Use Of Combined Oral Contraceptives Research Articles

Development of breakthrough bleeding model of combined-oral contraceptives utilizing model-based meta-analysis.

Breakthrough bleeding (BTB) is a common side effect of hormonal contraception and is thought to impact adherence to combined oral contraceptives (COCs) but respective dose-response relationships are not yet fully understood. Therefore, the objective of this model-based meta-analysis (MBMA) was to establish dose-response for COCs containing different progestin/EE combinations using BTB as the pharmacodynamic endpoint. Data from 25 studies containing BTB information of 4 progestins (desogestrel, drospirenone, gestodene, and levonorgestrel) in combination with ethinyl estradiol (EE) at various dose levels was used for this analysis. The results of our MBMA show that BTB is significantly increased upon initiation of COC use but subsides over time. The time needed for BTB to return to baseline depends on the EE dose and differs marginally between progestins during the initial months of use at the same EE dose. BTB typically returns to baseline within 3 months at the highest (30 μg) dose, whereas it can take significantly longer to reestablish a regular bleeding pattern at lower EE doses (15 and 20 μg), irrespective of the progestin used. The dose-response relationships established for BTB across different progestin/EE combinations can now be used to support the selection of optimal COC dosing/treatment regimens and serve as the scientific basis for evaluating the impact of clinically relevant factors, including drug-drug interactions and demographics, on BTB.

Combined oral contraceptive use and obesity in women with polycystic ovary syndrome. A meta-analysis of randomized clinical trials.

Polycystic ovary syndrome (PCOS) is a heterogenous endocrine condition and combined oral contraceptives (COCs) have been demonstrated to be the first-line treatment to women who do not intend to become pregnant. The combination of COCs and PCOS may or may not amplify the risks of cardiovascular events. To investigate whether surrogates for obesity may be influenced by the use of COCs containing different formulations in women with PCOS. From January 2024 a literature search was conducted in Google Scholar and Pubmed databases using PCOS, COC, and obesity terms. Hand search of randomized clinical trials in the references of obtained manuscripts was also performed. After the exclusion of reviews and articles that did not fulfill eligibility criteria, compared the results obtained before and after the use of COCs in 13 randomized clinical trials (RCTs). Random-effects model was used to estimate the standardized mean differences (SMD) and standard errors (SE). Risk of bias was examined using the Rob2 tool. Thirteen heterogeneous RCTs reported no difference in waist circumference with the use of different COC formulations (p = 0.714). On the contrary, body fat mass increased with the use of pill (p = 0.013). Waist triglyceride index and lipid accumulation product tended to be higher after the use of COCs (p = 0.073 and p = 0.064, respectively). Combined oral contraceptives with different formulations might increase fat mass accumulation in women with PCOS. Lipids may also be increased in PCOS users. Because some concerns about the quality and heterogeneity identified in various RCTs, caution should be taken before a definitive conclusion regarding the use of COCs and obesity.

Lower reporting of venous thromboembolisms events with natural estrogen-based combined oral contraceptives compared to ethinylestradiol-containing pills: A disproportionality analysis of the Eudravigilance database

ObjectivesPharmacovigilance data analysis can accelerate the identification of drug-related safety signals or reassure on the safety profile. This study evaluates the venous thromboembolism (VTE) risk of newer combined oral contraceptive (COC) formulations with natural estrogens, such as estradiol (E2) and estetrol (E4), using data from the EudraVigilance database. Study designWe conducted a disproportionality reporting rate analysis of VTE events associated with various COC formulations by extracting individual case reports from EudraVigilance database up to July 28, 2024. The study compared the proportionality reporting rate between natural estrogen-based COCs (E2 and E4) and conventional synthetic estrogen-based COCs (ethinylestradiol [EE]), with a comparison to EE-levonorgestrel. ResultsThe analysis revealed that COCs containing natural estrogens exhibited significantly lower proportionality reporting rates for thrombotic events compared to EE-based COCs. Specifically, E4-drospirenone (E4-DRSP) showed the lowest proportionality reporting rate (0.12), similar to progestin-only pills. EE-DRSP had the highest proportionality reporting rate (2.25), suggesting an increased thrombotic risk. ConclusionsThe study supports the safer thrombotic profile of natural estrogen-based COCs, particularly E2 and E4 formulations, over synthetic estrogen-based COCs containing EE. These findings support the hypothesis that E2- and E4-based pills are safer than EE-based pills, aligning with a shift toward safer contraceptive options in clinical practice. ImplicationsNatural estrogens such as E2 and E4 may emerge as safer alternatives to synthetic estrogens like EE, particularly when combined with progestins like DRSP. This multilevel evidence underscores the importance of evidence-based prescribing practices to enhance patient safety and minimize thrombotic risks associated with COC use.

