Use Of Contraceptive Pills Research Articles

Mortality in COVID-19 among women on hormone replacement therapy: a retrospective cohort study.

BackgroundLimited recent observational data have suggested that there may be a protective effect of oestrogen on the severity of COVID-19 disease. Our aim was to investigate the association between hormone replacement therapy (HRT) or combined oral contraceptive pill (COCP) use and the likelihood of death in women with COVID-19.MethodsWe undertook a retrospective cohort study using routinely collected computerized medical records from the Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) primary care database. We identified a cohort of 1,863,478 women over 18 years of age from 465 general practices in England. Mixed-effects logistic regression models were used to quantify the association between HRT or COCP use and all-cause mortality among women diagnosed with confirmed or suspected COVID-19 in unadjusted and adjusted models.ResultsThere were 5,451 COVID-19 cases within the cohort. HRT was associated with a reduction in all-cause mortality in COVID-19 (adjusted OR 0.22, 95% CI 0.05 to 0.94). There were no reported events for all-cause mortality in women prescribed COCPs. This prevented further examination of the impact of COCP.ConclusionsWe found that HRT prescription within 6 months of a recorded diagnosis of COVID-19 infection was associated with a reduction in all-cause mortality. Further work is needed in larger cohorts to examine the association of COCP in COVID-19, and to further investigate the hypothesis that oestrogens may contribute a protective effect against COVID-19 severity.

MO245: Risk Factors for Venous Thrombosis in ANTI-PLA2R + VE AND−VE Primary Membranous Nephropathy: A 6-YEAR Retrospective Analysis

Abstract BACKGROUND AND AIMS Venous thrombosis (VT) is an established cause of increased morbidity and mortality amongst patients with nephrotic syndrome. Previous studies suggest primary membranous nephropathy (PMN) to be associated with the highest risk of developing VT amongst all nephrotic diseases. Antibodies to the phospholipase A2 receptor (anti-PLA2R) is identified as a pathogenic marker to the disease activity of PMN, and considered a strong prognostic marker toward disease progression and treatment response. Recent evidence cites the potential of anti-PLA2R as an independent risk factor of VT in PMN. Nevertheless, the pathophysiology of VT for anti-PLA2R + ve and –ve PMN is not fully known. Whether the common risk factors of VT remain as significant within the anti-PLA2R + ve and –ve PMN context is also not convincingly elucidated of yet. Our study aimed to evaluate and compare risk factors for VT in patients with anti-PLA2R + ve and –ve PMN. METHOD This is a retrospective analysis of patients diagnosed with PMN between October 2015 and September 2021. Patients included are age ≥18 years, have biopsy-diagnosed PMN and anti-PLA2R direct immunofluorescence assay testing following PMN diagnosis. Patients excluded were those with secondary causes of membranous nephropathy, history of previous immunosuppression, kidney transplantation before or following PMN diagnosis, or where iatrogenic causes such as major surgery or prolonged immobilization led to VT. Study patients were screened until 28 November 2021 for any VT event and were grouped between those with anti-PLA2R + ve and −ve test results. Demographic and clinical parameters from age, gender, presence of co-morbidities and common risk factors associated with increased risk of VT (hypertension, diabetes mellitus, atrial fibrillation, CHA2DS2-VASC ≥ 3, BMI >30, malignant disease, hormonal treatment and contraceptive pill use), serum and urine biochemical test results at PMN diagnosis (albumin, 24-h proteinuria, proteinuria/albumin ratio, creatinine, eGFR, cholesterol, triglycerides and IgG) were collected. The comparison of demographic and clinical parameters for patients with and without VT in each of the anti-PLA2R + ve and –ve groups was conducted through chi-squared, t and Mann–Whitney U tests. Multivariate regression analysis determined the significance of association between each parameter and VT event occurrence. RESULTS Seventy patients with PMN were included in this study, of which 39 patients are anti-PLA2R + ve and 31 patients are anti-PLA2R−ve. Eight patients (20.5%) had VT in the anti-PLA2R + ve group during follow-up whilst this was the case for four patients (12.9%) in the anti-PLA2R−ve group. In both groups, patients with VT were found to have higher serum cholesterol levels (P < 0.05). Lower serum albumin levels, and greater 24-h proteinuria and proteinuria/albumin ratio was observed in patients with VT within the anti-PLA2R−ve group (P < .05). Full results from the multivariate regression analysis are presented in Tables 1 and 2. Serum cholesterol is demonstrated to be significantly associated with VT in the anti-PLA2R + ve (OR 1.42, 95% confidence interval (CI) 1.12–1.72) and anti-PLA2R−ve groups (OR 1.45, 95% CI 1.15–1.76), respectively. Serum albumin (OR 0.72, 95% CI 0.49–0.96), 24-h proteinuria (OR 1.33, 95% CI 1.03–1.63) and proteinuria/albumin ratio (OR 1.32, 95% CI 1.04–1.59) are shown to be significantly associated with VT within the anti-PLA2R−ve group. CONCLUSION There is supporting evidence that serum cholesterol, albumin and proteinuria may all present as important markers of risk prediction for VT in patients with PMN, though this will require further validation in prospective multi-center studies with larger patient samples. Close monitoring of these markers, and early intervention in response to hypercholesterolemia, hypoalbuminemia and proteinuria with consideration of anti-PLA2R status should ensue as part of primary prevention strategies to reduce VT incidence in the PMN population.

