Oral Contraceptive Users Research Articles

A Pharmacoepidemiologic Approach to Evaluate Real-world Effectiveness of Hormonal Contraceptives in the Presence of Drug-drug Interactions.

Background:Accurate estimation of conception is critical in the assessment of the effects of drugs used during pregnancy or to prevent pregnancy. In a novel application, we studied the effectiveness of oral contraceptives (OCs), where misclassification of conception relative to OC exposure may obscure effect estimates.Methods:We studied OC failure, in a large claims database, among women who used antiepileptic drugs with metabolizing enzyme-inducing properties (carbamazepine or oxcarbazepine), which reduce OC’s effectiveness or enzyme-neutral properties (lamotrigine or levetiracetam), with no expected impact on OC effectiveness. We compared conception rates in women 12–48 years of age concomitantly using OCs and enzyme-inducing drugs with rates in concomitant users of OCs and enzyme-neutral drugs. We measured conception with a validated algorithm that estimates gestational age based on pregnancy endpoints. We estimated relative and attributable risk using generalized estimating equation models after standardized mortality ratio weighting.Results:We identified 89,777 concomitant use episodes with adjusted contraceptive failure rates of 1.6 (95% confidence interval (CI) = 1.4, 1.8) per 100 person–years among users of enzyme-neutral drugs and 18,964 episodes with a rate of 2.3 (1.9, 2.8) among users of enzyme-inducing drugs. The relative risk of conception for enzyme-inducing group was 1.4 (1.1, 1.8), and the rate difference was 0.7 (0.2, 1.2).Conclusions:OCs in combination with antiepileptic drugs that interact with metabolic enzymes were associated with increased contraceptive failure rates. Measurement of conception in claims data had adequate accuracy to uncover a strong drug–drug interaction, offering promise for broader application in comparative effectiveness studies on hormonal contraceptives to inform clinical and regulatory decisionmaking.

Impact of oral contraceptives and breastfeeding on disease activity in a sample of Egyptian rheumatoid arthritis patients

BackgroundWomen are more affected by rheumatoid arthritis (RA) than men and the incidence of RA in women increases around the age of menopause indicating that hormonal factors may have a role in disease pathogenesis and progression. Despite several studies on the role of sex hormones and oral contraceptives (OCs) in RA patients, the effect of combined oral contraceptives on RA disease activity is still controversial, and since few studies have been performed in Egypt on this issue so we aimed to study the effect of OCs, breastfeeding, and prolactin on disease activity and their relation to the titer of autoantibodies in female Egyptian RA patients.ResultsOne hundred twenty married female RA patients were classified into three groups based on the OCs use (n = 40 each); current, past and non-users and according to lactation into three groups; lactating using OCs (n = 22), lactating not using OCs (n = 30), and non-lactating (n = 68). Our patients were using combined estrogen-progestin oral contraceptives. Clinical manifestations, disease activity, and laboratory findings were determined. The clinical manifestations including arthritis, and morning stiffness were significantly reduced in current users in comparison to past and non-users. Mean DAS28 was reduced significantly (p < 0.05) in current and past users of OCs. Also, using OCs during lactation reduced the clinical manifestations significantly. Lactating women who were not using OCs had significantly high DAS28 and ESR (p < 0.05) in comparison to lactating using OCs and non-lactating. On the other hand, using OCs reduced serum prolactin significantly. Lactating women not using OCs had significantly high serum prolactin (p < 0.05) and (p < 0.001) in comparison to lactating using OCs and non-lactating respectively which was correlated with DAS28 score.ConclusionOral contraceptives may be considered in RA female patients not only as a suitable birth control method but also it has a controlling effect on disease activity even during lactation.MessageOral contraceptives ameliorate disease activity in RA patients

Pregravid contraceptive use and fecundability: prospective cohort study

ObjectiveTo evaluate the association between pregravid use of a variety of contraceptive methods and subsequent fecundability.DesignProspective cohort study.SettingDenmark and North America, 2007-19.Participants17 954 women who had tried to conceive for...

Molecular markers of skeletal muscle hypertrophy following 10 wk of resistance training in oral contraceptive users and nonusers.

