Oral Contraceptives Research Articles

Relationship between renin, aldosterone, aldosterone-to-renin ratio and left ventricular mass index in young adults

Abstract Background Primary aldosteronism (PA), characterised by excessive aldosterone production and mineralocorticoid receptor activation, is associated with adverse cardiovascular outcomes including left ventricular hypertrophy and failure. Elevated cardiovascular risk is observed even in milder and subclinical forms of PA, especially in middle-aged and elderly populations. It is unclear if early changes in PA biomarkers can affect left ventricular mass index (LVMI), which is a strong predictor of cardiovascular diseases. Aim To evaluate the relationship between PA biomarkers, namely renin concentration, aldosterone concentration and aldosterone-to-renin ratio (ARR), and LVMI in young adults. Methods The Raine Study is a longitudinal, population-based cohort study in Western Australia that enrolled women during pregnancy. We analysed the data from the offspring of these women at age 27. Participants with PA biomarkers and LVMI measured by cardiac magnetic resonance imaging were included. Females who were on oral contraception were excluded due to its confounding effect on the ARR. We examined the relationship between LVMI and plasma renin, aldosterone, and ARR using multivariate-adjusted linear regression and used mediation analysis to test whether these relationships were dependent on systolic blood pressure (SBP). Results Of 758 participants, 252 (33.2%) were females and the mean (SD) age was 26.7 (0.4) years. Females had lower median plasma renin concentration (12.0 vs 15.4mU/L; p<0.001) and higher median ARR (21.0 vs 15.6; p<0.001) than males. There was no sex-difference in median plasma aldosterone concentration (257 vs 237pmol/L in males; p=0.143). Females had lower LVMI (52.2 vs 70.2 g/m²; p<0.001) than males. A significant association between LVMI and aldosterone was detected in males (β-coefficient 0.009; 95% CI 0.001 to 0.017; p=0.027), and between LVMI and ARR in females (β-coefficient 0.098; 95% CI 0.001 to 0.196; p=0.050) after adjusting for confounders. This relationship was not mediated by brachial SBP. Conclusion An elevated aldosterone concentration or ARR was associated with higher LVMI in young adults, independent of brachial SBP. Long-term follow-up is required to determine if the relationship persists over time and leads to reduced cardiac function. One may speculate that an intervention trial in young adults with subclinical PA is warranted to determine the role of aldosterone blockade in preventing future cardiovascular diseases.

Workplace health promotion measures and use of medical services in the German Federal Armed Forces

Abstract Introduction Workplace health promotion measures (WHPM) are among recommended options for maintaining employees health, important for the German Federal Armed Forces as an employer. In order to detect associations between WHPM and health care utilization, we recorded the number of outpatient visits and hospital stays, differentiated according to gender, military or civilian activity. Methods Prospective longitudinal observational substudy with cross sectional analysis of items regarding use of medical services at T0 (6-9/2022). Analysis for T1 (2023) and T2 (2024) follow. Data were obtained with a web-based employee survey to record self-reported endpoints. A total of about 224.000 employees by the German Armed Forces were addressed. Results Survey participation rate was 10.5% (n = 23.568) of all employees in T0, 29.1% were women and 0.3% reported being diverse, 43.2% of the participants were <40 years of age. Independently of taking part in WHPM, we did not detect differences in the proportion of male soldiers receiving treatment in hospitals of the German Federal Armed Forces. Among female soldiers without WHPM, 37.5% stayed in hospitals and with WHPM 30.5%. Higher % of women (84%) than men (78%) presented to the military - or family physician (w: 81%, m: 73%), independent of participation in WHPM and assignment for civil or military. In last 4 weeks, more women (81.3%) than men (65.6%) were prescribed medication. Female employees in civilian w.p.(84.8%) took more medications than those in military w.p (77.7%). Oral contraception was used by 20% of women in both civilian and military w.p. Conclusions There are no gender differences nor difference for civilian or military employees concerning the number of days staying in hospital. More women than men recieved regular outpatient medical care and more women than men take medication regularly. *Ludwig S and Roy R share last authorship Key messages • There are no gender differences nor difference for civilian or military employees concerning the number of days staying in hospital. • More women than men recieved regular outpatient medical care and more women than men take medication regularly.