Association of Use of the Oral Contraceptive Pill (OCP) with the Expression Pattern of Different Molecular Subtypes of Breast Cancer

Background: Triple-negative breast carcinoma (TNBC) is a breast cancer subtype associated with high mortality and inadequate therapeutic options when compared to non-TNBC. Clinical data indirectly suggests where Oral Contraceptive Pill (OCP) usage is high, the prevalence of Estrogen Receptor+ (ER+) breast cancer is high, and the prevalence of TNBC is low. This has lead to our hypothesis that OCP use may increase the risk of ER+ breast cancer, and OCP use may reduce the risk of TNBC. We aimed to compare the prevalence and association of subtypes of breast cancer in OCP users with that of non-users among women 30 to 60 years of age. Methods: This hospital-based observational study of three-year duration included 155 subjects of primary invasive breast cancer who got admitted to our institution. The data was obtained for ER, PR, HER2 status, clinical classification, and data in relation to demographic factors, reproductive history, and history of OCP use. 155 subjects were divided into two groups. Group-1 included 48 patients with a history of OCP use, and group-2 included 107 patients who have not used OCP. Data was analysed using SPSS-20. Results: A significant increase in the prevalence of molecular subtypes ER+, Progesterone Receptor+ (PR+) and Luminal B breast cancer in OCP users was observed compared to non-users. There was a significant decrease in the age at the time of admission in ER+ cancer in OCP users (45.3 years) compared to non-users (52.2years). While age at the time of admission of Basal (TNBC) cancer patients in OCP users (53.1 years) was higher when compared to non-users (45.4years). Upon logistic regression, the likelihood of ER+, PR+ and Luminal B in OCP users was 11%,10% and 13% less, respectively, with 1 year of higher age and the likelihood of TNBC in OCP users was 18% more and 8% less in non-users. Conclusion: OCP use may be associated with increased prevalence of ER+, PR+ and Luminal B breast cancer. On the contrary, OCP use may be associated with a delay in the progression of the TNBC.

Effect of oral hormonal contraceptive pill use on the hemodynamic response to the cold pressor test.

Acute increases in sympathetic nervous system activity (SNA) often elicit peripheral vasoconstriction and increases in blood pressure (BP). Given sympathetic support of BP is modulated by ovarian sex hormones (e.g., estradiol), we sought to examine the effect of menstrual cycle and oral hormonal contraceptive pill (OC) phase on the hemodynamic response to acute increases in SNA. We hypothesized sympathoexcitation via cold pressor test (CPT) would elicit greater peripheral vasoconstriction and increases BP in females with natural menstrual cycles (NC) compared with females taking OC. We further hypothesized that SNA-mediated vasoconstriction would be attenuated during the high estradiol (HE) phase versus the low estradiol (LE) phase of the menstrual/pill cycle. Female NC (n = 11, 25 ± 1 yr) and OC (n = 10, 24 ± 1 yr) participants were studied during the LE (early follicular, placebo pill) and HE (late follicular, active pill) phase of the menstrual/pill cycle. BP (finger photoplethysmography), heart rate (HR, ECG), and forearm blood flow (FBF, venous occlusion plethysmography) were measured during a 5-min baseline and a 2-min CPT. CPT elicited an increase in BP in both groups (time, P < 0.01). During CPT, OC participants exhibited greater and sustained increases in HR compared with NC participants (group × time, P < 0.01). Higher HRs were met with increases in FBF in OC participants during the CPT, which was not observed in NC participants (group × time, P < 0.01). OC participants exhibit greater increases in HR, and paradoxical vasodilation during acute sympathetic activation compared with NC participants. Group differences are unaffected by menstrual/pill phase.NEW & NOTEWORTHY Acute increases in sympathetic nervous system activity often elicit peripheral vasoconstriction and increases in blood pressure (BP). Given sympathetic support of BP is modulated by ovarian sex hormones (e.g., estradiol), we sought to examine the effect of menstrual cycle and oral hormonal contraceptive pill (OC) phase on the hemodynamic response to acute increases in sympathetic nervous system activity via the cold pressor test. We show OC participants exhibit paradoxical vasodilation during acute sympathetic activation compared with participants with natural menstrual cycles; notably, group differences were unaffected by menstrual/pill phase.

