Low-dose Oral Contraceptive Pill Research Articles

Endocrine-disrupting substances: I. Relative risks of PFAS in drinking water.

Concentrations of per and polyfluorinated alkyl substances (PFAS) in drinking water are significantly lower than in vivo levels of the native target hormone. These concentrations are orders of magnitude lower than the hormone in question, particularly when corrected for transactivation. A pregnant woman can excrete about 7,000 μg/day of total estrogens. A low-dose oral contraceptive pill contains 20 μg estradiol. Soy-based baby formula contains phytoestrogens equivalent to a low-dose oral contraceptive pill. A woman on a low-dose oral hormone replacement therapy consumes about 0.5-2 mg/day of one or more estrogens. The levels of endocrine-disrupting substances (EDSs) exposure by oral, respiratory, or dermal routes have the potential to make removing PFAS from drinking water due to its estrogenic activity divert valuable resources. These levels become even less of a threat when their estrogenic potencies are compared with those of the target hormones present as contaminants in water and even more so when compared with levels commonly present in human tissues. The fact that PFAS constitute a tiny fraction compared to exposure to phytoestrogens makes the effort even more insignificant. If PFAS are to be removed from drinking water, it is not due to their estrogenic activity.

Carpal tunnel syndrome ascribed to low-dose combined oral contraceptive pills.

Carpal tunnel syndrome (CTS) is the most prevalent compressive focal mononeuropathy brought on by median nerve compression, and common manifestations include pain in the wrist joint, decreased sensations along the distribution of the median nerve, a reduction in two-point discrimination, nighttime awakening, and, in more advanced stages, thenar muscle wasting and weakening. CTS, although common, yet underreported adverse effects of oral contraceptives. We report a case of 21-year-old female who developed CTS after using low-dose combined oral contraceptive pills for irregular cycles with polycystic ovary disease.

Treatment of Primary Dysmenorrhea Affecting Menstruating Women Using Herbs: A Review

Abstract: Primary dysmenorrhea is a common condition that affects menstruating women, especially young women. Painful cramping in the lower abdominal area, nausea, vomiting, headache, and fatigue is associated with primary dysmenorrhea, which restricts women from normal living life. The productivity and work performance of women are heavily affected by the symptoms of primary dysmenorrhea. Non-steroidal anti-inflammatory drugs (NSAIDs) and low dose oral contraceptive pills (OCPs) are commonly prescribed for the treatment of primary dysmenorrhea. However, variability in individual response to the drugs and their side effects hinder their long-term use among women. Complementary medicine such as herbs is a promising alternative for the treatment of primary dysmenorrhea, but it lacks scientific evidence. The pharmacological and clinical studies of 9 herbs were included in this review. Although excellent analgesic effects of herbs were reported by clinical studies, the detailed mechanism of action of most herbs remains unelucidated. Several studies discovered that herbs exert analgesic effects through direct uterine muscle relaxation effect, inhibition of cyclooxygenase-2 (COX-2), inhibition of intracellular calcium level, and reduction of prostaglandin synthesis. Further investigation of pharmacological action and the recommended dosages of the herbs for the optimal analgesic effect is needed.

Polyherbal Formulation for Primary Dysmenorrhea: A Review

Primary dysmenorrhea (PD) is defined as painful menstrual flow in teenagers who have no other gynaecological symptoms. High absenteeism to school and work have been reported in women with primary dysmenorrhea. Non-steroidal anti-inflammatory drugs (NSAIDs) and low dose oral contraceptive pills (OCPs) are the conventional treatment for primary dysmenorrhea. Despite their effectiveness, various side effects hinder the patients away from long time management with conventional treatment. Various polyherbal formulation have been used for centuries in the management of primary dysmenorrhea. However, scientific evidence of its mechanism of action and clinical effectiveness are scarce. A summarised overview of the molecular pathogenesis of the primary dysmenorrhea has been provided to understand the mechanistic pathway involved in primary dysmenorrhea. A total of 8 polyherbal formulations have been included. Pre-clinical and clinical trials of polyherbal formulation commonly used in primary dysmenorrhea have been discussed in this review to provide a picture of the current practice of traditional medicines in the management of primary dysmenorrhea. Most of the preparations demonstrated their actions through regulation of inflammatory markers and hormones in vivo. Inconsistency in sample size, doses of herbal preparation and primary outcomes of clinical trials created controversial findings on the effectiveness of the polyherbal preparation in human.

