Past Oral Contraceptive Use Research Articles

Characteristics of HRT users in Japan: Evidence from the Japan Nurses' Health Study

ObjectivesLittle is known about what type of women use hormone replacement therapy (HRT) in Japan. Based on the Japan Nurses' Health Study (JNHS), a large population cohort study, we determined the characteristics of HRT users by comparing the characteristics of new HRT users and the characteristics of women who did not use HRT during a 10-year follow-up period. Study designOf the 15,019 JNHS participants, 4886 women reported an experience of menopausal transition during the 10-year follow-up period. Main outcome measurementCharacteristics of new HRT users. ResultsThe proportion of HRT users during the 10-year period was 8.5 %. Advanced age at menopause was significantly associated with a low rate of use of HRT. Past use of oral contraceptives, dysmenorrhea with disturbance in daily life and vasomotor symptoms were significantly associated with a high rate of use of HRT. The occupations of public health nurse and midwife and a history of bilateral oophorectomy were also significantly associated with a high rate of use of HRT. ConclusionsWe determined the characteristics of new HRT users among middle-aged women during a 10-year follow-up period. Women who had sufficient knowledge about endocrinological hormones and women who had less reluctance to visit doctors for gynecological problems were likely to use HRT.

Association between past oral contraceptive use and the prevalence of hypertension in postmenopausal women: the fifth (2010\u20132012) Korea National Health and Nutrition Examination Survey (KNHANES V)

BackgroundThere is little evidence as to whether the use of oral contraceptives(OC) during the fertile years affects the development of postmenopausal hypertension. This study aimed to evaluate the association between past use of OC and development of hypertension in postmenopausal women.MethodsThis was a cross-sectional study conducted using data from the Fifth Korea National Health and Nutrition Examination Survey of postmenopausal women. Subjects were classified into three groups based on past OC use duration: nonusers, short-term users(0–30 months), and long-term users(≥ 30 months). We evaluated the development of hypertension in women after menopause. A multivariable logistic regression model was used to identify the association between the use of OC during the fertile years and the prevalence of hypertension after menopause following adjustment for potential confounding factors.ResultsOf the 3,386 postmenopausal women, 2,713 were nonusers of OC, 489 were short-term users, and 184 were long-term users. Women who had used OC for 30 months or more had a significantly greater prevalence of hypertension after menopause than those who had never taken OC. The association between taking OC for 30 months or more during the fertile years and the prevalence of hypertension after menopause was significant following adjustment for potential confounding factors (adjusted OR:1.75; 95%CI:1.12–2.74).ConclusionThis study identified an association between past OC use and an increased prevalence of hypertension in postmenopausal women. Our results suggest that long-term use of OC during the fertile years can be an important risk factor for subsequent hypertension after menopause.

Oral Contraceptive and Menopausal Hormone Therapy Use and Risk of Pituitary Adenoma: Cohort and Case-Control Analyses.

No prospective epidemiologic studies have examined associations between use of oral contraceptives (OCs) or menopausal hormone therapy (MHT) and risk of pituitary adenoma in women. Our aim was to determine the association between use of OC and MHT and risk of pituitary adenoma in two separate datasets. We evaluated the association of OC/MHT with risk of pituitary adenoma in the Nurses' Health Study and Nurses' Health Study II by computing multivariable-adjusted hazard ratios (MVHR) of pituitary adenoma by OC/MHT use using Cox proportional hazards models. Simultaneously, we carried out a matched case-control study using an institutional data repository to compute multivariable-adjusted odds ratios (MVOR) of pituitary adenoma by OC/MHT use. In the cohort analysis, during 6 668 019 person-years, 331 participants reported a diagnosis of pituitary adenoma. Compared to never-users, neither past (MVHR = 1.05; 95% CI, 0.80-1.36) nor current OC use (MVHR = 0.72; 95% CI, 0.40-1.32) was associated with risk. For MHT, compared to never-users, both past (MVHR = 2.00; 95% CI, 1.50-2.68) and current use (MVHR = 1.80; 95% CI, 1.27-2.55) were associated with pituitary adenoma risk, as was longer duration (MVHR = 2.06; 95% CI, 1.42-2.99 comparing more than 5 years of use to never, P trend = .002). Results were similar in lagged analyses, when stratified by body mass index, and among those with recent health care use. In the case-control analysis, we included 5469 cases. Risk of pituitary adenoma was increased with ever use of MHT (MVOR = 1.57; 95% CI, 1.35-1.83) and OC (MVOR = 1.27; 95% CI, 1.14-1.42) compared to never. Compared to never use, current and past MHT use and longer duration of MHT use were positively associated with higher risk of pituitary adenoma in 2 independent data sets. OC use was not associated with risk in the prospective cohort analysis and was associated with only mildly increased risk in the case-control analysis.