The objective was to determine whether skeletal muscle molecular markers and SC number were influenced differently in users and nonusers of oral contraceptives (OCs) following 10 wk of resistance training. Thirty-eight young healthy untrained users (n = 20) and nonusers of OC (n = 18) completed a 10-wk supervised progressive resistance training program. Before and after the intervention, a muscle tissue sample was obtained from the vastus lateralis muscle for analysis of muscle fiber cross-sectional area (fCSA) and satellite cell (SC) and myonuclei number using immunohistochemistry, gene expression using PCR, protein expression, and myosin heavy chain composition. Following the training period, quadriceps fCSA (P < 0.05), SCs/type I fiber (P = 0.05), and MURF-1 mRNA (P < 0.01) were significantly increased with no difference between the groups. However, SCs/total fiber and SCs/type II fiber increased in OC users only, and SCs/type II fCSA tended (P = 0.055) to be greater in the OC users. Furthermore, in OC users there were a fiber type shift from myosin heavy chain (MHC) IIx to MHC IIa (P < 0.01), and expression of muscle regulatory factor 4 (MRF4) mRNA (P < 0.001) was significantly greater than in non-OC users. Use of second-generation OCs in young untrained women increased skeletal muscle MRF4 expression and SC number following 10 wk of resistance training compared with nonusers.NEW & NOTEWORTHY The effect of oral contraceptive use on the skeletal muscle regulatory pathways in response to resistance training has not been investigated previously. Here we present novel data, demonstrating that use of second-generation oral contraceptives in young untrained women increased skeletal muscle regulatory factor 4 expression and satellite cell number following 10 wk of resistance training compared with nonusers.

Oral contraceptive use, especially during puberty, alters resting state functional connectivity

Millions of women worldwide use oral contraceptives (OCs), often starting during puberty/adolescence. It is, however, unknown how OC use during this critical period of development affects the brain. The objective of the current study was to examine resting state functional connectivity (FC) in the default mode network (DMN), central executive network (CEN), salience network (SN), reward network (RN), and subcortical limbic network of the brain using independent component analysis (ICA) between pubertal- and adult-onset OC users (n = 27) and naturally cycling women (n = 48). It was hypothesized that OC use would result in network-specific increases and decreases in FC and that pubertal-onset OC use would result in differences to the aforementioned networks compared to adult-onset OC use. Pubertal-onset OC use is related to heightened FC in the SN compared to adult-onset OC users. In general, OC use also increases connectivity in the SN, CEN, RN, and subcortical limbic network compared to NC women. No significant differences in connectivity were observed in the DMN between OC users and NC women. These findings provide a mechanistic insight for the altered executive functioning and emotion/reward processing previously seen in OC users, which may then increase their vulnerability to mental health conditions.

Hormonal Contraceptive Use, Menstrual Dysfunctions, and Self-Reported Side Effects in Elite Athletes in Denmark.

To identify the prevalence of hormonal contraceptive (HC) use, menstrual cycle disturbances, and self-perceived physical and emotional symptoms related to the menstrual cycle/pill cycle in elite female athletes. One hundred eighty-six Danish elite female athletes completed an online questionnaire to assess menstrual status and history, use of HCs, and self-perceived physical and emotional symptoms related to the menstrual cycle or HC use. Fifty-seven percent of elite female athletes in Denmark use HC, with 74% using combined HCs and 26% using progestin only. Sixty percent of oral contraceptive users reported having manipulated their menstrual cycle by continuous oral contraceptive use. Forty-nine percent of non-HC users had a regular menstrual cycle, while 51% experienced menstrual disturbances, with 1 athlete being primary amenorrheic and 13 athletes having secondary amenorrhea. Menstrual disturbances were experienced by a larger proportion of endurance athletes (69%) compared with athletes performing power and technical disciplines. In endurance athletes amenorrhea was associated with a higher cardiovascular training volume (P < .001). Negative symptoms related to the menstrual/pill cycle were reported by both HC and non-HC users, whereas positive physical symptoms were experienced more often among the non-HC (14%) versus HC users (2%) (P < .01). Notably, 13% of the athletes reported that negative symptoms sometimes/always caused them to not participate in or complete the scheduled training. HC use is common among elite athletes, and continuation of HC is used to manipulate the menstrual cycle in relation to sport competitions. HC use does not abolish dysmenorrhea, but it may reduce emotional-related side effects. Menstrual disturbances are frequent in endurance athletes and are associated with cardiovascular training volume.

