Side Effects Of Oral Contraceptives Research Articles

Knowledge of Reproductive Age Women About Oral Contraceptive Pills in Al-Qunfudah, Saudi Arabia.

ObjectiveTo study the knowledge of Saudi women regarding contraceptive use.MethodologyIn Al-Qunfudah, Saudi Arabia, 1107 Saudi women aged 18 to 45 years old participated in a cross-sectional descriptive study utilizing a closed-question survey. Data were compiled using SPSS v 21 software.ResultsThe participants in our study were 1107 females between the ages of 18 and 45. The majority of them were married, educated, and had used or were using oral contraceptives (OC) (50.2%), mostly for family planning (81.1%). Fear of OC side effects was stated by 39.9% of women who had never used it as a reason for not using it, and some women were unsure about consequences, such as mood changes (20.2%) and headaches (28%); 44.7% of women did not believe that they needed OC. Many women were ignorant of OC’s health and menstrual cycle benefits, with only 7.9% and 5.8% agreeing that it can help with premenstrual syndrome and acne problems, respectively. Majority of women said that they learned about contraception through doctors and friends/relatives, but 73.0% felt that the information available from health-care service was inadequate.ConclusionThe findings revealed that women in this region were lack awareness regarding contraceptive techniques, including OC, as well as its side effects and potential health hazards. It is necessary to strengthen family knowledge and how they can planning and contraception initiatives.

Association between adolescent oral contraceptive use and future major depressive disorder: aprospective cohort study.

BackgroundBecause of the widespread use of oral contraceptives (OCs) and the devastating effects of depression both on an individual and a societal level, it is crucial to understand the nature of the previously reported relationship between OC use and depression risk. Insight into the impact of analytical choices on the association is important when interpreting available evidence. Hence, we examined the association between adolescent OC use and subsequent depression risk in early adulthood analyzing all theoretically justifiable models.MethodsData from the prospective cohort study TRacking Adolescents’ Individual Lives Survey, among women aged 13–25 years were used. Adolescent OC use (ages 16–19 years) was used as a predictor and major depressive disorder (MDD) in early adulthood (ages 20–25 years), as assessed by the Diagnostic and Statistical Manual of Mental Disorders‐IV oriented Lifetime Depression Assessment Self‐Report and the Composite International Diagnostic Interview, was used as an outcome. A total of 818 analytical models were analyzed using Specification Curve Analysis in 534 adolescent OC users and 191 nonusers.ResultsOverall, there was an association of adolescent OC use and an episode of MDD in early adulthood [median odds ratio (OR)median = 1.41; ORmin = 1.08; ORmax = 2.18, p < .001], which was driven by the group of young women with no history of MDD (ORmedian = 1.72; ORmin = 1.21; ORmax = 2.18, p < .001).ConclusionsIn summary, adolescent OC use was associated with a small but robust increased risk for experiencing an episode of MDD, especially among women with no history of MDD in adolescence. Understanding the potential side effects of OCs will help women and their doctors to make informed choices when deciding among possible methods of birth control.

A cross-sectional study on knowledge, attitude and practice towards contraception among medical students in a tertiary care center of coastal Karnataka, India

High rates of unplanned pregnancies are due to continued gaps in awareness and access to contraception. An exemplary health care infrastructure would play a major role in resolving this issue. To investigate knowledge, attitude and practice towards contraception among medical students in a tertiary care center of Karnataka. A cross-sectional study was conducted including 100 undergraduate medical students during September 2018 to February 2019 using predesigned questionnaire on contraception and analyzed using percentages. Nearly 93% of students chose condom as best way to prevent sexually transmitted infections and 47% chose emergency contraceptive pills as risk factor for ectopic pregnancy. Failure rates of natural methods was 20-25% according to 33% of the students. Majority of participants believed that both sexes have equal responsibility for contraception and chose intrauterine contraceptive devices as best contraception for nulliparous women. Oral contraceptive pills had least failure rates as per 70% of the subjects compared to diaphragm, condom or natural methods. Irregular bleeding was considered as most common side effect of oral contraceptives by half of participants while 91% thought condoms were best for couples who were not regularly sexually active. Around 84% of undergraduates preferred to consult a doctor for contraceptive advice and were comfortable discussing contraception with partner. Overall, students had reasonably good knowledge on contraception. Similar studies in future would pave the way for upgrading current health curriculum to strengthen knowledge base of future clinicians.