The asthma predictive index as a surrogate diagnostic tool in preschoolers: Analysis of a longitudinal birth cohort.

To evaluate if the asthma predictive index (API) can be used as surrogate for asthma diagnosis in preschoolers. Birth cohort of 339 pregnant women enrolled at delivery and their offspring, who were followed for atopy, wheezing, and other respiratory illnesses through 30 months of age. The API was determined at 30 months of age by the researchers; and examined its association with physician-diagnosed asthma during the first 30 months, made independently by the primary care physician not involved in the study. Among 307 offspring with complete follow-up, 44 (14.3%) were API+. Maternal body mass index, maternal education, past oral contraceptive use, birthweight, placenta weight, age of daycare at 12 m, gastroesophageal reflux disease at 12 m, acute otitis media at 18 m, bronchiolitis, croup and pneumonia, cord blood adiponectin were all associated with API+. In the multivariable analysis, API+ was associated with almost sixfold odds of asthma diagnosis (adjusted OR = 5.7, 95% CI [2.6-12.3]), after adjusting for the relevant covariates above including respiratory infections like bronchiolitis and pneumonia. The API sensitivity was 48%, specificity 92%, 61% PPV, 88% NPV, 6.4 LR+, 0.56 LR-, 0.84 diagnosis accuracy. The adjusted odds for asthma was 11.4. This longitudinal birth cohort suggests, for first time, that API (a structured definition for asthma), could be used as a diagnostic tool, not only as a prognostic tool, in toddlers and preschoolers.

Complement and its environmental determinants in the progression of human rheumatoid arthritis

Rheumatoid arthritis (RA) is a complex autoimmune disease with an etiology that is not yet well understood, disproportionally affects women and also varies in incidence and prevalence by population. The presence of anti-citrullinated protein antibodies (ACPA) is a highly specific biomarker for the diagnosis of clinically apparent RA. ACPA are also present in the serum for an average of 3–5 years prior to the onset of RA during an asymptomatic period characterized by mucosal inflammation and local ACPA production at these sites. We hypothesized that systemic complement activation products might be generated during the pre-clinical initiation of RA and/or provide a second hit that promotes subsequent arthritis development in the joints. In addition, we evaluated which demographic and genetic features and environmental exposures could influence the complement activation process. We analyzed plasma from healthy subjects, subjects at-risk for the development of RA based on serum ACPA positivity in absence of inflammatory arthritis (IA), and ACPA positive RA subjects by Multiplex Assay and ELISA for eighteen complement system components, factors and activation products belonging to the classical, lectin and alternative pathways. By using regression models, associations between complement proteins and various demographic, genetic, and environmental factors previously found to be associated with RA, including sex, smoking, shared epitope, and oral contraceptive use, were examined. We found no evidence of systemic complement activation in ACPA positive subjects without IA, but in contrast found evidence of systemic involvement of the both classical and alternative pathways during the stage of the disease where classified RA is present, (i.e. during joint inflammation and damage). With regard to the demographic, genetic, and environmental variables, females who reported current or past oral contraceptive use and subjects with current tobacco exposure demonstrated alterations of the alternative pathway of complement. Furthermore, RA subjects with established disease who have a body mass index categorized as obese demonstrated higher levels of C2 compared to RA subjects who are not considered obese. In sum, the complement system may be involved in the pathogenesis of RA, with only localized mucosal effects during the preclinical period in those at-risk for RA but in the joint as well as systemically in those who have developed clinically apparent arthritis.

