Effect Of Low-dose Oral Contraceptives Research Articles

Low-dose combined oral contraceptive and cervicovaginal shedding of human immunodeficiency virus

Background The role of low-dose oral contraceptives on HIV cervicovaginal shedding among HIV-positive women is controversial. Study Design We evaluated the effect of low-dose oral contraceptives on HIV cervicovaginal shedding in a cohort of 285 HIV-seropositive women followed for a median of 20 months. A sensitive, competitive polymerase chain reaction (cPCR) and a reverse transcription PCR (cRT-PCR) were applied for the quantification of HIV-associated and cell-free RNA and proviral DNA in cervicovaginal cells, as well as HIV-RNA in plasma. Results In multivariable logistic generalized estimating equations, plasma viral load >100 copies/mL (OR=1.81, 95% CI=1.3–2.53) and bacterial vaginosis (OR=1.49, 95% CI=1.1–2.02) were associated with an increased risk of HIV-1 DNA shedding, whereas current use of oral contraceptive was associated with a reduced risk (OR=0.55, 95% CI=0.33–0.92). Oral contraceptives were also associated with a reduction of risk (OR=0.38, 95% CI=0.21–0.69) of cell-associated but not cell-free HIV-1 RNA. Conclusions In HIV-positive women with low levels of HIV viremia, low-dose oral contraceptives were associated with a modest but significant reduction of HIV-1 DNA and cell-associated HIV-1 RNA genital shedding.

Unfavorable lipid profile in women with endometriosis

Similar to dyslipidemia, the oxidative stress and intrinsic inflammatory status may be associated with the development of endometriosis. Thus, we performed a cross-sectional study and found that women with endometriosis had an increased low-density lipoprotein (LDL) and non-high-density lipoprotein (HDL) cholesterol levels compared with controls presumably without endometriosis.

Gonadotropin-releasing hormone analog combined with a low-dose oral contraceptive to treat heavy menstrual bleeding

Objective To compare the effects of low-dose oral contraceptives used alone and in combination with a gonadotropin-releasing hormone (GnRH) analog to treat heavy menstrual bleeding. Methods Fifty-eight patients with heavy menstrual bleeding were prospectively randomized into two treatment groups to receive either a low-dose oral contraceptive alone (group 1), or combined with a GnRH analog (group 2) for 6 months. The patients' hormonal profiles, and hemoglobin and hematocrit levels were measured at the beginning and at the end of the treatment period. Results Hemoglobin and hematocrit levels significantly improved in both groups after 6 months of treatment ( P < 0.05 and P < 0.01, respectively). Even in the first month of the study, the number of pads used and the duration of menstruation were significantly decreased in both groups and markedly lower in group 2 ( P < 0.01). Conclusion The addition of a GnRH analog to low-dose oral contraceptive treatment for heavy menstrual bleeding resulted in better control of vaginal bleeding, even in the first month of therapy.

Effect of Low-Dose Oral Contraceptives on Metabolic Risk Factors in African-American Women

The effect of oral contraceptive pill (OCP) use on cardiovascular risk in African-American women is unknown. Our objective was to examine in African-American women the effect of OCP use on insulin resistance, glucose intolerance, and triglycerides (TGs). This was a cross-sectional study. The study was conducted at the National Institutes of Health Clinical Research Center. A total of 104 healthy nondiabetic African-American women [21 OCP users, 83 controls, age mean +/- sd, 34.7 +/- 7.6 yr, body mass index (BMI) 31 +/- 8.4 kg/m(2)] was included in the study. Subjects had oral glucose tolerance tests, insulin-modified frequently sampled iv glucose tolerance tests, and fasting lipid profiles. Insulin resistance was determined by the insulin sensitivity index (S(I)). Insulin resistance, glucose tolerance status, and TG levels were determined. Fasting glucose did not differ between OCP users and controls (P = 0.27). In contrast, compared with controls, 2-h glucose (135 +/- 23 vs.120 +/- 25 mg/dl; P = 0.01) and fasting TGs (73 +/- 31 vs.57 +/- 27 mg/dl; P = 0.02) were higher in OCP users. OCP users tended to be more insulin resistant than controls (S(I): 2.51 +/- 2.01 vs. 3.46 +/- 2.09; P = 0.09). Multiple regression analysis revealed that BMI, age, and OCP use were significant determinants of 2-h glucose (adjusted R(2) = 0.37; P < 0.001) and TG levels (adjusted R(2) = 0.21; P < 0.001). As BMI was a determinant of both 2-h glucose and TGs, participants were divided into nonobese and obese groups, and the analyses repeated. Among the nonobese women, the OCP users were more insulin resistant (S(I): 2.91 +/- 1.58 vs. 4.35 +/- 1.88; P = 0.03) and had a higher prevalence of glucose intolerance than controls (odds ratio 5.7; 95% confidence interval 1.4-24; P = 0.01). In African-American women, OCP use is associated with an increase in markers of cardiovascular risk manifested by increased insulin resistance, glucose intolerance, and elevated TGs.