Pregnancy protection in women of child-bearing age prescribed ACE inhibitors, ARBs or statins - A nationwide cohort study

Abstract Background Cardiometabolic disorders, including hypertension, type-2 diabetes, and hyperlipidemia are increasingly prevalent among younger people. Consequently, women of child-bearing age may be prescribed renin-angiotensin system (RAS) inhibitors and statins. Both angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are known teratogens. Statins are considered possibly teratogenic. In Denmark, ACEIs and ARBs have a ‘Do not use’ recommendation in pregnancy while statins ‘Should not be used’ in pregnancy. Previous studies have reported widespread use of RAS inhibitors without concomitant contraception among women of child-bearing age. This study investigated the situation in Denmark. Purpose To examine prescribing patterns of RAS inhibitors and statins alongside use of concomitant contraception among women of child-bearing age in Denmark. Methods Using nationwide Danish registers, women aged 15–50 years initiating ACEIs, ARBs and statins during 1995–2021 were identified and use of concomitant contraception was evaluated. Contraception was categorized as oral pill, implant, intrauterine device (IUD), or non-use. The duration of protection was assumed to be 1 year for oral contraceptives, 2 years for implants and 4 years for IUDs. Where multiple types of contraceptives were retrieved by individual patients, they were categorized as taking the contraceptive retrieved most recently. Data on non-prescription contraceptives were unavailable, e.g., condoms. Women unable to conceive due to infertility were excluded. Results 79 547 women (median age: 44 years; [interquartile range (IQR): 39–47]) on ACEIs, 64 326 women (median age: 44 years [IQR: 38–48]) on ARBs, and 71 499 women (median age: 45 years [IQR: 40–48]) on statins were included (Figure 1). Correspondingly, 69.1%, 62.8%, and 73.5% were not on contraceptives when starting treatment. Among women prescribed contraception: 70.2%/56.2%/63.1% were on oral contraceptives, 25.3%/30.9%/26.6% had IUDs and 4.5%/12.9%/10.3% had implants, respectively (Figure 1). Younger patients aged 15–29 years were least likely to be unprotected with 41.8%/29.7%/33.4% being unprotected. Among women aged 25 to 35 years the percentage of unprotected women was 51.3%/41.1%/47.7%. Older patients were more likely to have IUDs. Conclusion Substantial numbers of women of child-bearing age were prescribed ACEIs, ARBs and statins from 1995–2021. Most were not prescribed contraceptives. The lack of prescribed pregnancy protection was prevalent even among the youngest women aged 15–29 years and women aged 25 to 35 years, who are the most likely to become pregnant—inferring a potential risk of teratogenic exposure during pregnancy (Figure 2). Subsequent studies should investigate the extent of exposure to ACEIs, ARBs, and statins during pregnancy and the impact of the exposure on pregnancy outcomes.Figure 1 Contraceptive useFigure 2 Study rationale

Prescribing contraceptives to minors without parental knowledge and consent

Abstract Background Sexually active adolescents may seek oral contraceptives without parental consent, posing challenges due to minors’ confidentiality and consent regulations. This is especially the case under the un-nuanced Israeli legal scheme regarding adolescents’ care. Methods Israeli OBGYNs were contacted through mailing lists and social media groups and asked to fill an online questionnaire regarding their experience and protocols concerning prescription of contraceptives to minors. They were also asked about their comprehension of the relevant legal obligations, the importance they ascribe to different ethical interests and considerations, as well as their training. Results Of the 177 responding gynecologists, 75% consulted minors about contraceptives during the past year, most of them without any training on providing care to adolescents. More than a third of respondents believed that parental involvement wasn’t legally required, while only 8% thought it mandatory for all minors under the age of 18. Most (75%) would ‘almost always’ prescribe contraceptives without parental knowledge upon request, while 20% never would. No correlation was found between respondents’ practices and their perception of the legal obligations. Participants agreed that the risk to the health of the minor due to having sex without contraceptives is of utmost importance. Those willing to prescribe gave greater weight to minor’s autonomy consideration, while those who do not prescribe were more concerned with the acts legal ramifications. The majority set the age of 15 as the threshold for consistently prescribing contraceptives to minors without parental involvement. Conclusions Access to contraceptives for mature minors without parental involvement is vital. There is great need for education and training for healthcare providers on providing medical treatment to adolescents, as well as for the development of policies and guidelines, addressing adolescents’ health disparities. Key messages • Israeli legal requirements challenge and hinder adolescents’ care as well contradict OBGYNs ethical and professional beliefs. • There is great need for education and training, as well as for the development of policies and guidelines, addressing adolescents’ health disparities.