Use of oral contraceptives and risk of ulcerative colitis – A systematic review and meta-analysis

Numerous studies have investigated the link between oral contraceptives and risk of ulcerative colitis (UC), but the results have been controversial. We systematically reviewed all relevant published studies and evaluated the association between the use of oral contraceptives and the development of UC by meta-analysis. Databases including PubMed, EMbase, CNKI and WanFang data were thoroughly searched from inception to September 2018 to collect the studies on the correlation between oral contraceptives and the risk of UC. The studies were screened according to the inclusion and exclusion criteria by two researchers independently, and the data were extracted and the quality was evaluated. Meta-analysis was performed using Stata 13.0 software. There were 12 studies involving 303,340 participants that reported on the association between oral contraceptives and UC. The pooled odds ratio (OR) of UC in oral contraceptive users was 1.25 [95% confidence interval (CI) 1.04–1.51, p = 0.02]. The risk was significant in the current oral contraceptive users (OR 1.49, 95% CI 1.12–1.96, p = 0.005) whereas the past oral contraceptive use was not significantly associated with UC (OR 1.17, 95% CI 0.95–1.43, p = 0.141). This study provides evidence of an association between the use of oral contraceptives and the onset risk of UC. The study also shows that the risk for patients who stop using the oral contraceptives was decreased. These findings may be used as important reference for the use of oral contraceptives and the management of UC patients.

Use of Oral Contraceptives at Child-Bearing Age Are Associated with the Prevalence of Diabetes in Postmenopausal Women

Objective: The effect of past use of oral contraceptives (OCs) at child-bearing on the incidence of diabetes and insulin resistance (IR) after menopause is not clearly elucidated. This study aimed to evaluate the association of past use of OCs with the development of diabetes and IR in post-menopausal women. Methods: This cross-sectional study was based on data from the Korea National Health and Nutrition Examination Survey from 2007 to 2012. Of the 50,4participants, 6554 post-menopausal women were selected and included in the analysis. The long-term effects of OCs use on the prevalence of diabetes in post-menopausal women were examined using multivariate logistic analysis. In addition, fasting glucose and insulin levels were measured in 3338 nondiabetic post-menopausal women, and the association between IR and OCs was examined by analysis of covariance. Results: The prevalence of diabetes was significantly higher in post-menopausal participants who had taken OCs for more than 6 months than in those who had never taken OCs. The association remained significant after adjusting for multiple confounding factors (odd ratio, 1.379; 95% CI, 1.115-1.707; P=0.003). The duration of OCs use was also positively associated with the prevalence of diabetes. Furthermore, taking OCs for more than 6 months led to a significant increase in fasting insulin levels and HOMA-IR in nondiabetic participants. Conclusion: Past use of OCs for more than 6 months led to a significant increase in the prevalence of diabetes in post-menopausal women, and increased IR in nondiabetes participants. These results suggested that prolonged use of OCs at a reproductive age is an important risk factor for developing diabetes in post-menopausal women. Disclosure S. Kim: None. R. Kim: None. E. Jeon: None. J. Lee: None. H. Shon: None.

