Hormonal Contraceptive Use Research Articles

Risk factors for fibroadenoma mammae (FAM) among adult women at the South Tangerang General Hospital in Indonesia

A frequent benign breast tumor, fibroadenoma mammae (FAM), has extra stromal and epithelial components in the breast tissue. Despite not being fatal, FAM increases breast cancer risk, highlighting the necessity to recognize it. Estrogen and progesterone levels during menstruation, pregnancy, and lactation may alter FAM development. Therefore, this study examines FAM risk variables in adult women at South Tangerang Regional General Hospital, Indonesia. Adult women in General Hospital of South Tangerang City, Indonesia were studied using a case-control design with 85 cases and 85 controls. South Tangerang General Hospital recruited volunteers between December 2023 and January 2024 using purposeful sampling. FAM patients with a history of therapy were cases, while Eye Clinic patients without FAM were controls. Viral diseases, major cardiovascular problems in the past three years, and unstable weight were excluded. Multivariate analyses employed multiple logistic regression, while univariate and bivariate analyses used percentages and chi-square test. Fibroadenoma mammae (FAM) prevalence in adult women at South Tangerang General Hospital is highly correlated with age, age of menarche, family history, hormonal contraceptive use, and nutritional status. Abnormal nutrition was the largest risk factor for FAM in hospitalized adult women (aOR = 8.678, p < 0.000). The study stresses the link between nutritional state and FAM, with abnormal nutritional status increasing risk. This shows how diet and nutrition affect FAM sensitivity. To reduce FAM prevalence, demographic, genetic, hormonal, and lifestyle factors must be understood and addressed due to their complex interaction. Dietary strategies that promote healthy eating may reduce FAM risk.

Effects of the Menstrual Cycle and Hormonal Contraceptive Use on Metabolic Outcomes, Strength Performance, and Recovery: A Narrative Review.

The effects of female sex hormones on optimal performance have been increasingly recognized as an important consideration in exercise and sport science research. This narrative review explores the findings of studies evaluating the effects of menstrual cycle phase in eumenorrheic women and the use of hormonal contraception (oral contraceptives and hormonal intrauterine devices) on metabolism, muscular strength, and recovery in active females. Ovarian hormones are known to influence metabolism because estrogen is a master regulator of bioenergetics. Importantly, the menstrual cycle may impact protein synthesis, impacting skeletal muscle quality and strength. Studies investigating muscular strength in eumenorrheic women report equivocal findings between the follicular phase and luteal phase with no differences compared to oral contraceptive users. Studies examining recovery measures (using biomarkers, blood lactate, and blood flow) do not report clear or consistent effects of the impact of the menstrual cycle or hormonal contraception use on recovery. Overall, the current literature may be limited by the evaluation of only one menstrual cycle and the use of group means for statistical significance. Hence, to optimize training and performance in females, regardless of hormonal contraception use, there is a need for future research to quantify the intra-individual impact of the menstrual cycle phases and hormonal contraceptive use in active females.

Hormonal contraceptive use among women living with hypertension in sub-Saharan Africa: insights from 12 countries

ObjectivesGiven the well-established link between hormonal contraceptives and hypertension risk, and the paucity of research on hormonal contraceptive use dynamics in this particular demographic, we hypothesize that there is a likelihood of low utilization of high-risk hormonal contraceptives among women living with hypertension in SSA. This study investigates the prevalence and factors associated with hormonal contraceptive use among women living with hypertension in the SSA.ResultsOnly 18.5% of women living with hypertension used hormonal contraceptives. Hormonal contraceptive use was high among women with a higher level of education (aOR = 2.33; 95%CI: 1.73–3.14), those currently working (aOR = 1.38; 95%CI: 1.20–1.59), those who have heard about family planning on the radio (aOR = 1.27, 95%CI: 1.09–1.47), listened to the radio at least once a week (aOR = 1.29, 95%CI: 1.10–1.51), and those residing in rural areas (aOR = 1.32; 95%CI: 1.14–1.54). Conversely, women aged 45–49 exhibited a substantial decrease in the odds of hormonal contraceptive use (aOR = 0.23, 95%CI: 0.14–0.38) compared to younger women (15–19 years). Likewise, the odds of HCU were low among cohabiting (aOR = 0.66; 95%CI: 0.48–0.89) and previously married women (aOR = 0.67; 95%CI: 0.50–0.91) than never married women.