Randomized Controlled Trial of Tranexamic Acid’s Effect on Bleeding Length: A Study on DMPA Users with Abnormal Uterine Bleeding Who Receive Low-Dose Oral Contraceptive Pill

ABSTRACTBackground: Contraceptive injection is the most common contraception used in Indonesia. Among the contraceptive injections, depomedroxy progesterone acetate (DMPA) is the most effective method with pregnancy rate of 0,3 pregnancy in 100 women annually. Abnormal uterine bleeding (AUB) is a common side effect occurred in DMPA users which leads to the discontinuation of contraception.Objective: To explore the effect of tranexamic acid on bleeding length for DMPA users with AUB who receive low dose Oral Contraceptive Pills (OCP).Methods: We performed double blind randomized control trial between two groups to investigate the effect of tranexamic in managing AUB in DMPA users who receive low dose OCP. This study was performed in Dr. Kariadi Hospital Semarang, Indonesia. Forty-four subjects were divided into two groups, equally. Group 1 received 250 mg tranexamic acid four times a day for 5 days and OCP once a day for 28 days, while Group 2 received placebo four times a day for 5 days and OCP once a day for 28 days. Both groups were evaluated for bleeding length during treatment and were analyzed using Mann Whitney for post treatment with tranexamic acid.Results: The mean bleeding length was 5.2±3.62 days and 9.2±6.16 days in group 1 and 2 respectively. These bleeding lengths were significantly different between both groups (p=0.018). The precentage of subjects in whom bleeding was stopped during the first week after initial treatment was significantly higher in group 1 than group 2 (77,3 % vs 45,5 %, p<0,030).Conclusion: Tranexamic acid significantly reduced the bleeding length in DMPA users who use OCP.

Effects of low-dose contraceptive pills on the risk factors of cardiovascular diseases among 15-35-year-old women: A retrospective cohort.

BackgroundCardiovascular diseases could be preventable; as a result, understanding the risk factors was regarded as the major priority for healthcare providers.ObjectiveThe main objective of this research was to achieve a deeper insight into the effect of long-term use of low-dose oral contraceptive pills (OCP) on the risk factors of cardiovascular diseases.Materials and MethodsThis research was a retrospective cohort conducted (historical and prospectively) conducted on 100 women with normal menstrual cycles aged 15 to 35 yr, who were referred to the healthcare centers in Yazd, Iran. The participants were categorized into two groups: The OCP group was consuming the pills for 0-3, 4-23, and 24-36 months, and the non-OCP group. Participants were followed up for a minimum of 3 months and a maximum of six months.ResultsThe highest level of low-density lipoprotein (LDL), homocysteine, cholesterol, triglyceride levels, and systolic blood pressure was observed in the OCP group in the duration of 24 to 36 months. The Tukey's test demonstrated that there were comprehensible differences in the LDL (p = 0.01), cholesterol (p = 0.01), triglyceride (p 0.001), and homocysteine levels (p 0.001), also systolic blood pressure (p = 0.04).ConclusionIt was realized that the long-term consumption of low-dose OCP can augment the incidence of some risk factors (systolic blood pressure, homocysteine levels, cholesterol, LDL-c, and triglyceride) and lead to developing cardiovascular diseases amongst the healthy women.

Ultralong-term cyclic use of low-dose monophasic combined oral contraceptive pills for the management of recurrent severe endometriosis after second-line surgery

Ultralong-term cyclic use of low-dose monophasic combined oral contraceptive pills for the management of recurrent severe endometriosis after second-line surgery

Relationship between Long Duration Use of Hormonal Contraceptive and Serum Lipid Profiles among the Women of Dhaka City