Family planning knowledge, use, and associated factors among women with mental illness and epilepsy in Rwanda: a cross-sectional study

IntroductionFamily planning knowledge and access to quality family planning services occupy a central position in the lives of all women of reproductive age. However, women with mental illness and epilepsy who are at a high risk of sexual violence, unwanted pregnancies, poor obstetric outcomes, and drug interaction consequences, need it the most. Understanding their family planning knowledge and utilization remains crucial for meeting their needs. The present study aims to assess knowledge, use of family planning, and associated factors among women living with mental illness and epilepsy who attend the Ndera Neuropsychiatric Hospital and affiliated branches.MethodologyA cross-sectional study was conducted between October 2022 and February 2023. The study involved a purposive sample of 289 women who attended the Ndera Neuropsychiatric Hospital and its two affiliated branches during the data collection period. Psychiatric nurses administered a structured questionnaire. Data were analyzed using descriptive statistics, and multiple logistic regression analysis was performed to assess the factors associated with the use of family planning methods.ResultsOut of 289 who participated in the study, the majority (96.9%) were aware of family planning methods, most (67.8%) had used one method once in their life course, a half (51.9%) were using a family planning method at the time of data collection, and a slight number (26%) expressed intentions of using a family planning method in the future. The most known and used methods were respectively the injectable (17.5%) and oral contraceptive pill (17.5%). Regarding the natural family planning methods, breastfeeding and withdrawal were less used. Being single (AOR = 66.4, 95% CI: 9.8, 44) or married (AOR = 51.4, 95% CI: 11.9–22), having a primary level of education (AOR = 5.6, 95% CI: 2.0, 15.9), knowing a contraceptive method (AOR = 5.8, 95% CI: 0.6, 49) and suffering from brief psychotic disorders (AOR = 2.7, 95% CI: 1.1, 6.6) predicted a higher utilization of family planning.ConclusionMost of the women with mental illness in this study were aware of family planning methods and had used one of the family planning methods in life. The national average is below when it comes to family planning awareness. It is important to improve family planning education and counseling for women who attend psychiatric outpatient clinics.

Comparison of Combined Oral Contraceptives and a Transdermal Estrogen Patch With Oral Progesterone: Treatment of Abnormal Uterine Bleeding in Adolescents

Comparison of Combined Oral Contraceptives and a Transdermal Estrogen Patch With Oral Progesterone: Treatment of Abnormal Uterine Bleeding in Adolescents

Acne vulgaris in adolescents – the review

Acne vulgaris is one of the most common chronic inflammatory skin disorders that affects almost 90% of the adolescents worldwide. Due to its effect on one’s appearance, it causes not only physical but also psychological consequences. The cause of acne involves increased sebum production, hyperkeratinisation of the follicle, bacterial colonization and inflammation, which result in formation of comedones, papules, pustules and nodules. Diet, Body Mass Index, hyperhidrosis and stress can be triggering factors. The pharmacological treatment of acne involves substances administered topically as well as orally. First line of treatment of mild-to-moderate acne involves topical benzoyl peroxide, retinoids, chemical peels, antibiotics and combinations of those agents. The treatment of moderate-to-severe or inflammatory acne consists of oral antibiotics, isotretinoin, oral contraceptives and spironolactone. New therapies are being investigated and show a great potential, however further research should be pursued in order to achieve long-lasting results of the treatment.

Healthy plasma lipidomic signatures depend on sex, age, body mass index, and contraceptives but not perceived stress.