Effects of E4/DRSP on self-reported physical and emotional premenstrual and menstrual symptoms: data from the phase 3 clinical trial in Europe and Russia

Purpose To describe the effects of estetrol (E4) 15 mg/drospirenone (DRSP) 3 mg on physical and emotional premenstrual and menstrual symptoms. Materials and Methods We used Menstrual Distress Questionnaire (MDQ) data from a phase-3 trial (NCT02817828) in Europe and Russia with participants (18 − 50 years) using E4/DRSP for up to 13 cycles. We assessed mean changes in MDQ-t-scores from baseline to end of treatment in premenstrual (4 days before most recent flow) and menstrual (most recent flow) scores for 4 MDQ domains in starters and switchers (use of hormonal contraception in prior 3 months) and performed a shift analysis on individual symptoms within each domain. Results Of 1,553 treated participants, 1,398(90.0%), including 531(38%) starters, completed both MDQs. Starters reported improvements for premenstrual Pain (−1.4), Water Retention (−3.3) and Negative Affect (−2.5); and for menstrual Pain (−3.5), Water Retention (−3.4), and Negative Affect (−2.7) (all p < 0.01). For switchers, no changes were significant except an increase in premenstrual (+1.0, p = 0.02) and menstrual (+1.5, p = 0.003) Water Retention. We observed a change in symptom intensity in >40% of participants for Cramps, Backache and Fatigue (domain Pain), Painful or Tender Breast and Swelling (domain Water Retention) and Mood Swings and Irritability (domain Negative Affect). Conclusion E4/DRSP starters experienced significant improvements in the domains Pain, Water Retention and Negative Affect particularly benefiting those with more severe baseline symptoms. Switchers showed minimal changes.

Longitudinal associations of reproductive factors and exogeneous estrogens with neuroimaging biomarkers of Alzheimer's disease and cerebrovascular disease.

Female-specific reproductive factors and exogeneous estrogen use are associated with cognition in later life. However, the underlying mechanisms are not understood. The present study aimed to investigate the effect of reproductive factors on neuroimaging biomarkers of Alzheimer's disease (AD) and cerebrovascular pathologies. We evaluated 389 females (median age of 71.7 years) enrolled in the Mayo Clinic Study of Aging with reproductive history data and longitudinal magnetic resonance imaging (MRI) scans. We used linear mixed effect models to examine the associations between reproductive factors and changes in neuroimaging measures. Ever hormonal contraception (HC) use was longitudinally associated with higher fractional anisotropy across the corpus callosum, lower white matter hyperintensity (WMH) volume, and greater cortical thickness in an AD meta-region of interest (ROI). The initiation of menopausal hormone therapy (MHT)>5 years post menopause was associated with higher WMH volume. HC use and initiation of MHT>5 years post menopause were generally associated with neuroimaging biomarkers of cerebrovascular pathologies. Hormonal contraception use was associated with better brain white matter (WM) integrity. Initiation of menopausal hormone therapy>5 years post menopause was associated with worsening brain WM integrity. Hormonal contraception use was associated with greater cortical thickness. Ages at menarche and menopause and number of pregnancies were not associated with imaging measures. There were few associations between reproductive factors or exogenous estrogens and amyloid or tau PET.

Menstrual blood loss is an independent determinant of hemoglobin and ferritin levels in premenopausal blood donors.