Correlates of sleep quality and sleep duration in a sample of urban-dwelling elderly Nigerian women

ObjectivesAging, female sex, and urbanization increase the risk of sleep impairment. Sleep in urban-dwelling elderly African women has been sparsely studied. We studied the characteristics and correlates of sleep quality and habitual sleep duration in a primary care population of urban-living Nigerian women. MethodsSleep quality and sleep duration over the previous 1 month were estimated using the Pittsburgh Sleep Quality Index (PSQI). Excessive daytime sleepiness, risk of obstructive sleep apnea (OSA), and depressive symptoms were also assessed. ResultsOf the 428 subjects included, 117 (27.3%) were poor sleepers endorsing PSQI scores >5, whereas 126 (29.4%) slept <7 hours. The poor sleepers were more likely to be obese (P = .022), to have a high risk for OSA (P = .013), and to have clinically significant depressive symptoms (P = .001) compared with the good sleepers. Habitual sleep duration of <7 hours was associated with past oral contraceptive use (P = .025) and a trend toward a higher likelihood of high risk for OSA (P = .05) and coffee consumption (P = .05). On regression, the odds of high risk for OSA were higher with poor sleep quality and sleep duration <7 hours, respectively, whereas the odds of coffee consumption were higher with sleep duration <7 hours. ConclusionsPoor sleep quality and inadequate sleep are common in our population of elderly women. High risk for OSA independently predicts poor sleep quality and, along with report of coffee consumption, independently predicts habitual sleep duration of <7 hours.

MRNA analysis of genes responsible for idiopathic hypogonadotrophic hypogonadism

Background. Hypogonadotropic hypogonadism (HH) is a disorder characterized by delayed or absent pubertal development due to pathology of the hypothalamic-pituitary-gonadal axis. HH may be both congenital (Kallmann’s syndrome) and sporadic. Congenital or isolated HH is divided into with anosmia/hyposmia (KS) and with normal olfaction (nIHH). Nowadays several tens of genes involved in the functioning of the reproductive axis are known. However DNA lesions can be found just in 5-15% of such cases of HH.Aim. So we decided to measure mRNA expression of several genes which can be found in leukocytes of peripheral blood - namely GNRHR and GNRH1 (are necessary for adequate biological effect of GnRH); PROK2 and CHD7 (are responsible for the migration of GnRH neurons), WDR11 and DUSP6 (are involved in normal sexual development).Methods. A quantitative determination of mRNA expression of these genes were comlpeted in the fresh peripheral blood sample by PCR in real time.Results. Examined patients: 9 women with hypogonadotropic hypogonadism (age from 18 to 28 y.o.); duration of the disease from 2 to 15 years; 3 of them – amenorrhea I and 6 – amenorrhea II. Reasons of amenorrhea II were: stress, excessive exercises, rapid body weight loss, past use of oral contraceptives. The control group: 19 healthy women; age from 19 to 37 y.o.; with regular ovalutory menstrual cycle, some of them have children. mRNA expression of examined genes differed from normal patterns in each case of hypogonadotropic hypogonadism. Changes in GNRHR, GNRH1 and DUSP6 mRNA expression were found in most of cases. However variations of mRNA expression were multidirectional in each case and there was no similarity among expression profiles of patients according to amenorrhea type or anamnestic factors.Conclusions. According to our preliminary results, in women with hypogonadotropic hypogonadism the functional activity damage of “reproductive-responsible” genes could be found in each case. Probably mRNA expression measuring could be a perspective method for proving hypothalamo-pituitary level of reproductive disorders and may help to determine which genes should be tested for DNA impairment.

Long-term effects of oral contraceptives on the prevalence of diabetes in post-menopausal women: 2007-2012 KNHANES.

There is little information on whether past use of oral contraceptives (OCs) at child-bearing age influences the incidences of diabetes and insulin resistance (IR) after menopause. This study aimed to evaluate the association of past use of OCs with the development of diabetes and IR in post-menopausal women. This cross-sectional study was based on data from the Korea National Health and Nutrition Examination Survey carried out from 2007 to 2012. Of the 50405 participants, 6554 post-menopausal women were included in the analysis. The associations of OC use with the prevalence of diabetes in post-menopausal women were examined using multivariate logistic analysis. In addition, fasting glucose and insulin levels were measured in 3338 nondiabetic post-menopausal women, and the association between IR and OCs was examined by the analysis of covariance. The prevalence of diabetes was significantly higher in post-menopausal participants who had taken OCs for more than 6months than in those who had never taken OCs. The association remained significant after adjusting for multiple confounding factors (odd ratio 1.379; 95% CI 1.115-1.707; P=0.003). The duration of OC use was also positively associated with the prevalence of diabetes. Furthermore, taking OCs for more than 6months led to a significant increase in fasting insulin levels and HOMA-IR in nondiabetic participants. Past use of OCs for more than 6months led to a significant increase in the prevalence of diabetes in post-menopausal women, and increased IR in nondiabetic participants. These results suggested that the prolonged use of OCs at reproductive age may be an important risk factor for developing diabetes in post-menopausal women.

