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At least 19 recordsLinked to original sources

Hormonal oral contraceptives, urinary porphyrin excretion and porphyrias.

The influence of hormonal oral contraceptives on the urinary porphyrin excretion of 40 healthy females has been studied. Two different hormonal oral contraceptives (combinations of gestoden or desogestrel, respectively, and ethinylestradiol) were applied for half a year. In each case twenty women received one of these two combinations. Porphyrin precursors delta-aminolevulinic acid and porphobilinogen were normal in all subjects as well as the mean of uroporphyrin and coproporphyrin. One healthy female developed a mild secondary coproporphyrinuria. In this case coproporphyrin isomer I was slightly enhanced and isomer III slightly lowered. Furthermore it could be shown that three females with repeated premenstrual clinical expression of an acute hepatic porphyria (acute intermittent porphyria and hereditary coproporphyria) could be treated successfully with a hormonal oral contraceptive or other exogenous hormones to stabilize the latent, subclinical phase of the disease.

Adult↗

Oral contraceptives, hormone replacement therapy, thrombophilias and risk of venous thromboembolism: a systematic review. The Thrombosis: Risk and Economic Assessment of Thrombophilia Screening (TREATS) Study.

Combined oral contraceptives, oral hormone replacement therapy and thrombophilias are recognised risk factors for venous thromboembolism in women. The objective of this study was to assess the risk of thromboembolism among women with thrombophilia who are taking oral contraceptives or hormone replacement therapy, conducting a systematic review and metaanalysis. Of 201 studies identified, only nine met the inclusion criteria. Seven studies included pre-menopausal women on oral contraceptives and two studies included peri-menopausal women on hormone replacement therapy. For oral contraceptive use, significant associations of the risk of venous thromboembolism were found in women with factor V Leiden (OR 15.62; 95%CI 8.66 to 28.15); deficiencies of antithrombin (OR 12.60; 95%CI 1.37 to 115.79), protein C (OR 6.33; 95%CI 1.68 to 23.87), or protein S (OR 4.88; 95%CI 1.39 to 17.10), elevated levels of factor VIIIc (OR 8.80; 95%CI 4.13 to 18.75); and factor V Leiden and prothrombin G20210A (OR 7.85; 95%CI 1.65 to 37.41). For hormone replacement therapy, a significant association was found in women with factor V Leiden (OR 13.16; 95%CI 4.28 to 40.47). Although limited by the small number of studies, the findings of this study support the presence of interaction between thrombophilia and venous thromboembolism among women taking oral contraceptives. However, further studies are required to establish with greater confidence the associations of these, and other, thrombophilias with venous thromboembolism among hormone users.

Adult↗

[Oral hormonal contraception: more or less estrogens?].

The availability of desogestrel with two doses of estrogen, makes a more elastic use in a number of situations in different users. In the author's experience, some preferences are mentioned. Use 20 mcg: a) in adolescents without acne; b) in thin users, less than 60 Kg. weight; c) in those with a large bosom and heavy cyclic bleedings; d) in obese patients, who have reached their ideal weight; e) in those women over 35 years or close to menopause and in those soon after menopause, if they are asymptomatic. Use 30 mcg: a) in adolescents with acne; b) in patients with a small or flat bosom and with scanty cyclic bleedings; c) in those heavier than 60 Kg. d) in obese patients on reducing treatment until they reach their ideal weight.

Contraceptives, Oral, Hormonal↗

[Contraceptive methods and adequacy of hormonal oral contraceptive use in the city of Pelotas, Rio Grande do Sul, Brazil: 1992-1999].

A cross-sectional study was conducted to assess contraceptive methods and the adequacy of oral contraceptive use by women aged 20 to 49 years in the city of Pelotas. The results were compared with another cross-sectional study performed in 1992. A sample was randomly selected, including 766 women aged 20 to 49 years. Some 495 of the sample (64.6%) used a contraceptive method, in the following order: oral contraceptives (55.4%), surgical sterilization (22.2%), condoms (10,5%), and IUD (7.7%). Among users of oral contraceptives, 62 (22.2%) had some contraindication. Incorrect use of contraceptive methods was associated with age but not with socioeconomic status. As compared to the previous study, there was a reduction in the use of oral contraceptives. Meanwhile, other methods such as surgical sterilization, condoms, and IUD were used more frequently than in 1992.

Adult↗

Oral contraceptives, hormone replacement therapy and thrombosis.

Oral contraceptives and hormone replacement therapy are used by hundreds of millions of women worldwide. Since the early 1960s it is known that female hormones increase the risk of venous thrombosis, myocardial infarction and stroke. This risk is still present with current low-dose oral contraceptives and, even though in absolute terms the risk is small, oral contraceptives form the major cause of thrombotic disease in young women. The risk is higher during the first year of use (up to I per 1000 per year), with the use of desogestrel- or gestodene-containing oral contraceptives ("third generation progestogens") and among women with a prothrombotic predispositon. Hormone replacement therapy increases the risk of venous thrombosis, while results of randomised trials so far do not substantiate the expectation of a beneficial effect on the risk of arterial cardiovascular disease. First results are emerging that specific subgroups of women, with prothrombotic or other abnormalities, may be at risk, especially during the first years of use of hormone substitution.

