Low-dose Oral Contraceptives Research Articles

Contraception and family planning at the extreme of reproductive life - climacteric.

Menopause is an endocrine phenomenon characterized by gradual estrogen decline. This is a stage in a woman's life in which contraception is extremely important as the risks associated with pregnancy and childbirth increase, both maternal issues associated with higher incidence of comorbidities and issues related to fetal abnormalities, mitochondrial abnormalities, or genetic syndromes. On the other hand, there is a growing number of women who have postponed motherhood and need effective contraception, but without prolonging the return to fertility. Long-acting reversible contraceptives (LARCs), low-dose oral hormonal contraceptives and non-oral contraceptives are preferred. The levonorgestrel-releasing intrauterine system is a very good alternative that can maintain endometrial protection after menopause. Definitive methods such as tubal ligation and vasectomy are options for couples that already have their offspring. In this review, we present evidence for contraceptive indication and the effects of hormonal methods on climacteric including options for contraception, control of bleeding during perimenopause and of climacteric symptoms, as well as the transition from such methods to hormone therapy if indicated.

Prevalencia de prescripción conjunta incorrecta de fármacos anticonvulsivantes y anticonceptivos hormonales Colombia, 2014

<p><strong>Objetivo:</strong> determinar la prevalencia de prescripción conjunta de fármacos antiepilépticos para identificar formulación incorrecta que podría afectar la efectividad de los anticonceptivos hormonales en un grupo de mujeres afiliadas al Sistema General de Seguridad Social en Salud de Colombia.</p><p><strong>Materiales y métodos:</strong> estudio de corte transversal, en el que se seleccionaron registros de mujeres de 15 a 45 años que recibían al menos un fármaco antiepiléptico, entre el 1 y el 31 de marzo de 2014, en una base de datos poblacional de dispensación de medicamentos de un operador logístico en Colombia, para población perteneciente al régimen contributivo y subsidiado en el Sistema General de Seguridad Social en Salud de Colombia. Se evaluaron el tipo de anticonceptivo hormonal y de fármaco antiepiléptico. Se utilizó estadística descriptiva.</p><p><strong>Resultados:</strong> de un total de 2092 pacientes usuarias de fármacos antiepilépticos, se identificaron 89 (4,3 %) casos que tenían por lo menos un antiepiléptico y un anticonceptivo simultáneamente. En 48 mujeres (54 %) se encontró formulación incorrecta de métodos de planificación, como el uso de fármacos antiepilépticos inductores enzimáticos e inyectables combinados (20 casos), el uso de anticonceptivos orales combinados de bajas dosis de estrógenos (16 casos), de progestinas orales (10 casos), y el uso de antiepilépticos no inductores enzimáticos y anticonceptivos orales combinados y dosis altas de estrógenos (2 casos).</p><p><strong>Conclusiones:</strong> un importante número de mujeres usuarias de medicamentos antiepilépticos utiliza métodos hormonales de anticoncepción, y cerca de la mitad de ellas tenían una prescripción anticonceptiva incorrecta, lo que podría resultar en embarazos no deseados o incremento del riesgo de enfermedad tromboembólica.</p>

Rationale for eliminating the hormone-free interval in modern oral contraceptives.

Although most low-dose combined oral contraceptives (COCs) include 7-day hormone-free intervals (HFIs), these COCs could incompletely suppress ovarian activity. To review the impact of HFIs on ovarian suppression and tolerability, and evaluate the utility of COCs without traditional 7-day HFIs. PubMed was searched for clinical studies published in English between January 1980 and April 2015 on the impact of HFIs and HFI modifications in COCs. Articles assessing contraceptive efficacy or tolerability as the primary focus were included. Abstracts of 319 articles were screened. Analysis of the 161 articles selected revealed that suppression of ovarian activity with low-dose COCs with 7-day HFIs is suboptimal. Loss of ovarian suppression during 7-day HFIs is commonly associated with follicular development, and most dominant follicles appear during this period. By contrast, increased ovarian suppression was noted in regimens that shortened or eliminated the HFI, or that substituted low-dose ethinyl estradiol for the HFI. Extended regimens with modified HFIs may provide greater ovarian suppression with the potential for increased contraceptive effectiveness. Additional research is needed to evaluate whether COC regimens that include 10μg ethinyl estradiol instead of an HFI may improve tolerability.

The influence of caffeine ingestion on strength and power performance in female team-sport players.