A comparative study of hormonal contraceptive use and vitamin D levels at Gondar Town 2023.

Vitamin D deficiency is an emerging public health problem globally, with devastating health consequences. Some studies suggest that exogenous sex hormones, found in hormonal contraceptives, may enhance vitamin D levels. However, the reasons for this association are not fully understood, as women using hormonal contraception may have different lifestyle habits affecting their vitamin D status. Therefore, this study seeks to explore the relationship between hormonal contraceptive use and vitamin D levels. A Facility based comparative cross-sectional study was conducted in Gondar town from February to April 2023, involving a total of 162 women using three types of hormonal contraceptives (Norplant, DMPA, and COC) and 162 age and BMI-matched non-users as controls in a 1:1 ratio. Participants were selected using systematic random sampling. A semi-structured questionnaire was used to collected data regarding the socio-demographic, economic, obstetric, lifestyle, and clinical information. 5 milliliters of blood samples were collected from each participant for Laboratory analysis of serum vitamin D, calcium, and alkaline phosphates using a Beckman Coulter chemistry analyzer. Independent t-tests, ANOVA with post hoc Bonferroni test was used to compare statistics between the two groups, and logistic regression models to identify factors associated with Vitamin D deficiency. The mean serum Vitamin D levels of Norplant, DMPA, and COC users were 24.08 (± 5.17), 24.83 (± 5.52), and 31.90 (± 6.94) respectively; whereas control group has mean Vitamin D level of 22.00 (± 7.97). On the current study the prevalence of Vitamin D deficiency (< 20 ng/ml) among hormonal contraceptive users was found to be 21.6% (35/162), whereas 48.14% (78/162) of non-user controls had vitamin D deficiency. The odds of having Vitamin D deficiency was higher among participants who attained higher education, who never eat fish and have never been used vitamin D Supplements. However, the use of combined oral contraceptives (COC) shown to reduce the odd of having vitamin D deficiency by 90%. Similarly, individuals with normal and hypercalcemia state shown to have lower odd of having Vitamin D deficiency. Users of combined oral contraceptives (COC) had significantly higher mean serum Vitamin D levels compared to users of Norplant and DMPA, as well as non-users. The prevalence of Vitamin D deficiency was lower among COC users compared to non-users, highlighting a potential protective effect of COC use against Vitamin D deficiency.

Oxidative Stress in Polycystic Ovary Syndrome: Impact of Combined Oral Contraceptives.

Polycystic Ovary Syndrome (PCOS) is a complex hormonal disorder that is associated with heightened metabolic risks. While oxidative stress (OS) is known to play a role in PCOS, the precise nature of the relationship between PCOS and increased OS remains not entirely understood. Combined oral contraceptives (COCs) are the first-line treatment to regulate menstrual cycles and androgen levels, but their impact on oxidative stress requires further study. We conducted a transcriptomic analysis using RNAseq and assessed the levels of various oxidative stress (OS) markers in serum samples from women with PCOS and controls and whether they were using combined oral contraceptives (COCs), including enzymatic activities, FRAP, and 8-isoprostane (8-iso). A total of 359 genes were differentially expressed in women with PCOS compared to control women. Genes differentially expressed were enriched in functions related to inflammation and, interestingly, oxidative stress response. In controls, 8-iso levels were increased in women using COCs, whereas in women with PCOS, 8-iso levels were reduced in those using oral contraceptives (191.1 ± 97 vs. 26.4 ± 21 pg/mL, p: <0.0001). Correlation analyses showed a trend for a negative correlation between 8-iso and Ferriman score in women with PCOS consuming COCs (r = -0.86, p = 0.06) and a negative correlation between GSH and hyperandrogenism in women with PCOS (r = -0.89, p = 0.01). These results reveal the presence of lipid peroxidation in women with PCOS, which was modified by the use of COCs, providing new insights into the pathophysiology of PCOS in the Chilean population.

