Hormonal Contraceptive Use Research Articles

Salivary microbiome of healthy women of reproductive age.

The salivary microbiome has been proven to play a crucial role in local and systemic diseases. Moreover, the effects of biological and lifestyle factors such as oral hygiene and smoking on this microbial community have already been explored. However, what was not yet well understood was the natural variation of the saliva microbiome in healthy women and how this is associated with specific use of hormonal contraception and with the number of different sexual partners with whom microbiome exchange is expected regularly. In this paper, we characterized the salivary microbiome of 255 healthy women of reproductive age using an in-depth questionnaire and self-sampling kits. Using the large metadata set, we were able to investigate the associations of several host-related and lifestyle variables with the salivary microbiome profiles. Our study shows a high preservation between individuals.

Influence of menstrual cycle and hormonal contraceptive use on MS symptom fluctuations: A pilot study.

In clinical practice, females with MS often report menstrually-related symptom fluctuations. Hypothetically, use of oral contraceptives (OCs) could reduce these fluctuations, particularly continuous OCs (11+ weeks of consistent exogenous hormones followed by 1 week placebo). To prospectively capture (1) whether neurologic and generalized symptoms vary with menstrual cycle phase and (2) whether type of contraception impacts symptom fluctuations. In this two-center pilot study, females with MS and a regular menstrual cycle prospectively tracked their menstrual cycles and completed symptom surveys for up to 6 months. Participants were categorized as 1) users of oral contraceptives, either a) cyclic or b) continuous, or 2) endogenously cycling, either c) hormonal intrauterine device (IUD) users or d) "none users" (e.g. no hormonal contraception; included condoms, copper IUD, tubal ligation, "fertility awareness methods"). There was no correction for multiple analyses. Altogether, 47/70 participants (67%) provided >4 weeks of data and were included in the analyses. Mean (SD) age was 35.0 (0.9) years, median (IQR) EDSS was 1.5 (1-2) and mean (SD) SymptoMScreen score was 10.4 (9.6). For endogenously cycling patients (IUD and none users), fatigue (MFIS) was lower in the perimenstrual period than in the luteal period (p<0.05). For continuous OC users, variability in symptoms was lower than for endogenously cycling females (MFIS: p<0.01; Daily Hassles, from Uplift & Hassles Survey: p<0.05) or cyclic OC users (MFIS: p<0.001). In this pilot study, symptom severity did not definitively fluctuate in relationship to the menstrual cycle in endogenously cycling participants. However, fatigue and daily hassles were less variable for participants using continuous OC than for cyclic OC users or no-OC users. Future confirmatory studies are warranted to further examine whether contraceptive choice can be leveraged to manage symptom fluctuation in cycling females with MS. Such studies could enroll larger cohorts over fewer cycles or employ incentivization and hormonal measurements to enhance participant retention and statistical power.

Profiling Hormonal Contraceptive Use and Perceived Impact on Training and Performance in a Global Sample of Women Rugby Players.

The potential impact of hormonal contraceptives (HCs) on player health and performance in women's rugby union (rugby) is not well understood, despite rugby's growing popularity worldwide. This study investigated the prevalence of HC use and reported associations with training and performance in a global sample of women rugby players. A globally distributed online survey, seeking to explore experiences in women's rugby, was completed by 1596 current or former adult women 7s or 15s rugby players (mean age 27 [6]y; 7 [5]y playing experience) from 62 countries. The survey included a section of questions about reported HC use, including the type, reason for use, symptoms, and experiences relating to rugby training and performance. A total of 606 (38%) participants from 33 of the 62 (53%) countries reported using HCs, with the combined oral contraceptive pill reported as the most frequently used (44%). Almost half of participants using HCs (43%) tracked HC-related symptoms. Over 10% reported altered rugby performance due to HC-related symptoms, 22% required medication to manage symptoms, and 11% used HCs to control or stop their menstrual periods for rugby training and performance. The current study highlights the prevalence of HC use in women's rugby, identifying practices that may negatively affect performance, health, and well-being. Thus, there is an urgent need to better understand the motivations for such practices and knowledge of potential side effects among women rugby players across all levels and countries.