Background: Long duration use of hormonal contraceptives can cause different metabolic effects.
 Objective: The purpose for the present study was to see the relationship between long duration of use of hormonal contraceptives and serum lipid profiles.
 Methodology: This cross-sectional study was carried out in the Department of Obstetrics & Gynaecology in collaboration with the Biochemistry Department at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2004 to December 2005 for eighteen (18) months. Women of reproductive age group who had given the history of taking low-dose oral contraceptive pills (OCP) containing 30 meg ethinyloestradiol (EE) plus 150 meg levonorgestrel (LNG) were included as study population. The women were divided into group A which was consisted of women who were using OCP for up to 5 years and group B who were using OCP for more than 5 years. Blood was collected from each woman in fasting state and serum was sent for estimation of serum lipids profiles like serum triglycerides, total cholesterol, LDL and HDL.
 Result: The women in group A was consisted of 20 women and the rest 20 women were in group B. Comparison of mean age between control and case groups showed no significant difference (31.75±4.85 vs 30.43±5.44 years). In women using OCP ≤5 years and >5 years, the mean (±SD) cholesterol levels were 252.50±48.86 and 239.55±48.73 mg/dl (p>0.10), triglyceride levels were 204.30±48.10 and 191.45±67.89 mg/dL (p>0.10), HDL levels were 42.82±8.96 and 43.00±6.46 (p>0.10) and LDL levels were 168.83±50.82 and 158.26±50.32 (p>0.10) respectively.
 Conclusion: The level of total cholesterol and triglycerides are not significantly varied with long duration (more than 5 years) of oral contraceptive pills use.
 Journal of Current and Advance Medical Research 2019;6(1):10-13

A comparative study of norethisterone and combined oral contraceptive pill in the treatment of dysfunctional uterine bleeding

Background: A significant percentage of women in India suffer from dysfunctional uterine bleeding (DUB), which has a negative impact on physical and social life. Norethisterone and low-dose combined oral contraceptive (COC) pills are used in the treatment of DUB. Aim: The aim of this study was to compare the efficacy and safety of norethisterone and low-dose COC pills in reduction of blood loss in DUB. Materials and Methods: A prospective randomized interventional study was conducted with patients with DUB. Pretreatment pictorial blood loss assessment chart (PBAC) and hemoglobin in blood were obtained from patients. Then, Group I (n = 50) and Group II (n = 50) patients were provided treatment with norethisterone and low-dose COC pills, respectively. Posttreatment PBAC and hemoglobin level in blood was obtained after 6 months of treatment. Improvements in PBAC and hemoglobin level (difference between posttest and pretest value) were compared by unpaired t-test with α = 0.05. Results: Mean age of Group I and Group II patients was 28.62 ± 9.84 and 28.42 ± 10.08 years, respectively. Improvement in PBAC score in patients treated with norethisterone versus low-dose COC pill was −98.62 ± 7.82 versus −96.44 ± 8.74 (P = 0.19). Improvement in hemoglobin level in patients treated with norethisterone versus low-dose COC pill was 2.75 ± 1.06 gm/dL versus 2.71 ± 0.86 gm/dL (P = 0.84). Conclusion: Norethisterone and low-dose COC pills were found to be equally efficacious in reducing bleeding in DUB. Hence, any one of the drugs can be used in the treatment of DUB according to patients' profile. However, considering the side effects, low-dose COC pills may be a better choice.

Duration of Oral Contraceptives Use and Risk of Development of Dyslipidemia among Women in Dhaka City

AbstractBackground: Duration of oral contraceptive use is an important issue for the development of dyslipidemia among women.Objective: The purpose of the present study was to see the duration of use of OCP and the development of dyslipidemia among the women.Methodology: This case control study was carried out in the Department of Obstetrics & Gynaecology and Family Planning Department in collaboration with the Biochemistry Department at Sir Salimullah Medical College & Mitford Hospital, Dhaka from June 2009 to May 2010 for a period of one (1) year. Women using low-dose OC pill for more than one year were considered as cases group while women not using low-dose oral contraceptive pill were taken as control group of the study. Lipid profiles were performed in the laboratory in the fasting state from blood.Result: A total of 80 subjects were recruited for this study of which 40 women in case group and the rest 40 women were in control group. Duration of contraceptive use and serum lipids profiles were recorded. Level of serum total cholesterol, serum triglyceride, and serum LDL were significantly higher among the contraceptive users of > 5 years duration than those among 5 or < 5 years duration (p < 0.001). However, serum HDL level was low among both users and non-users (p=0.556). The risk of developing dyslipidaemia in women using low-dose oral contraceptive was more than 3-fold higher than that in non-users.Conclusion: In conclusion the greater the duration of oral contraceptive use the higher is the chance of dyslipidaemia.Journal of Science Foundation 2016;14(2):40-43