Chronic venous disease of the lower extremities as a risk factor for PE when taking combined oral contraceptives: a clinical case

The use of combined oral contraceptives (COCs) is one of the risk factors for thrombotic complications, particularly pulmonary embolism (PE). Although clinical observations suggest that the risk of thrombotic complications with OCs is low and decreases after several months of use, medical counseling is necessary as with any other hormonal therapy. A clinical case of PE in a young patient taking COCs is presented. In the context of early diagnosis, thrombolysis was successful because thrombus retraction had not yet occurred. After completion of treatment of the underlying pathology, the patient was recommended to be followed up with a vascular surgeon for treatment of lower limb venous disease. Exclusion of lower extremity venous disease is critical before prescribing COCs, as it increases the risk of PE at any age.

Risk Factors for Endometrial Cancer in the World: A Narrative Review of the Recent Literature

Objective: Endometrial cancer is the sixth most common cancer in women. Extensive studies have been conducted around the world to determine the risk factors of endometrial cancer. Although each of these studies provides useful findings, review studies provide a clear view of the different aspects of a phenomenon. Therefore, this review study was conducted to determine the risk factors of endometrial cancer in the world. Mechanism: A comprehensive search was conducted in Medline, Web of Science Core Collection (Indexes = SCI-EXPANDED, SSCI, A&amp;HCI Timespan), and Scopus databases with the keywords; “endometrial cancer”, “endometrial carcinoma”, “endometrial neoplasm”, “risk factor” and a combination of these words to find quality articles published from 2000 to 2024. Findings in brief: According to the literature, demographic factors, reproductive factors, gynecological factors, hormonal factors, lifestyle factors, medical conditions, and drugs can contribute to endometrial cancer. The study findings indicated that higher parity, oral contraceptive use, and regular physical activity may reduce the risk of developing endometrial cancer. Conversely, advanced age, prolonged reproductive period, infertility, polycystic ovary syndrome, postmenopausal hormone therapy, obesity, alcohol consumption, metabolic syndrome, and diabetes are associated with an increased susceptibility to this type of cancer. Conclusions: The findings of this study showed that reproductive factors such as early menarche, late menopause, nulliparity, and infertility increase the risk of endometrial cancer. Evidence shows that obesity, metabolic syndrome, and diabetes play a role in the occurrence of endometrial cancer. Although the use of menopausal hormone therapy increases the risk of endometrial cancer, the use of combined oral contraceptives is associated with a reduced risk.

The use of a pill containing ethinylestradiol-norgestimate improves female sexuality despite the decrease in circulating androgens: a pilot study

Purpose To evaluate the initial impact of a combined oral contraceptive (COC) containing norgestimate (NGM) on female sexuality and on circulating androgen levels in users. Materials and methods Six months modification in the McCoy Female Sexuality Questionnaire (MFSQ) and testosterone (T) and dehydroepiandrosterone sulphate (DHEAS) serum levels in women starting a monophasic pill containing ethinyl-estradiol (EE) 35 µg and NGM 0.250 mg. Results The study was completed by 36 subjects. There was a significant increase in MFSQ during treatment (p < 0.0001) (and its domains with the exclusion of vaginal lubrication domain) with concomitant decreases in T (−4.45%, p < 0.0001) and DHEAS (−19.41%, p < 0.0001) serum levels. Conclusions Contraception with EE/NGM was associated with a short term non-deteriorating effect on sexuality despite the evident decrease in androgen levels. Female sexuality during COC use is a complex topic and is not only linked with changes in serum androgen levels.