Prevalence of Varicose Veins Among Nurses in Different Departments in Jazan Public Hospitals, Saudi Arabia: A Cross-Sectional Study.

Varicose veins (VV) in the lower limbs are the most prevalent vascular condition in humans. They can cause significant signs and symptoms and, in extreme cases, death. This study aims to investigate the prevalence and identify the risk factors for varicose veins among nurses working in multiple departments at Jazan King Fahd Central Hospital and Prince Muhammad bin Nasser Hospital. A cross-sectional study was conducted by sending a questionnaire to female and male nurses in these hospitals. This study included 482 nurses, 415 (86.1%) of whom were female and 67 (13.9%) male. The prevalence of varicose veins among the nurses of both hospitals was 76 (15.8%), compared with 406 (84.2%) not diagnosed with varicose veins. The prevalence of varicose veins was 67 (88.2%) in female nurses, compared with 9 (11.8%) in male nurses. The risk factors associated with varicose veins were ethnicity (p = 0.007), carrying heavy items (p = 0.001), lack of exercise (p = 0.031), family history (p = 0.001), use of hormonal therapy (p = 0.001), use of contraceptive pills (p = 0.0035), type of delivery (p = 0.002), number of children (p = 0.004), and hours sitting per shift (p = 0.002). The comorbidities associated with varicose veins were deep vein thrombosis (p = 0.001), hypertension (p = 0.002), chronic constipation (p = 0.006), diabetes (p = 0.001), kidney disease (p = 0.001), rheumatoid arthritis (p = 0.001), coronary artery disease, and severe occupational injury to the lower extremities (p = 0.001). Nurses are responsible for most of the health system's services. Increasing the number of nursing workers for patient care, encouraging physical exercise, and lowering the pension age appear to be required to avoid the occurrence and development of varicose veins among nurses.

Exploring Oral Contraceptive Use and Perceived Weight Among Women Aged 20 to 49 in the United States

Objective There is a myth that oral contraceptive pill (OCP) use increases body weight. The objectives of this exploratory study were to examine the relationship between OCP use and perceived weight and to test whether OCP ever use moderates the relationship between measured body mass index (BMI) and perceived weight. Setting and participants The sample included 6,897 females aged 20 to 49 from the 2007 to 2018 National Health and Nutrition Examination Surveys (NHANES). Perceived weight was the dependent variable; OCP ever use and measured BMI were independent variables. Covariates included socioeconomic variables and perceived health. Results In a crude model, the odds of participants perceiving themselves as overweight relative to perceiving themselves as “just about the right weight” were 40.4% higher for each 1-unit increase in measured BMI. In an adjusted model, participants had 40.6% greater odds of having overweight self-perception compared to “right weight” with every 1-unit increase in BMI and OCP ever users had 35.9% higher odds of overweight self-perception compared to “right weight” than never users. OCP moderates the association between measured BMI and perceived weight. In stratified models, OCP users had 44.6% higher odds of overweight self-perception, while never users had 33.6% higher odds of overweight self-perception compared to “right weight” self-perception for every 1-unit BMI increase. Conclusions OCP use moderates the relationship between measured BMI and perceived weight. For two women with different OCP use history and the same measured BMI, the ever OCP user has 11% higher odds of perceiving herself as overweight compared to the never user.

The Influence of Lifestyle Variables on Primary Dysmenorrhea: A Cross-Sectional Study.