Perceived stress is thought to contribute to the pathogenesis of metabolic, vascular, mental, and immune diseases, with different susceptibilities in women and men. The present study investigated if and how perceived stress and/or demographic variables including sex, age, body mass index, regular prescription drugs, occasional analgesics, or dietary supplements manifested in plasma lipidomic profiles, obtained by targeted and untargeted mass spectrometry analyses. The study included 217 healthy women and 108 healthy men, aged 18-68 years, who were recruited in a 2:1 female:male ratio to account for women with/without contraceptives. As expected, dehydroepiandrosterone sulfate (DHEAS) and ceramides were higher in men than women, and DHEAS decreased with age, while ceramides increased. Contrary to expectations, neither DHEAS nor ceramides were associated with perceived stress (PSQ30 questionnaire), which was however, associated with BMI in men, but not in women. None of the lipid species or classes showed a similar "age X sex X BMI" interaction, but the endocannabinoid palmitoylethanolamide (PEA) correlated with BMI and hypertension. Independent of perceived stress, lysophosphatidylcholines (LPCs) were lower in women than men, whereas LPC metabolites, lysophosphatidic acids (LPAs), were higher in women. The LPA:LPC ratio was particularly high in women using oral contraceptives suggesting a strong hormone-induced extracellular conversion of LPCs to LPAs, which is catalyzed by the phospholipase D, autotaxin. The results reveal complex sex differences in perceived stress and lipidomic profiles, the latter being exacerbated by contraceptive use, but perceived stress and lipids were not directly correlated.

Assessment of Knowledge, Attitudes, and Practices towards Sexual and Reproductive Health among Secondary School Students in Kicukiro District, Rwanda

Sexual and reproductive health (SRH) is intricately connected to a variety of factors, including cultural norms, psychological influences, and individual experiences. This study explores the experiences of late adolescents regarding SRH, focusing on their knowledge, attitudes, and practices in Kicukiro District, Rwanda. Despite government efforts to educate youth on SRH, many secondary school students remain vulnerable to issues like unplanned pregnancies and sexually transmitted infections (STIs). To evaluate the knowledge, attitudes, and practices regarding sexual and reproductive health among secondary school students in Kicukiro District, Rwanda. The study targeted secondary school students from two schools: Groupe Scolaire Saint Vincent Pillotie Gikondo (urban) and EFOTEK (rural). Using Fisher’s formula, a sample size of 423 respondents was determined through stratified random sampling. Data were collected via structured questionnaires and analyzed using SPSS and descriptive statistics, including frequency, percentages, means, and standard deviations. The findings revealed that 88% of students were aware of puberty and pregnancy processes, while 78.7% were knowledgeable about contraceptive methods, particularly condoms and oral contraceptives. Positive attitudes towards SRH were noted, with a mean score of 4.00 for pre-marital relationships, but significant misconceptions existed, such as 11% of respondents lacking knowledge on HIV protection. The overall mean for practices related to SRH was 3.98 for seeking medical check-ups, indicating a willingness to engage with health services. However, practices promoting healthy lifestyles received a lower mean of 3.25, suggesting areas needing improvement. The study highlights the need for enhanced sexual and reproductive health education among secondary school students in Kicukiro District. While students demonstrate good knowledge and positive attitudes toward SRH, targeted interventions are necessary to address misconceptions and promote healthier practices, particularly in areas related to lifestyle and open communication.

Psychosocial Burden of Women Who Are to Undergo Additional Diagnostic Procedures Due to Positive Screening for Cervical Cancer.

Background/Objectives: This study aimed to evaluate psychosocial burden and its associated factors in women who were referred for additional diagnostic procedures following receipt of a positive cervical-cancer-screening smear result. Methods: A cross-sectional study was performed in a consecutive cohort of only women who received an abnormal Papanicolaou screening result and therefore presented to a gynecologist for additional diagnostic examinations (colposcopy/biopsy/endocervical curettage) at the Clinic for Gynecology and Obstetrics of the Clinical Center. Multivariate linear regression was used for data analysis, with Bonferroni correction applied for multiple comparisons. Results: Significant independent predictors for the occurrence of psychosocial burden-worry in women with a positive Papanicolaou screening test before diagnostic procedures were the use of oral contraceptives (β = -0.174, p < 0.001), alcohol consumption (β = 0.188, p < 0.001), anxiety (β = -0.189, p = 0.001), high burden of depressive symptoms (β = 0.191, p = 0.001) and insufficient knowledge of the meaning of the term dysplasia/precancerous (β = -0.187, p < 0.001), according to the multivariate linear regression. The significant independent predictor for the occurrence of psychosocial burden-satisfaction with information/support in women with a positive Papanicolaou screening test before diagnostic procedures was psychological distress (β = -0.210, p = 0.001). Conclusions: Providing information in order to improve understanding of the term dysplasia/precancerous, as well as identifying which women are at risk of psychosocial burden, may help protect against this potential harm among women who receive a positive cervical-cancer-screening result and may facilitate their intention to undergo further diagnostic procedures.

