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PubMed1977

Altered plasma-lipids associated with oral contraceptive or oestrogen consumption. The Lipid Research Clinic Program.

Mean plasma cholesterol and triglyceride concentrations were measured in White female users and non-users of oral contraceptives and oestrogens in 10 diverse, demographically defined North American populations. About 50% of the younger women (20-24 years old) were taking oral contraceptives. In these women mean triglyceride concentrations were up to 48% higher and mean cholesterol concentrations were about 5% higher than in non-users. The 95% percentile of the total lipid distribution among non-users was used to define hyperlipidaemia. In young women on oral contraceptives hypercholesterolaemia was up to three times more common and hypertriglyceridaemia was up to five times more common than in non-users. 37% of older women (50-54 years) (presumably intramenopausal and postmenopausal) were hormone users, and in this group there were small, inconsistent alterations in plasma-triglyceride and a modest but consistent reduction in mean cholesterol concentration.

Adolescent↗
PubMed1989

Plasma reduced and total ascorbic acid in healthy women: effects of smoking and oral contraception.

This is the first report of both reduced (RAA) and total (TAA) plasma ascorbic acid levels in women who smoke and are on oral contraception. 155 normal healthy subjects were investigated. A study questionnaire was completed including age, method of contraception, smoking status, and food intake at breakfast, prior to attending the clinic. Biochemical assays were promptly carried out without knowledge of subject's clinical or dietary status. One-way analysis of variance revealed that oral contraception per se, barrier or IUD methods have no effect on plasma ascorbic acid levels. The mean values (mg/dl +/- SD) for plasma RAA between smokers and nonsmokers were 0.512 +/- 0.241 and 0.601 +/- 0.263; and that for TAA were 0.565 +/- 0.232 and 0.682 +/- 0.231, respectively. Significant decreases in both plasma RAA (p less than 0.05) and TAA levels (p less than 0.001) were observed in smokers. Age was an interacting variable. No association of smoking or oral contraceptive use was seen with RAA or TAA levels among women less than 26 years, but decreases in both RAA and TAA levels were evident among smokers aged 26 years or older. The present study emphasizes the total exposure to smoking, e.g., pack years, is a significant confounding variable in the study of plasma ascorbic acid levels.

Adolescent↗
PubMed2002

A male genital tract-specific carbohydrate epitope on human CD52: implications for immunocontraception.

The identification of unique sperm surface epitopes that are not expressed or exposed in the female reproductive tract is a key element in the development of antibody-based contraceptives. Western blotting and immunohistochemistry were performed to define the tissue distribution of the S19 epitope, which has been proposed as a target for immunocontraception. S19 is an IgG1 murine monoclonal antibody (mAb) directed to an N-linked carbohydrate epitope on a 15-25 kDa glycoprotein, sperm agglutination antigen-1 (SAGA-1), containing a peptide core identical to that of the lymphocytic surface protein CD52. In this study, the S19 epitope was shown to be absent from human lymphocytes, demonstrating a distinction between this epitope and the CAMPATH epitope that is recognized by an antibody against the terminal tripeptide and GPI-anchor of CD52. Further tissue specificity analysis identified the S19 epitope in the epithelium of the human epididymis and vas deferens, as well as on both epididymal and ejaculated spermatozoa. In contrast, the S19 epitope was absent in the five human female reproductive tract and 18 other somatic tissues tested. These results support the use of the S19 epitope as a contraceptive immunogen and the suitability of the S19 mAb as an intravaginal contraceptive. To test the agglutinating activity of the S19 mAb in a formulation designed for vaginal use, S19 mAb were bound to the surface of Novasomes, a multilamellar liposome delivery vehicle. S19-Novasome formulations agglutinated human spermatozoa and were as effective as unbound S19 mAb, demonstrating the feasibility of spermistatic contraceptives targeted to the male reproductive tract specific carbohydrate epitope.

Antibodies, Monoclonal↗
PubMed1994

Analysis of polymorphic variation in drug metabolism: III. Glucuronidation and sulfation of diflunisal in man.