Effect of Low Dose Oral Contraceptive Pill on Coagulation Status in Women with Normal and Low Body Mass Index

Background: Oral contraceptive pill (OCP) is widely used by millions of women of various socioeconomic conditions.Use of low dose oestrogen and newer progesterone in OCP now associated with less thromboembolic and cardiovascular risk. The safety aspects of these pills had not been investigated in details in malnourished women of developing countries. In the present study the effects of the pillson coagulation status have been studied.Objective: To explore the effect of the most widely used low dose OCP (Shukhi) on coagulation status of Bangladeshi women with normal and low BMI(Body Mass Index). Materials and Methods: The study population group (n=29) comprised of women with normal BMI and the underweight group (n=11,BMI<18.5). Both groups use low dose OCP(30?g ethinyl estradiol and 150?g levonorgestrel) for 6-60 months. The coagulation status were assessed as follows: Plasma Fibrinogen, Prothrombin time and Platlete aggregation and Anticoagulation statuseg: AntithrombinIII (ATIII).Result:Coagulation status showed no significant difference in platelet aggregation between the groups. Plasma fibrinogen median value (450mg/dl) just exceeded the upper limit of reference range (normal range: 200-400mg/dl) in normal BMI. In contrast, the corresponding value in the low BMI (318mg/ dl) group was almost at the middle of the reference range. A significantly prolonged prothrombin time (13.80 seconds) was found in the low BMI group (p=0.058); values were still within the reference range (10-14 seconds). No significant correlation existed between plasma fibrinogen, prothrombin time and platelet aggregation in normal BMI or low BMI groups. Antithrombin IIIactivity in normal BMI group was 108% and in low BMI group it was 105%. Atendency of positive correlation existed between antithrombin III activity and BMI in low BMI pill users (r=0.591,p=0.072).Conclusion:The study suggested that a) Reported risk of procoagulant or thromboembolic changes in pill users is lower in low BMI &normal BMI and b) Low BMI users showed significantly longer prothrombin time due to the effect of malnutrition itself or due to the effect of pills in this nutritional background.J Bangladesh Coll Phys Surg 2017; 35(1): 3-8

Effect of Low Dose Oral Contraceptive Pill on Glycemic and Lipidemic status in Women with Normal and Low BMI

Objective (s): Aim of the study was to explore the effect of the most widely used low dose OCP (Shukhi) on glycemic and lipidemic factors of under weight (Low BMI) Bangladeshi women.Materials and Methods: This case control study was conducted at the Department of Cell and Molecular Biology, Research Division, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic disorders (BIRDEM) and Family Planning Center of Dhaka Medical College Hospital during the period of Jan 2011 to Dec 2011. A total number of 40 women were included in this study having age range between 25-45 years. Twenty nine (29) were with normal BMI (>18.5) and 11 were with low BMI (<18.5) consuming Shukhi for six months to five years. The control group (n=29) constituted of women with normal BMI and the case group (n=11) constituted the women with low BMI ( BMI<18.5). Both groups use low dose OCP (30?g ethinyl estradiol and 150 ?g levonorgestrel for 6-60 months. Glycemic status was assessed by measuring blood glucose fasting and 2 hrs after 75g glucose, insulinemic status by measuring C-peptide and lipidemic status by measuring TG, T Chol, HDL, LDL.Results:There was no significant differences between two groups in fasting blood glucose and two hours after 75g glucose. A significantly high C-peptide (p=0.043) level was found in low BMI users, but a significantly negative correlation was found between fasting blood glucose and BMI in underweight OCP users (r=622, p=0.041). A better insulin sensitivity was found in low BMI as compared to normal BMI. Significantly lower total cholesterol (p=0.018) and LDL cholesterol (p=0.017) levels were found in low BMI OCP users than those of normal BMI OCP users. However, no significant correlation existed between any lipids.Conclusion: This study suggested that OCP don’t affect the glycemic, insulinemic ( insulin secretory and sensitivity) and lipidemic status of underweight subjects.Bangladesh J Obstet Gynaecol, 2014; Vol. 29(2) : 65-72