BackgroundThe aim of this study was to examine the influence of caffeine supplementation on knee flexor and knee extensor strength before, during and after intermittent running exercise in female team-sport players taking oral contraceptive steroids (OCS).MethodTen healthy females (24 ± 4 years; 59.7 ± 3.5 kg; undertaking 2–6 training sessions per week) taking low-dose monophasic oral contraceptives of the same hormonal composition took part in a randomised, double-blind, placebo-controlled crossover-design trial. Sixty minutes following the ingestion of a capsule containing 6 mg∙kg−1 body mass anhydrous caffeine or artificial sweetener (placebo), participants completed a 90-min intermittent treadmill-running protocol. Isometric strength performance and eccentric and concentric strength and power of the knee flexors and knee extensors (using isokinetic dynamometer), as well as countermovement jump (CMJ), was measured before, during and after the exercise protocol, as well as ~12 h post-exercise. Blood samples were taken before, during and post-exercise to measure glucose, insulin and free fatty acids (FFA).ResultsCaffeine supplementation significantly increased eccentric strength of the knee flexors (P < 0.05) and eccentric power of both the knee flexors (P < 0.05) and extensors (P < 0.05). However, there was no effect on isometric or concentric parameters, or CMJ performance. FFA was elevated with caffeine supplementation over time (P < 0.05) while levels of glucose and insulin were not affected by caffeine intake.ConclusionCaffeine supplementation increased eccentric strength and power in female team-sport players taking OCS both during an intermittent running protocol and the following morning.

Impact of Preventing Pregnancy Methods and Their Relationships with the Level of Growth Fitness Body Health housewife Case Women Newlyweds

Our aims for this study interest on the Preventing Pregnancy Methods based on the pills contraceptive or the calculus of cycle of ovum women. From that, our aims upon the effect of physical activity on the improvement of the Fitness Body Health. Based on the Medical studies similar that, the effects of low-dose estrogen oral contraceptives on weight, body composition, and fat distribution in young women. For homogeneity of our Samples, we have calculated the age and five-test fitness, for 20 participants’ voluntaries Housewife women Newlyweds average age ≤ 24 for the duration of four cycles of ovum. Where we distributed in four groups based on plan experimental (group1 take Pill and practice sport, group2 take Pill and do not practice sport, group3 do not take Pill and practice sport and group 4 do not take Pill and do not practice sport) and the same marital lifestyle. From that, our assessment was based on the analysis of the Anova and LSD, correlation Paired Samples Test to compare implementations of the proposed conditions as limits of this modest study, we confirm: 1. The proposed conditions Prevent pregnancy. 2. Sport decreased Body Fat and promoted positive Fitness Body Health. 3. Taking the pill in the lack of sport practice promoted increase of Body Fat, which contribute to negative Fitness Body Health. 4. There is a strong positive relationship between body fat and the proposed conditions to back off or develop the Fitness Body Health.

Caffeine ingestion enhances perceptual responses during intermittent exercise in female team-game players

We examined the influence of caffeine supplementation on cognitive performance and perceptual responses in female team-game players taking low-dose monophasic oral contraceptives of the same hormonal composition. Ten females (24 ± 4 years; 59.7 ± 3.5 kg body mass; 2–6 training sessions per week) took part in a randomised, double-blind, placebo-controlled crossover-design trial. A 90-min intermittent treadmill-running protocol was completed 60 min following ingestion of a capsule containing either 6 mg • kg−1 anhydrous caffeine or artificial sweetener (placebo). Perceptual responses (ratings of perceived exertion (RPE), feeling scale (FS), felt arousal scale (FAS)), mood (profile of mood states (POMS)) and cognitive performance (Stroop test, choice reaction time (CRT)) were completed before, during and after the exercise protocol, as well as after ~12 h post exercise. Caffeine ingestion significantly enhanced the ratings of pleasure (P = 0.008) and arousal (P = 0.002) during the exercise protocol, as well as increased vigour (POMS; P = 0.007), while there was a tendency for reduced fatigue (POMS; P = 0.068). Caffeine ingestion showed a tendency to decrease RPE (P = 0.068) and improve reaction times in the Stroop (P = 0.072) and CRT (P = 0.087) tests. Caffeine supplementation showed a positive effect on perceptual parameters by increasing vigour and a tendency to decrease fatigue during intermittent running activity in female games players taking low-dose monophasic oral contraceptive steroids (OCS).