To prevent blood donors from developing iron deficiency (ferritin <15 μg/L) and subsequent anemia (hemoglobin <120 g/L), blood services rely on information about known risk factors, including the donor's sex and age. For example, while Finnish women are able to donate whole blood with a minimum donation interval of 91 days, women in the 18 to 25-year-old age group are recommended to donate no more than once per year. Menstrual blood loss is not accounted for in blood donation interval recommendations, despite being a known risk factor of iron deficiency. We aim to investigate to what extent menstrual bleeding is associated with ferritin and hemoglobin levels in female blood donors, and quantify the association of other menstruation-related variables not currently accounted for by blood services (i.e., use of hormonal contraception, heavy menstrual bleeding) with iron deficiency or anemia. The study population consisted of 473 premenopausal and 491 postmenopausal Dutch whole blood donors. Exclusion criteria were current pregnancy, BMI ≥50, ferritin ≥200, pictorial blood assessment chart (PBAC) ≥400, and age <18 or ≥70 years. Menstrual blood loss was quantified using a PBAC, a semiquantitative method to evaluate the number of used menstrual products and the degree of staining. We identified predictors of log(ferritin)/hemoglobin and iron deficiency/anemia using Bayesian linear and logistic regression models and quantified the average percentage of variance in log(ferritin) and hemoglobin explained by the covariates. Menstrual blood loss accounted for most of the explained variance in hemoglobin (8%) and second only to the number of days since last donation for ferritin (8%). Heavy menstrual bleeding (PBAC ≥150, OR = 3.56 [1.45-8.85], prevalence 13%) was associated with anemia, and use of levonorgestrel-releasing intrauterine device was negatively associated with iron deficiency (OR = 0.06 [0.01-0.44]). After statistical control for menstrual blood loss, age was not associated with iron status. Menstrual blood loss and blood donation were the most important determinants of iron status in premenopausal women. Thus, results suggest that accounting for menstrual blood loss in donation interval guidelines may benefit blood donors.

Xenoestrogen concentration in women with endometriosis or leiomyomas: A case-control study.

Xenoestrogens are synthetic or naturally occurring chemicals capable of altering the endocrine system of humans and animals owing to their molecular similarity to endogenous hormones. There is limited data regarding their effects on women´s health. Chronic exposure to xenoestrogens can promote the development of estrogen-related diseases. To examine xenoestrogen concentration (TEXB-α) differences between women with leiomyomas or endometriosis and control women, and to study the relationship between the clinical and sociodemographic characteristics of these patients and their xenoestrogen levels. Prospective case-control study. We selected 221 women who underwent surgery at Quironsalud Madrid University Hospital between 2017 and 2021. The cases included 117 patients: 74 women who underwent surgery for uterine leiomyomas, 21 with endometriosis, and 22 with both pathologies. The control group comprised 104 healthy women who underwent surgical procedures for other reasons. TEXB-α was determined in the omental fat of all patients. Using a questionnaire and reviewing the patients' medical records, we collected sociodemographic data and other relevant variables. A significant majority of study participants (68.8%) had detectable levels of xenoestrogens. We found no association between TEXB-α levels in omental fat and the presence of myomas or endometriosis. In the case group, women living or working in Madrid Community exhibited, on average, 3.12 Eeq pM/g higher levels of TEXB-α compared to those working in other areas (p = 0.030). Women who referred to the use of estrogen-containing hormonal contraceptives had, on average, 3.02 Eeq pM/g higher levels of TEXB-α than those who had never used them (p = 0.022). This study found no association between omental xenoestrogen levels and leiomyomas or endometriosis. However, their presence in most participants and their association with highly polluted areas emphasizes the importance of limiting environmental exposure to these substances. We also identified an association between hormonal contraceptive use and xenoestrogen concentration.