A life-threatening benign vascular lesion of the uterus, cavernous hemangioma: A case report

The objective of this clinical report is to present the first local case of rare cavernous uterine hemangioma. This is a case of a 28-year-old G2P1 (1001) during her first trimester of pregnancy who was admitted to our institution for the second time due to profuse vaginal bleeding and severe anemia. The transvaginal scan revealed an embryonic demise of 8 weeks age of gestation noted at the endocervical canal. There is a posterofundal heterogeneous mass measuring 6.3 cm × 5.7 cm × 5.0 cm (volume: 94.2 ml) with multiple cystic spaces, which on Doppler studies showed abundant vascularity suggestive of uterine hemangioma. Antifibrinolytics were administered. The patient underwent emergency hysterectomy with bilateral salpingectomy due to profuse vaginal bleeding with histopathology result of cavernous hemangioma of the uterus. Cavernous uterine hemangioma is a rare vascular lesion that poses a great challenge in the diagnosis and management. There were limited published articles regarding cavernous hemangioma of the uterus. There were conservative treatment options such as uterine artery embolization, the use of hormonal oral contraception, intralesional glucocorticoid therapy, the use of interferon-α, laser therapy, and surgical excision. Hysterectomy is the definitive treatment for intractable bleeding. It is recommended to establish an international registry for this rare case. The experts in different specialties such as obstetrician-gynecologists, interventional radiologists, and vascular surgeons, can also formulate an algorithm for its diagnosis and treatment.

Hormonal contraception and the recognition of sexual receptivity by facial expression

The possible influence of exogenous sex hormones present in hormonal contraceptives on the recognition of emotions by facial expression may interfere with interpersonal relationships. The objective of this study was to test the agreement between women with and without oral hormonal contraceptive (OC) use on the perception of sexual receptivity by facial expression, a complex social emotion. A total of 135 women participated in the study, 30 with and 105 without OC use, all older than 18 (Mean age 40.3). The volunteer participants completed an online form containing the Sexual Receptivity by Facial Expression (SRFE) scale images. The scale data were observed as means, with no significant differences between the groups. The results corroborate data from the literature regarding the interference of OC use on female emotional processing. Although without statistically significant differences, women using OC tend to agree less with the presence of sexual receptivity in facial expressions. In situations of clinical cases regarding altered female perception, the use of OC is a data to be investigated.

Resting energy metabolism and sweet taste preference during the menstrual cycle in healthy women.

Differences in blood concentration of sex hormones in the follicular (FP) and luteal (LP) phases may influence energy metabolism in women. We compared fasting energy metabolism and sweet taste preference on a representative day of the FP and LP in twenty healthy women (25·3 (sd 5·1) years, BMI: 22·2 (sd 2·2) kg/m2) with regular self-reported menses and without the use of hormonal contraceptives. From the self-reported duration of the three prior menstrual cycles, the predicted FP and LP visits were scheduled for days 5-12 and 20-25 after menses, respectively. The order of the FP and LP visits was randomly assigned. On each visit, RMR and RQ by indirect calorimetry, sweet taste preference by the Monell two-series forced-choice tracking procedure, serum fibroblast growth factor 21 by a commercial ELISA (FGF21, a liver-derived protein with action in energy balance, fuel oxidation and sugar preference) and dietary food intake by a 24-h dietary recall were determined. Serum progesterone and oestradiol concentrations displayed the expected differences between phases. RMR was lower in the FP v. LP (5042 (sd 460) v. 5197 (sd 490) kJ/d, respectively; P = 0·04; Cohen effect size, d rm = 0·33), while RQ showed borderline significant higher values (0·84 (sd 0·05) v. 0·81 (sd 0·05), respectively; P = 0·07; d rm = 0·62). Also, in the FP v. LP, sweet taste preference was lower (12 (sd 8) v. 16 (sd 9) %; P = 0·04; d rm = 0·47) concomitant with higher serum FGF21 concentration (294 (sd 164) v. 197 (sd 104) pg/ml; P < 0·01; d rm = 0·66). The menstrual cycle is associated with changes in energy expenditure, sweet taste preference and oxidative fuel partitioning.