The urinary excretion of diflunisal (D) and its metabolites diflunisal sulfate (DS), diflunisal phenolic glucuronide (DPG), and diflunisal acyl glucuronide (DAG) were measured in 110 healthy, drug-free Caucasian volunteers given 50 mg of diflunisal by mouth. When expressed as fractional recoveries, DS, DPG, and DAG were strongly negatively correlated with one another. Metabolic ratios, on the other hand, correlated positively and tended to localize variability within a single enzyme pathway. Thus, females using estrogen-containing oral contraceptives were shown to excrete 50% less DS and 20% more DAG than non-users, and recoveries of DS were reduced by about 30% in cigarette smokers. Kernel density analyses of the log metabolic ratios of DS and DPG were broad-based and unimodal. However, kernel density estimates of the distribution of log metabolic ratios of DAG showed 3 peaks, 1 of which (an extensive metabolizer polymorph) could be removed by excluding contraceptive-using females. Similarly, there were 2 poor metabolizer peaks in the distribution of log metabolic ratios of DS attributable to cigarette smoking and, in females, use of an oral contraceptive. Thus, we conclude that the metabolism of diflunisal is altered by cigarette smoking and oral contraceptives, and that kernel density estimation, as applied to log metabolic ratios, is a sensitive and specific method for detection of polymorphic variation in drug metabolism.

Adolescent↗
PubMed2004

Fertility trend and pattern in a rural area of South Africa in the context of HIV/AIDS.

Little is known about the dynamics of fertility transition in South Africa, though recent studies have begun to shed light on demographic changes in the country. This study presents trends and patterns of fertility observed in a rural South African population. Various demographic and statistical techniques were used to examine fertility patterns in a population of 21,847 women in a rural KwaZulu-Natal (KZN) demographic surveillance area. These are compared with patterns seen in another South African rural population under demographic surveillance, and with data from the 1998 South Africa Demographic and Health Survey. Findings are interpreted in light of contraceptive use patterns and HIV prevalence in the population. In South Africa, the end of the fertility transition is now in sight. In rural KZN, where national fertility levels are highest, fertility has declined rapidly for about two decades and would have reached below replacement level in 2003. While fertility has declined rapidly among all women over age 18 years, fertility levels among adolescents have not changed in decades. Although most adolescents in rural KZN were sexually active (60%), few had ever used contraception (200%). High HIV seroprevalence appears to explain a small part of the fertility decline (12%); however, this effect is likely to grow in the near future as the HIV/AIDS epidemic continues in South Africa. If the current trends continue in the future, below replacement fertility, together with high mortality due to AIDS, it could soon lead to negative natural population growth in rural South Africa.

Adolescent↗
PubMed2002

Venous thromboembolism in the Chinese population--experience in a regional hospital in Hong Kong.

OBJECTIVE: To estimate the incidence and determine the characteristic features of venous thromboembolism in the Hong Kong Chinese population. DESIGN: Retrospective study. SETTING: Regional hospital, Hong Kong. SUBJECTS AND METHODS: Data were collected during a period of four years (1997-2000). Patients with duplex doppler ultrasonography or venography-documented venous thromboembolism and new episodes of deep vein thrombosis were identified from Department of Diagnostic Radiology records. Patients with high-probability ventilation-perfusion scans were identified from Department of Nuclear Medicine records and these scans were taken as evidence of pulmonary embolism. Patients with intermediate-probability ventilation-perfusion scans, with pulmonary embolism documented by either pulmonary angiography or spiral computed tomography scan, were also included in the study. Patients with autopsy-verified fatal pulmonary embolism were identified from Department of Pathology records. Patients with deep vein thrombosis at other sites were sought from patient discharge diagnostic coding data. Medical records were reviewed for patient characteristics and conditions associated with the development of venous thromboembolism. RESULTS: Three hundred and seventy-six Chinese patients had venous thromboembolism during the study period. Of these, 352 had peripheral deep vein thrombosis, five had deep vein thrombosis at other sites (cerebral sinus and portal vein thrombosis), 40 had pulmonary embolism (26 had concomitant deep vein thrombosis), and six had fatal pulmonary embolism shown at autopsy. CONCLUSION: The calculated annual incidence of venous thromboembolism in Hong Kong Chinese people was estimated at 16.6 events per 100,000 population, which is lower than incidence rates reported in Caucasians. The four conditions most commonly associated with venous thromboembolism were medical illness, malignancy, orthopaedic surgery, and intravenous drug use. Conditions associated with venous thromboembolism in patients younger than 45 years included intravenous drug use, thrombophilia, pregnancy, and the use of oral contraceptives.