Toplum Tabanlı Kanser Taraması: Hedef Topluma Ulaşmak

Objective: The aim of this study is to determine the risk factors and the results of the community-based screening program of the women who attended the Cancer Early Diagnosis, Screening, and Education Center between 2005-2011. Methods: This study was planned on a descriptive design. Data of the women who attend to cancer screening center between 2005-2011 years for breast cancer and cervical cancer screening program were collected retrospectively and evaluated. Incomplete forms were excluded. Results: Research has been completed by the records of 3162 women. The age of the study group was between 25-69 years old. The majority of them has been educated for 5 years and/or less, or not educated (89%), more than one-third of patients had more than four birth (38%), the breastfeeding rate was high (93.6%), the oral contraceptive drugs and HRT medication usage ratios were low (7.2%, 7.2%), respectively), the smoking rate was low (14.9%). The number of women who consulted for cervix cancer screening was 215 in 2008 and 142 for breast cancer screening; by the end of June 2011. Those numbers increased to 1271 and 1012, respectively. Conclusion: Community-based cancer screening programs are much more successful to reach the target population although single women, LGBT individuals, “working class” are still the missing parts of the puzzle.

Drug Utilization Study on Oral Contraceptives provided from Social Security, Buenos Aires-Argentina: Risk and cost analysis according to the type of combination used

Oral contraceptive pill is the most prescribed option to avoid birth-rate around the world. It is a combination of estrogens/progestin. Unfortunately, new combinations raise the risk of thrombosis. To determine the prescription profile and the incidence of thrombotic events associated to oral contraceptive use, we developed the present study. Method: It is a drug utilization study among beneficiaries of Buenos Aires Social Security Organization. Variables studied were age, sex, combination consumed, doses, co-morbidities, thrombotic events.Results: 69,653 women were enrolled in the study. 66,043 of them (94.84%) used new progestogen generation combination (desogestrel, gestodene, drospirenone,) while 3610 (5.18%) used either levonorgestrel or norgestrel as progestin. The number of thrombotic events (either depth vein thrombosis of lower limbs, thromboembolism or arterial thrombosis) was 77 (75 with new progestin and 2 using 1st/2nd generation options). Adjusting these values to 100,000 users; the occurrence of thrombotic events were doubled with new generation progestins when compared to older options. The price of the new generation combinations were 10.2 times more expensive that the safer ones. Conclusion: Among the beneficiaries of Buenos Aires State Social Security, the users of oral contraceptives with new generation progestin denote a greater risk of thrombotic events when compared with users of levonorgestrel or norgestrel. Public reproductive health policies that provide contraceptives to the population are crucial in guaranteeing rights such as avoiding unwanted pregnancies and reproductive planning. However, the combinations provided should not expose population to additional and unnecessary risks.&#x0D; Keywords: oral contraceptives, thrombosis, progestin, risk, public health

Hormonal treatments for preventing recurrence of endometriomas

: Endometriosis is a chronic condition determined by the presence of ectopic endometrial glands and stroma. The disease affects approximately 10% of women of reproductive age and 35-50% of women with chronic pelvic pain and/or infertility. Transvaginal ultrasonography is a very sensitive and specific instrument for the diagnosis of endometrioma. Surgical and/or medical therapies for endometriomas aim to control symptoms (in particular, chronic pelvic pain and dysmenorrhea) and prevent cyst growth; medical therapy may be employed to reduce recurrence rate after surgery. After surgical approach, the reported postoperative recurrence rate of endometriomas is high, ranging from 30% to 40%; therefore, several hormonal therapies, such as oral contraceptives (OC), progestins (PG), GnRH analogs (GnRHa), and antagonists, danazol, aromatase inhibitors, selective estrogen receptor modulators (SERMs) and selective progesterone receptor modulators (SPRMs), have been employed in order to prevent disease recurrence. The objective of this systematic review is to assess the impact of the adjuvant use of hormonal treatment on endometrioma recurrence. Two evaluators extracted from MEDLINE, EMBASE, and Cochrane Library and reviewed published studies on this topic, following pre-determined selection criteria. Finally, data were extracted from 16 selected prospective or retrospective studies, of which 8 were randomized controlled trial and 8 were cohort studies. Most of them reported a beneficial impact on endometrioma recurrence by the usage of OC, PG, and GnRH analogs (GnRHa); however, conflicting results exist in the current literature about this topic. The duration of adjuvant therapy seems to have a crucial role in this context, but it is still not clear which type of postoperative hormonal treatment represents the best choice.