Levonorgestrel intrauterine device and depression: A Swedish register-based cohort study

BackgroundThe levonorgestrel intrauterine device (LNG-IUD) is traditionally viewed as a safe contraceptive with limited systemic effects. However, three recent studies have indicated an increased risk of depression subsequent to LNG-IUD use. This study aimed to examine the potential associated risk between LNG-IUDs and depression, and determine which women are at risk. MethodsThis longitudinal cohort study was based on data from seven Swedish national population-based registers. All Nordic-born women aged 15–24 years residing in Sweden between 2010 and 2017 were included. Cox regression was implemented to estimate the adjusted hazard ratio (AHR) for developing depression, defined as first depression diagnosis or redeemed prescription for antidepressant treatment. We adjusted for age, education level, parental country of origin, parental psychiatric health, previous hormonal contraceptive use and medical indications for contraceptive use. Findings703,157 women were included in the analysis. The LNG-IUD was associated with 57 % increased risk of depression [AHR 1.57 (95 % CI 1.51–1.64)]. The greatest risk increase was seen in adolescent women [AHR 2.57, (95 % CI 2.36–2.80)] and women who used the LNG-IUD as their first hormonal contraceptive method [AHR 1.63, (95 % CI 1.50–1.78)]. The risk of depression decreased at the end of study period [AHR 1.43, (95 % CI 1.36–1.51)], once the LNG-IUD became more widely accessible among nulliparous women. ConclusionsAdolescent women who use the LNG-IUD as their first-ever hormonal contraceptive are at increased risk of developing depression. However, additional impact from confounding factors is likely as risk estimates decreased over the study period. Further research needs to determine if there is a causal relationship between LNG-IUDs and depression.

Comparison of thromboembolism outcomes in patients with sickle cell disease prescribed hormonal contraception

AbstractPatients with sickle cell disease (SCD) are at a risk of thromboembolism (TE), and use of hormonal contraception can further increase that risk. This study aims to assess patterns of hormonal contraceptive use and compare risk of contraception-related TE between combined hormonal contraceptives (CHCs) and progestin-only contraceptives (POCs). Patients with SCD aged between 12 and 44 years with a new prescription of a hormonal contraceptive in the Centers for Medicare and Medicaid Services Medicaid Analytic eXtract database (2006-2018) were followed up to 1 year. We identified 7173 new users: 44.6% initiated CHC and 55.4% initiated POC. Combined oral contraceptive pills (OCPs; 36.5%) and progestin-only depot medroxyprogesterone acetate (33.9%) were the most frequently prescribed agents. A total of 1.8% of contraception users had a new diagnosis of TE within 1 year of the first identified contraception prescription. There were no significant differences in TE event rates between CHC and POC users (17.2 and 24.7 events per 1000 person-years, respectively). In patients prescribed OCP, there were no differences in TE event rates based on estrogen dose or progestin generation. Transdermal patch had a 2.4-fold increased risk of TE as compared with that of OCP. Although limited by the retrospective study design and use of administrative claims data, this study found no significant differences in TE rates between new users of CHC and POC in patients with SCD. Careful evaluation of underlying TE risk factors should be considered for each patient with SCD before initiation of hormonal contraception.

Perspectives on the side effects of hormonal contraceptives among women of reproductive age in Kitwe district of Zambia: a qualitative explorative study

BackgroundGlobally, hormonal contraceptives have proved to be effective in the prevention of unwanted pregnancies. However, despite evidence of the many benefits associated with the use of hormonal contraceptives, concerns related to their safety and side effects have been reported. We conducted a study to explore the perspectives on the side effects of hormonal contraceptives among women of reproductive age in Kitwe district of Zambia.MethodsAn explorative qualitative study was done among 32 women of reproductive age (18–45 years). Participants were selected conveniently as they accessed family planning services at a designated reproductive, maternal, and child health facility. Data collection was done through in-depth interviews (IDIs). Recruitment of participants and data collection continued until the saturation point was reached. The interviews were recorded, translated, and transcribed verbatim. Data were imported into NVivo.x64 for coding and node generation after which categories and themes were developed manually.ResultsOverall, participants demonstrated a considerable amount of knowledge of family planning, recounting the economic and health benefits as well as demerits of family planning use. The main reasons for discontinuing and switching hormonal contraceptive methods were the desire to get pregnant and the fear of unpleasant side effects, including excessive bleeding or prolonged menstruation, headache, dizziness, lower abdominal/back pain, and weight gain. Most importantly, participants cited concerns about the delay in the resumption of fertility after the termination of contraception and how the side effects disrupted their daily activities at home.ConclusionThere is a need for family planning providers to offer family planning services that address the side effects of hormonal contraceptives during counselling and how women can manage them. Family planning services should adopt a patient-centred approach that takes into consideration the concerns regarding side effects and how this affects the quality of life among women. Also, there is a need to extend family planning services to include scheduled follow-ups and clinical management of contraceptive side effects among women.