Adult↗
PubMed1989

Oral contraceptives and breast cancer: results from an expanded case-control study.

The relationship between oral contraceptives and breast cancer was evaluated among 2,022 cases and 2,183 controls participating in a multicentre breast cancer screening programme. Ever use of oral contraceptives was not related to breast cancer risk (RR = 1.0, 95% CI 0.9-1.2), and no overall patterns of increasing or decreasing risks were observed according to the duration of use, or time since first or most recent use. Although we had no women with extended periods of oral contraceptive use early in life, no evidence of adverse effects attributable to short-term use before age 25, before first live birth or during the perimenopausal period were observed. Further, oral contraceptives did not interact with other breast cancer risk factors, except among those with a history of two or more breast biopsies (RR = 2.0). Analyses by stage of disease revealed that risk was related to the duration of oral contraceptive use: greater than or equal to 5 years use was associated with reduced risk for in situ cancer (RR = 0.59) and increased risks for invasive cancers (RR = 1.5 and 1.4 respectively for small and large lesions). These data suggest that oral contraceptive effects may vary by stage of disease, but provide no overall evidence of an association between oral contraceptives and breast cancer.

Adult↗
PubMed1989

Oral contraceptive use and premenopausal breast cancer in Sweden and Norway: possible effects of different pattern of use.

Different use of oral contraceptives (OCs) in relation to reproductive histories and age might explain the conflicting results found in studies from different countries of OC use and premenopausal breast cancer. A population-based case-control study in Sweden and Norway has been analysed separately for the two countries. The study consists of 317 Swedish and 105 Norwegian cases diagnosed 1984-1985 with 317 Swedish and 210 Norwegian controls. The results for each country separately are consistent with the joint analysis showing increased risk for breast cancer with increased duration of OC use with the exception of that for women with more than 15 years since first use. The relative risk of breast cancer for more than four years of use among Norwegian women was 0.6 (95% confidence internal (Cl), 0.2-1.8). In both countries there was a non-significant higher risk associated with increasing duration of use before first full-term pregnancy. Analyses for surveillance bias show no evidence of bias as explanation for the association between total duration of OC use and breast cancer.

Adult↗
PubMed1983

Desogestrel, a new progestational compound, and the liver.

The short- and long-term effects on the liver of oral contraceptive preparations containing the new progestational compound 13-ethyl-11-methylene-18,19-dinor-17 alpha-pregn-4-en-20-yn-17-ol (desogestrel) and ethinylestradiol (EE) were studied in multicentre efficacy trials. The following combinations (desogestrel/EE content per daily tablet in micrograms) were investigated: 150/30, 125/50, 100/50 and 75/50, to be taken once daily for 21 days, and a normophasic preparation containing 7 tablets with 50 micrograms EE and 15 tablets containing 125 micrograms desogestrel and 50 micrograms EE. Liver function parameters (SGOT, SGPT, alkaline phosphatase and total bilirubin) were monitored in the serum of 1856 women for periods of up to 36 treatment cycles. The incidence of values (single and combined) above the upper normal limits before treatment was 3.3%. A combination of values above upper normal limits before treatment was observed in 31 women (1.6%). In practically all cases values normalized during treatment; no deterioration was observed. During treatment a combination of values above the upper normal limits was observed in 30 women (having normal pretreatment values); they were distributed over the various preparations and unrelated to the period of contraceptive treatment. The values normalized in the majority of women during the course of treatment. This study shows that with oral contraceptive combinations containing desogestrel and EE (30 or 50 micrograms) liver function is not affected.