(039) DIVERSITY OF CAUSES OF DYSPAREUNIA IN REAL CLINICAL PRACTICE IN THE OUTPATIENT GYNECOLOGY DEPARTMENT

Abstract Introduction Dyspareunia is a women's sexual health problem that still often goes undiagnosed, despite its high prevalence and negative impact on sexual, marital and psychological well-being. Genito-pelvic pain/penetration disorder (GPPPD) refers to significant pain and difficulty with penetrative sex that lasts for at least six months and might be caused by various diseases alone and their combinations. Objective Thus, the purpose of this study is to determine the contribution of different conditions to the total number of patients who applied for a primary appointment for GPPPD. Methods Women who agreed to participate in the study were presenting complaints on painful intercourse or inability to have intercourse for more than 6 months. Patients underwent a gynecological examination consisted of inspection, Q-tip testing, pelvic floor muscle testing and bimanual palpation in the lithotomy position (if it was possible). Diagnoses were documented according to the International Classification of Diseases Tenth Revision World Health Organization guidelines. Pain was assessed via the McGill Pain Questionnaire and a visual analogue scale. Assessment of pelvic floor muscle dysfunction was based on an International Continence Society report on the terminology for pelvic floor muscle assessment. Vulvar pain conditions were classified based on the consensus vulvar pain terminology committee of the International Society for the Study of Vulvovaginal Disease, the International Society for the Study of Women's Sexual Health, and International Pelvic Pain Society. Statistical analyses were performed by SPSS Statistics. Results The average age of the examined women was 30,63±0,69 years. As a cause of GPPPD vaginismus and dyspareunia were diagnosed in 19.31 and 80.69 % respectively. Predominant cause of dyspareunia was pelvic floor muscles dysfunction (66,19%) which was combined with other pathologies (scar deformity of the perineum, endometriosis and chronic pelvic pain, candidiasis, etc.) in 20 cases. The percentage of women diagnosed with endometriosis without the formation of central pain mechanisms was 11.36%. The overlapping chronic pain conditions such as migraine, interstitial cystitis/bladder pain syndrome, irritable bowel syndrome, endometriosis and vulvodynia were diagnosed in 21.13% patients with dyspareunia. Dyspareunia due to vaginal atrophy associated with lactation, combined oral contraception use and menopause was diagnosed in 4 patients (2.82%, 1.41% and 1.41%, respectively). Scar changes of the perineum due to traumatic delivery or episiotomy amounted to 4.23%. Lichen planus was diagnosed in one patient (1.41%). Vulvodynia was diagnosed in 8 patients with dyspareunia (11.26%) and was associated with pelvic floor tension myalgia and pelvic floor myofascial pain syndrome in 75% of cases. Conclusions GPPPD can be caused by various conditions with significant involvement of the pelvic floor muscles in the process of pain formation. Taking into account the risk of overlapping chronic pain conditions, a multidisciplinary approach is required in the treatment of this group of patients. Disclosure No.

Incidences of Pregnancy During Concurrent Use of Hormonal Contraceptives and Antiretroviral Therapy at Nakuru County Referral and Teaching Hospital in Kenya

With concerns on the efficacy and effectiveness of hormonal contraceptives and antiretroviral therapy in curbing incidences of unplanned pregnancies among women living with Human Immunodeficiency virus infection, a study to examine these concerns was carried out at Nakuru County Referral and Teaching Hospital (NCRTH). A cross-sectional retrospective study was carried out at the Comprehensive Care Centre (CCC) at NCRTH from March 2023 to April 2023 with a sample size of 226 participants however the estimated sample size using the Taro Yamane formula was 358. Data was collected using structured questionnaires with both open and close-ended questions and analyzed using the Statistical Package for Social Sciences (SPSS). Frequency tables, bar graphs, and percentages were used to present descriptive statistics. Chi-square was used to conduct inferential statistics, and P&lt;0.05 was considered significant. The majority (86.7%) of participants were on TLD (Tenofovir, Lamivudine, Dolutegravir). Most participants (37.17%) had used ART for 6-10 years. 79.65% of participants avoided pregnancy with concurrent hormonal contraceptives and ART, while 20.35% experienced pregnancies. 15.22% of pregnant participants also used other medications, especially anti-TBs, due to drug-drug interactions. Injectables were the most common contraceptive (41.3%) used by participants who had pregnancy incidences. A significant association was noted between the incidence of unplanned pregnancy and the use of combined oral contraceptives. Incidences of unplanned pregnancies were higher among those aged 30-34 (32.61%), married (73.91%), with secondary education (43.48%), self-employed (60.87%), and Protestant (73.91%). From this study, TLD was the most commonlyused antiretroviral, injectables were the most commonly used contraceptive, and the majority of the participants had used antiretrovirals for 6-10 years. Despite the concurrent use of hormonal contraceptives and antiretrovirals to avoid pregnancy incidences, 20.35% of the participants had unplanned pregnancy incidences. 15.22% of these participants who got pregnant were using other medications. Unplanned pregnancies were more common among certain demographic groups. From this study, data on pregnancy incidents during concurrent use of hormonal contraceptives and antiretroviral therapy is availed however limitations such as study design and time limit necessitatemore research. To reduce the risk of unplanned pregnancies and ensure the appropriate use of hormonal contraceptives, more support and counseling programs should be established for women using antiretrovirals.

Combined oral contraceptive utilization and uterine fibroid incidence: A prospective study in a cohort of African-American women.