BackgroundPrimary dysmenorrhea is a common and often debilitating, gynaecological condition.ObjectiveTo investigate the effects of specific lifestyle variables on the prevalence and severity of primary dysmenorrhea.Materials and MethodsA cross-sectional study of Jordanian women aged between 18–25 years old utilized a questionnaire as the main instrument of the study.ResultsPrimary dysmenorrhea was reported by 660 women out of 1988. It was found that approximately two thirds of them were students. Overall, 54.5% of the participants reported severe dysmenorrhea. A statistically significant correlation was found between severe dysmenorrhea and smoking at p value ˂0.001, sleeping less than 7 hours per 24 hours at p = 0.005, holding a university degree at p = 0.032, non-alcohol consumption at p = 0.044, frequent energy, fizzy, tea, coffee drinks and sugar intake. Interestingly, we found that severe dysmenorrhea was statistically significantly associated with women who never eat meat at p ˂0.001, cereals and fish consumers and with those who take less than 3 servings of fruit or none at all per week at p = 0.006. In addition to the previous variables, water intake of less than 1.0 litre a day, irregular cycles, non-OCP use and positive family history were found significantly associated with severe dysmenorrhea. Severe dysmenorrhea was significantly related to working less hours per week, higher stress level and longer bleeding duration at p = 0.021, 0.017 and 0.008, respectively. On the other hand, there was no statistically significant difference found between severe dysmenorrhea and the following variables: age, body mass index (BMI), weekly studying hours and age of menarche.ConclusionPrimary dysmenorrhea is prevalent in the Jordanian population. To overcome severe dysmenorrhea, women should increase their intake of fish and fresh fruits, drinking water and use of oral contraceptive pills. The study concluded that smoking, frequent sugar intake, fizzy drinks, coffee, tea and energy drinks were associated with severe dysmenorrhea. It is also worth mentioning that alcohol consumption had a positive impact on dysmenorrhea.Trial RegistrationRegistered in Clinicaltrial.gov (ID: NCT04583943).

Cancer cervix: Epidemiology and disease burden.

Cervical cancer remains a major public health problem, ranking as the fourth most common cause of cancer incidence and mortality in women worldwide. Wide variations in cervical cancer incidence and mortality were observed with highest incidence rates in Sub Saharan Africa and with 85% of deaths occurring in developing regions of the world. Non-existent or inadequate screening in public health care settings and limited access to the standard treatment options explains the large geographic variation in cervical cancer rates. Persistent infection with high-risk Human papillomavirus (HPV) types is the major risk factor for cervical cancer. High parity, long-term use of oral contraceptive pills, tobacco consumption, co-infection with other sexually transmitted agents, lifestyle factors such as multiple sexual partners, younger age at first sexual intercourse, immunosuppression, and diet have been identified as the co-factors most likely to influence the risk of acquisition of HPV infection and its further progress to cervical carcinogenesis. Differential screening rates and changes in epidemiological patterns have contributed to decreasing trends in cervical cancer in some developed regions of the world. Lower rates were also observed in North Africa and the Middle East, which may be attributed to cultural norms and conservative sexual behaviors. Across world regions, HPV prevalence was highest in women younger than 35 years of age, declining to a plateau in middle age and showed significant association between national age standardized incidence rates and corresponding estimates of HPV prevalence. The five most common HPV types in HPV-positive women worldwide were HPV16, HPV18, HPV31, HPV58, and HPV52, representing 50% of all HPV infections with HPV-16 and HPV-18 infections accounting for about 70% of the total infection burden. Tracking changing trends in the cervical cancer epidemiological patterns including HPV genotypes will immensely contribute toward effective prevention and control measures for cervical cancer elimination.

Knowledge and awareness on breast cancer among midwives and auxiliary midwives from three townships in Lower Myanmar

Background: In Myanmar, more than seventy percent of the population reside in rural areas and as the midwives (MW) and auxiliary midwives (AMW) are the basic health care workers who provide crucial health information to the rural women, their knowledge and awareness on breast cancer needs to be explored.Methods: A cross-sectional descriptive study was carried out to assess the perceived knowledge and awareness of MWs and AMWs regarding the early signs and symptoms, risk factors, and screening of breast cancer.Results: A total of 203 respondents (including 154 MWs and 49 AMWs) participated in the study. The mean age of the participants was 20.27±3.6 years and the majority (96%) was single. The majority of respondents (94%) had heard of breast cancer and breast cancer screening. AMWs had a significantly lower knowledge on risk factors such as: family history (68% versus 19%); nulliparity (62% versus 43%); change in shape of breast (47% versus 25%); dimpling (44.3% versus 18.45%); lumps in axilla (42% versus 21%); use of oral contraceptive pills (34% versus 8%) than the MWs.Conclusions: More knowledge on breast cancer and breast cancer screening need be imparted to the MWs and AMWs to be able to convey knowledge and information of breast cancer to the women residing in rural areas.