Contraceptives, Oral, Combined↗
PubMed1991

Prevalence of smoking and oral contraception in a sample of Danish young women.

A representative sample of 286 Danish females aged 16-20 years were interviewed during the period April 1984--February 1985. The response rate was 75%. Both use of oral contraception (OC) and smoking were common; 46.6% used OC, 34.2% smoked and 19.6% combined smoking and OC. The prevalence of smoking was significantly higher (42.0%) among OC-users than among non-users (27.2%). The combination of smoking and OC was especially prevalent among young women with sexual debut before 16 years (36.8%). The association between smoking and the use of OC was significant both when tested unstratified (p less than 0.05) and stratified by age at sexual debut (p less than 0.01). Smoking was also associated with early debut of intercourse (p less than 0.001). It has been reported that the combination of these two factors in adult women increase the risk for cardiovascular mortality. However, the health consequences later in life of combining smoking and OC at young ages have not been illuminated in the literature. These findings indicate the necessity for prospective studies of young women.

Adolescent↗
PubMed1989

Sexual behavior, contraception and unintended pregnancy among young females.

Information about contraceptive usage and sexual experiences was sampled in 1985-86 from 16-20-year-old Danish females admitted for legally induced abortion on Funen (N = 140). In attempts to elucidate the causal relations behind undesired pregnancy among teenagers, data were in the present context compared with answers to the same questions from a representative Danish sample of sexually experienced, non-pregnant females of the same age (N = 201). Of the reference sample, 83.6% were using contraceptives at the time of the interview--mostly oral contraceptives (O.C.). Of the abortion sample, 90.7% said they had used contraception earlier in their reproductive life. Approximately one third conceived in spite of contraception (most frequently the condoms). O.C. was the contraceptive method used most recently (by 43.6%). Thus, a pause in an effective contraceptive often precedes an unintended pregnancy, pointing to the need for follow-up counselling when O.C. is prescribed to teenagers. Only the minority could state the total number of times they had experienced sexual intercourse. Significantly more females in the abortion sample were in an alliance with a male partner with whom they had regular sexual intercourse. However, they also reported a higher average number of different sexual partners, indicating an association between changing sexual relationships and undesired pregnancy. In the abortion sample significantly more pregnancies prior to the index pregnancy were reported during a corresponding period of risk of conception lasting only a few years. Taking the widespread use of contraception into account, it is possible that an increased fecundity might be a co-factor behind unsuccessful contraception.

Adolescent↗
PubMed1987

Contrasting diet and body mass among users and nonusers of oral contraceptives and exogenous estrogens: the Lipid Research Clinics Program Prevalence Study.

Mean dietary constituent levels using the 24-hour recall method and body mass measures were examined among oral contraceptive and exogenous estrogen users and nonusers in the Lipid Research Clinics Program Prevalence Study. Among women aged 20-44 years, oral contraceptive users had a significantly lower mean Quetelet index of body mass and triceps skinfold thickness and a significantly higher total caloric intake. Among women aged 45-69 years, those taking exogenous estrogens had a significantly lower mean Quetelet index. No significant differences between hormone users and nonusers were seen for per cent of calories from fat (saturated or unsaturated), protein, carbohydrates, starch, sucrose, or alcohol. The higher total caloric intake in oral contraceptive users in contrast to nonusers and the lower body mass in both groups of gonadal hormone users may in part be indicative of other differences in life-style and behavior between the study groups. Further documentation of specific eating patterns, nutrient intake, and energy metabolism in women consuming gonadal hormones and in suitable control subjects seems to be indicated.

Adult↗
PubMed1988

Lack of impairment of fluocortolone disposition in oral contraceptive users.

Seven healthy women chronically (greater than 6 months) treated with oral contraceptives and 7 age- and weight-matched female controls were studied. Each subject was given 20 mg fluocortolone orally and the plasma concentrations of total and unbound fluocortolone in multiple samples obtained during the following 24 h were determined by HPLC and equilibrium dialysis. In the subjects on oral contraceptives there was no significant change in total clearance, unbound clearance or volume of distribution at steady-state of total and unbound fluocortolone, but there was a significant increase in hydrocortisone concentration compared to the control subjects. It appears that the elimination of the synthetic corticoid fluocortolone was not impaired by chronic administration of contraceptive steroids.