Current oral contraceptive use affects explicit and implicit measures of depression in women

Some data suggest that increased depressive symptoms may occur in women using combined oral contraceptives (OCs). However, this idea is controversial and the existing evidence is conflicting. The present study compared negative affect in 53 healthy women (Mage = 19.9 years) during intervals of active daily OC hormone intake and during the washout week of the contraceptive cycle when no exogenous estrogens or progestins are used. A prospective counterbalanced repeated-measures study design was employed. Depressive affect was evaluated using standard psychometric tests of explicit (self-perceived) and implicit negative affect. Implicit measures are considered less subject to bias related to social expectations, self-awareness, or willingness to disclose. Other than their usual OCs, participants were medication-free and had been using OCs for a median of 12 mo. We found that measures of implicit affect (e.g., Affect Misattribution Procedure, Emotional Stroop Test) displayed a more depressive-like pattern of performance during active hormone intake, particularly among a subgroup of OC users who reported experiencing high levels of depressive affect more generally. In contrast, participants’ self-perceptions suggested that they perceived their negative symptoms to be greater during the ‘off’ phase of the OC cycle, when OC steroids are withdrawn and menses occurs. The present findings reinforce the possibility of depressive mood effects associated with OC usage, and highlight the utility of including implicit measures, but also illustrate the complexity of mood assessment in OC users.

Medication-induced changes on magnetic resonance imaging of the brain

In this review the authors focus on abnormal brain magnetic resonance imaging caused by drugs given to patients in any age group for any disease. The review includes viral infections with fever in children/infections in general, epilepsy, psychiatric diseases, multiple sclerosis, neoplasms, bone marrow/organ transplantations, total parenteral nutrition, vaccinations, oral contraceptives and other prothrombotic drugs, and gadolinium deposition. Knowledge of patients’ diseases and medications they receive is crucial to establish the correct diagnosis. The absence of these data in a referral for a brain MRI scan can result in completely wrong suspicions and unleash unnecessary, complicated, time-consuming and expensive diagnostics, causing additional stress in patients and their guardians.

Endometriosis in Focus: Modern Therapeutic Approaches for Enhanced Patient Outcomes - Review

Endometriosis (EM) is a chronic condition affecting millions of women globally, characterized by the growth of endometrial-like tissue outside the uterus. This review highlights the latest advancements in understanding and treating endometriosis, focusing on new therapeutic strategies aimed at improving patient care. The article briefly discusses the pathogenesis of endometriosis and reviews traditional treatment methods, including hormonal therapies (progestins, GnRH agonists, and oral contraceptives) and surgical interventions. It then explores the limitations of these conventional therapies and delves into newer strategies targeting specific molecular pathways, offering more effective symptom relief with fewer side effects. Emerging treatments that modulate the immune response and reduce inflammation are also examined, along with innovative approaches to pain management, both pharmacological and non-pharmacological. The review further considers alternative and supportive therapies, such as dietary changes, gut microbiota interventions, and complementary treatments like acupuncture, which may improve the overall management of endometriosis. This review emphasizes the shift toward more personalized, holistic care in treating endometriosis, with a focus on emerging therapies like Aromatase Inhibitors, GnRH receptor antagonists, and hormone receptor modulators. These approaches represent a significant advancement in improving the quality of life for women with this condition.

Perspectives of healthcare providers around providing family planning services to women living with HIV attending six HIV treatment clinics in Lusaka, Zambia

ABSTRACT While international guidelines recommend integration of family planning (FP) and HIV services, limited research has been done to explore how healthcare providers perceive the feasibility and utility of integrated services. To address this gap, we administered a standardized questionnaire to 85 providers from 6 HIV clinics in Lusaka, Zambia, before (April–May 2018) and after (May–June 2019) implementing an enhanced model of FP/HIV service integration. We tested for differences in FP knowledge, attitudes and practices between the two time periods with tests appropriate for paired observations. The proportion of providers self-reporting direct provision of contraceptives increased significantly for several methods including oral contraceptives (14% vs. 26%, p = 0.03), injectables (9% vs. 25%, p < 0.001), implants (2% vs. 13%, p = 0.007) and intra-uterine devices (2% vs. 13%, p = 0.007). In-depth interviews were also conducted post-integration with 109 providers to solicit their feedback on the benefits and challenges of offering integrated services. While providers were highly supportive of integrated services, they identified several challenges including widespread belief in FP myths among female clients, the need to consult a male partner prior to starting FP, lack of trained staff and space, and frequent stockouts of contraceptives and equipment. Addressing these challenges will be critical in designing future services.