Oral Contraceptives and Oral Health:An Insight

Oral contraceptive pills are a safe and effective means of avoiding pregnancy followed by women worldwide. These drugs were first introduced in 1960s and 70s and contained higher dose of estrogen and progesterone and were reported to cause unwanted side effects like gingival inflammation, localized osteitis, alterations in salivary flow rate, changes in salivary components and gingival melanosis in oral tissues. With the advent of new generation formulations of low dose oral contraceptive pills, the effects on oral health is minimized and presently users are not considered as risk group for developing gingival and periodontal disease. This review briefs the effects of oral contraceptive pills on general health and oral health in particular and controversies surrounding their use.

Estradiol: micrograms or milligrams

SummaryEstrogen is used to induce puberty in peripubertal girls with hypogonadism. Although both synthetic and natural forms are available, along with different routes of administration, in the UK oral ethinyl estradiol and the low-dose oral contraceptive pill are commonly used as hormone replacement therapy for practical reasons. We present five peripubertal girls (aged 12.5–14.9 years) with hypogonadism (two with primary hypogonadism due to Turner syndrome and three with central (secondary) hypogonadism as part of multiple pituitary hormone deficiency) who for a variety of reasons have received milligram doses of estradiol (E2) in error for between 6 weeks and 6 months, instead of the expected microgram doses of ethinyl estradiol. Although there are no direct comparisons in peripubertal girls between synthetic and natural estrogens, all girls had vaginal bleeding whilst receiving the milligram doses and have ended up with reduced final heights, below the 9th centile in 1 and below the 2nd centile in 4. Whilst reduction in final height may be part of the underlying condition (especially in Turner syndrome) the two girls with height predictions performed prior to receiving the estrogen overdose have not achieved their predicted height. Estrogen is one of the few drugs which is available in both milligram and microgram formulations. Clinicians need to be alert to the possibility of patients receiving the wrong formulation and dosage in error.Learning pointsGirls with primary and secondary gonadal failure require assistance with pubertal induction.Although several different formulations and route of administration are available, for practical reasons, the majority of girls in the UK receive oral ethinyl estradiol.Estrogen preparations are available in both milligram and microgram formulations, with potential for receiving the wrong dose.Girls receiving milligram rather than microgram preparations all had vaginal bleeding and a short final height.

The Effects of Hormonal Contraception on the Voice: History of Its Evolution in the Literature

Women of reproductive age commonly use hormonal contraceptives, the vocal effects of which have been studied. Otolaryngologists should be aware of this relationship to make recommendations on hormonal contraception as it relates to each patient's voice requirements. A comprehensive literature review of PubMed was completed. The terms "contraception," "vocal folds," "vocal cords," and "voice" were searched in various combinations. Articles from 1971 to 2015 that addressed the effects of contraception on the vocal folds were included. In total, 24 articles were available for review. Historically, contraception was believed to affect the voice negatively. However, more recent studies using low-dose oral contraceptive pills (OCPs) show that they stabilize the voice. However, stabilization generally occurs only during sustained vowel production; connected speech appears unaffected. Therefore, singers may be the only population that experiences clinically increased vocal stability as a result of taking hormonal contraceptives. Only combined OCPs have been studied; other forms of hormonal contraception have not been evaluated for effects on the voice. Significant variability exists between studies in the physical attributes of patients and parameters tested. Hormonal contraception likely has no clinically perceptible effects on the speaking voice. Singers may experience increased vocal stability with low-dose, combined OCP use. Other available forms of contraception have not been studied. Greater consistency in methodology is needed in future research, and other forms of hormonal contraception require study.

Impact of Oral Contraceptive Pills (LDs) and Condoms on Women's Sexual Function: A Prospective Study in Iran

Introduction: Female sexual function may be affected by negative or positive effects of contraceptive methods, which needs more investigation. The aim of this study was to determine the impact of low dose oral contraceptive pills (OCPs, LD) and condoms on female sexual function. Material & Methods: A sample of 62 Iranian women, who were first time users of OCPs, LD (n=32) and condoms (n=30) were assigned for the study. The women's sexual function was assessed using a standard questionnaire both before and four months after using the contraceptive methods. Results: In the OCPs, LD group, there was a significant increase in total sexual function score (p<0.001) and the four domains of sexual function (desire, arousal, orgasm, and satisfaction) four months after the recruitment. In the condom group a significant reduction was found in the five domains as well as the total sexual function score (p<0.001) four months after recruitment. Conclusion: The results of this study indicated an improvement in sexual function after using OCPs, LD and a significant negative effect on women's sexual function with the use of condoms.