Is It Necessary to Adapt Training According to the Menstrual Cycle? Influence of Contraception and Physical Fitness Variables.

(1) Background: The influence of the menstrual cycle on physical fitness in athletes is controversial in the scientific literature. There is a marked fluctuation of sex hormones at three key points of the menstrual cycle, where estrogen and progesterone vary significantly. Hormonal contraception induces hormonal levels different from the natural menstrual cycle, requiring specific study in relation to physical fitness. (2) Method: Women aged 18 to 40 years with regular natural menstrual cycles and women using hormonal contraception were recruited, creating two study groups. All participants needed to be athletes classified as level II-III, based on training volume/physical activity metrics, among other variables. To assess their physical fitness, cardiorespiratory fitness (measured by V˙O2max), high-speed strength, hand grip strength, and flexibility were evaluated. Blood samples were taken to determine the menstrual cycle phase through analysis of sex hormone levels. Additionally, urine tests for ovulation detection were performed for the natural menstrual cycle group. Neurosensory stimulation tests were incorporated to measure sensory thresholds and pain thresholds in each phase. Body composition in each phase and its relationship with the other variables were also taken into account. (3) Results: Athletes in the natural cycling group showed differences in V˙O2max (mL·kg-1·min-1) (phase I = 41.75 vs. phase II = 43.85 and (p = 0.004) and phase I vs. phase III = 43.25 mL·kg-1·min-1 (p = 0.043)), as well as in body weight (phase I = 63.23 vs. phase III = 62.48 kg; p = 0.006), first pain threshold (phase I = 1.34 vs. phase II = 1.69 (p = 0.027) and phase III = 1.59 mA (p = 0.011)), and sensitive threshold (phase I = 0.64 vs. phase II = 0.76 mA (p = 0.017)). The pain threshold was found to be an important covariate in relation to V˙O2max, explaining 31.9% of the variance in phase I (p = 0.006). These findings were not observed between the two phases of contraceptive cycling. (4) Conclusion: The natural menstrual cycle will cause significant changes in the physical fitness of athletes. The use of hormonal contraception is not innocuous. Women with natural cycles show an increase in cardiorespiratory fitness in phases II and III, which is a factor to be considered in relation to training level and workload.

Assessment of liver function tests of women taking hormonal contraceptives at University of Gondar comprehensive specialized hospital and Family Guidance Association of Gondar (FGAE), 2022; a comparative cross-sectional study.