Effects of low-dose OCs on weight in women with Central European nutritional habits and lifestyle

The aim of the study was to evaluate the acceptance and tolerance of combined low-dose oral contraceptives (OCs) (containing 20 μg ethinylestradiol and 75 μg gestodene) in a cohort of Polish women, and to present a relationship between the use of combined OCs and changes in body weight. Changes in body weight with combined low-dose OC have not been demonstrated in placebo-controlled trials, nor were such trials performed in a population whose nutritional/dietary habits and lifestyle resemble that of the population of Poland. We performed the clinical study on a group of 800 patients living in several regions of Poland. Patients used the low-dose OC for a period of 6 months. They were assessed every third cycle of OC use (initial examination and examinations after three and six cycles of OC use). On the basis of this investigation, a relationship between OC use and weight gain was not found.

Low-dose oral contraception and bone density

Oral contraceptives (OC) with 20 or 30 mcg Ethinyl-Estradiol (EE) inhibit bone remodeling in all age groups investigated until today as far as the biochemical parameters are considered. In perimenopausal women, OC with 20 or 30 mcg EE reduce the decrease in bone density and may, depending on the starting point, induce an increase in bone density. OC with 20 mcg EE might impede the formation of a physiological peak bone mass in very young women (probably women less than 20 years of age) by a reduction of bone metabolism. This possibility provoked a certain insecurity. However, it should not lead to the consequence that a safe contraceptive method is refused to young women. Unfortunately, there is still a lack of reliable studies allowing a final statement on the effect of low-dose OC on bone density in teenagers. Such studies are urgently needed so that we are able to guarantee in very young women that a reasonable contraception has not to be payed by a long-term risk for the skeletal health. The administration of a progestagen-only pill might be an alternative method for contraception in adolescence. A preparation containing 30 mcg of Levonorgestrel, nearly out of use today, could be of particular interest. A British study (20) has shown that during regular peroral administration of 30 mcg Leveonorgestrel per day, mean serum estradiol concentration decreased only slightly, from 653 to 500 pmol/l. This Estradiol concentration should still allow a normal bone metabolism and therefore a normal formation of the peak bone mass. However, the data actually available do not point convincingly to the conclusion that OC with 20 mcg EE or less might result in an insufficient estrogen concentration for normal bone metabolism. To reach peak bone mass, other factors than estrogens only are needed, such as Calcium, Vitamin D and physical activity.

Effects of low-dose oral contraceptives on lipid metabolism in women with insulin-dependent diabetes mellitus

Effects of low-dose oral contraceptives on lipid metabolism in women with insulin-dependent diabetes mellitus

Effect of low-dose oral contraceptives on androgenic markers and acne

Oral contraceptives (OC) suppress excess androgen production; however, different progestins in combination with low-dose estrogens produce divergent effects on sex hormone-binding globulin (SHBG) and testosterone that may influence clinical outcomes. This multicenter, open-label, randomized study compared biochemical androgen profiles and clinical outcomes associated with two OC containing the same amounts of ethinyl estradiol (EE, 20 μg) but different progestins, levonorgestrel (LNG, 100 μg), and norethindrone acetate (NETA, 1000 μg). Fifty-eight healthy women (18–28 years old) received three cycles of treatment with LNG/EE (n = 30) or NETA/EE (n = 28). The results showed that LNG reduced androgen levels in three compartments—adrenal, ovarian, and peripheral. NETA reduced only adrenal and peripheral androgens. Despite a 2.2-fold greater relative increase in SHBG with NETA than LNG, bioavailable testosterone (T) was reduced by the same amount with LNG and NETA. Both treatments improved acne and were well tolerated. Low-dose OC (EE, 20 μg) are effective in reducing circulating androgens and acne lesions without causing weight gain. Although LNG and NETA affected secondary markers differently, both OC formulations produced an equivalent decrease in bioavailable T.