Correcting oral contraceptive pharmacokinetic alterations due to obesity: a randomized controlled trial

ObjectiveTo determine if increasing the hormone dose or eliminating the hormone-free interval improves key pharmacokinetic (PK) alterations caused by obesity during oral contraceptive (OC) use. Study designObese [body mass index (BMI)≥30 kg/m2], ovulatory, otherwise healthy, women received an OC containing 20 mcg ethinyl estradiol (EE)/100 mcg levonorgestrel (LNG) dosed cyclically (21 days active pills with 7-day placebo week) for two cycles and then were randomized for two additional cycles to the following: continuous cycling (CC, a dose neutral arm using the same OC with no hormone-free interval) or increased dose (ID, a dose escalation arm using an OC containing 30 mcg EE/150 mcg LNG cyclically). During Cycles 2, 3 and 4, outpatient visits were performed to assess maximum serum concentration (Cmax), area under the curve (AUC0–∞) and time to steady state as well as pharmacodynamics. These key PK parameters were calculated and compared within groups between baseline and treatment cycles. ResultsA total of 31 women enrolled and completed the study (CC group, n=16; ID group, n=15). Demographics were similar between groups [mean BMI: CC, 38 kg/m2 (S.D. 5.1); ID, 41 kg/m2 (S.D. 7.6)]. At baseline, the key LNG PK parameters were no different between groups; average time to reach steady state was 12 days in both groups; Cmax were CC: 3.82±1.28 ng/mL and ID: 3.13±0.87 ng/mL; and AUC0–∞ were CC: 267±115 h ng/mL and ID: 199±75 h ng/mL. Following randomization, the CC group maintained steady-state serum levels whereas the ID group had a significantly higher Cmax (p<.001) but again required 12 days to achieve steady state. However, AUC was not significantly different between CC (412±255 h ng/mL) and ID (283±130 h ng/mL). Forty-five percent (14/31) of the study population had evidence of an active follicle-like structure prior to randomization and afterwards this decreased to 9% (3/31). ConclusionBoth increasing the OC dose and continuous dosing appear to counteract the impact of obesity on key OC PK parameters. ImplicationsObesity adversely affects the pharmacokinetics of very low dose OC pills. Although the impact of these changes on OC efficacy is still under debate, PK parameters can be normalized in obese users by continuous dosing or increasing to a low-dose pill.

Serum calcium level is associated with lipids in young Nigerian women using low-dose oral contraceptive pills

Background: The formulation of low‑dose oral contraceptive pill (OCP) has not been able to completely eliminate the cardiovascular risks associated with its use. Studies have associated serum calcium with metabolic syndrome, high blood pressure and lipids in the general population. Aim: To examine the association of serum total calcium with lipids levels and blood pressure in young Nigerian women who use OCP. Subjects and Methods: Fasting serum triglyceride, total cholesterol, high‑density lipoprotein cholesterol (HDL‑c), low‑density lipoprotein cholesterol (LDL‑c), very low‑density lipoprotein cholesterol (VLDL‑c), total lipids and total calcium were assayed in 160 young women (110 OCP users and 50 controls) using colorimetric methods. Body mass index (BMI) and blood pressure were also measured. Results: Serum triglyceride (1.19(0.01) vs 0.94(0.02), total cholesterol (4.08(0.06) vs 3.52 (0.05), LDL‑c (1.79(0.04) vs 1.24 (0.02), VLDL‑c (0.25(0.02) vs 0.18(0.03), total lipids (7.55(0.2) vs 6.26(0.2), total calcium (2.25(0.01) vs 2.06(0.03), systolic (108.9(0.9) vs 103.1(0.9) and diastolic (67.7(0.7) vs 65.0(0.5) blood pressures were significantly higher (P < 0.001) in OCP users than non‑users. Conversely, HDL‑c levels in OCP users were lower (1.77(0.08) vs 1.84(0.02); P = 0.30) compared with non‑users. Serum calcium positively correlated with blood pressure and lipid parameters except HDL‑c in women OCP users. Women on OCP who had lower serum total calcium levels had statistically significant lower lipid parameters while those women on OCP who had higher serum calcium levels had significantly higher lipid parameters. The BMI of both study population and control was not significantly different. Conclusion: Low‑dose OCPs induce increased levels of serum lipids, calcium and blood pressures. Serum total calcium level was positively associated with blood pressure, measured lipid parameters except HDL‑c in women on OCP. These data suggest that serum calcium may have some influences on lipids and blood pressure in subjects who use OCP irrespective of their BMI. Keywords: Blood pressure, oral contraceptive pill, serum total calcium, total lipids and lipoproteins