Precise health perspectives: Unraveling the interplay of reproductive factors in hormone receptor–positive and triple-negative breast cancer among Bangladeshi women.

e22503 Background: Breast cancer is a major cause of cancer-related deaths in Bangladesh, with an incidence rate of 22.5 per 100,000 females per year. Urbanization is linked to the increasing incidence of breast cancer, altering lifestyles and reproductive behaviors. Reproductive factors play a key role in breast cancer risk, with variations between TNBC and Hr+BC. This study aims to investigate the relationship between TNBC and Hr+BC and reproductive factors among Bangladeshi women to provide valuable insights for breast cancer prevention and management in the region. Methods: Conducted in a tertiary hospital-based setting, our survey included 1000 adult Bangladeshi females aged 18 or older. Among them, 250 had TNBC, 250 had Hr+BC, and the remaining 500 were non-cancer individuals. Propensity score matching (PSM) was utilized to match the age and age of menarche of 500 healthy individuals with 250 TNBC and 250 Hr+BC individuals separately. The presence of TNBC or Hr+BC was confirmed through participants' previous histopathology reports. Detailed reproductive characteristics and demographics were collected using a structured questionnaire. Significant variables identified in the bivariate model were included in the adjusted multivariable multinomial logistic regression. Results: Demographic and reproductive characteristics in the Hr+BC, TNBC, and healthy groups were analyzed. The mean ±SEM age was Hr+BC (44.96±0.65), TNBC (42.74±0.65), and healthy (39.31±0.55) years. Patients with Hr+BC and TNBC, compared to healthy individuals, were older, with delayed first marriage and first birth, and more abortions. Both demographic and reproductive factors correlated with Hr+BC and TNBC, with higher likelihood in postmenopausal, irregular menstruation, vaginal delivery, breastfeeding &gt; 6 months, and hormonal contraceptive use. Reproductive factors associated with Hr+BC and TNBC risk were outlined. The adjusted model revealed delayed menarche increased Hr+BC risk by 1.71 times (OR 1.71, 95% CI 1.19-2.44) but decreased TNBC risk by 30% (OR 0.70, 95% CI 0.52-0.95). Longer time between first marriage and first birth (OR 1.40, CI 95% 1.10-1.78), irregular menstruation (OR 2.83, 95% CI 1.31-6.10), and hormonal contraceptive use (OR 5.68, 95%1.52-21.25) increased Hr+BC risk; pre-obesity decreased risk (OR 0.36 95% CI 0.18-0.72). Irregular menstruation (OR 4.30, 95% CI1.87-9.42) and hormonal contraceptive use (OR 8.54, 95% CI 1.81-40.14) increased TNBC risk. Higher abortions raised TNBC risk (OR 2.27, 95% CI 01.30-3.98) but not Hr+BC. Living in rural Bangladesh increased risk for both Hr+BC (4.81 times) and TNBC (16.77 times). Conclusions: Our findings highlight the significant impact of reproductive factors on Hr+BC and TNBC development in Bangladeshi women, emphasizing variations in risk profiles among different breast cancer types.

Prevalence of Depression Among Women Using Hormonal Contraceptives in Mogadishu, Somalia: A Cross-Sectional Study.

Depression is a global health concern with significant consequences, especially for women. Hormonal changes and gender disparities contribute to its prevalence. Hormonal contraceptives are widely used among women of reproductive age, but some users report mood-related side effects. This study aims to investigate the relationship between hormonal contraceptive use and depression among women in Mogadishu, Somalia. An analytical cross-sectional study was conducted at two hospitals in Mogadishu, targeting married women aged 15-49 using hormonal contraceptives. A sample size of 227 participants was determined, and data was collected using semi-structured questionnaires, including the Patient Health Questionnaire-9 (PHQ-9) to assess depression. The data were analyzed using SPSS version 25, including multivariate logistic regression. The prevalence of depression among participants was 33.5%, with significant associations observed between depression and occupation, income level, type of hormonal contraceptive used, and duration of contraceptive use. Housewives, individuals with lower income, users of oral pills and implant methods, as well as those with shorter durations of contraceptive use, constituted the high-risk groups for depression. Depression poses a concern among women using hormonal contraceptives in Mogadishu, Somalia. Healthcare providers should educate women about potential side effects and consider individualized contraceptive recommendations. Mental health support initiatives and awareness campaigns should be introduced. Future research is recommended to further understand and address depression in this context.