Published associations between combined oral contraceptive use and uterine fibroid development have lacked prospective imaging with ultrasound to distinguish between incident and prevalent fibroids. The Study of Environment, Lifestyle, and Fibroids prospectively followed fibroid-free, African-American women (the group with the highest disease burden in the U.S.) to identify incident cases. We examined associations between combined oral contraceptive use and the 40-month cumulative risk of fibroids. History of hormonal contraceptive use was collected via telephone interview at enrollment. Fibroid identification was performed using transvaginal ultrasonography at enrollment, and at 20 and 40-months of follow-up. Inverse probability weights for exposures and censoring were used to construct weighted risk ratios (wRR) and weighted risk different (wRD) estimators which control for differences in fibroid risk factors between exposure groups. In addition, unweighted fully adjusted log-binomial regression models (aRR) were run for comparison. Of the 1,308 participants in the analysis sample, 70% had used combined oral contraceptives and 17% developed fibroids by 40 months. We observed an inverse association between ever use of combined oral contraceptives and cumulative fibroid incidence (wRR: 0.78; 95% Confidence Interval (CI): 0.60, 1.00; wRD: -0.05, 95% CI: -0.11, 0; aRR: 0.76, 95% CI: 0.60, 0.98). Fibroid incidence was greater in participants who started using combined oral contraceptives after age 17 years than among younger initiators, though the restriction to ever-users made this estimate less precise (wRR: 1.25; 95% CI: 0.89, 1.76; wRD: 0.04, 95% CI: -0.02, 0.10). No consistent patterns of fibroid incidence were seen among ever-users for duration of, or years since, last combined oral contraceptives use.

Comparative evaluation of the effectiveness and safety of acne treatment with systemic isotretinoin in monotherapy and together with combined oral contraceptives in women

Objective. To give a comparative evaluation of the effectiveness and safety of acne treatment with systemic isotretinoin in monotherapy and together with combined oral contraceptives in women. Materials and methods. 65 women with severe papulo-pustular acne took part in the study. They were divided into two groups: group I consisted of 35 women who used systemic isotretinoin for acne in monotherapy; group II included 30 women who took systemic isotretinoin together with combined oral contraceptives. A comprehensive clinical and laboratory study was conducted. The study included a biochemical blood test to determine the lipid profile, liver transaminases, and hormonal homeostasis. The obtained results were analyzed using the methods of parametric and nonparametric statistics, the standard error (m) was used in the calculations, the level of statistical significance was noted at p 0.05. Results. In women treated for acne with systemic isotretinoin in monotherapy relief occurs in 4 weeks, and complete clinical recovery in 24 weeks after the beginning of therapy; when using systemic isotretinoin together with combined oral contraceptives, relief is determined in 2 weeks, and complete clinical recovery in 16 weeks of treatment. The main side effects of systemic isotretinoin were cheilitis, skin xerosis, retinoic dermatitis and telogen alopecia. Cheilitis was revealed in the majority of patients in both groups equally. Xerosis of the skin, retinoic dermatitis and telogen alopecia were more often observed in the 1st group. In women of the 1st group, the level of progesterone was significantly higher and the level of estradiol was lower than in women of the 2nd group. Conclusions. Systemic isotretinoin has shown high efficacy and safety in treatment for acne in women. Combined oral contraceptives normalize hormonal homeostasis, which helps to eliminate acne. When using systemic isotretinoin in combination with combined oral contraceptives, the main clinical effect occurs earlier, and adverse reactions are less frequent and less severe than in monotherapy. The combined use of systemic isotretinoin and combined oral contraceptives is the optimal method of acne treatment in women.

Female magnesium deficiency and its management: review of current knowledge

Magnesium is an important cofactor for metabolic reactions involving more than 300 enzymes, regulating a series of fundamental processes, such as myocardial contraction and blood pressure control, glucose regulation, participation in neuromuscular transmission. The prevalence of magnesium deficiency in various cohorts of fertile age women comprises up to 73.8 %. In clinical studies it was demonstrated that magnesium deficiency is associated with diseases and states such as dysmenorrhea, premenstrual syndrome (PMS), polycystic ovary syndrome (POS), climacteric syndrome, osteoporosis, use of combined oral contraceptives (COCs) and menopausal hormone therapy (MHT). Magnesium supplementation in combination with basic therapy can positively affect course and outcome of such pathologies. Magnesium organic salts could be used for countering magnesium deficiency. Among such agents, magnesium citrate has some advantage used in combination with pyridoxine (vitamin B6) providing additional effects. Health care professionals should be guided by the criteria for Mg-containing preparation selection, defined by the Russian Society of Obstetricians and Gynecologists (RSOG).