Determinants of emergency contraceptive pill use in Bangladesh

Objective: To examine the determinants of emergency contraceptive pill use in Bangladesh. Methods: Data for this cross-sectional study came from 2017-2018 Bangladesh Demographic and Health Survey. Characteristics of 906 reproductive age women who were potential candidates for using emergency contraceptive pill were analysed in this study. Data were analysed using univariate and multivariate analyses. Stepwise binary logistic regression was employed as multivariate analysis. Results: Only 10.9% candidates were found to ever use emergency contraceptive pill. The odds of using emergency contraceptive pill for women visited by family planning field worker was significantly higher than that for those who were not visited by family planning field worker [odds ratio (OR) 1.94; 95% confidence interval (CI) 1.19–3.17; P=0.008], while the odds of using emergency contraceptive pill for women with high socioeconomic status was higher than that for those with low socioeconomic status (OR 3.10; 95% CI 1.61–5.97; P=0.001). Additionally, having some media access was linked to an increase in the odds of using emergency contraceptive pill (OR 3.01; 95% CI 1.33–6.83; P=0.008). Women empowerment related factors did not show any significant effect on emergency contraceptive pill use. Conclusions: The findings indicate that family planning programme has a great opportunity of playing an important role in increasing emergency contraceptive pill use in Bangladesh by increasing the knowledge and awareness of women about emergency contraceptive pill.

Saddle versus non-saddle pulmonary embolism: differences in the clinical, echocardiographic, and outcome characteristics

ABSTRACT The central location, the size, and instability of saddle pulmonary embolism (PE) have raised considerable concerns regarding its hemodynamic consequences and the optimal management approach. Sparse and conflicting reports have addressed these concerns in the past. We aimed to evaluate the clinical presentation, hemodynamic and echocardiographic effects, as well as the outcomes of saddle PE, and compare the results with those of non-saddle type. This was a retrospective study of 432 adult patients with saddle and non-saddle PE. Overall, 432 patients were diagnosed with PE by computed tomography pulmonary angiography (CTPA). Seventy-three (16.9%) had saddle PE, and 359 had non-saddle PE. Compared to those with non-saddle PE, patients with saddle PE presented more frequently with tachycardia (68.5% vs. 46.2%, P= .001), and tachypnea (58.9% vs. 42.1%, P= .009) on admission, required more frequent intensive care unit (ICU) admissions (45.8% vs. 26.6%, P= .001) and thrombolysis/thrombectomy use (19.1% vs. 6.7%, P= .001), and were at more risk of developing decompensation and cardiac arrest after their initial admission (15.3% vs. 5.9%, P= .006). On echocardiography, right ventricular (RV) enlargement (60% vs. 31.1%, P= .000), RV dysfunction (45.8% vs. 22%, P= .000), and RV systolic pressure (RVSP) of greater than 40 mmHg (61.5% vs. 39.2%, P= .003) were significantly more observed with saddle PE. The two groups did not differ concerning the rates of hypotension (17.8% vs. 18.7%, P= .864) and hypoxemia (41.1% vs. 34.3%, P= .336) on admission and mortality rates. A logistic regression model indicated that the use of oral contraceptive pills (OCP), RVSP > 40 mmHg, and development of hypotension and decompensation following admission were associated with an increased likelihood of having saddle embolus. Saddle PE accounts for a higher proportion among all PE cases than previously reported. Patients with saddle PE tend to present more frequently with adverse hemodynamic and echocardiographic changes and decompensate after their initial presentation. OCP use, development of hypotension, and decompensation following admission and RVSP > 40 mmHg are significant predictors of saddle PE. These characteristics should not be overlooked when managing patients with saddle PE.