Emotional contagion and intuitive response in oral contraceptive users

Emotional contagion and intuitive response in oral contraceptive users

Cerebral Venous Sinus Thrombosis in Women: Subgroup Analysis of the VENOST Study.

Background Early diagnosis of cerebral venous sinus thrombosis (CVST) associated with reproductive health-related risk factors (RHRF) including pregnancy, puerperium, and oral contraceptive (OC) use can prevent severe neurological sequelae; thus, the symptoms must be documented in detail for each group. Methods Out of 1144 patients with CVST, a total of 777 women were enrolled from a multicenter for the study of cerebral venous sinus thrombosis (VENOST). Demographic, biochemical, clinical, and radiological aspects were compared for 324 cases with RHRF and 453 cases without RHRF. Results The mean age of the RHRF (-) group (43.2 ± 13 years) was significantly higher than of the RHRF (+) group (34 ± 9 years). A previous history of deep venous thrombosis (3%), isolated cavernous sinus involvement (1%), cranial neuropathy (13%), comorbid malignancy (7%), and its disability scores after 12 months (9%) were significantly higher in the RHRF (-) group. The RHRF (+) group consisted of 44% cases of puerperium, 33% cases of OC users and 23% of pregnant women. The mean age was found to be higher in OC users (38 ± 9 years). A previous history of deep venous thrombosis was slightly higher in the pregnancy subgroup (4%). Epileptic seizures were more common in the puerperium group (44%). Conclusion The results of our study indicate that the risk of CSVT increases parallel to age, OC use, and puerperium period. In addition, when considering the frequency of findings and symptoms, epileptic seizures in the puerperium subgroup of the RHRF (+) group and malignancies in the RHRF (-) group may accompany the CSVT. In daily practice, predicting these risks for the CSVT and early recognition of the symptoms will provide significant benefits to patients.

ESTRADIOL IS ASSOCIATED WITH DECREASED CARDIOVASCULAR RISK COMPARED TO ETHINYLESTRADIOL WHEN CONTAINED IN COMBINED HORMONAL PREPARATIONS: IMPLICATIONS FOR THE DEVELOPMENT OF NEW ENDOMETRIOSIS THERAPIES

Combined estrogen-progestin preparations have a long history in women’s health and are currently used for multiple indications, including the treatment of endometriosis-related symptoms. Empirically, estradiol (E2) and its ester, estradiol valerate (E2Val) carry a reduced cardiovascular risk due to their reduced impact on the hepatic system compared to the most-widely used estrogen ethinylestradiol (EE). However, robust comparative studies in pre-menopausal women are limited. A new hormonal product containing E2 in combination with the progestin norethindrone acetate (NETA) and the gonadotropin-releasing hormone receptor antagonist, relugolix, has been developed for the treatment of uterine fibroids and endometriosis. This analysis tries to quantify the cardiovascular risk of E2/E2Val-NETA in pre-menopausal women. A pooled analysis of four large cohort studies assessing the risk of cardiovascular events in users of combined oral contraceptives (COCs). Data regarding users of COCs containing either E2/E2Val or EE≤30μg were retrieved from four large prospective, controlled, observational, cohort studies in 14 European countries, US and Canada. Baseline characteristics, including reproductive, contraceptive and medical history, were summarized using descriptive statistics. Propensity score sub-classification was applied to balance baseline parameters between cohorts and time-to-event analysis of venous and arterial thromboembolic events was carried out based on the extended Cox model to calculate crude and adjusted hazard ratios (HR) including 95%-confidence intervals (CI). The analysis was based on 210,000 women, who contributed 470,000 women years of exposure. The observed prevalence of prognostic factors at baseline showed typical features of US and European COC users. However, the mean age in the E2/E2Val cohort was higher compared to the EE≤30μg cohort (31.7 years ±9.76 and 26.1 years ±7.89, respectively). A time-to-event analysis of the VTE data was carried out based on the extended Cox model. Validity of the model was demonstrated by the standardized differences summarized over strata as weighted average yielded upon PS sub-classification, which were consistently <0.25 and mostly <0.1. A comparison between cohorts showed a decreased risk of venous thromboembolism in users of COCs containing E2/E2Val vs users of COCs containing EE≤30μg; adjusted hazard ratio: 0.49 (95% CI, 0.28-0.84). A risk reduction in the E2/E2Val cohort was also observed with regards to arterial thromboembolic events; adjusted hazard ratio: 0.26 (95% CI, 0.08-0.83). Data presents a solid safety assessment of combined hormonal preparations in over 200,000 pre-menopausal women and shows a decreased cardiovascular risk of E2/E2Val when compared to low-dose EE. This provides reassurance for current users of E2/E2Val-containing COCs and opens new perspectives for the development of safe and effective endometriosis treatments, such as the recently developed product containing E2/NETA, in combination with relugolix.