Adolescent oral contraceptive use and future major depressive disorder

IntroductionPreviously reported associations between oral contraceptives (OCs) use and depression have been conflicting. Insight into the impact of analytical choices on the association may help to reconcile previous heterogeneous findings.ObjectivesWe aimed to examine the association between adolescent OC use and subsequent depression risk in early adulthood analyzing all theoretically justifiable models.MethodsWomen from the prospective cohort study Tracking Adolescents’ Individual Lives Survey (TRAILS) were included in this study. All justifiable associations between adolescent OC use (ages 16-19 years) and major depressive disorder (MDD) in early adulthood (ages 20-25 years) as assessed by the Diagnostic and Statistical Manual of Mental Disorders-IV oriented Lifetime Depression Assessment Self-Report and the Composite International Diagnostic Interview were tested.ResultsA total of 818 analytical models were analyzed in 534 adolescent OC users and 191 nonusers. Overall, there was a tentative association of adolescent OC use and an episode of MDD in early adulthood (median odds ratio [OR] median=1.41; ORmin=1.08; ORmax=2.18, permutation testing p-value 1 = .052, and p-value 2 = .046), which was primarily driven by the group of young women with no history of MDD (ORmedian=1.72; ORmin=1.21; ORmax=2.18, both permutation testing p-values = .02).ConclusionsAdolescent OC use was associated with an increased risk for experiencing an episode of MDD, but only among women with no history of MDD in adolescence. Understanding the potential side effects of OCs will help women and their doctors make informed choices when deciding among possible methods of birth control.DisclosureNo significant relationships.

La « crise des pilules » en France : les femmes ont-elles davantage consulté un.e gynécologue afin d’accéder plus facilement au DIU ?

BackgroundIn December 2012, a media controversy about negative side-effects of oral contraceptives on women's health, also called “pill scare”, broke out in France. While several analyses highlighted a change in women's contraceptive practices following this media controversy, no analysis has been conducted to determine the possible changes in their choices of health professionals and its repercussions on their contraceptive use. MethodsOur study is based on data from three population-based cross-sectional surveys conducted in 2010, 2013 and 2016 (Fecond 2010, Fecond 2013 and Baromètre Santé 2016) that collected information on women's contraceptive practices and the specialties of the health professionals having prescribed the methods they were using. ResultsBetween 2010 and 2016, women went to a gynecologist or a midwife more often than to a general practitioner for prescription of a reversible contraceptive method. However, their changes in visiting prescribers did not explain the changes in their contraceptive practices observed over the period. In 2016, access to health professional remained largely dependent on women's socio-demographic characteristics: older ones and those from a more privileged social background or living in urban areas were more likely to consult a gynecologist for prescription of their contraceptive method. On the other hand, consultations of midwives for contraceptive prescription were more frequent among women with children and among those who relied on public health insurance alone. ConclusionFollowing the “pill scare” that occurred in France in December 2012, the decision by some women to use the IUD instead of the pill led them to change health professionals, and also led practitioners to change their prescribing practices.

Anthropometric Risk Index and Their Association with Lipid Profiles Among Married Versus Spinster