Eating Attitudes, Menstruation Cycles and Physical Profiles of Turkish Female Elite Artistic Gymnasts

It is thought that female artistic gymnasts (AG) who do long-term and high-intensity exercise and whose body fat percentage should be low may have disorders in their eating attitudes and menstruation cycles. These problems can lead to poor performance and, more importantly, undesirable health problems in the future. Therefore, the aim of this study is to examine the eating attitudes, menstrual cycles and physical profiles of female elite AG who train for long periods and at high intensity. Thirteen elite female AG participated in this study (Turkey National Team gymnasts). The height of all participants was measured with an ultrasonic height meter (Langen Messstab 5003, Germany). Body weight, body mass index (BMI), body fat percentage, total muscle mass, bone mineral weight, basal metabolic rate and body fluid ratios were determined by body composition monitor (Tanita BC 401, Japan). Eating attitudes of the participants were determined with the Eating Attitudes Test (EAT-26). With the Menstrual Cycle Form, the participants' menstrual cycles, pain conditions during menstruation, whether they had a gynecological operation, whether they gave birth or not, and the use of oral contraceptive pills were obtained. Training histories and temporal training intensities were determined with the Training Information Form. The EAT-26 Test results, which were within the normal range in the results of this study, were not different in gymnasts with and without menarche (p&lt;0.05). However, the fact that 46.2% (6 gymnasts) of the elite female AG with a mean age of 18.31 ± 4.54 years did not start menarche, suggesting primary amenorrhea in these athletes. Keywords: Female artistic gymnasts, eating attitudes, menstruation cycles, physical profiles

Evaluation of Prevalence of Vaginal Candidiasis and Related Risk Factors: A Cross Sectional Study

Aim: The study aims to evaluate the prevalence of vaginal candidiasis and associated risk factors Study design: Cross sectional study Place and duration: This study was conducted in Muhammad Medical and Dental College Mirpurkhas, Pakistan from March 2020 to March 2021. Methodology: The present study includes a total of 216 participants who had presented with symptoms of vaginal candidiasis. During this whole duration, 1800 patients visited the department. The laboratory investigations used in this regard were Gram-stained smears, vaginal cultures, and wet mount microscopy. Evaluation of risk factors such as diabetes mellitus, pregnancy, and use of contraceptive pills and antibiotics was keenly done. The data was recorded and analyzed in IBM SPSS version 26. Result: Vaginal candidiasis was diagnosed in 26 (12.03%) participants. The most common symptom observed was pruritus in 184 (85.18%), the second was vaginal discharge in 143 (66.20%), the third was soreness in 67 (31.01%) and dyspareunia was seen in 11 (5.09%) participants. Candida albicans were present in 172 (79.63%) participants, while non-albicans were present in 44 (20.37%) participants. Diabetes, pregnancy, reproductive age, and use of contraceptive drugs and antibiotics were associated with both Candida albicans and non-albicans. However, dyspareunia and soreness were significantly associated with non-albicans. The rate of recurrence was 8.8%. Recurrence was positively correlated with non-albicans species. Conclusion: The prevalence of Candida albicans specie is much greater than non-albicans species. Vaginal candidiasis is a common health issue in the community as well as in hospitalized patients. Common risk factors of vaginal candidiasis are reproductive age, pregnancy, sexual activeness, diabetes, use of contraception, use of antibiotics, and cancer. The most common clinical symptom of vaginal candidiasis is pruritus. Keywords: Candida albicans, non-albicans, vaginal candidiasis

Oral contraceptive pill and metabolic syndrome: Fasa Persian Cohort Study (Descriptive study)

Background and aimsThe contraceptive use is 56% and prevalence of metabolic syndrome (MetS) is 30% in Iran. The aim of this study investigates relationship between oral contraceptive pills (OCP) use and MetS in women in the cohort population of Fasa city. MethodsIn a cross-sectional study, 5489 women aged 35–70 years were studied for 5 years in the Sheshdeh area in 2016. MetS were calculated using adult treatment panel III (ATP III) and international diabetes federation (IDF) methods. The odds ratio (OR) with a 95% confidence interval (CI) was reported. Linear regression was used to eliminate the confounding effect. ResultsThe OR of developing MetS in the OCP recipients was estimated as higher than the non-recipients. The OR of developing MetS using IDF criteria in OCP recipients was (OR = 0.896,95% CI:0.800–1.004). that increased to (OR = 1.230,95% CI:1.084–1.395) after adjusting for confounding variables. Also, the odds ratio using ATP (III) criteria was (OR = 0.900,95% CI:0.804–1.009). that increased to (OR = 1.245,95% CI:1.098–1.413) after adjusting for confounding variables. Also, the OR of developing MetS in OCP recipients decreased with increasing the number of MetS components from 1.199 to 0.812,95% CI:0.771–1.864,0.467–1.413, but after adjustment, increased from 1.151 to 1.747,95% CI:0.733–1.805,0.815–3.746. ConclusionThe results of the present study showed that the OR of developing MetS in OCP recipients using both IDF and ATP (III) methods was higher after adjusting by confounder effects so it is recommended monitoring by physicians.