Low-dose combined oral contraceptive use is associated with lower bone mineral content variation in adolescents over a 1-year period

BackgroundLow-dose combined oral contraceptives (COCs) can interfere with bone mass acquisition during adolescence. This study aimed to evaluate bone mineral density (BMD) and bone mineral content (BMC) in female adolescents taking a standard low-dose COC (ethinylestradiol 20 μg/desogestrel 150 μg) over a 1-year period and to compare their data with those of healthy adolescents from the same age group not taking COCs.MethodsThis was a non-randomized parallel-control study with a 1-year follow-up. Sixty-seven adolescents aged from 12 to 19 years, divided into COC users (n = 41) taking 20 μg ethinylestradiol/150 μg desogestrel and COC non-user controls (n = 26), were evaluated by bone densitometry examinations at baseline and after 12 months. Comparisons between the groups at the study onset were performed using the Mann–Whitney test with the significance level fixed at 5% or p < 0.05. Comparisons between the groups at the study onset and after 12 months were based on variations in the median percentages for bone mass variables.ResultsThe COC users presented with low bone mass acquisition in the lumbar spine, and had BMD and BMC median variations of 2.07% and +1.57%, respectively, between the measurements at baseline and 12 months. The control group had median variations of +12.16% and +16.84% for BMD and BMC, respectively, over the same period. The total body BMD and BMC showed similar evolutions during the study in both groups. Statistical significance (p < 0.05) was seen for the BMC percentage variation between COC users and non-users.ConclusionsUse of a low-dose COC (ethinylestradiol 20 μg/desogestrel 150 μg) was associated with lower bone mass acquisition in adolescents during the study period.Trial registrationRegistry Number, RBR-5h9b3c.

Speech Articulation of Low-Dose Oral Contraceptive Users

In the female life cycle, hormonal fluctuations may result in impaired verbal efficiency and vocal worsening during the premenstrual phase. Oral contraceptives may interfere with vocal range. Voice, resonance, and articulation variations clarify speech content. To investigate the phonoarticulatory sounds produced by oral contraceptive users aged between 20 and 30 years. This is a cross-sectional study. Our study included four groups of women (n = 66): two groups used low-dose oral contraceptives and two groups did not use any oral contraceptives. Questionnaires and sound records were used. Acoustic analysis was performed using the Computerized Speech Laboratory program, Model 4341 (Kay Elemetrics Corp, Lincoln Park, New Jersey). The statistical analysis of the SPPS database, version 13.0, was performed by means of generalized estimating equation. In the groups that did not use oral contraceptives, sustained vowel tones were more acute in the two phases and cycles of women older than 25 years (w/oOC1, 175 ± 74 to 190 ± 55 Hz; w/oOC2, 194 ± 56 to 210 ± 32 Hz). At the midfollicular phase (Fph) and midluteal phase (Lph) of the two cycles, the speed of the speech was slower in this group (w/oOC1: Fph, 5.3 ± 1.6/s and Lph, 5.4 ± 1.4/s; w/oOC2: Fph, 4.5 ± 1.7/s and Lph, 4.8 ± 1.1/s). In both groups that used oral contraceptives, there was a higher modulation frequency in the sentences when compared with nonusers (OC1, 33 ± 10 Hz; w/oOC1, 28 ± 10 Hz; OC2, 34 ± 10 Hz; w/oOC2, 27 ± 10 Hz). Vocal intensity was closer between the OC1 (62 ± 4 dB), w/oOC1 (61 ± 3 dB), and OC2 (63 ± 4 dB) groups when compared with the w/oOC2 (67 ± 6 dB) group. We demonstrated hormonal influences on speech articulation of contraceptive users and nonusers.

Daisaikoto for menstrual pain: a lesson from a case with menstrual pain successfully treated with daisaikoto.

Menstrual pain is one of the common symptoms among women. It is estimated that 5–14% of women are sometimes absent from school or work because of pain. Usually gynecologists prescribe analgesics and/or low-dose oral contraceptives. However, such treatment is not always effective and sometimes causes an adverse effect, such as stomach pain or low body temperature. Kampo medicine is one of the choices for the menstrual pain in Japan. Tokishakuyakusan, kamishoyosan, or keishibukuryogan is commonly used for the treatment of menstrual pain. Here we report a case of menstrual pain successfully treated with daisaikoto which is not commonly used for such a case. Twenty-five-year-old woman suffered from severe menstrual pain and stress at company. She also had constipation and abdominal distension. We prescribed daisaikoto extract 7.5 g per day. Not only menstrual pain but also constipation and abdominal distension improved within 6 months. Here we propose that daisaikoto is one of the choices for the treatment of menstrual pain with mental stress.

