study period, 0.33 pregnancies per 100 women-years (95% confidence interval [CI] 0.16-0.60) were observed with the 13.5 mg intrauterine contraceptive system compared with 0.31 per 100 women-years (95% CI 0.15-0.57) with the 19.5 mg intrauterine contraceptive system. Kaplan-Meier estimates for that period were 0.009 and 0.010, respectively. At least partial expulsions occurred in 4.56% and 3.58% and discontinuation rates resulting from a reported adverse event occurred in 21.9% and 19.1%, respectively. Ten of the 20 pregnancies were ectopic. Serious adverse events included six cases of pelvic inflammatory disease and one partial uterine perforation. Both lower-dose levonorgestrel intrauterine contraceptive systems were highly effective for 3 years of use and generally well tolerated. ClinicalTrials.gov, www.clinicaltrials.gov, NCT00528112. : I.

The effects of menstrual cycle phase on the development of peak torque under isokinetic conditions

BACKGROUND: There are alterations in strength in relation to menstrual cycle phase but little data attributing these responses to female sex hormone levels using a pseudo-menstrual cycle group as control. OBJECTIVE: Examining the effects of menstrual cycle phase on the development of peak torque across a range of isokinetic speeds. METHOD: 17 well trained females, 11 formed the non-oral contraceptive group (n-OC) (age 20.7 ± 1.4 yrs, mass 59.2 ± 6.9 kg, height 166.8 ± 7.1 cm) and 6 the oral contraceptive control group (OC) (age 20.3 ± 0.5 yrs, mass 60.5 ± 4.2 kg, height 164.8 ± 4.8 cm). Concentric strength of the knee flexors and extensors (60–240°/s) was assessed, corresponding to menstruation (MEN), mid-follicular (mFOL), mid-luteal (mLUT) and pre-menstrual (pMEN). RESULTS: For n-OC significant decreases in peak torque production of the extensors at 120°/s (P=0.0207) (MEN) and of the flexors at 60°/s (P=0.0116) (MEN) and 120°/s (P=0.0282) (MEN) were observed compared to pMEN. No significant differences were observed across any menstrual cycle phase and peak torque for the OC group (p> 0.05). Significant positive correlations were observed (mLUT) between peak torque and oestrogen at 60°/s (P=0.040) and 120°/s (P=0.031). CONCLUSIONS: There are significant fluctuations in peak torque of the knee extensors in response to phases of the menstrual cycle associated with variances in the female sex hormones. The findings have implications for the planning of strength training in female athletes.

Long Term Follow Up of Women Using Reversible Contraceptive Methods-Conclusions from Combining Data of 3 Different Audits

Objective: The matter of the choice of the available contraceptive methods has increased in the last few years. Physicians have a wide range of contraceptive methods to choose but in the same time are in a big concern about the appropriate type of contraception they should select for their patient and the effects in woman’s health and couple’s wellbeing. We present the outcome of 3 different audits in a large population of Northern Greece and we discuss the outcome of their results. Method: Three different audits studied medical data from 14.880 women, of different ages, which presented to the outpatient family planning clinic of our hospital. They were all interviewed using a standardized questionnaire, from which we got important information about behavior, the use, effects and reactions of contraceptive methods. The only exclusion criterion from the study was the use of the pill for less than three months, removal of IUD in less than three months, failure to attend for follow up and women who had moved away from the geographical area. The data of our analysis were retrospectively selected from the case files of 11.129 women between 15 to 40 years old, who used reversible contraception between the years 1984-2011. Results: In the first audit, 2120 women participated, users of any type of oral contraceptive pills? They gave information about the satisfaction, the side-effects and the main reasons of discontinuing the use of the pill. In the second audit 9009 women chose different types of Intrauterine Devices (IUD) as a contraceptive method. All of them have been examined in outpatient department and they have been checked for the safety of their IUD in correlation with unexpected pregnancy. Data about outcome, side effects and unexpected pregnancies were recorded. The third audit refers to the concerns about the use of oral sex steroids in relationship with cervical cancer and pathology in smear test. In the IUD group, we had more often results of inflammatory changes, negative for malignancy, in comparison with the contraceptive pill group. There was not statistically significant difference between the two groups regarding low and high grade squamous intraepithelial lesions (LGSIL/HGSIL). Conclusions: By studying the results of all these audits, we can get some important information about the behavior, the side-effects and ways of improving the usage of all types of reversible contraception. These results can be used as a baseline from which to monitor trends in the use of contraception in correlation to similar studies.