Analysis of Prediagnostic Circulating Levels of Gonadotropins and Androgens with Risk of Epithelial Ovarian Cancer.

Background Prevailing experimental and epidemiological evidence supports the role of circulating endogenous sex steroid hormones in the pathogenesis of ovarian carcinogenesis by dysregulation of cell differentiation, proliferation, and apoptosis but is scarce and inconclusive. Objectives This article evaluates the role of circulating levels of gonadotropins (follicle-stimulating hormone [FSH], luteinizing hormone [LH]) and androgens (testosterone, dehydroepiandrosterone-sulfate [DHEA-S]) for the risk of epithelial ovarian cancer in a case–control approach using samples collected in advance of clinical diagnosis. Materials and Methods A total of 100 epithelial ovarian cancer (EOC) patients and 100 healthy female controls were consequently enrolled in this hospital-based case–control study. Serum FSH, LH, testosterone, and DHEA-S were measured based on the principle of electrochemiluminescence immunoassay. Suitable descriptive statistics were used for different variables. Results Median values of FSH (58.9 vs. 45.5 IU/L, p = 0.02) and DHEA-S (163.43 vs. 142.2 ug/dL, p = 0.03) were significantly high in EOC patients compared with controls. Conditional logistic regression was used to estimate the odds ratio (OR) across increasing thirds of FSH and DHEA-S concentrations, and the results revealed that the highest third tertile of FSH (> 72.6 IU/L; OR = 3.0, confidence interval [CI] = 1.24–7.29, p trend = 0.04) and DHEA-S (> 194.2 ug/dL; OR = 3.8, CI = 1.26–11.61, p trend = 0.03) were significantly associated with increased risk of ovarian cancer in postmenopausal and premenopausal women, respectively. The statistically significant trend observed for FSH in postmenopausal women, remained only for the subgroup with menopause duration greater than 10 years (OR = 5.9, CI = 1.33–26.66, p trend = 0.04). FSH and DHEA-S concentrations and ovarian cancer risk were internally consistent with groups defined by oral contraceptive pill use, hormone replacement therapy, and smoking. However, no evidence was found for the association between serum LH and testosterone level with the occurrence of ovarian tumorigenesis. Conclusion Prediagnostic circulating concentration of FSH and DHEA-S unveiled a significant positive association with augmented risk of EOC, thus might serve as a predictive marker for the susceptibility to ovarian carcinogenesis and should be added in the screening profile of EOC for early recognition and scheduling necessary interventions/management strategies.

Oral Contraceptive Pills use and adverse effects

Oral Contraceptive Pills use and adverse effects

Frekuensi Hubungan Seksual dan KB Pil Kombinasi terhadap Terjadinya Erosi Portio pada Wanita Pasangan Usia Subur

Portio erosion is a wound or inflammation of the cervix (portio). Inflammation can be caused by hormonal changes, during pregnancy, contraceptive pill use, installation and removal of IUDs, and lack of personal hygien. This erosion can bleed easily and cause bleeding or metrorrhagia. This study aims to determine the relationship between the frequency of sexual relations and the use of the combined oral contraceptive pill to erosion of portion in reproductive women. This research is an analytic study with a cross sectional design with accidental sampling. Data collection was carried out using interviews and direct observation. Data analysis by a cross tabulation with Spearman Rank test through SPSS software. The results obtained are severe portio erosion covering more than 2/3 of the total cervical area of ​​8 women (53%) based on the frequency of sexual intercourse, and mild portio erosion covers less than 1/3 of the total cervical area of ​​10 women (67%) based on the combined oral contraceptive pill. The study concludes that the frequency of sexual intercourse affected the incidence of portio erosion. The use of the combined oral contraceptive pill has affected the incidence of portio erosion in the POSKESDES Binor Paiton Probolinggo. The results of this study are input for women of childbearing age who are sexually active and use combined pill contraceptives to be more aware of the health of their reproductive organs by routinely performing an IVA or Pap smear at least once a year.