Effects of Low-Dose Oral Contraceptives on Very Low-Density and Low-Density Lipoprotein Metabolism

Effects of Low-Dose Oral Contraceptives on Very Low-Density and Low-Density Lipoprotein Metabolism

The effects on hemostasis of oral contraceptives containing desogestrel

Epidemiologic research has shown that current low-dose estrogen oral contraceptives are associated with a low risk of vascular events (e.g., myocardial infarction, stroke, and venous thrombosis or thromboembolism). Yet questions still persist about the effects of low-dose oral contraceptives on the cardiovascular system. Changes in the coagulation system have been linked primarily to the estrogen component; however, it has been proposed that the progestin may have an influence on the fibrinolytic system. Desogestrel, a new gonane progestin, has been commercially available in Europe since 1981. It has been widely shown to produce minimal changes of the coagulation and fibrinolytic systems, and it has not been associated with an increased risk of thromboembolic disorders.

The effect of low-dose oral contraceptives and Norplant on blood pressure and body weight of Nigerian women.

Blood pressure (BP) and body weight were assessed at entry, 6 months and 12 months of use in a prospective study of 117 and 76 women using low-dose oral contraceptives (LD-OCs) and Norplant, respectively. The results showed that mean systolic BP (mmHg), diastolic BP (mmHg) and weight (kg) for LD-OCs and Norplant at entry, 6 months and 12 months, respectively, were not significantly different. During the one year of use, the study found that moderate increase in BP occurred at the same frequency as reduced BP, and that observed variation in BP was within a narrower range in Norplant users compared with LD-OC users.

The effect of low-dose oral contraceptives on lipids and lipoproteins in two at-risk populations: Young female smokers and older premenopausal women

Young women who smoke and women over age 35 are considered to be at high risk for cardiovascular complications associated with oral contraceptive use. This study evaluated the effects of low-dose oral contraceptives on lipid and lipoprotein concentrations in 45 high-risk patients before, during, and after 6 months of treatment. Neither group showed a significant change from baseline in cholesterol, HDL cholesterol, LDL cholesterol or cholesterol ratios. Triglycerides increased and HDL 2a levels decreased significantly in both groups but returned to baseline after treatment was discontinued, with the largest changes in both triglycerides and HDL 2a levels occurring at 1 month. The change in triglyceride and HDL 2a blood levels were within the laboratories' reference range. The lipid profile of these patients, therefore, was not worsened significantly through 6 months of oral contraceptive use. The young women who smoked did have consistently lowered levels of HDL cholesterol and its HDL 2a subfraction when compared to their elder non-smoking cohort.

Effects of low-dose oral contraceptives on female whole saliva

The composition and flow rate of paraffin-stimulated whole saliva were analysed in 22 women, of whom 11 used oral contraceptives and 11 did not. Ten men served as the controls. The salivary samples were collected during one month (oral contraceptive users and men), or during one menstrual cycle (non-users). The saliva analyses included flow rate, pH, buffer effect, sialic acid, thiocyanate, peroxidase, lysozyme, amylase, immunoglobulins A, G and M, total protein, mutans streptococci, lactobacilli, yeasts and total numbers of aerobic bacteria. The salivary buffer effect of oral contraceptive users was significantly ( p < 0.005) higher than that of non-users. All the other constituents showed intra- and interindividual variation in all groups, but with no apparent hormone-dependency.

An investigation of the influence of expectancy on affective and physical changes associated with oral contraceptive use

The effect of low-dose oral contraceptives on psychological and physical complaints was investigated prospectively in a group of 19 first-time users. Their responses to questionnaires assessing depressionanxietyphysical symptomslife changesand expectations of negative or positive consequences of oral contraceptives were compared to a group of age-matched women who had been using the same type of oral contraceptive for at least 6 months. All subjects were assessed at recruitment1 monthand 3 months later. No group differences were found prior to initiation of contraceptive use by the first-time usersor 1 and 3 months after the first-time users began taking oral contraceptives. Non-significant correlations were found between negative expectancy (expected increases in depressionanxietymenstrual discomfortand other negative psychological or physical changes)anxietydepressionphysical complaintsand life changes in first-time usersalthough 65% did expect at least one negative effect of oral contraceptives. Our fi...