Association Between Long-term Oral Contraceptive Use and Risk of Crohn’s Disease Complications in a Nationwide Study

Use of exogenous hormones, in the form of oral contraceptives (OCs), has been linked consistently to risk of Crohn's disease (CD). Nonetheless, it is not clear how OCs might contribute to the progression of CD. We conducted a prospective study of female patients with CD (age, 16-51 y), identified from the inpatient and outpatient care components of the Swedish National Patient Register from January 2002 through December 2013. Information on current OC use was obtained from the Prescribed Drug Register starting in July of 2005 and updated until December of 2013. Primary outcomes were defined as first CD-relatedsurgery and first steroid prescription. We used Cox proportional hazard modeling with time-varying covariates to estimate multivariable-adjusted hazard ratios (MV-adjusted HRs). We identified 482 incident cases of surgery among 4036 patients with CD, with a median follow-up period of 58 months. Compared with nonusers, the MV-adjusted HRs for surgery were 1.14 (95% confidence interval [CI], 0.80-1.63) forpast users and 1.30 (95% CI, 0.89-1.92) for current users. The risk of surgery increased with longer duration of use (Ptrend= .036) and higher prescribed daily dose (Ptrend= .016). Specifically, for women with more than3years of OC use, theMV-adjusted HR for surgery was 1.68 (95% CI, 1.06-2.67). The association was confined to the combination type of OC. We estimated that for every 83 patients with CD receiving the combination type of oral contraceptives for at least 1 year, 1 extra surgery is required. The rate of steroid prescriptions did not appear to increase with past or current use of OCs, compared with patients whohave not taken OCs (all Pcomparisons > .20). In a nationwide analysis of patients in Sweden, long-term use of OCs, particularly the combination type, was associated with an increased risk of surgery among women with established CD. Clinicians carefully should evaluate and monitor contraceptive options among women with established CD.

Prevalence and associated factors of knee osteoarthritis in a rural Chinese adult population: an epidemiological survey.

BackgroundThe exact pathogenic mechanism of knee osteoarthritis (OA) is still unknown. With the exception of clinical treatment to alleviate symptoms, or total knee replacement, there is currently no effective treatment method. Consequently, an in-depth etiological and epidemiological study of knee OA can provide clues for diagnosis, treatment and scientific research, and will ultimately have a beneficial effect on public health.MethodsA cross-sectional community study in the rural village of Gaoyou was conducted in 3428 Chinese adults (aged ≥ 40 years). Subjects completed an interviewer-administered questionnaire, evaluating knee pain and associated disability, analgesia, use of health services, past medical history, walking, income, smoking, and use of oral contraceptives, and standardized weight-bearing knee radiographs were obtained. Patient demographic characteristics and biochemical parameters were recorded.ResultsSingle-factor regression analysis indicated that age, overweight, central adiposity, high low-density lipoprotein cholesterol (LDLC), high total cholesterol (TC), high triglycerides (TG), dyslipidemia, hypertension and low income were the associated factors for knee OA in females; age, high LDLC, hypertension, low income and frequent walking were the associated factors for knee OA in males. Interestingly, male heavy smokers were less likely to develop severe knee OA compared with non-smokers. Stepwise logistic regression analysis indicated that age and overweight were the associated factors for knee OA for all individuals. Although central adiposity, high LDLC, high TC, high TG, dyslipidemia, hypertension and low income appeared to be related to knee OA in females according to univariate analysis, these factors were not identified in stepwise logistic regression analysis. In addition although age, high LDLC, hypertension and frequent walking were also the associated factors for knee OA in males by stepwise logistic regression analysis, smoking as a protective factor was not identified in this analysis.ConclusionsIn this study, aging, obesity, frequent walking, low income and relevant multiple metabolic disorders were the associated factors for knee OA. Smoking might be associated with a lower prevalence of OA in male smokers according to univariate analysis. A retrospective association of smoking with OA may constitute an important etiologic clue, but further well-designed, large-scale prospective controlled trials are required to confirm these findings.