Mechanical and Physical Behavior of Fibrin Clot Formation and Lysis in Combined Oral Contraceptive Users.

Combined oral contraceptives (COCs) are commonly prescribed and increase the risk of venous thromboembolism (VTE). We have previously found that two COCs, both containing drospirenone (DRSP) and ethinyl estradiol (EE), cause spontaneous fibrin formation in whole blood. The aim of this study was, therefore, to use platelet-poor plasma (PPP) from the same cohort of DRSP/EE users to determine the impact of these COCs on the fibrin component, specifically the fibrin clot viscoelasticity, turbidimetry, and biophysical traits. PPP from 25 females per test group and a control group (n = 25) were analyzed using thromboelastography (TEG), turbidimetry, and scanning electron microscopy. The results highlight abnormal fibrin clot formation, lysis, and architecture; DRSP/20EE showed the greatest effect. DRSP/EE use increased the fibrin fiber diameter and showed dense matted clots. Only when the influence of COCs on the structural properties and behavior of fibrin fibers during thrombus formation and lysis is better understood are we able to predict and prevent coagulopathies associated with these synthetic hormones. Clinical practitioners should take this into consideration for female patients that either have comorbidities, which could burden the coagulation system, or may be exposed to external factors that could increase their risk for VTE.

Total T4 rise in pregnancy: a relook?

BackgroundTotal T4 (TT4) measurement is preferred to free T4 (FT4) especially in last part of pregnancy. Guidelines by American Thyroid Association, European Thyroid Association and Endocrine Society state that TT4 increases 1.5 times pre-pregnant levels after week 16 of pregnancy. However, this is based on a small study conducted 40 years ago which used radioimmunoassay for determination in changes in TT4.Materials and methodsA cross-sectional study was undertaken to find reference interval for thyroid function in different trimester of pregnancy with special reference to look at the degree of elevation of TT4 as compared to non-pregnant women. Two hundred non-pregnant women (excluding oral contraceptive users) and 600 pregnant women (200 from each trimester) aged 18–40 years were consecutively recruited starting from around 6th week of pregnancy having confirmed singleton pregnancy diagnosed at 8th week by ultrasound. The exclusion criteria included: (1) a personal or family history of thyroid disease; (2) presence of goiter or nodule confirmed by ultrasound; (3) anti-TPO antibody positive state (titre > 35 IU/ml). All subjects were tested for urinary spot iodine concentration and those with UIC < 150 μg/L were excluded. Finally, thyroid function tests (TSH, FT4, TT4, TT3) of 168 non-pregnant women and 163, 153 and 148 women at 1st, 2nd and 3rd trimester respectively were analysed..ResultsTotal T4 (mean ± SD, μg/dl) in non pregnant women and in different trimesters was 8.95 ± 1.71, 9.71 ± 2.39, 12.11 ± 1.55, 11.83 ± 1.49 respectively. Rise in TT4 occurred between 10-18th week. The mean TT4 in second trimester increased by 25% as compared with the value at 6-9th week and by 35% as compared to non-pregnant value.ConclusionRise in total T4 in second trimester pregnancy is only around 25% as compared to first trimester value and 35% than the non-pregnant value. Hence multiplying non-pregnant T4 value by 1.5 may actually over-diagnose maternal hypothroxinemia and lead to inappropriate diagnosis and treatment of isolated maternal hypothyroxinemia in a significant proportion of subjects.

Oral contraceptives and the serotonin 4 receptor: a molecular brain imaging study in healthy women.