The epidemiological profile of cancer in Beni Mellal: a cross-sectional descriptive study

In Morocco, where cancer is a major public health problem, the characteristics of cancer in the Beni Mellal-Khenifra region of Morocco are unknown. Our objective was to establish the epidemiological profile of cancer in this region and the main risk factors influencing cancer. We conducted a cross-sectional study, including all types of cancer, with a sample of 100 patients at the Beni Mellal regional oncology center. Data collected in June and July 2021 using a questionnaire, pre-tested, and analyzed using SPSS and Excel. The questionnaire included sections on cancer-related clinical characteristics and other items related to cancer risk exposures. Gyneco-mammary cancers occupied the first position (49%). The most common localization of cancer in women was breast cancer, with a proportion of 63% of cases recorded during the period studied. In men, lung cancer was the most frequent location at 17%. We found some possible risk factors for cancer: tobacco and alcohol use, dietary habits, use of hormonal contraceptive methods, low income, pollution, sun radiation, exposure to asbestos, family history of cancer, and diseases associated with cancer. Women’s cancers are very common in the region. Several factors are responsible for this frequency. These results suggest several avenues for further research.

A reproducible, self-reported, field-based tool for monitoring ovarian hormone status and body weight variations in female athletes: the Answ'Her questionnaire.

Intra-individual factors like ovarian hormone profiles and body weight variations may influence sports practice and performance in female athletes and need to be characterized. The "Answ'Her" questionnaire was designed to develop a relevant and reproducible field-based tool to assess self-reported ovarian hormone status (natural menstrual cycle and hormonal contraceptive use) and body weight variations practices among female athletes. French females with a regular sports practice responded (once: N.=210; twice: N.=86; thrice: N.=66) to this 73-item questionnaire reporting their ovarian hormone status, associated symptoms, perceived influence on sports practice, and body weight variations. Reproducibility was evaluated, then a descriptive cross-sectional analysis was conducted on athletes. Reproducibility was verified with 92% of Lin's correlation concordance coefficients above 0.7 and 100% of weighted agreements above 70%. Ultimately 185 female athletes (23.0±4.8 years) were included in the cross-sectional analysis. Whether they used hormonal contraceptive (46.5%) or not (53.5%), most of the athletes perceived a negative impact of their ovarian hormone status on sports practice (78.7%) and performance (84.7%). Overall, 77.3% of the athletes had experienced body weight variations that were significantly associated with an interruption of menses (>3 months) and menses irregularity over the last three years. The Answ'Her questionnaire is a simple and effective reproducible field-based tool for the self-reported characterisation of female athlete ovarian hormone status and body weight variations. It could be used for a unique and simple overview of the athlete situation but also in a longitudinal design to assess the athlete's evolution and/or effectiveness of implanted training strategies.

Gut microbiome and symptoms in females with irritable bowel syndrome: a cross-sectional analysis.

Irritable bowel syndrome (IBS), a disorder of gut-brain interaction, is associated with abdominal pain and stool frequency/character alterations that are linked to changes in microbiome composition. We tested whether taxa differentially abundant between females with IBS vs healthy control females (HC) are associated with daily gastrointestinal and psychological symptom severity. Participants (age 18-50 year) completed a 3-day food record and collected a stool sample during the follicular phase. They also completed a 28-day diary rating symptom intensity; analysis focused on the three days after the stool sample collection. 16S rRNA gene sequencing was used for bacterial identification. Taxon abundance was compared between IBS and HC using zero-inflated quantile analysis (ZINQ). We found that females with IBS (n= 67) had greater Bacteroides abundance (q= 0.003) and lower odds of Bifidobacterium presence (q= 0.036) compared to HC (n= 46) after adjusting for age, race, body mass index, fibre intake, and hormonal contraception use. Intestimonas, Oscillibacter, and Phascolarctobacterium were more often present and Christensenellaceae R-7 group, Collinsella, Coprococcus 2, Moryella, Prevotella 9, Ruminococcaceae UCG-002, Ruminococcaceae UCG-005, and Ruminococcaceae UCG-014 were less commonly present in IBS compared to HC. Despite multiple taxon differences in IBS vs HC, we found no significant associations between taxon presence or abundance and average daily symptom severity within the IBS group. This may indicate the need to account for interactions between microbiome, dietary intake, metabolites, and host factors.