The concentration of hemoglobin is associated with the dietary iron availability, food insecurity and the use of oral contraceptives among women in socially vulnerable areas of a capital city in northeastern Brazil.

This study aimed to assess hemoglobinconcentration and its association with oral contraceptive (OC) use, food insecurity (FI) and dietary iron availability (DIA) in adult women of reproductive age (20-44 years). This is a population-based cross-sectional study that analysed 505 women living in favelas and urban communities in a capital city in northeastern Brazil. Hemoglobin concentration was determined using capillary blood samples. FI and DIAwere assessed using the Brazilian Food Insecurity Scale and the 24-h food recall, respectively. Association analysis was carried out using logistic regression. A directed acyclic graph (DAG) was designed to illustrate the causal paths between hemoglobin concentration and DIA. A significance level of 5 % was adopted. Low hemoglobin concentrations (11·2 g/dl: (1·79)) and a high prevalence of anaemia (64·0 %) were observed; 28·7 % used OC (28·7 %) and 76·4 % were in FI. An average energetic intake of 1495 kcal/d (482·0) and 0·46 mg/d (0·27) of DIA were also observed. In the DAG-guided multivariable analysis, it was observed that hemoglobin concentrations ≥ 12 mg/dl were directly associated with higher DIA(OR: 1·67; 95 % CI (1. 08, 2·59)) and OC use (OR: 1·67; 95 % CI (1·10, 2·55)) and inversely associated with mild FI (OR: 0·60; 95 % CI (0·37, 0·96)) or severe FI (OR: 0·37; 95 % CI: (0·18, 0·76)). Women taking OC and with a higher DIA were less likely to have low hemoglobin concentrations, while those in the context of FI were in the opposite situation.

Beneficial Effects of Curcumin in Polycystic Ovary Syndrome: A Review of Recent Literature and Underlying Mechanisms.

Polycystic Ovary Syndrome (PCOS) is a common endocrinological disorder that affects women of reproductive age and can lead to infertility. The prevalence of PCOS ranges from 5-21% depending on the diagnostic criteria and study population. Clinical manifestations include irregular or absent menstrual periods, obesity, and signs of hyperandrogenism. PCOS can also lead to long-term consequences such as metabolic syndrome, increased risk of cardiovascular diseases, endometrial cancer, diabetes mellitus, and hypertension. Metformin and oral contraceptive pills are the most commonly used drugs for PCOS management, but their efficiency is limited and they have some considerable side effects. Researchers are looking into alternative therapeutic options such as phytochemicals. Curcumin (CUR) is a polyphenolic compound found in the rhizome of Curcuma longa and has shown promising effects for females with PCOS. CUR exerts its anti-PCOS effects through different mechanisms such as reducing oxidative stress and inflammation, balancing hormone levels, and controlling the blood sugar and lipid profile. It can also reduce insulin resistance, regulate menstruation, and improve ovarian morphology and function. Despite its beneficial effects, CUR faces several challenges and limitations in clinical use, such as low bioavailability, instability, and rapid elimination. Therefore, researchers are investigating the potential of CUR nanoformulations and new drug delivery systems to overcome these barriers. With growing evidence regarding the potential role of CUR in PCOS treatment, we decided to provide an updated summary of the recent literature from clinical and preclinical studies on this topic.

The Effect of the Oral Contraceptive Pill on Acute Glycaemic Response to an Oral Glucose Bolus in Healthy Young Women: A Randomised Crossover Study.