ObjectiveSex steroid hormones potently shape brain functions, including those critical to maintain mental health such as serotonin signaling. Use of oral contraceptives (OCs) profoundly changes endogenous sex steroid hormone levels and dynamics. Recent register‐based studies show that starting an OC is associated with increased risk of developing depression. Here, we investigate whether use of OCs in healthy women is associated with a marker of the serotonin system in terms of serotonin 4 receptor (5‐HT4R) brain imaging.Methods[11C]SB207145‐PET imaging data on 53 healthy women, of whom 16 used OCs, were available from the Cimbi database. We evaluated global effects of OC use on 5‐HT4R binding in a latent variable model based on 5‐HT4R binding across cortical and subcortical regions.ResultsWe demonstrate that OC users have 9–12% lower global brain 5‐HT4R binding potential compared to non‐users. Univariate region‐based analyses (pallidostriatum, caudate, hippocampus, amygdala, anterior cingulate cortex, and neocortex) supported the global effect of OC use with the largest difference present in the hippocampus (−12.8% (95% CI [−21.0; −3.9], P corrected = 0.03).ConclusionWe show that women who use OCs have markedly lower brain 5‐HT4R binding relative to non‐users, which constitutes a plausible molecular link between OC use and increased risk of depressive episodes. We propose that this reflects a reduced 5‐HT4R gene expression, possibly related to a blunted ovarian hormone state among OC users.

The story of oral contraceptive users and bacterial vaginosis…. Is it real?

The story of oral contraceptive users and bacterial vaginosis…. Is it real?

Cardiorespiratory Variables During A Maximal Running Test In Well-trained Females With Different Hormonal Profiles

Differences in estrogen and progesterone levels along a natural menstrual cycle and an oral contraceptive (OC) cycle may influence female´s performance. Previous literature reported lower strength, maximal oxygen consumption (VO2 max) and systolic volume in OC users. According to postmenopausal women, their low and stable levels of sex hormones may affect them in a different way than in young women. PURPOSE: To elucidate the effect of different hormonal profiles on maximal VO2, heart rate (HR) and ventilation (VE) in well-trained females. METHODS: Thirty-three eumenorrheic females (30.1±6.2 years, 59.3±8.4 kg, and 164.1±6.3 cm), twenty-three monophasic OC users (24.8±4.3 years, 58.6±5.8 kg, and 163.3±5.1 cm) and thirteen postmenopausal women (51.0±3.7 years, 54.9±4.1 kg, and 161.5±5.4 cm) participated in the study. A maximal graded test with a computerized treadmill was performed. Expired gases were measured breath-by-breath with the gas analyser Jaeger Oxygen Pro. HR was continuously monitored with a 12-lead ECG. Participants began with a warm-up of 3 minutes at 6 km/h. Then, the speed was set at 8 km/h, increasing 0.2 km/h every 12 seconds until exhaustion. RESULTS: One way ANOVA reported lower values in post-menopausal females compared to the other two groups (eumenorrheic and OC users) for all variables measured: VO2 max (2924.2±389.7 ml/min for the eumenorrheic; 2808.8±366.7 ml/min for the OC; and 2455.15±281.04 ml/min for the postmenopausal; p=0.001), maximal HR (184.2±10.3; 189.9±8.4; and 172.1±12.9 bpm respectively; p<0.001) and maximal VE (111.8±17.5; 114.7±15.1; and 96.4±10.4 l/min, respectively; p=0.003). Nonetheless, no significant differences in VO2max, HR and VE were found between eumenorrheic females and OC users. CONCLUSION: The drastic decrease of sex hormones in postmenopausal females, along with other hormonal and physiological changes caused by the age, may explain the drop in VO2 max, HR and VE in this population. In terms of young women, despite literature reported lower values in OC users, the lack of difference observed in this study may be due to the lower concentrations of sex hormones that OC pills have nowadays, or because of the fact that all were well-trained participants. Funding: DEP2016-75387-P (Spanish National Plan 2013-2016)