Lifestyle and reproductive risk factors associated with anal cancer in women aged over 50 years.

Background:Anal cancer incidence increases with age and is higher in women than men. Risk factors in this group other than high-risk human papillomavirus infection are unclear.Methods:In all, 1.3 million women were recruited in 1996–2001 and followed for incident anal cancer. Cox regression models were used to calculate relative risks (RRs) for anal cancer by various potential risk factors.Results:Five hundred and seventeen incident anal cancers were registered over 13 years of follow-up. The largest RR was associated with a history of cervical intraepithelial neoplasia grade 3 (CIN 3; RR=4.03, 95% CI 2.59–6.28). Other factors associated with significantly increased risks in multivariate analyses were: ever smoking (RR=1.49, 1.24–1.80); previous use of oral contraceptives (RR=1.51, 1.24–1.83); nulliparity (RR=1.61, 1.24–2.07); tubal ligation (RR=1.39, 1.13–1.70) and not living with a partner (RR=1.82, 1.40–2.38). The association with smoking was significantly greater for squamous cell carcinoma than adenocarcinoma of the anus (RR 1.66 vs 0.89, P for heterogeneity=0.04).Conclusions:History of CIN 3, smoking, past oral contraceptive use, nulliparity, tubal ligation and not living with a partner are risk factors for anal cancer in women. There was a significant increase in risk associated with smoking for squamous cell anal cancers but not adenocarcinomas.

Past oral contraceptive use and self-reported high blood pressure in postmenopausal women.

BackgroundStudies have reported current hormonal contraceptive use is associated with adverse cardiovascular outcomes, including high blood pressure. The aim of this study was to determine the association between past hormonal contraception use and high blood pressure in Australian postmenopausal women.MethodsWomen were recruited from the 45 and Up Study, an observational cross-sectional study, conducted from February 2006 to December 2009, NSW Australia. All of the variables used in this study were derived from self-reported data. These women reported being postmenopausal, having an intact uterus, and had given birth to one or more children. Odds ratios and 99% confidence intervals for the association between past hormonal contraceptive use and current treatment for high blood pressure, stratified by current age (<58 yrs, 58–66 yrs, and ≥67 yrs) were estimated using logistic regression, adjusted for income, country of origin, BMI, smoking, alcohol, exercise, family history of high blood pressure, menopausal hormone therapy use, number of children, whether they breastfed, and age of menopause.ResultsA total of 34,289 women were included in the study. No association between past hormonal contraception use and odds of having high blood pressure were seen in any of the age groups (<58 yrs: odds ratio (OR) 1.1, 99% confidence interval (CI) 0.8 to 1.5, p = 0.36; 58–66 yrs: OR 0.9, 99% CI 0.7 to 1.1, p = 0.11; and ≥67 yrs: OR 0.9, 99% CI 0.8 to 1.0. p = 0.06). In women with a history of hormonal contraception use, no association between duration of hormonal contraception use and high blood pressure was observed.ConclusionsPast hormonal contraception use and duration of use is not associated with high blood pressure in postmenopausal women.

Absence of protective effect of oral contraceptive use on the development of rheumatoid arthritis: a meta-analysis of observational studies.