Background: Previous Algerian epidemiologic studies have revealed that obesity has become an epidemic in many parts of the community, due to the cumulative body mass index (BMI) allied to upper total cholesterol and low-density lipoprotein (LDL) cholesterol asserting by medical scholarships in these topics. Objectives: This study aimed at evaluating the association between anthropometric risk index with lipid profiles among some Algerian females. Methods: This case-control study was performed female workers and spinster at the OPAPS laboratory during academic years 2015 and 2016. All participants in this study accepted venous blood withdrawal under fasting conditions and anthropometric measurement (weight, height, waist size (WC) and BMI). The SPSS 22 software using Levene’s statistic, independent t-test and the stepwise multiple linear regression was performed on the data. Results: The samples included 36 females; 18 spinsters and 18 married, their average age was 22.75 ± 2.56 years, weight ≈ 65.52 ± 4.58, BMI ≈ 25.15 ± 2.10, ABSI ≈ 0.07 ± 0.01, ABSIz ≈ -0.38 ± 0.09, TC (g/L) 1.28 ± 0.12, and TG ≈ 1.11 ± 0.17. The homogeneity of the 2 groups was based on administrative workers with the same education, the social status, age, and weight categories. On the basis of the laboratory results, records with applied anthropometric measurements as a protocol, were used in this experiment. The practical statistics with a significant set at 0.05, confirmed that total cholesterol (LDL and HDL) level as part of lipid profile increased with increasing BMI in married females in contrast to spinsters. To predict the health risk, it is important to take into account the amount of fat and calculate the cumulative risk index based on all relevant measurements and indicators, such as ABSI and ABSI z-score to capture the risk profile associated with body size and shape. Conclusions: On the basis of anthropometric characters related to blood test practice, lower lipid profile was in the benefit of spinsters. The results indicate that upper lipid profile control by BMI and ABSI was inversely associated with HDL and TG. Established by the association between upper quartile of ABSI related to BMI and both HDL and TG interpret in the case of this study to the side effects of oral contraceptives causing a decrease in Apoprotein, cholesterol, HDL, triglycerides reported the case of married females. In contrast, the conclusions are in agreement with similar studies, which advised a positive relationship between upper quartile of ABSI related to BMI and triglycerides related to lower HDL cholesterol and its relationship to lipoprotein lipase activity as part of lipid profile associated with obesity as a health risk in the benefit of married versus spinster females.

Programas de orientación cristiana en relación con la regulación de la natalidad en el Perú

Un programa de la paternidad responsable se encuentra en las clínicas parroquiales de varias zonas de tugurios, iniciado en abril de 1967 y orientados dentro de un enfoque Católica Romana se describe. Aspectos educativos reciben mayor énfasis a través de un sistema de parejas católicas, trabajadores sociales y educadores familiares. Estos actúan dando información sobre los aspectos morales, así como médicos de la paternidad responsable. Los anticonceptivos orales se han proporcionado a 4.028 mujeres durante hasta dos años después del parto para espaciamiento de los nacimientos. Además una clínica ritmo también está en funcionamiento. Los datos de fertilidad, así como dato sobre los efectos secundarios de los anticonceptivos orales se proporciona.

The Influence of Oral Contraceptive Knowledge on Oral Contraceptive Continuation Among Young Women

Using a multidimensional approach, we assessed young women's knowledge of oral contraceptives (OC) and its influence on OC continuation rates. We used data from 659 women aged 13-25 years participating in a randomized controlled trial of an educational text message OC continuation intervention. Women received 6 months of daily text messages or routine care. At baseline and 6 months, we administered a comprehensive 41-item questionnaire measuring knowledge of OC's mechanism, effectiveness, use, side effects, risks, and benefits. We ascertained OC continuation status and reasons for discontinuation at 6 months. We analyzed relationships between OC knowledge and continuation with multivariable logistic regression. Young women scored, on average, 22.8 out of 41 points on the OC knowledge assessment at baseline and 24.7 points at 6 months. The 6-month OC continuation rate was 59%. OC continuers had >2-points-higher OC knowledge scores at 6 months than discontinuers (p<0.001). Those who reported discontinuing their OCs for side effects and forgetfulness scored >2 points lower than women who discontinued for other reasons (p-values<0.001). In multivariable regression models, each correct response on the baseline and 6-month knowledge assessments was associated with a 4% and 6% increased odds of OC continuation, respectively. Six-month OC knowledge scores were negatively associated with OC discontinuation due to side effects (odds ratio [OR] 0.94) and forgetfulness (OR 0.88). OC knowledge, which was low among young women in our study, was associated with OC continuation and common reasons for discontinuation. Continued efforts to characterize relationships between OC knowledge and behavior and to test the effectiveness of different components of interventions aimed at increasing knowledge, addressing side effects, and improving use of OCs are warranted.

Selected aspects of oral contraception side effects

The first hormonal pill was approved in the 60s of the twentieth century Since that time, oral contraception has been used worldwide by dozens of women due to its high availability as well as relative ease and safety of taking. The main side effects of oral contraception include elevated risk for venous thromboembolism (VTE). Estrogens increase the probability of VTE development, depending on the dose in medication, and third-generation progestins increase the risk of VTE development more than older-generation progestins. Also, the coexistence of hereditary thrombophilia increases the risk of VTE development in women using oral contraceptives. Other side effects include changes in the carbohydrate and lipid economy Progestins in oral contraceptives decrease HDL cholesterol levels but increase LDL cholesterol and total cholesterol levels. Additionally estrogens are a recognized mitogenic factor for the epithelium of the mammary gland, acting proliferative on the glandular tissue and in the same way influence on the increased risk of breast cancer development. Patients sometimes complain about some subjective side symptoms such as headache, mood changes, nausea, back pain, breast pain and swelling, as well as decreased libido. Some patients discontinue oral contraception due to fear of side effects or temporary ailments before con- sulting their doctor what may result in unintended pregnancy The aim of the following paper was to present most frequent side effects of oral contraception, ways of their moni- toring and diagnosis.