The comparative study of Yaz and Ovocept-ld on patients with simple ovarian cysts referring to Iran-Isfahan Shariati Hospital

Background:Functional ovarian cysts include follicular, corpus luteum, and theca lutein cysts are the most common adnexal masses (about 50%) in women of reproductive age. Treatment with the combined monophasic oral contraceptives reduces functional ovarian cysts. Yaz (drospirenone/ethinyl estradiol) is a low-dose combined oral contraceptive pill containing 20 μg ethinyl estradiol and 3 mg drospirenone. In addition to contraceptive effects, Yaz has anti-mineralocorticoid and anti-adrenergic effects. Ovocept- low-dose LD is also a low-dose combined oral contraceptive drug containing 30 μg ethinyl estradiol and 3 mg norgestrol. Ovocept-LD has some side-effects such as weight gain, spotting, breast tenderness, nausea, and headache.Materials and Methods:Being a clinical study, the present research was carried out on 42 patients with the simple ovarian cysts from 2010 to 2012. 84 Patients were assigned to A and B groups. Group A received Yaz once a day for a period of 28 days and group B received Ovocept-LD once a day for a period of 21 days. After treating by Yaz and Ovocept-LD, Cysts were evaluated by ultrasound. Results were analyzed by the SPSS software. A P < 0.05 was considered the significance threshold.Results:Obtained results indicated that both Yaz and Ovocept-LD had an effect on the simple ovarian cysts. Statistical tests, however, has shown that the effect of Yaz has been significantly more than that of Ovocept-LD.Conclusion:Given the faster and better recovery effect, and the lesser side effects of Yaz as compared to Ovocept-LD, it is recommended to use Yaz for the simple ovarian cysts.

Comparative study of low-dose oral contraceptive pill and ormeloxifene in the treatment of dysfunctional uterine bleeding

Background: Role of oral contraceptive pill (OCP) and ormeloxifene (ORM) in dysfunctional uterine bleeding (DUB) is still in an exploring level. Aim: The aim was to observe the improvement of the menstrual bleeding pattern in terms of the amount, regularity, and hemoglobin (Hb) status of the women. Setting: Study was conducted in the Department of Obstetrics and Gynecology of IPGMER and SSKM Hospital, Kolkata a tertiary care teaching hospital. Design: Prospective randomized study with patients having subjective complaints of menorrhagia. Materials and Methods: A total of 36 women was treated with ORM 60 mg and OCP containing 30 μg ethinyl estradiol and 150 μg desogestrel was given to 34 women. Pictorial blood loss assessment chart (PBAC) was applied to assess the amount of bleeding. Statistical Analysis Used: Data were compared using a t-test (paired and unpaired) and Mann-Whitney U-test for numerical variables and McNemar's Chi-square test for categorical variables. Results: The primary outcome showed a comparable PBAC score of ORM in first posttreatment cycle and significantly better in following two cycles (PBAC - postC1: 0.118, PBAC - postC2: 0.016, and PBAC - postC3: 0.04). Group receiving OCP was observed to have good cycle regularity in comparison to ORM (P = 0.006). Hb rise in both groups was almost similar, OCP group revealed an improvement in mean Hb concentration of 0.65 g%, whereas ORM showed a rise of 0.72 g%. Secondary outcomes were adverse reactions, satisfaction level, and poor responders in both groups. Conclusion: ORM is effective in treating DUB in almost in all aspects and can be considered as nonsteroidal option of therapy.