Effect of low-dose oral contraceptives on carbohydrate and lipid metabolism in women with recent gestational diabetes: Results of a controlled, randomized, prospective study

Women with recent gestational diabetes mellitus were randomly assigned to one of two low-dose oral contraceptives to evaluate the effect of low-dose oral contraceptives on carbohydrate and lipid metabolism. A cohort of similar women requesting a non-oral-contraceptive method served as controls. The two oral contraceptives studied were ethinyi estradiol (0.035 mg)-norethindrone (0.40 mg) and ethinyl estradiol (0.030 to 0.040 mg) -levonorgestrel (0.050 to 0.125 mg). A 75 gm, 2-hour oral glucose tolerance test and a fasting lipid profile (total cholesterol, triglyceride, high- and low-density lipoprotein cholesterols) were performed at entry, after 3 months, and after 6 to 13 months of treatment. The prevalence of diabetes at 6 to 13 months (271156 patients) was not significantly different between groups (non-oral-contraceptive group, 17%; ethinyl estradiol-norethindrone, 15%; ethinyl estradiol-levonorgestrel, 20%). When examined by prior gestational diabetes mellitus class, diabetes mellitus was present in 7% of prior class A, and 29% of women with prior class AZ disease (p<0.001). Mean cholesterol and low-density lipoprotein cholesterol levels were significantly improved in all three groups at 3 months and at 6 to 13 months, whereas triglycerides remained unchanged. There were no differences in cholesterol, low-density lipoprotein cholesterol, or triglycerides levels between the groups. After 6 to 13 months, there was a significant increase in high-density lipoprotein cholesterol in the ethinyl estradiol-norethindrone group compared with the ethinyl estradiol-levonorgestrel and non-oral-contraceptive groups.

Low-dose oral contraceptives and carbohydrate metabolism

Combined oral contraceptive use has been associated with increased incidence of impaired and diabetic glucose tolerance. Although increased risk of overt symptoms of diabetes has not been associated with oral contraceptive use, increased risk of coronary heart disease has been consistently demonstrated. Diabetes is associated with increased risk of coronary heart disease, especially in women. Elevated plasma glucose and insulin concentrations are also associated with increased risk of coronary heart disease. Studies of the effects of low-dose oral contraceptives on glucose tolerance test plasma glucose and insulin levels are reviewed. Low-dose combined oral contraceptives induced changes in measures of carbohydrate metabolism in directions consistent with increased risk of coronary heart disease. The magnitude of these changes may depend on the dose and type of progestogen. The clinical implications of these changes are unknown, but it would seem advisable to minimize them where possible. (Am J Obstet Gynecol 1990;163:348-353.)

Hemostasis profile in women taking low-dose oral contraceptives

Thirty-six young, healthy, nonsmoking women have been selected to check the effect of low-dose oral contraceptives on hemostasis. Two identical groups were treated by Marvelon (a monophasic oral contraceptive containing ethinyl estradiol and desogestrel) or Trigynon (a triphasic oral contraceptive containing ethilyl estradiol and levonorgestrel) for a 6-month period. In the absence, previously controlled, of substantial differences between the effects of each treatment on hemostasis, all the results were pooled at the third and sixth month of the study. The effects of oral contraceptive treatment were as follows: (1) platelet number, platelet aggregating ratio, and plasma ~-thromboglobulin level were not significantly altered, and (2) antithrombin III activity was not reduced despite a slight decrease or antigen concentration. The von Willebrand factor parameters, factor VIII: C, factor VII: C, and clottable fibrinogen were significantly increased. Plasminogen (activity and antigen concentrates) and lX2-antiplasmin levels were also significantly increased. Activated partial thromboplastin time and euglobulin lysis time measured after venous occlusion were significantly shortened. Although statistical analysis did not show dramatic changes in all these parameters, some individual extreme values were substantially altered. Therefore we believe that these later values are worthy of cautious consideration for weighing the role that hemostasis factors might play in individual thrombotic risk. (Am J Obstet Gynecol 1990;163:420-3.)

Effect of low-dose oral contraceptives on natural killer cell activity

Several reports indicate an association between oral contraceptives and increased infection rates. One mechanism that could explain this increased infection rate is a decrease in immune function. A study comparing T cell subsets showed no differences in numbers between oral contraceptive users and controls. In this study, natural killer cell activity was compared in women before and 3 and 6 months after oral contraceptive use. There was a statistically significant decrease in NK cell activity after three months. There was no further decrease by six months and the differences were no longer significant due to greater variability. No infections were reported during the study period. Thus, the observed reduction in NK activity was either physiologically insignificant or the previously reported increase in infections may be the result of non-immunological factors.

The Effect of Low-Dose Oral Contraceptives on Cardiorespiratory Function, Coagulation, and Lipids in Exercising Young Women

NOTELOVITZ, MORRIS; ZAUNER, CHRIS; MCKENZIE, LYNDA; SUGGS, YVONNE; FIELDS, CAROL; KITCHENS, CRAIG Author Information

The Effect of Low-Dose Oral Contraceptives on Cardiorespiratory Function, Coagulation, and Lipids in Exercising Young Women

The Effect of Low-Dose Oral Contraceptives on Cardiorespiratory Function, Coagulation, and Lipids in Exercising Young Women