Comparative Study of Acute Anogenital Injury Between Consensual and Nonconsensual Postmenarche Adolescents.

In Thailand, sexual activity involving those under the legal age of consent may be legally and medically problematic, even if it is consensual. Thus, differentiating anogenital injury characteristics that occur during consensual versus nonconsensual acts with adolescent female subjects could aid legal advocates and improve health care and social support for these patients. Our study included postmenarche female patients having acute anogenital injuries after consensual and nonconsensual penetration. We found that nonconsenting patients had more cases of anogenital injury than consenting (69.8% vs 55.5%), with at least 1 abrasion, contusion, laceration, labia major or minor injury, and external or internal site injury. Both consensual and nonconsensual cases had the same common sites for injury type, reflecting the same injury mechanism; prior sexual intercourse was a significant protective factor against some anogenital injury prevalence, types, and sites for both groups. Adolescents forced into nonconsensual acts had more nonanogenital injuries. Looking at factors such as age, prior sexual activity history, and use of condom and/or contraceptive pills, it is very clear that early sexual education, particularly around consent, is critically needed in Thailand for the best interests of adolescents and children so that they and/or their guardians can access the health and legal resources required.

Demographic and biochemical risk factors of Down Syndrome in pregnant women: A pilot study in Sylhet division of Bangladesh

Worldwide research in down syndrome have shown that advanced maternal age (˃30 years) at conception, lower folate status and/or impaired folate metabolism, maternal weight gain during pregnancy, low socioeconomic conditions, radiation exposure, use of contraceptive pills, and taking tobacco/smoking are major maternal risk factors for giving birth child with DS. However, the occurrence of those factors in pregnant women at advanced age has not yet been investigated in Bangladesh. Therefore, a large scale study was needed to explore the overall scenario in Bangladesh. This pilot cross sectional study was aimed to determine the serum folate and homocysteine status at advanced age pregnant women. We measured serum folate and homocysteine concentrations using the Enzyme-Linked Immunosorbent Assay (ELISA). Out of 70 pregnant women, serumfolate level was low (&lt;5 ng/ml) in 13 (18.57%), intermediate (5-6.9 ng/ml) in 8 (11.43%) and normal in 49 (70%) whereas homocysteine concentrations were found low (&lt;5 ng/ml) in all participants. Finally, questionnaire data indicates, low socioeconomic status, overweight during pregnancy, taking contraceptive pills and taking tobacco/smoking was higher percentage in folate-deficient pregnant women than normal serum folate level women. Additionally, women (n=13) with low folate level belongs to low socioeconomic status, overweight, taking contraceptive pills and tobacco/smoking did not give birth child with DS phenotypes. Together, our preliminary findings give an overview of DS associated risk factors in Bangladeshi pregnant women. Large scale study is going on. In next study, we might able to investigate DS risk factors, their associations with serum folate and homocysteine levels and finally with DS phenotypes in child throughout the country. Keywords: Down syndrome; risk factors; folic acid; homocysteine; pregnant women; Bangladesh.

Reproductive factors and the risk of incident dementia: Results from the UK Biobank

AbstractBackgroundAge‐standardised prevalence and deaths for dementia have been reported to be higher in women compared with men. The role of female‐specific endocrine and reproductive events in modulating dementia risk needs to be further clarified to explain some of these sex disparities.MethodThe UK Biobank recruited over 500,000 middle‐aged women and men. After 11.3 years, 3,701 (45% women) incident dementia occurred. Cox proportional hazard regressions estimated hazard ratios (HRs) for reproductive factors and hormone use with dementia in women; number of children in both sexes.ResultAdjusted HRs (95% CI) for dementia were 1.20 (1.08, 1.35) for menarche at &lt;12, 1.24 (1.10, 1.39) at ≥15, compared to 13 years; 1.29 (1.12, 1.49) for menopause at &lt;47 compared to 50 years; 1.13 (1.01, 1.27) for hysterectomy; 0.80 (0.72, 0.90) for use of oral contraceptive pills, and 1.56 (1.40, 1.73) for hormone replacement therapy. The number of children and dementia risk were similarly associated for women and men.ConclusionHormonal transition and reproductive experiences were associated with women’s dementia risk, although the biological factors associated with childbearing are unlikely to account for the risk variation in women.