To investigate the association between oral contraceptive (OC) use and development of rheumatoid arthritis (RA). We conducted a systematic review and meta-analysis based on observational studies. Summary estimates were obtained using fixed- or random-effects models as appropriate. Dose-response meta-analysis, subgroup analysis, cumulative meta-analysis, sensitivity analysis and publication bias tests were performed. Our meta-analysis of 28 studies included 18 case-control, three nested case-control, and seven cohort studies. In case-control studies, the risk of RA of ever, current and past OC users was 0.69 (95% confidence interval [CI], 0.53-0.89), 0.71 (95% CI, 0.48-1.06) and 0.67 (95% CI, 0.44-1.01), respectively, compared to that of never OC users. In prospective studies, the corresponding odds ratios (ORs) of ever, current and past OC use were 1.00 (95% CI, 0.87-1.15), 0.93 (95% CI, 0.70-1.23) and 0.93 (95% CI, 0.78-1.12), respectively. A cumulative meta-analysis showed that the pooled ORs moved to the midline with an increase in sample size as years passed. There was an inverse association between OC use and severity of RA (OR, 0.41; 95% CI, 0.22-0.78). Dose-response meta-analysis of the study data revealed that the association between OC use and risk of RA was independent of duration of OC use. OC use has no protective effect on RA onset, but appears to prevent progression to severe RA. In addition, OC use has a lower protective effect on the risk of RA with change in OC composition. Finally, no cumulative effect was found between OC use and risk of RA.

The effect of oral contraceptive different patterns of use on circulating IGF-1 and bone mineral density in healthy premenopausal women.

Both insulin-like growth factor-1(IGF-1) and oral contraceptive (OC) use have been linked to premenopausal breast and colorectal cancers, osteoporosis and cardiovascular disease. Understanding the effects of different patterns of use of OC on IGF-1 levels and bone mineral density (BMD) may offer insight into its influence on osteoporosis. We conducted a cross-sectional study, which included 135 women, who were then divided into three groups: Group A who were OC current users, 41 women; Group B who never use OC, 51 women; and Group C who were past users of OC, 41 women. Each patient completed a questionnaire on demographic parameters, marital state history and contraception history including duration of use and type of contraceptive pills or used method. Lower-end radius, proximal femur and lumbar spine BMD were measured by dual-energy X-ray absorptiometry. IGF-1 was assessed with chemiluminescent immunometric assay. The three groups were similar in total body T value of BMD (with slight better results in past users than the other two groups but it was statistically insignificant difference), and past users showed significantly higher BMD values compared to current users at spine, femur and forearm. Nonusers also had better BMD values compared to current users (spine and forearm BMD). Among past users, the mean level of circulating IGF-1 was higher than the other two groups and that difference was statistically significant. Past OC use and/or nonuse has a more favorable impact on BMD compared to current use and that this relationship is in part mediated by IGF-1. Hence, it appears that OC use is beneficial to BMD if used in the past and then discontinued or if never used at all compared to current use.

Risk factors for ovarian cancers with and without microsatellite instability.

In a population-based sample of epithelial ovarian cancers, the objective of this study was to evaluate the association between microsatellite instability (MSI) status and the following factors: (1) ovarian cancer risk factors and (2) the distribution of the specific histologic subtypes. Participants were drawn from 3 population-based studies of primary epithelial ovarian cancer; tumor DNA was analyzed using 5 standardized microsatellite markers to assess the MSI status. Patients were divided into 3 groups (MSI-high, MSI-low, and MSI-stable) according to the National Cancer Institute criteria. We compared the prevalence of specific known risk and protective factors among the 3 subgroups, including body mass index, smoking history, parity, BRCA1 and BRCA2 mutation status, past oral contraceptive use, and tubal ligation. Similarly, we compared the distribution of the histologic subtypes among the 3 subgroups. A total of 917 ovarian cancer patients were included. One hundred twenty-seven cases of cancer (13.8%) were MSI-high. Subgroup analyses according to smoking, body mass index, parity, past oral contraceptive use, and past tubal ligation did not reveal any statistically significance differences among the groups. Among the 29 patients with BRCA1 mutations, 20.7% had MSI-high cancers compared with 5.9% among 17 patients with BRCA2 mutations. The proportions of different ovarian cancer histologies among the various MSI subgroups were similar. The prevalence of risk and protective factors among ovarian cancer patients is similar for cancers with and without MSI. The distributions of MSI do not differ significantly among ovarian cancers with different histologies. Ovarian cancer patients with BRCA1 mutations had a 21% rate of MSI-high tumors compared with 6% among patients with BRCA2 mutations, but this difference was not statistically significant.