子宮内膜症治療薬が原因と推測された横静脈洞血栓症の1 例

子宮内膜症治療薬が原因と推測された横静脈洞血栓症の1 例

Maximal fat oxidation, but not aerobic capacity, is affected by oral contraceptive use in young healthy women.

Synthetic ovarian hormones contained in oral contraceptives (OC) may alter the aerobic capacity and lipid metabolism in oral contraceptive users (OC+) compared with non-users (OC-). The aim of this study was thus to investigate the differences between OC- and OC+ (1) in cardiorespiratory parameters at the anaerobic threshold (AT) and at the maximal aerobic capacity and (2) in the exercise intensity (Lipoxmax) at which lipid oxidation rate is maximal (MLOR). Twenty-one healthy untrained women (22.0 ± 0.6 years old) who took OC (OC+; low-dose monophasic OC, n = 11) or not (OC-; n = 10) performed two experimental exercise sessions. In the first one, cardiorespiratory parameters at the AT and at the maximal aerobic capacity were assessed during a maximal incremental exercise session. In the second one, Lipoxmax and MLOR were measured during a submaximal incremental exercise session. No significant difference was observed in cardiorespiratory parameters at the AT and at the maximal aerobic capacity between OC+ and OC- women. OC+ women showed higher MLOR (7.6 ± 1.9 vs 4.6 ± 1.0 mg min(-1) kg FFM(-1); p < 0.01) that was elicited by higher Lipoxmax (45.2 ± 5.2 vs 36.2 ± 4.1 % of VO2max; p < 0.001) compared to OC- women. OC+ and OC- women did not differ in cardiorespiratory parameters at the AT and at the maximal aerobic capacity. However, OC+ women show higher MLOR and Lipoxmax compared with OC- women. The hormonal status appears to be an important MLOR and Lipoxmax determinant in untrained women.

The effect of pycnogenol on patients with dysmenorrhea using low-dose oral contraceptives.

ObjectiveMenstrual symptoms such as dysmenorrhea usually occur during the hormone-free interval in oral contraceptive users. Progestin withdrawal activates NF-κB transcription factor, which upregulates both vascular endothelial growth factor (VEGF) and Cox-2 expression in the endometrium. The use of natural NF-κB inhibitors such as pycnogenol may block this response, improving dysmenorrhea.Patients and methodsTwenty-four patients with severe dysmenorrhea were allocated to one of two treatment groups. In Group A (n=13), women were treated with an oral contraceptive containing 15 μg of ethinyl estradiol and 60 mg of gestodene (Adoless®) in a 24/4 regimen for three consecutive cycles. Women in Group B (n=11) used the same contraceptive regimen together with 100 mg of pycnogenol (Flebon®) continuously for 3 months. Pain scores were graded using a visual analog scale (VAS) before and during the hormone-free interval at the end of the third treatment cycle.ResultsBefore treatment, VAS pain scores for dysmenorrhea were 8 and 9 in Groups A and B, respectively. However, by the end of the third treatment cycle, pain scores had decreased significantly (P<0.05) both in groups A and B. The final pain scores were 6 in Group A and 2 in Group B, a difference that was statistically significant (P<0.0001). In Group B, 27% of the patients became pain-free, while in Group A, none of the women reported complete disappearance of this symptom. The number of bleeding days was also lower in Group B.DiscussionPycnogenol effectively decreased pain scores and the number of bleeding days when administered concomitantly with a low-dose 24/4 oral contraceptive containing gestodene.

Recent oral contraceptive use by formulation and breast cancer risk among women 20 to 49 years of age.