Suppressed response to hormonal contraceptives in women of Khairpur, Sindh, Pakistan

Objective: Contraception has gained gradual popularity in many parts of the developing world including Pakistan. Despite this increase in acceptance, the birth rate remains high. Failure of contraception has been reported in the literature, which made us aim to conduct this study. The efficiency of hormonal contraceptives in the study area was assessed and this is the first report from Pakistan. Methods: A total of 200 women (aged 20-30 and 31-40 years; n = 100 each) with minimum consistent use of hormonal contraceptives in the form of pills (Combined oral contraceptives) for 12 months were enrolled in this study. Blood samples were collected from women of each age group and corresponding control groups (n = 100) from local hospitals and reproductive health service center. Serum levels of the fertility hormones viz leutinizing and follicle stimulating hormones were measured through ELISA technique. Results: Our data revealed that over all in the both age groups, 72% women had normal, 16% increased and 12% showed decreased levels of leutinizing hormone (p > 0.05) and 67% women showed normal, 33% showed decreased and no increased levels were found for follicle stimulating hormone (p > 0.05). No age-wise significant difference in response was observed among both the age groups tested. Conclusion: Statistically insignificant difference in serum leutinizing hormone and follicle stimulating hormone seen among both the age groups of hormonal contraceptive users and control group indicates less effective hormonal contraception response in the study area.

Trends in Contraceptive Use among Florida Women: Implications for Policies and Programs

Our study objective was to assess changes in effective contraceptive use among women at risk of unintended pregnancy in Florida in 2008 and 2009 compared with 2002 and 2004. Contraceptive use questions were available from Florida's Behavioral Risk Factor Surveillance System (BRFSS) for both periods (n=4,606). Log binomial regression was used with appropriate methods to account for complex sampling in the BRFSS. We examined the change in four effective contraceptive use groups: sterilization, long-acting reversible contraceptive (LARC), short-acting reversible contraceptive (SARC), and barrier methods. Prevalence ratios comparing the two time periods were adjusted by demographic characteristics, employment, insurance status, children at home, poverty level, health behaviors, and health status. No evidence of change was found in sterilization (Adjusted Prevalence Ratio APR=0.96; 95% CI: 0.84-1.10) or SARC (APR=1.01; 95% CI: 0.87-1.18). The overall use of LARC increased and use of barrier methods decreased significantly over the two periods (APR=1.68; 95% CI: 1.09-2.60 and APR=0.77; 95% CI: 0.61-0.98, respectively). Only two population groups experienced significant changes in prevalence in the four use groups over this period. Non-Hispanic White women increased their use of LARC (APR=2.89; 95% CI: 1.58-5.29) and women who have never been married decreased their use of barrier methods (APR=0.51; 95% CI: 0.33-0.77). Contraceptive use in Florida continues to be low overall with some shift towards more effective long-term methods. New efforts are needed to promote and increase family planning practices, which include the use of effective contraceptives.

ANTICIPATORY TESTOSTERONE IN FEMALE COLLEGIATE RUNNERS DURING COMPETITION

The purpose of the current study was to examine the relationship between competitiveness and the anticipatory total serum testosterone response to athletic competition in female collegiate endurance athletes. Twelve college‐aged female athletes participated in a track relay‐style race. A $10 gift card was awarded to each member of the fastest team. Blood serum was obtained 24 hours prior and 15 minutes prior to a competition. An IMMULITE total serum testosterone competitive chemiluminescent immunoassay was used for analysis. The Revised Competitiveness Index (RCI) was completed. A dependent t‐test was used to calculate differences between the two serum samples and between oral contraceptive groups. A Pearson correlation (α&lt;0.05) assessed the relationship between RCI scores and 15 minute pre‐race serum testosterone levels. No significant differences were found between oral contraceptive groups (p=0.715) or between 24 hour and 15 minute pre‐race serum testosterone levels (p=0.855). There was no correlation between RCI scores and 15 minute pre‐race total serum testosterone level (R=0.05, p=0.915). These results suggest that for this specific population, competitiveness in a simulated race is unaffected by changes in testosterone secretion.