Oral contraceptive use and risk of vulvodynia: a population‐based longitudinal study

To assess whether the risk of vulvodynia is associated with previous use of oral contraceptives (OCs). Longitudinal population-based study. Four counties in south-east Michigan, USA. A population-based sample of women, aged 18 years and older, enrolled using random-digit dialling. Enrolled women completed surveys that included information on demographic characteristics, health status, current symptoms, past and present OC use, and a validated screen for vulvodynia. The temporal relationship between OC use and subsequent symptoms of vulvodynia was assessed using Cox regression, with OC exposure modelled as a time-varying covariate. Vulvodynia, as determined by validated screen. Women aged <50 years who provided data on OC use, completed all questions required for the vulvodynia screen, and had first sexual intercourse prior to the onset of vulvodynia symptoms were eligible (n = 906). Of these, 71.2% (n = 645) had used OCs. The vulvodynia screen was positive in 8.2% (n = 74) for current vulvodynia and in 20.8% (n = 188) for past vulvodynia. Although crude cross-tabulation suggested that women with current or past vulvodynia were less likely to have been exposed to OCs prior to the onset of pain (60.7%), compared with those without this disorder (69.3%), the Cox regression analysis identified no association between vulvodynia and previous OC use (HR 1.08, 95% CI 0.81-1.43, P = 0.60). This null finding persisted after controlling for ethnicity, marital status, educational level, duration of use, and age at first OC use. For women aged <50 years of age, OC use did not increase the risk of subsequent vulvodynia.

Risk Factors for Ovarian Cancers With and Without Microsatellite Instability

The objective of this study was to evaluate the association between microsatellite instability (MSI) status and (1) ovarian cancer risk factors and (2) the distribution of the specific histologic subtypes in a population-based sample of epithelial ovarian cancers. Participants were drawn from 3 population-based studies of primary epithelial ovarian cancer. Tumor DNA was analyzed using 5 standardized microsatellite markers to assess MSI status. Patients were divided into 3 groups (MSI-high, MSI-low, and MSI-stable) according to National Cancer Institute criteria. We compared the prevalence of specific known risk and protective factors among the 3 subgroups, including body mass index, smoking history, parity, BRCA1 and BRCA2 mutation status, past oral contraceptive use, and tubal ligation. Similarly, we compared the distribution of the histologic subtypes among the 3 subgroups. A total of 917 ovarian cancer patients were included. One hundred twenty-seven (13.8%) cancers were MSI-high. Subgroup analyses according to smoking, body mass index, parity, past oral contraceptive use, and past tubal ligation did not reveal any statistically significant differences among the groups. Among the 29 patients with BRCA1 mutations, 20.7% had MSI-high cancers compared with 5.9% among 17 BRCA2-mutation patients. The proportions of different ovarian cancer histologic findings among the various MSI subgroups were similar. The prevalence of risk and protective factors among ovarian cancer patients is similar for cancers with and without MSI. The distributions of MSI do not differ significantly among ovarian cancers with different histologic findings. Ovarian cancer patients with BRCA1 mutations had a 21% rate of MSI-high tumors, compared with 6% among patients with BRCA2 mutations, but this difference was not statistically significant.

THU0535 Significantly Better Patient-Reported Outcomes in Women with Early Inflammatory Arthritis Using Oral Contraceptives Compared to Never Users

BackgroundData on the effects of oral contraceptives (OC) on the course of inflammatory arthritis (IA) are controversial. While some observations suggested a beneficial effect on disease activity, others did not....