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.

Risk factors for the development of cervical cancer: analysis of the evidence

IntroductionCervical cancer (CC) is the fourth most prevalent female cancer globally. Understanding its epidemiology is crucial for devising practical strategies suited to geographic and social contexts to attain the global eradication of CC. Hence, this study examined the latest evidence of risk factors contributing to CC development.MethodsAn independent literature search was conducted on PubMed using MESH terms. The primary sources were meta-analyses published from 2010 to 2023, which detail updated evidence on risk factors associated with CC. Additionally, the quality of the evidence was evaluated using the GRADE system and recommendations were made accordingly.ResultsThe main risk factors related to the cause of CC include co-infections with other sexually transmitted infections, genetic markers, cervicovaginal microbiota, nutritional factors, comorbidities that affect the immune response, smoking, and the use of hormonal contraceptives with a quality evidence based on the GRADE scale moderate.ConclusionsSince the necessary cause for CC is persistent cervicovaginal HPV, all the risk factors implicated in the causality of CC act as non-independent cofactors that increase the risk of CC. Thus, changes in public policies aimed at addressing these risk factors are highly recommended and can substantially decrease the risk of CC.

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.

Oral hormonal contraceptives and cardiovascular risks in females.

Oral hormonal contraception (OHC) is a widely employed method in females for the prevention of unintended pregnancies, as well as for the treatment of menstrual disorders, endometriosis, and polycystic ovarian syndrome. However, it is believed that with OHCs use, some females may have higher risk of cardiovascular diseases, such as hypertension, diabetes, myocardial infarction, thrombosis, and heart failure. Although such risks are infrequently detected in healthy young females with the use of oral contraceptives, slightly elevated risks of cardiovascular diseases have been observed among reproductive-aged healthy females. However, prolonged use of OHC has also been claimed to have protective cardiac effects and may contribute to reduced risk of cardiovascular disease. In fact, the debate on whether OHC administration increases the risk of cardiovascular diseases has been ongoing with inconsistent and controversial viewpoints. Nevertheless, a great deal of work has been carried out to understand the relationship between OHC use and the occurrence of cardiovascular risk in females who use OHC for preventing the unwanted pregnancy or treatment of other disorders. Therefore, in this review we summarize the most recent available evidence regarding the association between the use of oral hormonal contraceptives and the risk for cardiovascular disease in females who are using OHC to prevent unintended pregnancy.

ART coverage and viral suppression among female sex workers living with HIV in eThekwini, South Africa: Baseline findings from the Siyaphambili study.