Hormonal contraceptives are artificial preparations that contain artificial progestins and Ethinylestradiol; these preparations are utilized by women of reproductive age to prevent pregnancy. Roughly a billion women in the world use some form of contraceptive worldwide. Despite the utility of these preparations, they are linked with several adverse effects, including disturbances of liver functionality and integrity. However, previous studies conducted to assess the association between hormonal contraceptive utilization and liver function tests reported conflicting results, and the effects remained a matter of concern. The study enrolled a total of 264 participants, who were allocated into two groups. One group of hormonal contraceptive users who use the medication for a minimum of six months: Depot medroxyprogesterone acetate (DMPA), combined oral contraceptives (COC), Norplant, and Implant users and another age-matched non-user control group in a ratio of 1:1. A semi-structured questionnaire was used to collect socio-demographic, behavioral, and clinical data. Five ml serum blood sample was collected for liver function test analysis on a Beckman Coulter Clinical Chemistry analyzer (DXC 700 AU). Independent t-test was used to compare liver function tests of hormonal contraceptive users and non-user controls, whereas ANOVA followed by a Bonferroni post hoc test was used for intra- (between classes of contraceptives) and inter-group (between each class of contraceptives and controls) comparisons and to identify factors associated. Hormonal contraceptive users were observed to have a statistically significant higher mean value of liver enzymes assessed compared to non-user control groups: aspartate aminotransferase (AST) (47.07±14.79 versus 25.92±7.37; p <0.001), alanine aminotransferase (ALT) (35.83±13.76 versus 16.56 ± 5.03; p <0.001), alkaline phosphatase (ALP) (63.34±14.74 versus 45.41±14.34, p <0.001) and for γ-glutamyl transferase (GGT) (47.37±24.32 versus 19.45 ± 6.86 p <0.001). Similarly, the mean value of total and direct bilirubin (mg/dL) among HC users showed a statistically significant elevation (0.68 ± 0.22 against 0.32 ± 0.13, p <0.001) for total bilirubin and (0.14 ± 0.06 against 0.06 ± 0.03, p <0.001) for direct bilirubin respectively. However, no statistically significant result was observed in the mean values of total protein and albumin. For total protein (6.7 ± 0.89 versus 6.5 ± 1.15, p 0.07) and for albumin (5.4 ± 0.92 versus 5.3 ± 1.08; p 0.30). The current study also indicates the level of hepatic function test alteration is related to the type of hormonal contraceptives, duration of usage, and level of adherence to a specific class of contraceptives. Hormonal contraceptive use was observed to affect hepatic function. Based on this finding, we strongly recommend to closely monitor liver function tests in women using hormonal contraceptives.

Women in their mid-follicular phase outcompete hormonal contraceptive users, an effect partially explained by relatively greater progesterone and cortisol reactivity to competition

Early evidence suggests that hormonal contraceptive (HC) use alters psychological functioning and competitive behavior. Yet, there is limited data on endocrine models for explaining how HC use affects these outcomes. In this pre-registered and open-data study, we test if HC users and naturally cycling (NC) females in their low (mid-follicular) and high (mid-luteal) progesterone phase differ in competitive persistence and whether progesterone and cortisol reactivity mediate of this effect. HC users (N = 73) in the active hormone-exposure phase and NC participants in the mid-follicular (N = 69) or mid-luteal (N = 72) phase completed two behavioral measures of competitive persistence, holding up a weight for time followed by attempting to solve an unsolvable anagram. Participants also completed measures of handgrip strength and self-reported competitiveness as well as gave saliva samples before and after the tasks for hormone assay. Results showed that NC-follicular group had greater competitive persistence in the weight-holding task compared to both NC-luteal (d = 0.38) and HC use (d = 0.43) groups independent of physical strength and self-reported competitiveness covariates. Although anagram task performance showed similar trends for group differences, analyses for this task were inconclusive. Baseline progesterone did not mediate the effect of cycle phase group on competitive persistence. HC users showed relatively blunted cortisol and progesterone reactivity, and this effect partially mediated the difference in competitive persistence between HC users and the NC-follicular group. In sum, results suggest that HC use could downregulate competitive behavior at least partly by dampening cortisol-progesterone reactivity. These findings offer a new endocrine model for understanding HC use and cycle phase effects on motivational and energetic outcomes required for optimal performance in competitive contexts.

The Relationship between the Use of Hormonal Contraceptive Devices on Body Weight of Family Planning Acceptors

Contraception is a way to prevent and space pregnancies as well as to plan the number of children to improve family welfare so that they can provide maximum attention and education to children. The level of contraceptive use or the Contraceptive Prevalance Rate (CPR) in Indonesia was 57% in 2015 to 61.4% in 2018. This study aims to determine the relationship between the use of hormonal contraceptives and the body weight of family planning acceptors. This type of research is a descriptive analytic study with a cross sectional research design. This research was conducted in the working area of the Landawe Health Center in August 2021. The analysis used the Fisher exact test. The results showed that most of the respondents' weight increased by 60%. The results of the analysis show that value is 0.032 &lt; = 0.05, which means that there is a relationship between the use of hormonal contraception and body weight in family planning acceptors.

Former long-term use of combined hormonal contraception and glucose metabolism disorders in perimenopausal women: A prospective, population-based cohort study.