Evaluating perceived side effects of SARS-CoV2 mRNA vaccines by lifestyle factors and nutritional status: Perspectives from a pilot study

Nutritional status, sex, and physical activity have been implicated in severe COVID-19 illness; however, the role of lifestyle factors and nutritional status in determining an individual's response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) vaccines is less well characterized. We evaluated whether self-reported side effects following SARS-CoV2 vaccination differed by body mass index (BMI) and lifestyle factors. We further evaluated whether associations between lifestyle, nutritional status, and self-reported side effects differed by sex or use of hormone-based medications. A survey was administered between May–September 2021 to collect respondents' self-reported demographics, dietary patterns, physical activity, medication and supplement use, history of COVID-19 illness, and SARS-CoV2 vaccine side effects. A total of 82 participants (61.2 % female, 38.8 % male) completed the survey and were included in the final analysis. Females trended toward reporting a greater level of subjective stress (71 %) and engaged in less physical activity (43.2 %) compared to males. While severity of COVID-19 illness and vaccine side effects did not differ by sex and there were no differences in dietary patterns between individuals reporting mild vs. more severe side effects, individuals with a higher BMI trended toward reporting a greater severity of vaccine side effects. Survey participants who engaged in physical activity for more than 30 min per day trended toward reporting a lower severity of side effects compared to those exercising for 30 min a day or less after the first dose (86.7 % vs. 50.0 %), whereas the opposite trend was observed following the second mRNA vaccine dose. In addition, survey participants reporting higher stress levels experienced a greater severity of side effects of the first SARS-CoV2 mRNA vaccine dose compared to those reporting lower stress levels (42.9 % vs. 2.0 %). Further, a greater percentage (75 %) of respondents taking combined oral contraceptives reported experiencing side effects following the first SARS-CoV2 mRNA vaccine dose, whereas participants not using hormone-based contraceptives were more likely to report not experiencing side effects (61.3 %). Together, our findings suggest that self-reported side effects from SARS-CoV2 mRNA vaccines differ by lifestyle characteristics and use of combined oral contraceptives. Further investigation is warranted to determine whether targeting these lifestyle factors is an effective strategy to mitigate vaccine side effects, and whether public health education pertaining to lifestyle and anticipated side effects may reduce the barriers to vaccine acceptance.

Predictors of Precancerous Diseases of the Cervix

Introduction. The incidence of malignant neoplasms in the population has increased by 1.66 times over the past 15 years, and the incidence of cancer of the cervix and body of the uterus, placenta — by 1.3 times.Materials and methods. 2 groups were formed by the continuous sampling method: 30 women with a diagnosis of cervical intraepithelial neoplasia (CIN) and 30 women without a diagnosis of CIN, who made up the control group. Statistical analysis was carried out using the StatTech 3.1.7 program (Stattech LLC, Russia).Results. Risk factors for precancerous diseases of the cervix include the presence of a history of cardiovascular diseases(p = 0.043), surgical interventions (p = 0.039), sexually transmitted infections (p = 0.023), a large number of pregnancies (regardless of the outcome) (p = 0.013), the presence of abortions (p = 0.04), a large number of sexual partners during life (p = 0.022).Discussion. Frequent change of sexual partners, and as a consequence — a high risk of STIs are also well-known risk factors for cancer and precancerous cervix, in these conditions HPV passes from free to episomal form faster and starts the process of transformation of cervical epithelial cells.Conclusion. The features of the anamnesis of women with precancerous diseases of the cervix are high parity and the presence of abortions, STIs, cardiovascular diseases and surgical interventions in the anamnesis, a large number of sexual partners in life, low adherence to the use of combined oral contraceptives (COCs).

Differential Effect of 2 Hormonal Contraceptives on the Relative Telomere Length of Youth With Type 1 Diabetes.

Adolescents and young women (AYA) with type 1 diabetes (T1D) may require hormonal contraception for an extended period. However, it is unclear what effect hormonal contraception has on telomere length, a marker of the risk for complications. To investigate the relative telomere length (RTL) in AYA with T1D (AYA-T1D) and healthy young women (AYA-C) after 18 months of combined oral contraception use (COC) with ethinyl estradiol/desogestrel, or a subdermal etonogestrel implant (IM). A nonrandomized prospective study was performed in which 39 AYA-T1D and 40 AYA-C chose the COC or the IM. RTL was measured by monochrome multiplex-quantitative PCR in DNA from peripheral blood mononuclear cells (PBMC). The impact of contraceptives and clinical variables on RTL was assessed using lineal regression analysis. Longer RTL compared to baseline was observed in AYA-T1D (P < .05) and AYA-C (P < .01) after using the IM. However, the total of AYA and the AYA-C group treated with COC decreased RTL after 18 months of treatment compared to baseline (P < .05). The type of contraceptive used was determinant for the changes in RTL compared to baseline in all subjects and controls (P ≤ .006). For AYA-T1D, HbA1c levels were not associated with RTL, but the high-sensitivity C-reactive protein was negatively related with the changes in RTL at 18 months compared to baseline (standardized R2 : 0.230, P = .003). IM was associated with longer RTL in AYA-T1D and AYA-C. In contrast, a shortening of telomere length in PBMC was observed after using COC.