Adult↗
PubMed1984

A case-control study of oral contraceptive use and breast cancer.

Among 989 cases of breast cancer and 9,890 controls selected from a cohort of married, female registered nurses aged 30-55 years, the relative risk (RR) of breast cancer for women who had ever used oral contraceptives (OC) compared with those who had never used them was 1.0, with 95% confidence limits 0.9-1.2. Among OC users, there was no consistent pattern of excess risk with increasing duration; in fact, the few women who had used OC longest (greater than 10 yr) had a slightly lower risk than never-users. Moreover, there was no association between OC use and breast cancer among women with a positive history of breast cancer in the mother or sister or with OC use before their first pregnancy. The only subgroup of women among whom any adverse effect was apparent was current OC users aged 50-55 years (two onsets expected vs. seven observed). This finding is consistent with earlier reports of an increased risk of breast cancer among older OC users; however, it is also likely to reflect, at least to some extent, the play of chance, since at ages 45-49 and in each younger age group fewer cases than expected were observed among current OC users.

Adult↗
PubMed2003

Women's networks and the social world of fertility behavior.

CONTEXT: Demographic phenomena occur within social contexts and, therefore, should be studied as social processes. However, how to conceptualize and measure the social worlds that individuals inhabit has been the subject of debate. METHODS: Data from a study conducted in Mali in 1996-1997 are used to explore the social networks of Bamanan women and their impact on fertility decisions. Ordinary least-squares and logistic regression techniques are employed to examine the relationship between selected household and social network characteristics and two fertility measures: children ever born and ever-use of contraceptives. RESULTS: Household characteristics do not have a significant effect on either outcome, whereas network attributes do. The more prominently conjugal kin are represented in a network, the fewer children a woman has ever had; however, fertility increases if the husband or unrelated older women are part of the network. Ever-use of contraceptives is elevated if the woman participates in a credit scheme, and rises as the proportion of network members located outside the village increases; it declines sharply as the proportion of network members who are conjugal kin increases, and is significantly elevated if the woman's mother is present. Network effects on fertility are much more pronounced for women aged 30 or older than for younger women, and network effects on contraceptive use are markedly different for younger and older women. CONCLUSIONS: Programs should consider not only women's individual and household characteristics, but also their larger social networks. Additionally, programs should be designed for specific age-groups, given the different network effects on older and younger women.

Adolescent↗
PubMed1977

Levels of reliability in fertility survey data.

A number of factual and attitudinal questions asked in the 1973 Taiwan KAP-4 survey were repeated in a postenumeration survey one month later in order to assess the reliability of responses of the 286 women reinterviewed. The level of reliability is found to vary depending on the measures used and on whether the focus is aggregate data or individual responses. Analysis of consistency of responses shows that while overall reliability at both aggregate and individual levels is reasonably good, there is greater reliability for factual than for attitudinal data. Nevertheless, consistency of responses on factual questions varies considerably depending on the salience of the topic to the respondent. Estimates of reliability are shown to depend on the measure used and on the skewness of the distributions of the responses.

Contraception↗
PubMed1985

The number and distribution of benign pigmented moles (melanocytic naevi) in a healthy British population.

Total body mole counts have been performed on 432 normal healthy Caucasian subjects aged 4 days to 96 years (204 males and 228 females). The mean total body mole count in the first decade of life is three for females and two for males, rising rapidly in the second decade to a mean of 23 for females and 18 for males. In the third decade numbers are highest, with a mean of 33 for females and 22 for males. Thereafter, numbers of moles slowly drop until in the eighth decade they have fallen to levels similar to those seen in pre-pubertal children. There is a significant association between the presence of naevi in early childhood (prior to 5 years of age) and the development in later life of large numbers of moles. In women there is no significant association between total mole counts and either parity or use of the oral contraceptive.

Adolescent↗