Current use of combined hormonal contraceptives worsens glucose tolerance and increases the risk of type 2 diabetes mellitus at late fertile age, but the impact of their former use on the risk of glucose metabolism disorders is still controversial. This was a prospective, longitudinal birth cohort study with long-term follow-up consisting of 5889 women. The cohort population has been followed at birth, and at ages of 1, 14, 31 and 46. In total, 3280 (55.7%) women were clinically examined and 2780 also underwent a 2-h oral glucose tolerance test at age 46. Glucose metabolism indices were analyzed in former combined hormonal contraceptive users (n = 1371) and former progestin-only contraceptive users (n = 52) and in women with no history of hormonal contraceptive use (n = 253). Compared with women with no history of hormonal contraceptive use, those who formerly used combined hormonal contraceptives for over 10 years had an increased risk of prediabetes (odds ratio [OR] 3.9, 95% confidence interval [CI]: 1.6-9.2) but not of type 2 diabetes mellitus. Former progestin-only contraceptive use was not associated with any glucose metabolism disorders. The results persisted after adjusting for socioeconomic status, smoking, alcohol consumption, parity, body mass index and use of cholesterol-lowering medication. Former long-term use of combined hormonal contraceptives was associated with a significantly increased risk of prediabetes in perimenopausal women, which potentially indicates a need of screening for glucose metabolism disorders in these women.

Faktor Risiko Kejadian Kanker Serviks di RSU Kertha Usada Buleleng

Cervical cancer is a silent killer for a woman. Most women infected with cervical cancer are known or come to health services after entering an advanced stage. This study goal was to analyze the risk factors for cervical cancer at Kertha Usada Public Hospital. The research method uses quantitative research with a case control approach. The independent variables of the study were characteristics (mother's age, age of marriage, education, occupation, parity), history of contraceptive use, length of use of contraception. While the dependent variable is the incidence of cervical cancer. The research data uses secondary data from 2020-2022 and is collected using data extract sheets. After the data was collected, it was analyzed using univariate, bivariate using chi square and multivariate using logistic regression. The results of the study found that the risk factor for cervical cancer was young marriage (AOR: 4.9, 95% CI 2.04-11.8). Then history of use of hormonal contraception (AOR: 3.01, 95% 1.3-6.9). In conclusion, there are 2 risk factors for cervical cancer at Kertha Usada General Hospital, namely young age of marriage and use of hormonal contraception.

Characteristics and prognosis of young breast cancer patients treated in a public comprehensive cancer centre in Brazil: A retrospective cohort study

BackgroundThe incidence of breast cancer among women under 41 years old varies worldwide, with higher rates observed in developing countries. These young women often face later-stage diagnoses. In this study, we examine a cohort of young women who were treated for breast cancer in São Paulo, Brazil. MethodsWe conducted a retrospective cohort study involving women under 41 years old. Our objective was to describe patient and treatment characteristics, with the main outcomes being overall and disease-free survival. Our analysis explored the associations between age of menarche, history of breastfeeding, use of hormonal contraceptives, and age at diagnosis. ResultsOur study included 493 patients with a mean follow-up of 62.8 months. The mean age of the patients was 34.6 (SD=4.19). Of the patients, 68% presented with locally advanced disease, and 19.27% were metastatic at the time of diagnosis. We observed significant associations between age of menarche and age at diagnosis (p = 0.0096), as well as age at diagnosis and breastfeeding (p = 0.0232). Chemotherapy was administered to 92.91% of the patients as part of their treatment, while 27.2% were eligible for breast-conserving surgery. During the follow-up period, 153 patients died, with disease progression being the cause of death in 73.2% of cases. The median survival time for the entire cohort is still under review, while the metastatic patients at diagnosis had a median survival time of 28.64 months (95%CI 20.21–40.89). ConclusionOur findings highlight significant associations between late-stage diagnosis and overall and disease-free survival in this patient age group. Given that the majority of patients present with locally advanced breast cancer, it is crucial to implement strategies that promote early-stage diagnosis and improve survival rates.

Social-psychological determinants of hormonal contraceptive use intentions among adolescent girls in the Bono East Region of Ghana.