L-glutamine ameliorates adipose-hepatic dysmetabolism in OC-treated female rats

Adipose dysfunction and inflammation with or without hepatic defects underlie metabolic obesity. Glutamine (GLU) improves glucoregulation and metabolic indices but its effects on adipose function and hepatic lipid deposition in estrogen-progestin oral contraceptive (EPOC) users are unknown. Therefore, we hypothesized that GLUT supplementation would protect against adipose dysfunction and excess hepatic lipid influx and deposition in EPOC-treated animals by suppressing adenosine deaminase/xanthine oxidase (ADA/XO) activity and improving glucose-6-phosphate dehydrogenase (G6PD)-dependent antioxidant defense. Female Wistar rats weighing 150-180 g were allotted into control, GLUT, EPOC and EPOC + GLUT groups (six rats/group). The groups received vehicle (distilled water, p.o.), GLUT (1 g/kg), EPOC containing 1.0 µg ethinylestradiol plus 5.0 µg levonorgestrel and EPOC plus GLUT, respectively, daily for 8 weeks. Results showed that the administration of EPOC caused glucose dysregulation and increased triglyceride-glucose index and visceral adiposity, but the body weight and liver weight were not affected. However, EPOC significantly decreased adipose lipid, G6PD and glutathione and increased glycogen synthesis, ADA, XO, uric acid, lipid peroxidation, lactate production and gamma-glutamyl transferase activity (GGT). On the other hand, EPOC increased hepatic lipid, ADA, XO, uric acid, lipid peroxidation and lactate production and decreased glycogen synthesis, G6PD and glutathione. Nevertheless, supplementation with glutamine attenuated these alterations. Collectively, the present results indicate that EPOC causes metabolically induced obesity which is associated with adipose dysfunction and hepatic metabolic disturbance. The findings also suggest that glutamine confers metabo-protection with corresponding improvement in adipose and hepatic metabolic function by suppression of ADA/XO activity and enhancement of G6PD-dependent antioxidant defense.

Use of the birth control pill affects stress reactivity and brain structure and function

Millions of women worldwide use oral contraceptives (i.e., birth control pill; OCs), often starting during puberty/adolescence; however, it is unknown how OC use during this critical period of development affects the brain, especially with regard to emotional working memory. Here, we examined stress reactivity, and brain structure and function in OC users using the Trier Social Stress Test and structural and functional magnetic resonance imaging (MRI). Our results show that OC use during puberty/adolescence gives rise to a blunted stress response and alters brain activation during working memory processing. OC use, in general, is also linked to increased prefrontal brain activation during working memory processing for negatively arousing stimuli. OC use is also related to significant structural changes in brain regions implicated in memory and emotional processing. Together, these findings highlight that OC use induces changes to brain structure and function and alters stress reactivity. These findings may provide a mechanistic insight for the increased vulnerability to mood-related mental illness in women after OC use.

Risk Factors of Cervical Cancer in Outpatient and Inpatient at Obstetric and Gynecology RSUP Dr. Mohammad Hoesin Palembang

&lt;div class="WordSection1"&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction&lt;/strong&gt;&lt;strong&gt;:&lt;/strong&gt; Cervical cancer is a malignant tumor originating from primary squamous epithelial cells and it is one of the several types of cancers that affects more to women.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This research uses descriptive analytic with case- control. The sample was 52 patients who divided into 26 patients with cervical cancer and 26 patients with non - cervical cancer were outpatient and inpatient at Department of Obstetrics and Gynecology Hospital Dr. Mohammad Hoesin Palembang during the period September 2016 -November 2016. This study uses primary data in the form of interviews. Data was analyzed by univariate and presented in a frequency distribution table. Furthermore, using bivariate analysis to determine the relationship and OR.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result:&lt;/strong&gt; From 8 risk factors studied, there is sygnificancy correlation between pathological vaginal discharge (p= 0,0005 OR= ∞), parity (p= 0,0005 OR= 22,7), age (p= 0,0005 OR= 19,2), oral contraception usage for a long time (p= 0,0005, OR= 12,4), age of the first intercourse (p= 0,006, OR= 6,1 ), and the husband’s occupation (p= 0,05 OR= 3,6) with the incidence of cervical cancer. While, there are two risk factors that don’t have a sygnificancy correlation between smoking (p= 1,0) and changing sexual partners (p= 1,0) with the incidence of cervical cancer.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt; The results of this research identified risk factors that significantly related to cervical cancer incidence was the age, the age of first sexual intercourse, parity, long-term oral contraceptive use, a history of vaginal discharge, and the husband's occupation.&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;/div&gt;&lt;em&gt;&lt;br clear="all" /&gt;&lt;/em&gt;