The Chocolate Coated Pill

From a dissertation on the side effects of Oral Contraceptives, read before the Society on Friday, 2nd December, 1966 The great increase in the world birth rate that is presently taking place, and which increases the population by 165,000 people per day, has been estimated to double the total human population by the turn of the century. The problems set by such a rise in numbers is not confined to the East or to the “underdeveloped” countries of Africa, but is calculated to increase the population of Britain by 50% in those same thirty-odd years.

Influence of Depressed Mood and Psychological Stress Symptoms on Perceived Oral Contraceptive Side Effects and Discontinuation in Young Minority Women

Background We examined the influence of depressed mood and psychological stress on oral contraceptive (OC) side effects and discontinuation.

Continuous use of oral contraceptives: an overview of effects and side‐effects

To describe the effects and side-effects of the continuous use of oral contraceptives. A review of articles concerning oral contraceptives taken continuously or in cycles with hormones taken for more than 21 days per cycle. We searched publications in PubMed and Embase. Randomized controlled trials were selected if possible, otherwise case-control studies or cohort studies with controls were chosen. A level of evidence as described by the Centre for Evidence Based Medicine (Oxford University, Oxford, UK) was assigned to all selected studies. Clinical and paraclinical effects and side-effects of oral contraceptives administered continuously. The studies suggest that the endometrium is inactive during continuous use of oral contraceptives and the risk of endometrial hyperplasia is not increased. Numbers of bleeding days are halved with continuous use; however, spotting and irregular bleeding are more often seen in the beginning of use, decreasing with time. Hemostatic parameters and serum lipid and carbohydrate profiles in continuous and conventional users do not differ. Menstrual cycle-related symptoms are relieved better by continuous treatment. After surgery for endometriosis, the effect of continuously used oral contraceptives on the risk of recurrence of pain has been found to be less than that of gonadotropin-releasing hormone (GnRH) analogues, but better than the rate seen during conventional cyclic use. Oral contraceptives taken continuously or in long cycles seem to offer benefits with regard to menstrual symptoms and the recurrence of symptoms related to endometriosis. Long-term studies, comprising large groups of women, are lacking.

Influence of depressed mood and psychological stress symptoms on perceived oral contraceptive side effects and discontinuation in young minority women

BackgroundWe examined the influence of depressed mood and psychological stress on oral contraceptive (OC) side effects and discontinuation. Study DesignWe administered standard psychological instruments to 354 young women (13–24 years old) beginning a 6-month OC continuation intervention trial and questions on OC side effects and use at 6 months. Logisitic regression determined the relationships between psychological conditions, perceived OC side effects and continuation rates. ResultsBaseline depressed mood (21%) and stress (19%) and 6-month mood (25%) and weight changes (57%) were relatively common. Only 38% continued OCs at 6 months. Depressed mood [odds ratio (OR) 2.27, confidence interval (CI) 1.25–4.15, p=.007] and stress (OR 2.07, CI 1.12–3.82, p=.02) were associated with perceived OC-related moodiness; depressed mood was associated with perceived weight loss (OR 1.89, CI 1.01–3.55, p=.05). Depressed mood (OR 0.54, CI 0.29–0.99, p=.04), stress (OR 0.48, CI 0.25–0.91, p=.03) and perceived weight change (OR 0.60, CI 0.38–0.94, p=.03) all reduced the likelihood of OC continuation. ConclusionYoung women with adverse psychological symptoms are at risk for perceived OC side effects and discontinuation.

Misleading Leadership: The Deliberate Deception of Recommendation 5.5.