In South Africa >60% of female sex workers (FSW) are living with HIV, the majority of whom are not virally suppressed. Identifying multi-level determinants of viral suppression is central to developing implementation strategies to promote retention in HIV care and viral suppression among FSW with unmet treatment needs. Adult cisgender FSW living with HIV for ≥6 months, conducting sex work as their primary source of income, and residing in Durban (South Africa) were enrolled into the Siyaphambili Study, a sequential multiple assignment randomized trial. Baseline viral load and CD4 were assessed, and an interviewer-administered survey was conducted, capturing socio-demographic, reproductive and sexual history and behaviors, vulnerabilities, substance use, mental health, and stigma. We assessed baseline determinants of viral suppression (<50 copies/mL) using bivariate and multivariable robust poisson regression, considering associations across the individual, network, environmental and macrostructural levels. From June 2018 -March 2020, 1,644 women were screened, with 1,391 eligible FSW living with HIV enrolled. The analyses were conducted among the 1,373 participants with baseline data. Overall, 65% (889/1,373) of participants were reported to be on antiretroviral therapy and 38% (520/1,373) were virally suppressed. In the multivariable model, FSW who experienced a lack of housing in the prior six months were less likely to be virally suppressed (aPR: 0.72, 95%CI 0.56-0.91), while older FSW (aPR: 1.46 95%CI: 1.16-1.83 for 30-39 years old vs. 18-29 years old; aPR: 2.15 95%CI: 1.64-2.80 for 40+ years vs. 18-29 years old) and FSW reporting hormonal or long-acting contraception use were more likely to be virally suppressed (aPR: 1.19 95% CI: 1.00-1.43). We found vulnerability to be high among FSW living with HIV in South Africa and identified individual and structural determinants associated with viral suppression. Taken together these results suggest optimizing HIV treatment outcomes necessitates supporting younger sex workers and addressing housing instability. Trial registration: NCT03500172.

Contraceptive use with breast cancer incidence in Indonesia.

Breast cancer is the most common cancer in women worldwide and is a significant threat to public health. This study aims to conduct a systematic review of the relationship between hormonal contraceptive use and breast cancer incidence. The search was conducted using Google Scholar, Proquest, Pubmed and one Indonesian database, Garuda, using English and Indonesian keywords. The inclusion criteria in this study were the publication year of the last five years, namely 2019-2023, English and Indonesian language, case-control observational research, using the Indonesian population, and full-text access. A total of 165 studies were obtained from the Google Scholar database, including 104 studies. The overall multivariate analysis revealed that there was a statistically significant association of hormonal contraception with the incidence of breast cancer with OR values in the range of 2-6. The findings of this systematic study suggest that the use of hormones can contribute to hormonal imbalances that further increase breast cell proliferation and disrupt gene expression, resulting in uncontrolled cell development/cancer. In addition, the findings recommend increasing the number of studies on this topic to obtain more adequate and possibly more diverse information.

Systemic Hormonal Contraceptive Use and Rates of Venous Procedures for Varicose Veins

Systemic Hormonal Contraceptive Use and Rates of Venous Procedures for Varicose Veins

Moderate associations between the use of levonorgestrel-releasing intrauterine device and metabolomics profile.

Use of levonorgestrel-releasing intrauterine device (LNG-IUD) has become common irrespective of age and parity. To date, only a few studies have examined its possible metabolic changes and large-scale biomarker profiles in detail and in a longitudinal design. To apply the metabolomics technique to examine the metabolic profile associated with the use of LNG-IUD both in a cross-sectional and in a longitudinal design. The study consists of cross-sectional and longitudinal analyses of a population-based survey (Health 2000) and its 11-year follow-up (Health 2011). All participants aged 18-49 years with available information on hormonal contraceptive use and metabolomics data (n=1767) were included. Altogether 212 metabolic measures in LNG-IUD users (n=341) were compared to those in non-users of hormonal contraception (n=1426) via multivariable linear regression models. Participants with complete longitudinal information (n=240) were divided into continuers, stoppers, starters, and never-user groups, and 11-year changes in levels of each metabolite were compared. After adjustment for covariates, levels of 102 metabolites differed in LNG-IUD current users compared to non-users of hormonal contraception (median difference in biomarker concentration: -0.12 SD): lower levels of fatty acids concentrations and ratios, cholesterol, triglycerides and other lipids, as well as particle concentration, cholesterol, total lipids and phospholipids in lipoproteins. The 11-year metabolic changes did not differ in relation to changes in LNG-IUD use. The use of LNG-IUD was associated with several moderate metabolic changes, mostly suggestive of a reduced arterial cardiometabolic risk. Changes in LNG-IUD use were not related to long-term metabolic changes.