Abstract 2195: Intrauterine device use and risk of invasive epithelial ovarian cancer: A population-based case-control study

Abstract Introduction: Ovarian, fallopian tube, and primary peritoneal cancers (hereafter referred to as ovarian cancer) are the most fatal gynecologic cancers. Thus, it is imperative to identify strategies that can reduce the risk of the disease. Several contraceptive methods have been shown to be associated with a reduced risk of ovarian cancer, including combined oral contraceptives, injectable progestins, and tubal ligation. However, the use of these contraceptive methods has been decreasing in the U.S., with a growing preference for intrauterine devices (IUDs) for pregnancy prevention. Previous case-control studies on the association between IUD use and ovarian cancer risk have found inconsistent results. Notably, previous studies had small sample sizes and did not restrict to invasive epithelial tumors. The current analysis assessed the association between IUD use and risk of invasive epithelial ovarian cancer in a large population-based case-control study. Methods: This analysis used data from 1,713 people diagnosed with primary invasive epithelial ovarian cancer (cases) and 2,348 cancer-free people (controls) participating in a case-control study conducted in Los Angeles, CA from 1992-2010. The study consisted of four waves of recruitment with similar enrollment and data collection methods. Logistic regression models were fit to assess the association between IUD use and risk of invasive epithelial ovarian cancer. All models were adjusted for age, race/ethnicity, education, first-degree family history of ovarian cancer, endometriosis, body mass index, duration of combined oral contraceptive use, parity, duration of breastfeeding, tubal ligation, and study wave. Heterogeneity across the study waves and the ovarian cancer histotypes was evaluated using standard meta-analysis techniques. Results: There was no statistically significant association between IUD use and risk of invasive epithelial ovarian cancer (odds ratio=1.09, 95% confidence interval 0.93-1.28). This result was consistent across the study waves and the ovarian cancer histotypes (p-values for heterogeneity&amp;gt;0.05). Conclusion: IUD use was not associated with the risk of invasive epithelial ovarian cancer. Analysis by IUD type (i.e., hormone-releasing vs copper IUDs) was not possible in this study as these data were not collected. Future research should examine whether the type of IUD (i.e. copper versus hormone-releasing) may have different effects on risk of ovarian cancer. Citation Format: Minh Tung Phung, Yuting Wang, Alice W. Lee, Malcolm C. Pike, Anna H. Wu, Celeste Leigh Pearce. Intrauterine device use and risk of invasive epithelial ovarian cancer: A population-based case-control study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2195.

Combined estrogen-progestin oral contraceptives and female sexuality: an updated review.

Sexual side effects of combined oral contraceptives (COCs) have not been fully understood, but increasing evidence prompts broader risk/benefit evaluation and merits inclusion in counseling on contraceptive options. The study sought to explore the impact of combined estrogens-progestin oral contraceptives on components of female sexuality, including sexual desire, anatomic genitourinary changes, lubrication, orgasm, provoked vestibulodynia, well-being, body image, partner preference, and relationship stability. A literature review was performed between April 2023 and January 2024 exploring the association between combined oral contraceptive pills and sexual health. Although COCs decrease free testosterone, it is unclear if COCs affect sexual function, including desire. Antiandrogenic COCs do seem to have a negative effect on sexual arousal, lubrication, and orgasm. Provoked vestibulodynia may be related to early onset of COC use, low-estrogen pills, and antiandrogenic progestins. Emotional and sexual side effects are strong predictors of COC discontinuation. Longitudinal data indicate that using COCs when meeting and selecting a partner has implications on sexual satisfaction and relationship length. Analysis of data is complicated by various doses and forms of estrogen and progestin in COCs, which have changed over time. Lack of randomized placebo-controlled studies and heterogenicity in study design hampers generalized statements about the effects of COCs on sexual function. Despite these challenges, consideration of sexual dysfunction when presenting and prescribing hormonal contraception is essential for informed consent, shared decision making, and ensuring reliable contraceptive choices.