On August 1, 2011, the Department of Health and Human Services accepted the Institute of Medicine's recommendation that all Food and Drug Administration-approved contraceptives and sterilization procedures be made available to women without incurring out-of-pocket costs. The Institute of Medicine and the Department of Health and Human Services have deliberately misled the American people by claiming that this mandate would not include abortifacient drugs, that conscientious objection would be honored, and that this provision is essential to preserving the health of women. The author rebuts each of these claims by appeal to the scientific, medical, legal, and political facts surrounding these claims. In doing so, he argues that the recommendations include at least three abortion-inducing contraceptive methods. Likewise, he illustrates that the current administration has shown no will to protect the inviolable right of conscience of both individuals and institutions. Finally, he draws the reader's attention to the known deleterious side effects of oral contraception, emphasizing that these recommendations ultimately encourage women to use drugs that put them at a greater risk of harm. The author concludes that the Institute of Medicine and the Department of Health and Human Services have neglected their responsibility to American women and have misled and deceived the American people. As the Patient Protection and Affordable Care Act was nearing passage, Senator Barbara Mikulski (D-Maryland) secured an amendment-the "Mikulski Women's Preventive Health Care Amendment"-that gave the Department of Health and Human Services (HHS) the authority to delineate preventive care uniquely necessary for women. The secretary of HHS, Kathleen Sebelius, tasked the Institute of Medicine (IOM) with undertaking a systematic review of those preventive services that should be covered, without payment, for all women. On July 19, 2011, the IOM submitted a 210-page report recommending eight preventive services. Seven of these recommendations involve important screening, counseling, and testing for common health risks facing women. Recommendation 5.5, unfortunately, was a recommendation of a different kind. It stated, "Women will have access to all Food and Drug Administration (FDA)-approved contraceptive methods, sterilization procedures, and patient education and counseling. These recommendations do not include abortifacient drugs." On August 1, 2011, in a quietly made announcement in the corner of the HHS website, the federal government accepted the IOM recommendations wholesale.

Elevated eating disorder symptoms in women with a history of oral contraceptive side effects

Previous research suggests a link between gonadal hormones and eating disorder symptomatology. This study examined the role of gonadal hormones and hormonal sensitivity in eating disorder (ED) symptoms by using oral contraceptive (OC) side effect history as an indicator of hormonal sensitivity. A questionnaire containing two scales of the Eating Disorder Inventory-2 and an OC side effect scale was completed by 174 healthy women who had used OCs. Histories of emotional and physical OC side effects were evaluated as predictors of body dissatisfaction and drive for thinness. Women with a history of negative OC side effects had higher levels of ED symptoms. After controlling for body mass index (BMI) and depression scores, OC side effect history remained a significant predictor of body dissatisfaction and drive for thinness. The experience of OC side effects may indicate a greater risk for increased eating disorder symptoms. The findings provide further support for a hormonal link to ED symptoms, as women who are more "sensitive" to exogenous gonadal hormones also experience more ED symptoms.

Hemizentralarterienverschluss bei Einnahme der „Pille” – Mitteilungen über Komplikationen von Kontrazeptiva

Low-dose oral contraceptives can still cause thromboembolic disorders with serious neurologic or ocular disabilities. A22-year-old woman having used oral contraceptives for several months noticed sudden painless visual loss in her left eye. One tablet of her contraceptive contained ethinylestradiol (0.03mg) and chlormadinonacetate (2mg). Because of the lower left eye visual field defect, the patient could only read with her right eye. She presented complete left inferior hemianopia, indicating a hemicentral retinal artery obstruction. Visual acuity in both eyes was 20/20. The left fundus revealed a distinct retinal edema in the area superior to the optic disc and macula due to vascular disturbances of the superior temporal superior and superior nasal retinal arteries. The right eye was normal. Fluorescein angiography revealed recanalized arteries in the superior retinal area with conspiciously early dye filling as a paradoxical sign. Doppler sonography of the neck and orbital arteries and transesophageal echocardiography (TEE) findings were inconspicious. However, blood examination revealed an elevated thrombin-antithrombin complex and reduced free protein S. Coagulopathy can be a side effect of oral contraceptives. Even nowadays, women taking contraceptives risk the danger of vascular occlusions especially if the women suffers from arterial hypertension, diabetes mellitus, have a coagulation anomaly, or if she is a chronic smoker. Before treatment with oral contraceptives commences, a thorough medical examination is necessary. If the family history reveals prominent cardiovascular risk factors, testing for thrombophilia is recommended. Even nowadays, patients should be warned of the risk of visual field defects as a potential side-effect associated with oral contraceptives.

