Contraception In Young Women Research Articles

Sex Hormone Treatment for Female Children and Young Adults with Disorders Affecting Hypothalamic, Pituitary, and Ovarian Function.

Normal hypothalamic-pituitary-ovarian (HPO) endocrine function is essential for female pubertal and psychosocial development and for ongoing adult physical, sexual, and psychosocial health. Girls with hypogonadism, any endocrine disorder causing abnormal uterine bleeding (AUB) or with contraception needs may require sex hormone treatment. Challenges include evolving needs of a young girl through the course of sexual maturation, potential health risks related to the use of sex hormones for pubertal induction, hormone replacement therapy (HRT), menstrual management, and/or contraception. To ensure optimal sex hormone treatment, both a comprehensive understanding of the underlying disorder affecting HPO endocrine function and a professional communication with the patient and physicians involved are warranted. In this narrative mini-review, we discuss pubertal induction and HRT for girls with hypogonadism and the management of AUB and contraception for young women up to age 30 years. Additionally, we provide advice on management of AUB and contraception in young women with common conditions including polycystic ovary syndrome, congenital adrenal hyperplasia and others. A PubMed-literature search including articles published over the last 20 years, together with clinical experience of the authors was integrated to provide treatment recommendations. Sex hormone treatment, where needed, requires comprehensive understanding of a range of available options. When tailored to individual needs, with flexibility to accommodate changing circumstance in young women it is safe, well tolerated and provides both physical and psychosocial health.

High Use of Estrogen-based Contraceptives in Young Women With Inflammatory Bowel Disease in the United States

High Use of Estrogen-based Contraceptives in Young Women With Inflammatory Bowel Disease in the United States

Some aspects of adherence to combined hormonal contraception in young women

Introduction. In addition to being protective against unwanted pregnancies, combined hormonal contraceptives (CHCs) can improve health and quality of life of women. The awareness of Russian women about CHCs is 85 %, however, only 13 % of women in Russia have a long-term experience with CHCs. This is why, it is essential to analyse drivers of adherence of young women to CHCs, and the reasons for refusal of them. Aim. Identification of the reasons affecting adherence to СHС in young women. Materials and methods. Group 1 consisted of 36 women who have tried using СHС, but stopped taking: 1A (19 women) – up to 1 year, 1B (17 women) – from 1 to 3 years; group 2 – 35 women who have never used СHС. Results. The level of education in group 2 was significantly lower, patients with secondary general education prevailed. Despite the high awareness of the benefits of СHС, the number of real users of these drugs was only 50.7 %, while half of them used CHС for 9 months on average. The refusal to use СHС in group 2 was motivated by the possible development of side effects, the lack of need for regular contraception, which requires improvement of counseling on using СHС, taking into account the characteristics of the contingent of patients. The reason for the rejection of СHС in groups 1A and 1B, regardless of the duration of use, was side effects in 42.1 and 47.1 % of cases, respectively, which included: headaches, decreased libido; nausea, epigastric pain, intermenstrual spotting, weight gain, emotional lability. Conclusion. Taking into account the level of education of patients and their needs, high-quality structured counseling when choosing a method of contraception will increase compliance with the use of СHСs, increase the frequency and duration of using СHСs.

Contraception for Adolescents and Young Women with Type 2 Diabetes-Specific Considerations.

This article reviews how to address contraception in young women with type 2 diabetes (T2D). The presence of obesity and comorbidities associated with insulin resistance increases the risk of thromboembolic disease and adverse cardiovascular outcomes. Recent studies have shown that adolescents with T2D are at high risk of unintended pregnancy with poor outcomes for the mother and offspring. Adolescents with T2D without severe obesity, micro- or macrovascular disease, or other cardiovascular risk factors can use any contraceptive method. However, only nonhormonal or progestin-only methods may be used when morbid obesity, severe hypertension, micro- or macrovascular disease, or multiple cardiovascular risk factors are present. The medical team must provide preconceptional counseling and contraception to reduce adolescent pregnancies in young women with T2D. Progestin-only or nonhormonal long-acting reversible contraception (LARC) should be recommended for women with T2D with compliance issues or adverse cardiovascular risk profiles.

Opportunities of treatment for primary dysmenorrhea in young women. Case report

Primary dysmenorrhea is one of the most common causes of pelvic pain in women. It can reduce quality of life and interfere with daily activities. The use of combined oral contraceptives in young women with primary dysmenorrhea is an effective and safe treatment option. The article presents a clinical case of the effective use of combined oral contraceptives containing drospirenone in a young woman with primary dysmenorrhea and severe pain syndrome, which is not relieved by analgesics and antispasmodics and significantly reduces the patient's quality of life.