Background/Objective: The oral contraceptive pill (OCP) is widely used by women worldwide, yet the influence of the OCP on carbohydrate metabolism remains under-investigated, with existing studies being few and largely cross-sectional. The study objective was to assess, for the first time, the effect of the combined OCP on postprandial glycaemic response to an oral glucose bolus, using a randomised crossover design. Methods: The effect of a combined monophasic OCP phase on glucose homeostasis and metabolic profile was investigated in 21 healthy young women, who were regular users of either androgenic or anti-androgenic OCP formulations. Plasma glycaemic markers (glucose, insulin and C-peptide) were assessed prior to a 60 g glucose drink (fasting) and for a further 4 h postprandially; once during the "active" (hormone-containing) pill phase and once during the "inactive" (hormone-free) pill phase of the OCP usage cycle. Results: Despite no change in fasting values, in androgenic pill users, postprandial glucose and insulin responses to an oral glucose bolus were ~100% and ~50% greater, respectively, during the active versus inactive phase. In contrast, in anti-androgenic pill users there was no significant change in response between the two OCP usage cycle phases. Conclusions: These findings highlight an acute, but potentially detrimental, influence of the combined OCP on glucose homeostasis, particularly in users of formulations containing androgenic progestogens. Given the high global prevalence of OCP use and increasingly common prolonged active pill regimens, which may continue for months, years or even decades, potential cumulative effects of such changes on metabolic risk demand further investigation.

Cervical Cytological and Colposcopic abnormalities in Cases Using Combined Oral Contraceptive Pills

Cervical Cytological and Colposcopic abnormalities in Cases Using Combined Oral Contraceptive Pills

The Most Common Side Effects, Concerns and Discontinuation Patterns of Oral Contraceptive Pills Among Polish Women: A Cross-Sectional Study.

Over the decade, variety and effectiveness of contraception methods have greatly improved, resulting in increased popularity of oral contraceptive pills (OCPs). However, hormonal contraception carries the risk of multiple side effects. The lack of sufficient knowledge often leads to the development of health concerns, which can affect patient's adherence. The aim of our research was to describe a side effect profile of OCPs and assess the most frequent concerns and discontinuation reasons in Polish women. The survey included questions regarding OCPs utilization patterns, side effects, health concerns and attitudes of the responders. This cross-sectional study was based on a survey, which was distributed online and open from 29 April to 15 May 2022. The survey included questions regarding OCPs utilization patterns, side effects, health concerns and attitudes of the responders. Out of 1699 respondents, the current OCPs intake was reported by two thirds of women and 22% had a history of using them in the past. Seventy-nine percent of all OCPs users experienced adverse effects while 9% reported having concerns about safety and potential adverse effects. Decreased libido and weight gain were the most significant reasons for ceasing hormonal contraception. Moreover, the most common concerns and the most unfavorable side effects varied in different age groups. The occurrence of anxiety depended on age and education. Healthcare professionals prescribing OCPs should provide their patients with comprehensive counseling. Understanding and addressing concerns of young women can improve their compliance and reduce the number of unintended pregnancies.

Use of Continuous Oral Drospirenone for Menstrual Suppression in Adolescents

PurposeTo describe experiences of adolescents taking continuous drospirenone (DRSP-C) oral contraceptives, without placebo, for menstrual suppression, including breakthrough bleeding and other side-effects. MethodsThis was a retrospective chart review of adolescents prescribed DRSP-C for menstrual suppression. Demographics and indications for DRSP-C were collected on the visit where DRSP-C was prescribed. Data through the final follow-up visit during the study period included documented effects and side-effects of DRSP-C and continuation of therapy. Statistical analyses were primarily descriptive. ResultsPatients prescribed DRSP-C were included (n = 136). Dysmenorrhea was the most common indication for DRSP-C (58.8%, n = 80/136) followed by endometriosis (44.8%, n = 61/136). The median time on DRSP-C for the 116 patients who were able to initiate treatment was 12.3 months (interquartile range [IQR] 6.8, 17.4). Patients trialed, on average, 2 other forms of menstrual management before starting DRSP-C (IQR 1, 3). Pelvic pain or dysmenorrhea resolution or improvement was reported in 84.6% (44/52) of dysmenorrhea patients, and 77.8% (28/36) of pelvic pain patients. Almost half of patients reported breakthrough bleeding on DRSP-C (41.3%, n = 48/116); however, only 11 patients (42%, 11/26) discontinued DRSP-C because of it. Within the study period, 22.4% (n = 26/116) of patients discontinued DRSP-C, with a median treatment duration of 101 days (IQR 71, 157). Among patients who discontinued DRSP-C, the most common reason was breakthrough bleeding (42%, n = 11/26). DiscussionDRSP-C for menstrual suppression was well tolerated in adolescents, with most patients reporting resolution or improvement of their indication for taking DRSP-C. Findings demonstrate DRSP-C is a viable option for menstrual suppression in adolescents.