The correct and consistent use of hormonal contraceptive (HC) methods by sexually active adolescent girls can prevent pregnancy and avert the health and social consequences of unwanted pregnancy for both the mother and her child. Despite these benefits, research shows that HC use is rather low among adolescent girls globally and especially among those in low and middle-income countries. This study was carried out to assess the social-psychological determinants of HC use intentions among adolescent girls and young women. A cross-sectional survey was conducted among 1,203 young women aged 15-24 years from 70 communities within the Kintampo North Municipality and Kintampo South District in the Bono-East Region of Ghana from April 2021 to September 2021. Multiple linear regression analysis was used to identify factors associated with the intention to use HC among the entire sample of 1,203 respondents and among two sub-samples of young women based on HC use experience. Attitude toward personal HC use (β = 0.268; p < 0.001), self-efficacy toward access and use of HC (β = 0.341; p < 0.001), and HC use experience (β = 0.647; p < 0.001) were found to be significant and unique correlates of HC use intention among the entire sample of adolescent girls. Attitude toward personal HC use and self-efficacy toward access and use of HC were also associated with HC use intention in the two sub samples significantly (p's < 0.001). In addition, among participants with no HC experience, being a Christian as opposed to participants that affiliate themselves with Islam, Traditional religion or being non-religious positively predicts future HC use (β = 0.230; p < 0.01). Our results demonstrate that different groups of adolescent girls need different interventions, focusing on different determinants for the motivation to use HC. Comprehensive sexuality education, informing all adolescent girls about the personal benefits of HC use and enhancing their skills in accessing and using HCs, can support their HC use intentions to promote their reproductive health and general wellbeing.

Robotic Left Hepatectomy for Hemorrhagic Hepatocellular Adenoma: The Role of Robotic Surgery in a Semi-Acute Setting.

Hepatocellular adenomas are benign liver tumors, more frequently seen in young women with a history of long-standing use of estrogenic hormonal contraception. An acute rupture of these adenomas can be the first sign of symptoms; however, they can be life-threatening. The definitive management of hepatic adenoma is liver resection for those larger than 4cm as this cutoff size is known to be associated with an exponential risk of harboring malignancy and an increased risk for intratumor bleeding. Once intratumor hemorrhage occurs however, the management of hepatic adenoma becomes much more timely critical. In this study, we describe the use of robotic liver resection for the management of hemorrhagic hepatocellular adenoma in a semi-acute setting. We also include a series of robotic hepatic adenoma resection completed in our hepatobiliary program since 2016, which demonstrated the safety, feasibility, and reproducibility of robotic technique in treating hepatic adenoma.

Influence of Two Kinds of Combined Oral Contraceptives on Some Red Blood Cell (RBC) Parameters in Women Attending Family Planning Unit in University of Port Harcourt Teaching Hospital

Background: The use of hormonal contraceptives is on the increase among women of reproductive age in Nigeria. In this study effort was made to examine the influence of combined oral contraceptives on some Red blood cell (RBC) parameters in women attending family planning unit. Materials and Methods: Data for this study were obtained through questionnaire administered on one hundred and twenty (120) respondents who were randomly purposively selected. The subjects blood samples were collected and analysed using appropriate techniques. One way ANOVA was adopted as statistical analysis method for the study. Results and Discussions: It was observed that while combined oral contraceptives therapy caused reduction in MCV value, MCHC was significantly raised. The significant increase in haematocrit value coupled with con-comitant reduction in haemoglobin concentration in circulation as reported by this study is of great advantage in terms of oxygen carrying and delivery capacity of red blood cells and maintenance of normal function in individuals. Conclusion: The combined oral contraceptives does not show the capacity of inducing anaemia in users.

Complex questions about combined hormonal contraception: A review

Combined oral contraceptives (COCs) containing synthetic analogs of sex steroids are considered the most effective and popular method of contraception worldwide. The low rate of hormonal contraceptive use is often because of the fear of side effects due to existing myths. Complex questions that most often arise among doctors and patients when choosing COCs include the risk of thrombosis and cancer, the effect on fertility after the use of COCs, the use of COCs in patients with COVID-19, etc. COCs are highly effective, well-studied, and pose minimal risks that are well understood, described in the labels, and can be avoided with proper use.