Real clinical practice and contraception for young women with children

The review presents the psychosocial characteristics of young women in todays millennial generation and survey data regarding their hormonal contraceptive requirements. The results of randomized clinical trials and real-life studies of the use of the combined oral contraceptive (COC) Qlaira containing estradiol valerate and dienogest (E2V/DNG) in a dynamic dosing regimen were analyzed, in which the reliability of the contraceptive effect of the drug was identified and confirmed, the restoration of fertility was population level after drug withdrawal, its minimal effect on metabolism and a reduced risk of cardiovascular complications (venous and arterial thrombosis) when using Qlaira COC in comparison with other COCs. The absence of a negative effect of COC E2V/DNG on body weight, sexual function and vaginal microbiocenosis in most women has been proven. The data on satisfactory characteristics of menstrual bleeding (lighter and shorter) in users of Qlaira COC and a decrease in symptoms associated with a hormone-free interval, which often occur when taking other COCs in the 21/7 regimen, are presented. The favorable efficacy and safety profile of COC E2V/DNG in real conditions, the advantages of estrogen bioidentical to the endogenous, in the composition of the drug, the dosage regimen 26/2, the positive effect on the lifestyle, determine the significant satisfaction of young women, including young women with children, and the ability to use the drug for a long time until menopause.

LB8. Microarray Patch Delivery of Long-Acting HIV PrEP and Contraception

BackgroundThe purpose of this research was to develop a microarray patch (MAP; also known as a microneedle patch) for delivery of long-acting cabotegravir (CAB LA) for HIV pre-exposure prophylaxis (PrEP) and co-delivery of long-acting CAB LA and a hormonal contraceptive to enable a future multi-purpose prevention technology. This abstract presents preclinical pharmacokinetic results of MAP delivery of CAB LA.MethodsMAPs are an alternative delivery technology in clinical development for intradermal delivery of vaccines and pharmaceuticals. A MAP consists of an array of micron-scale projections (<1 mm in height) amassed on a baseplate and applied to the skin like a bandage. MAPs could provide a discreet delivery system that enables self-administration, which could be particularly important for HIV prevention and contraception for young women and girls in low-resource settings. The purpose of this 3-year, USAID-funded project is to develop a MAP for delivery of long-acting HIV PrEP through to the point of Phase I clinical readiness. Key attributes of the MAP for long-acting HIV PrEP, as defined by our target product profile, include patch size similar to commercially available transdermal patches (20 to 140 cm2), wear-time of less than 24 hours (ideally 20 minutes), weekly or monthly administration to achieve therapeutic efficacy, and ideally successful self-administration after reading simple product instructions.ResultsWe successfully formulated and optimized MAP projection geometry to accommodate high drug-loading requirements of CAB LA (5.86 mg CAB LA per 1 cm2 MAP), a hydrophobic drug. The MAPs are stable for 6 months under accelerated aging conditions in foil packaging, readily pierce the skin, and rapidly dissolve. In rats, plasma concentration levels of CAB LA were maintained above therapeutic targets of 4xPA-IC90 for 28 days; however, bioavailability was lower than IM or ID injection controls. Photos: QUB. MAPs dissolving over time in phosphate-buffered solution; MAP projections fully dissolved within 25 minutes.ConclusionAdditional development work is warranted, including optimizing bioavailability, evaluating MAPs as a maintenance dose in vivo, conducting cost of manufacturing and cost of delivery analyses, and assessing potential end-user acceptability. DisclosuresBill Spreen, PharmD, ViiV Healthcare (Employee), Trevor Scott, RPh, PhD, ViiV Healthcare (Employee). Others Authors: No reported disclosures.