Previous studies of oral contraceptives and breast cancer indicate that recent use slightly increases risk, but most studies relied on self-reported use and did not examine contemporary oral contraceptive formulations. This nested case-control study was among female enrollees in a large U.S. integrated health care delivery system. Cases were 1,102 women ages 20 to 49 years diagnosed with invasive breast cancer from 1990 to 2009. Controls were randomly sampled from enrollment records (n = 21,952) and matched to cases on age, year, enrollment length, and medical chart availability. Detailed oral contraceptive use information was ascertained from electronic pharmacy records and analyzed using conditional logistic regression, ORs, and 95% confidence intervals (CI). Recent oral contraceptive use (within the prior year) was associated with an increased breast cancer risk (OR, 1.5; 95% CI, 1.3-1.9) relative to never or former OC use. The association was stronger for estrogen receptor-positive (ER(+); OR, 1.7; 95% CI, 1.3-2.1) than estrogen receptor-negative (ER(-)) disease (OR, 1.2, 95% CI, 0.8-1.8), although not statistically significantly different (P = 0.15). Recent use of oral contraceptives involving high-dose estrogen (OR, 2.7; 95% CI, 1.1-6.2), ethynodiol diacetate (OR, 2.6; 95% CI, 1.4-4.7), or triphasic dosing with an average of 0.75 mg of norethindrone (OR, 3.1; 95% CI, 1.9-5.1; Pheterogeneity compared with using other oral contraceptives = 0.004) was associated with particularly elevated risks, whereas other types, including low-dose estrogen oral contraceptives, were not (OR, 1.0; 95% CI, 0.6-1.7). Our results suggest that recent use of contemporary oral contraceptives is associated with an increased breast cancer risk, which may vary by formulation. If confirmed, consideration of the breast cancer risk associated with different oral contraceptive types could impact discussions weighing recognized health benefits and potential risks.

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.

Exercise per se masks oral contraceptive-induced postprandial lipid mobilization.

Because of their hormonal content, oral contraceptives may alter lipolytic activity under resting or exercise conditions in women. The aim of the present study was to compare lipid mobilization in a postprandial state at rest and during exercise in oral contraceptive users (OC+) versus nonusers (OC-). The metabolic (glucose, glycerol, free fatty acids) and hormonal (insulin, atrial natriuretic peptide (ANP), growth hormone, insulin-like growth factor-1 (IGF-1), and catecholamines) concentrations were determined in 11 OC+ (monophasic low-dose oral contraceptives) and 10 OC- during a resting and an exercise session (45 min at 65% maximal oxygen consumption). Results were expressed as plasma concentrations and area under the concentration versus time curve values. ANP concentrations were higher in OC+ compared with OC- women at baseline (p = 0.04). Plasma concentrations of glycerol (p = 0.04), free fatty acids (p = 0.04), ANP (p = 0.02), and noradrenaline (p = 0.04) were higher in OC+ compared with OC- when both sessions were pooled. The plasma growth hormone, IGF-1, and adrenaline concentrations were not significantly different between the 2 groups. When the effect of exercise was isolated to overcome food intake and daytime variations (exercise per se using the area under the curve), no difference was observed between groups for all metabolic and hormonal variables. Overall, oral contraceptives increased lipid mobilization in the postprandial state, but this effect was blunted when lipolytic activity was stimulated by exercise per se. Oral contraceptive-induced greater lipolytic mobilization could be partly explained by greater ANP levels in OC users.

The Usefulness of Low-Dose Oral Contraceptive in the Treatment of Women of Reproductive Age with Severe Motor and Intellectual Disabilities: Five Case Reports

Menstrual cycle has an influence on mind and body of any woman. A collection of symptoms that emerges one or two weeks before menstruation begins is called premenstrual syndrome (PMS), and that involves variety of complex emotional and physical changes. However, aggravation of epileptic attacks during premenstrual period alone has been focused in women with severe motor and intellectual disabilities (SMID). Exacerbation of various symptoms, other than epilepsy, was recognized as PMS in five cases, and these include muscular hypertonia, fever, tachycardia, flushing on face, nausea and vomiting. In these cases, the PMS symptoms were successfully managed with the low-dose oral contraceptive preparations. PMS among patients with SMID are often found to be difficult to diagnose. The use of the low-dose oral contraceptive was effective in women with SMID and improve the quality of their lives (QOL).

Hormonal contraception in women with diffuse nontoxic goiter and autoimmune thyroiditis

The article considers the influence of combined oral contraceptives on size and function of thyroid gland in women of reproductive age. We examined 215 women, taking low dose and microdose combined oral contraceptives for 12 months as monotherapy or in combination with potassium iodide. The first group consisted of 75 women with diffuse nontoxic goiter, second – of 70 women with autoimmune thyroiditis. Control group consisted of 70 women without pathology of thyroid gland. Prior to therapy with combined contraceptives and after 12 months of treatment, we determined serum levels of free triiodothyronine, free thyroxine, and thyrotropin releasing hormone, antibodies to thyroid peroxidase and antibodies to thyroglobulin (ELISA) and performed sonography of thyroid gland. Results of our study suggest that combined oral contraceptives may increase the size of thyroid gland among women with diffuse nontoxic goiter without changing its function. In women with autoimmune thyroiditis, application of combined oral contraceptive significantly decreases blood levels of autoantibodies to thyroid peroxidase and thyroglobulin. Application of combined oral contraceptives in healthy women doesn’t influence the size and function of thyroid gland.