Hormonal contraception and the risk of HIV acquisition among women in South Africa

To evaluate the effect of hormonal contraception including combined oral contraceptives (COCs), and the injectable progestins depo-medroxyprogesterone acetate (DMPA) and norethisterone enanthate (Net-En) on the risk of HIV acquisition among women in South Africa. We analyzed data from 5567 women aged 16-49 years participating in the Carraguard Phase 3 Efficacy Trial. Participants were interviewed about contraceptive use and sexual behaviors and underwent pelvic examinations and HIV testing quarterly. We used marginal structural Cox regression models to estimate the effect of hormonal contraception exposure on HIV acquisition risk among women overall and among young women (16-24 years) in particular. Two hundred and seventy participants became HIV-infected (3.7 per 100 woman-years); HIV incidence was 2.8, 4.6, 3.5 and 3.4 per 100 woman-years in the COC, DMPA, Net-En and nonhormonal contraceptive groups, respectively (P = 0.09). The adjusted hazard ratios (AHRs) were 0.84 [95% confidence interval (CI) 0.51-1.39], 1.28 (95% CI 0.92-1.78) and 0.92 (95% CI 0.64-1.32) among COC, DMPA and Net-En users, respectively, compared with the nonhormonal group controlling for covariates. Age modified the effect of hormonal contraception on HIV acquisition risk; among young women, the AHRs were 1.02 (95% CI 0.46-2.28) for COCs, 1.68 (95% CI 0.96-2.94) for DMPA and 1.36 (95% CI0.78-2.35) for Net-En users. In this study conducted among South African women, hormonal contraception did not significantly increase the risk of HIV acquisition. However, the effect estimate does not rule out a moderate increase in HIV risk associated with DMPA use found in some other recent studies.

Oral Contraceptive Use May Attenuate Menstrual Cycle-Induced Ventilatory Changes in Endurance Trained Runners

The relationship between two menstrual cycle phases and cardio respiratory fitness in athletes on oral contraceptives and not on oral contraceptives was assessed in a pilot study. Twelve endurance-trained college cross country runners underwent maximal oxygen consumption treadmill testing, during the late follicular/ovulatory phase and late luteal/premenstrual phase of their menstrual cycle. No significant differences were detected in maximal oxygen consumption between the oral contraceptive group and non-oral contraceptive group or between the two phases. There was a non-significant phase effect in the non-oral contraceptive group with maximal ventilation averaging 90.5±14.6 L/min during the late follicular/ovulatory phase and decreasing to 79.1±9.8 L/min during the late luteal/premenstrual phase (p=0.102). Maximal ventilation was significantly lower by 15.6% between oral contraceptive and non-oral contraceptive users during the late luteal/premenstrual phase (93.7+7.2 L/min vs 79.1+9.8 L/min, p=0.014, respectively). There was no significant phase effect in the oral contraceptive group for maximal ventilation. While oral contraceptive use was associated with an attenuation of the negative effect of the late luteal/premenstrual phase on ventilator performance, there was no effect on maximal oxygen consumption.

Differences in Cervical Cytologic and Histologic Findings Between Women Using Depot-Medroxyprogesterone Acetate and Oral Contraceptives

This study aimed to compare cervical cytologic and histologic findings between women using depot-medroxyprogesterone acetate (DMPA) and oral contraceptives (OCs) referred for colposcopy and to determine whether there were differences in the occurrence of false-positive cytologic finding between the 2 contraceptive groups. Retrospective cohort of 1,569 premenopausal women using either DMPA or OC who were evaluated for abnormal cervical cytologic findings. Cytologic and histologic data were collected in conjunction with routine gynecologic examinations or follow-up colposcopic evaluations. χ2 tests were used to determine differences in cervical cytologic and histologic findings and the proportion of false-positive results across contraceptive groups. Nominal logistic regression was used to evaluate the association between contraceptive use, cervical, and histologic abnormalities while controlling or age and smoking status. The mean age of all participants was 23.5 years, with no significant difference between OC (n = 1194) and DMPA (n = 375) users. Although there were no differences in the proportion of false-positive cytologic results (21.8% overall), DMPA users were more likely to smoke (p < .001), have atypical glandular cell (AGC) on referral cytology (p < .001), and have histologic confirmation of cervical intraepithelial neoplasia 2, 3 (p = .004). Users of DMPA remained more likely to have AGC cytology after considering smoking status; however, cervical intraepithelial neoplasia 2, 3 was found to be associated with smoking status and not use of DMPA. We found no difference in the proportion of false-positive cytologic results between DMPA and OC users referred for evaluation of abnormal cytology. Users of DMPA were more likely to have AGC, which necessitates a more comprehensive evaluation.