167. Depressed Mood, Psychological Stress, and Eating Disordered Symptoms are Associated with Perceived Oral Contraceptive Side Effects in Minority Adolescents

Perceived oral contraceptive (OC) side effects are common, leading to discontinuation and unwanted pregnancy. Depression, psychological stress and eating disordered (ED) symptoms contribute to reported side effects with general medications, yet how they affects OC-attributed symptoms is unknown. We examined relationships between these psychological conditions and mood and weight changes in minority, adolescent OC-users.

Daily context matters: predictors of missed oral contraceptive pills among college and graduate students

The purpose of this study was to understand the relationship between daily contextual factors and oral contraceptive (OC) adherence among students who attend college or graduate school. Data on OC adherence, demographics, contextual factors, and side-effects were collected as part of the acceptability of the NuvaRing (Merck & Co, Whitehouse Station, NJ) vs OC study, in which students were assigned randomly to the contraceptive vaginal ring or to a low-dose OC. We performed bivariate and multivariable analyses to create an explanatory model for nonperfect OC adherence (missed at least 1 pill during 3 months of use). In a multivariable predictive model, missing a pill was associated positively with high perceived stress (odds ratio [OR], 3.16; P = .007), having ≥10 hours per week of paid employment (OR, 2.13; P = .075), and living with a partner (OR, 9.92; P = .040). Stressful and hectic lives contribute to poor OC adherence. When counseling women about contraception, clinicians should consider the influence of daily life on contraceptive adherence.

The EVAPIL® scale, a new tool to assess tolerance of oral contraceptives

Background The EVAPIL® scale is a self-questionnaire aimed to assess tolerability of oral contraceptives (OC). Methods For initial development: a list of questions addressing the more frequent or more unpleasant minor side effects of OC was developed by a group of gynecologists and submitted to several sets of OC users. A final version with 14 questions was issued with scoring rules. For validation, the EVAPIL® scale was submitted to 3502 women who were OC users for at least 6 months to evaluate internal consistency and factorial structure. Test-retest reproducibility was studied 30 days apart in 53 other OC users. Results Internal consistency was good (Cronbach's alpha .71) without redundant questions. Principal components analysis with Varimax rotation was used to summarise information given by the 14 questions in a smaller number of multivariate dimensions. Dimension 1 explained 22% of the total variance, strongly correlated with all symptoms except oily skin, acne and cycle control. Dimension 2 accounted for 10% of the total variance and was correlated with oily skin and acne. Dimensions 3 and 4 were better correlated with cycle control. Reproducibility was excellent (intraclass correlation 0.88). The EVAPIL® scale was found easy to use and took no more than 5 min to complete. Conclusion The EVAPIL® scale demonstrated interesting psychometric properties to evaluate the tolerability of OCs in OC users. Further research is needed to address sensitivity to change and usefulness in new OC users.

Putting a finger on potential predictors of oral contraceptive side effects: 2D:4D and middle-phalangeal hair

Many women experience emotional or physical side effects when taking oral contraceptives (OCs). Despite the potential impact on women's health and well-being, there are no valid methods to screen women for their risk of OC side effects. The present paper presents the results of two studies where anthropometric indicators of androgen exposure, 2D:4D and middle-phalangeal hair, were examined for their potential as predictors of OC side effects. In study 1, 2D:4D was associated with women's reports of a history of: (a) negative mood side effects; (b) discontinuation due to negative mood side effects; (c) specific mood side effects (i.e., crying, sadness, and altered trust in one's partners) and (d) specific physical side effects (i.e., headaches, fatigue, and decreased sex drive). In study 2, 2D:4D and/or middle-phalangeal hair was/were associated with a reported history of: (a) discontinuation due to negative mood side effects; (b) specific mood-related side effects (i.e., negative mood, disrupted sleep, increased aggression, and altered trust in one's partner) and (c) specific physical side effects (i.e., headaches, decreased menstrual cramps, and increased sex drive/arousal). The general pattern was that adverse OC side effects were experienced by women with lower 2D:4D and fewer middle-phalangeal hairs. Almost all relationships remained significant when response bias was controlled. These results suggest a possible role for prenatal testosterone exposure and both androgen action and sensitivity in women's experience of OC side effects. Furthermore, these two digit measures may be useful predictors of hormonal contraceptive side effects in women.