Basal and Meal-Stimulated Ghrelin, PYY, CCK Levels and Satiety in Lean Women With Polycystic Ovary Syndrome: Effect of Low-Dose Oral Contraceptive

Ghrelin is an orexigenic peptide that stimulates food intake, whereas peptide YY (PYY) and cholecystokinin (CCK) are anorexigenic gut hormones. Patients with polycystic ovary syndrome (PCOS) appear to have alterations in appetite regulation. We aimed to determine whether fasting or meal-stimulated ghrelin, PYY, CCK, and satiety responses are different between lean PCOS patients and healthy women. We also aimed to assess the potential effect of oral contraceptive use on these hormones and satiety response. We conducted a prospective observational study in a university practice. Eighteen lean PCOS patients and 18 healthy control women matched for age and body mass index underwent measurements of circulating ghrelin, PYY, CCK, and satiety index (SI) before and after a standardized mixed meal at 0, 15, 30, 45, 60, 90, 120, and 180 minutes. For PCOS patients who were treated with ethinyl estradiol 30 μg/drospirenone 3 mg for 3 months, measurements were repeated. We measured ghrelin, PYY, and CCK levels and SI. At baseline, fasting ghrelin, PYY, CCK, and SI values in PCOS patients were not different from controls. Meal-stimulated PYY, CCK, and SI were also not different between the groups, whereas PCOS patients had significantly lower meal-stimulated ghrelin levels compared to controls (P = .04). Ghrelin, PYY, CCK, and SI did not show a significant change after treatment with ethinyl estradiol/drospirenone for 3 months. Basal and stimulated hunger and satiety hormones in lean PCOS patients are not different from lean healthy women, except for a lower meal-stimulated ghrelin response. Short-term use of a low-dose oral contraceptive does not have an effect on appetite regulation of PCOS.

Norethindrone Acetate 1.0 Milligram and Ethinyl Estradiol 10 Micrograms as an Ultra Low-Dose Oral Contraceptive

To assess the efficacy, safety, and tolerability of an extended-duration, combined hormonal oral contraceptive pill (OCP) that reduces the estrogen exposure by almost half compared with other OCPs. This open-label, uncontrolled, multicenter study used an ultra low-dose OCP (1.0 mg norethindrone acetate and 10 micrograms ethinyl E2). The OCP was administered in a regimen of 24 days of a 28-day cycle followed by 10 micrograms ethinyl E2 for 2 days and an inactive tablet for 2 days. The study included healthy, heterosexually active women aged 18-45 years who were at risk of pregnancy. The discontinuation rate was 41.7% (692/1,660 patients). Twenty-six pregnancies occurred in 1,555 participants during 15,596 at-risk cycles, resulting in a Pearl Index of 2.2 and a cumulative pregnancy rate of 2.1 for the overall population. Participants experienced an average of 2.6 days of intracyclic (unscheduled) bleeding or spotting per cycle over treatment cycles 213. Intracyclic bleeding was more common in users new to OCPs than in users switching from another OCP and in women aged 18-35 years compared with those aged 36 years or older. The frequency of bleeding episodes decreased after cycle 2 and throughout treatment in all subpopulations. The findings of this study demonstrate that this ultra low-dose OCP regimen is effective in preventing pregnancy with a safety and tolerability profile that is comparable with that reported for other low-dose OCPs. ClinicalTrials.gov, www.clinicaltrials.gov, NCT00391807. III.

Knowledge of users of low-dose oral combined contraceptives about the method

to identify the knowledge of users of combined oral contraceptive about correct use, side effects and complications; to verify the correlation between knowledge about the method with age, education, family income and time of use. cross-sectional study performed in Fortaleza, Ceará, Brazil, from March to July 2010, with 294 women. Data were collected through interviews. 75% had substantial knowledge about the proper use and side effects and no knowledge about complications. The higher the educational level and family income, the higher the women's knowledge about the correct use of the method. Positive correlation suggests that women who used the method for longer knew more about its side effects. there are knowledge gaps about the method, which are influenced by socioeconomic variables and use time.