Effect on Endoplasmic Reticulum Stress of the Combined Oral Contraceptives in the Liver

Objective: We aimed to evaluate the effects of combined oral contraceptive active ingredients ethinylestradiol, drospirenone, and ethinylestradiol+drospirenone for histopathological changes, and endoplasmic reticulum stress levels in the liver.&#x0D; &#x0D; Methods: In the study, 37 to 8-week-old Balb/c female mice were used. Mice were randomly divided into the control, sham, ethinylestradiol, drospirenone, and ethinylestradiol+drospirenone groups. Experimental groups were administered ethinylestradiol, drospirenone, and ethinylestradiol+drospirenone with gavage for 35 days. In liver tissue sections, histopathological changes were detected with hematoxylin&amp;eosin, orcein, Mallory's Azan, and periodic acid-Schiff, and the presence of endoplasmic reticulum stress was detected by Chop and Grp78 immunostaining.&#x0D; &#x0D; Results: The ethinylestradiol+drospirenone group showed significant histopathological changes compared to the control group. Some degenerative changes were noted such as swelling and size differences in hepatocytes in the ethinylestradiol+drospirenone group. When compared to the control group, an increased collagen and elastic fibers density around the vena centralis was observed in the ethinylestradiol+drospirenone group. The expression level of Grp78 protein in female mice given ethinylestradiol+drospirenone was statistically significantly increased compared to the control group. The expression level of Chop protein was significantly increased in the ethinylestradiol, drospirenone, and ethinylestradiol+drospirenone groups. &#x0D; &#x0D; Conclusion: We concluded that the use of combined oral contraceptives increases endoplasmic reticulum stress in mouse liver tissue, and as a result, it may cause liver histopathological disorders by promoting cell death.

The effect of lavender on mood disorders associated with the use of combined oral contraceptives (COCs): a triple-blinded randomized controlled trial

BackgroundThe use of contraceptive methods is influenced by their effectiveness, availability, and minimal side effects. OCPs are one of the most effective and widely used methods of pregnancy prevention worldwide. This method not only prevents pregnancy but also helps prevent and treat other diseases. One of the main reasons for discontinuing this method is the emotional disturbances associated with its use. Lavender is an evergreen, fragrant plant that has gained significant attention for its anti-anxiety effects. This study was conducted to investigate the effect of lavender essential oil capsules on mood disorders during the use of COCs.MethodsThis triple-blinded clinical trial was conducted on 60 married women (aged 15–49 years old) who were consumers of COCs, referring to 26 health centers in Tabriz, Iran. The participants were randomly assigned to either the intervention (consuming one gelatin capsule containing 80 mg LEO daily) or control (consuming one placebo capsule daily) group. The intervention continued for 56 days. Scores for positive and negative were determined using the Positive and Negative Affect Schedule (PANAS) questionnaire; and for stress, depression, and anxiety were measured using the DASS-21 questionnaire on day’s 28th and 56th post-intervention. Data analysis was conducted using the t-test and ANOVA with repeated measures, and a p-value of < 0.05 was considered significant for all analyses.ResultsA statistically significant difference was observed in mood disorders, stress, and depression between women receiving LEO or placebo. The consumption of LEO increased the positive mood on day 28 [MD (95% CI): 4.5 (2.1 to 7.0), p = 0.001] and day 56 [5.9 (3.4 to 8.3), p < 0.001] while decreased the negative mood on day 28 [MD (95% CI): -3.5 (-5.3 to -1.3), p < 0.001] and day 56 [-4.3 (-6.3 to -2.2), p < 0.001], stress on day 28 [MD (95% CI): -4.9 (-7.1 to -2.8), p = 0.001] and day 56 [-5.3 (-7.6 to -3.1), p < 0. 001], and depression on day 28 [MD (95% CI): -3.0 (-4.9 to 1.1), p = 0.003] and day 56 [-3.1 (-5.0 to 1.2), p = 0.002]. There was no statistically significant difference between the two groups in terms of anxiety.ConclusionsThe consumption of LEO with COCs improved mood disorders and reduced stress and depression. The use of hormonal contraceptives and mood changes should be considered by providers. Therefore, regarding the possibility of mood changes, it is expected that appropriate counseling and education will be provided to women who consume COC., providing appropriate solutions, including the simultaneous use of LEO.