Безболевая ишемия миокарда и гормональная контрацепция (при метаболическом синдроме у молодых женщин)

Безболевая ишемия миокарда и гормональная контрацепция (при метаболическом синдроме у молодых женщин)

813 Melanoma and chronic low dose ethinyl estradiol contraceptives in young women: A large midwestern U.S. patient population retrospective study

813 Melanoma and chronic low dose ethinyl estradiol contraceptives in young women: A large midwestern U.S. patient population retrospective study

Корректность использования микродозированных комбинированных оральных контрацептивов у молодых женщин

Корректность использования микродозированных комбинированных оральных контрацептивов у молодых женщин

A multicentre, open-label, randomised phase III study comparing a new levonorgestrel intrauterine contraceptive system (LNG-IUS 8) with combined oral contraception in young women of reproductive age

Objectives: To compare user satisfaction and adverse events (AEs) with a levonorgestrel intrauterine system (LNG-IUS 8; average levonorgestrel release rate approximately 8 μg/24 h over the first year [total content 13.5 mg]) and a 30 μg ethinyl estradiol/3 mg drospirenone (EE/DRSP) combined oral contraceptive (COC) in a population of young women.Methods: Nulliparous and parous women (aged 18–29 years) with regular menstrual cycles (21–35 days) were randomised to LNG-IUS 8 or EE/DRSP for 18 months. The primary endpoint was the overall user satisfaction rate at month 18/end of study visit.Results: Overall, 279 women were randomised to LNG-IUS 8 with attempted placement and 281 women were randomised to EE/DRSP and took ≥1 pill; the mean age was 23.7 and 23.9 years, and 77.4% and 73.3% were nulliparous, respectively. At month 18/end of study, 82.1% and 81.9% of women, respectively, reported being ‘very satisfied’ or ‘satisfied’ with their treatment; however, significantly more LNG-IUS 8 users reported a preference to continue their treatment post-study (66.2% vs 48.8%; p = 0.0001). There were two pregnancies (one ectopic pregnancy, one spontaneous abortion) reported in the LNG-IUS 8 group and six (three live births, two spontaneous abortions, one induced abortion) in the EE/DRSP group.Conclusions: LNG-IUS 8 and EE/DRSP were associated with similarly high user satisfaction rates. However, LNG-IUS 8 users were significantly more likely to prefer to continue their contraceptive method post-study, indicating that a levonorgestrel intrauterine system is an appealing contraceptive option for young women.

70. Determination of Satisfaction With the Use of the Subdermal Etonogestrel Implant “Implanon” as a Contraception Method, Its Side effects and Reasons for Discontinuing the Same, Compared With Other Hormonal Methods of Contraception in Young Women in a Rural

70. Determination of Satisfaction With the Use of the Subdermal Etonogestrel Implant “Implanon” as a Contraception Method, Its Side effects and Reasons for Discontinuing the Same, Compared With Other Hormonal Methods of Contraception in Young Women in a Rural

Practical Advice for Emergency IUD Contraception in Young Women.

Too few women are aware of the very high efficacy of intrauterine copper devices (IUDs) to prevent pregnancy after unprotected intercourse. Women who frequently engage in unprotected intercourse or seek emergency contraception (EC) are at high risk of unplanned pregnancy and possible abortion. It is therefore important that these women receive precise and accurate information about intrauterine devices as they may benefit from using an IUD for EC as continuing contraception. Copper IUDs should be used as first choice options given their rapid onset of action and their long-term contraceptive action which require minimal thought or intervention on the part of the user. In the United States, there is only one copper IUD presently available which limits treatment options. There are numerous copper IUDs available for use in EC, however, their designs and size are not always optimal for use in nulliparous women or women with smaller or narrower uteruses. Utilization of frameless IUDs which do not require a larger transverse arm for uterine retention may have distinct advantages, particularly in young women, as they will be suitable for use in all women irrespective of uterine size. This paper provides practical information on EC use with emphasis on the use of the frameless IUD.

Contraception for young women

The options for oral tablets and long-acting reversible contraception are outlined by Suneeta Kochhar

دالة الاستهلاك الكلية : تطوراتها النظرية و تطبيقاتها العملية في الإمارات العربية المتحدة = Total Consumption Function : Theoretical Developments and Practical Applications in United Arab Emirates

Introduction: oral contraceptive pills (OCPs) are the most popular form of hormonal contraception in young women. Aim of the work: the present study focused on evaluating the effects of two different contraceptive pills including combined pills (estrogen and progesterone) and mini pills (progesterone only) on the cervix of female rabbit. Material and methods: after three months of daily oral administration of these contraceptive pills the animals were sacrificed. The excised organs were dissected, processed and stained with H & E, PAS reaction and Masson’s trichrome stain and orcein stain. This was followed by morphometric measurements and statistical study. Results: this study revealed that contraceptive pills administration - specially the combined one - caused marked alterations in the form of hyperplastic cervical mucosal cells and hypertrophied muscular layer. Also, there was a significant increase in collagenous and elastic fibres content in the muscular layer of the cervix. There was also a statistically significant increase in PAS positive materials in the lumina of the mucosal glands of the cervix. All these changes were less marked in the case of mini pill treatment Conclusion: pills of progesterone only showed marked histopathological change, in the cervix as a contraceptive mean, but in less manner than the combined pills (estrogen and progesterone).

Uptake and continuation rates of the intrauterine system in a university student general practice population in the UK

ObjectiveTo follow a series of 100 women attending for fitting of the levonorgestrel-releasing intrauterine system (LNG IUS) registered at a single urban general practice serving the students of the local...

A survey of opinions on emergency contraception in young women in Southern Italy

ABSTRACTObjective To assess opinions and attitudes towards the use of hormonal emergency contraception (HEC) in a sample of young women in Puglia, Italy.Methods A self-administered standardised anonymous questionnaire was administered to female school-leavers who were attending a preparatory course at the University of Bari.Results Seven hundred and fifty-four women, with an average age of 19.5 years, completed the questionnaire. Sixteen percent of respondents had used HEC and 3% had used it more than once. The reasons given for resorting to HEC were: rupture of the condom (57%), the lack of thought about the risk of an undesired pregnancy (25%), and the unavailability of contraceptives at the time of coitus (18%).Conclusions The opinions expressed by the interviewees in our survey do not suggest that the use of HEC would increase the risks linked to sexual behaviour. In Italy, over-the-counter availability of HEC should be implemented in parallel with the improvement of sex education programmes aimed at the young.

A 21-Year-Old White Woman Diagnosed With Cerebral Venous Sinus Thrombosis Related to Oral Contraceptive and Factor V Leiden

Empirical research has established the fact that the use of oral contraceptives in young women with the Factor V Leiden mutation increases the relative risk of cerebral venous sinus thrombosis. Cerebral venous sinus thrombosis is a rare cerebral vascular injury whose ambiguous presentation contributes to delayed and often-inaccurate diagnosis. This case report presents a 21-year-old White woman with a severe headache who presented to the emergency department and was diagnosed with cerebral venous sinus thrombosis. The purpose of this article is to educate advanced practice emergency care nurses on the importance of understanding genetic and acquired risk factors in diagnosing cerebral venous sinus thrombosis. A genetic risk assessment tool is introduced that advanced practice nurses may incorporate into their routine assessments to evaluate the likelihood of a genetic predisposition for illness, such as shown in this case study.

Pregnancy and contraception in young women with congenital heart disease: General considerations

Young women with heart disease are increasingly being seen in obstetrical referral centres owing, in large part, to the dramatic improvements in survival of young adults with congenital heart disease in recent years. Although pregnancies in most women with heart disease result in favourable outcomes, there are important exceptions that must be recognized. These exceptions pose significant mortality risk to the mother and/or the fetus. The present article outlines cardiovascular adaptations to pregnancy, general outcomes and management considerations for practitioners caring for pregnant young women with congenital heart disease. A lesion-specific review is published in a complementary article.

No protection of the ovarian follicle pool with the use of GnRH-analogues or oral contraceptives in young women treated with escalated BEACOPP for advanced-stage Hodgkin lymphoma. Final results of a phase II trial from the German Hodgkin Study Group

Background: The reduction of treatment-related toxic effects is the main goal in the current trials of the German Hodgkin Study Group (GHSG). In this regard, the protection of the ovarian reserve in young women is very important. Therefore, the GHSG investigated the use of gonadotropin-releasing hormone-analogues (GnRH-a) and oral contraceptives (OC) in young women with advanced-stage Hodgkin lymphoma (HL).Patients and methods: Women (18–40 years) were randomly assigned either to receive daily OC or monthly GnRH-a during escalated combination therapy with bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPPesc). Hormonal levels were determined at baseline, during therapy, and at follow-up.Results: The study was closed prematurely after an interim analysis of 12 patients in arm A (OC) and 11 in arm B (GnRH-a), 9 and 10 are assessable for the primary end point. Women’s median age was 25 years in both arms. The anti-Mullerian hormone level after at least 12 months was reduced in all patients. For the entire study cohort, the respective ovarian follicle preservation rate was 0% (95% confidence interval 0% to 12%).Conclusion: We observed no protection of the ovarian reserve with hormonal co-treatment during BEACOPPesc. This result supports efforts of ongoing trials to reduce chemotherapy intensity and toxicity. Alternative strategies for the protection of fertility must be offered to young female HL patients before the start of BEACOPPesc therapy.