Clinical Trials as Topic↗

[Evolution of antithrombin activity and plasma fibrinogen levels and of hematologic values among women in child-bearing age on treatment with the new hormonal oral contraceptives].

OBJECTIVE: To study the evolution of antithrombin (AT) and plasma fibrinogen levels and of hematologic values among women in child-bearing age on treatment with the new hormonal oral contraceptives (HOC): in microdose, ultramicrodose and Diane-35. METHOD: Retrospective review of 100 randomized cases out of a total registry of 1,245 clinical records. RESULTS: The mean age in our series was 23.4 years (range: 18-39 years). The mean study time was 3.3 years (range: 1-5 years). During the study period, there was not a single woman with an AT lower than 70%. There were no significant changes at the end of the study period regarding AT, plasma fibrinogen, hematocrit, hemoglobin, prothrombin activity and activated partial thromboplastin time. A significant decrease was observed for platelet count (246,113 5,842 vs. 215,636 4,383 platelets/mm3; p = 0.003). There was not a single case of thrombocytopenia registered. No relevant differences were observed between the treatment groups with microdosaged, ultramicrodosaged and Diane-35. CONCLUSIONS: At mid-term (3.3 years), the new HOC (in microdose, ultramicrodose and Diane-35), do not cause significant changes in AT, plasma fibrinogen, hematocrit, hemoglobin, prothrombin activity and activated partial thromboplastin time. In our series, a moderate but significant decrease in the platelet count was observed but there were no cases of thrombocytopenia. The effect of the different new HOC on the studied parameters was similar.

Adult↗

[Liver tumors in women using oral hormonal contraceptives].

The association between the use of oral contraceptives and the induction of liver tumors was first discussed by Baum et al. in 1973 [4]. Since the introduction of the pill a slight increase in the incidence of benign liver tumors has been found. In recent studies this could not be shown for liver cell carcinomas. In the world literature (1971-1994) 637 cases of patients with liver tumors who had taken oral contraceptives at any time of their lives have been reported. 233 liver cell adenomas, 210 focal nodular hyperplasia and 194 liver carcinomas were found. The incidence of liver tumors was not influenced by the type of progestin used.

Adenoma, Liver Cell↗

Oral contraceptive hormones, folate metabolism, and the cervical epithelium.

The currently available evidence concerning disorders of folate metabolism in women taking oral contraceptives has been reviewed. A disturbance in folate balance serious enough to cause symptoms (i.e., megaloblastic anemia) occurs very rarely. In some series, but not in others, serum and/or red cell folate concentrations have been reduced in oral contraceptive users. It is doubtful whether sex steroids affect polyglutamate folate absorption. About 20 percent of women taking contraceptive hormones manifest mild megaloblastic changes on Papanicolaou smears of the cervicovaginal epithelium which disappear after folic acid therapy. The current evidence, however, would not indicate that any significant benefit would ensue from routine folate supplementation in women on oral contraceptives.

Anemia, Megaloblastic↗

The acceptability of combined oral hormonal contraceptives in Shanghai, People's Republic of China.

Although combined oral hormonal contraceptives have been described as the most significant medical advance of the 20th century, the usage rate in the People's Republic of China is considerably lower than in developed countries. This survey aimed to explore the acceptability of combined oral hormonal contraceptives (COC) amongst women aged 18-35 years who attended the family planning clinic in the International Peace Maternity and Child Health Hospital in Shanghai, as well as amongst gynecologists who worked in the same hospital. In total, 500 clients and 89 gynecologists were recruited. Only 12% of the clients had ever used COC. Women with a lower educational level or parous women were more likely to use COC (p < 0.05). COC was the third most popular method recommended by the gynecologists (85.4%). Both groups were concerned about the risks and side effects of COC, especially younger doctors and doctors with fewer years of experience (p < 0.01). The results of the survey suggest that it is necessary to provide improved training about COC to reproductive-aged women and professionals to dispel misunderstandings of the pill.

Adolescent↗

Modification of active cutaneous vasodilation by oral contraceptive hormones.

It is not clear whether the altered thermoregulatory reflex control of the cutaneous circulation seen among phases of the menstrual cycle also occurs with the synthetic estrogen and progesterone in oral contraceptive pills and whether any such modifications include altered control of the cutaneous active vasodilator system. To address these questions, we conducted controlled whole body heating experiments in seven women at the end of the third week of hormone pills (HH) and at the end of the week of placebo/no pills (LH). A water-perfused suit was used to control body temperature. Laser Doppler flowmetry was used to monitor cutaneous blood flow at a control site and at a site at which noradrenergic vasoconstrictor control had been eliminated by iontophoresis of bretylium (BT), isolating the active cutaneous vasodilator system. The oral temperature (Tor) thresholds for cutaneous vasodilation were higher in HH at both control [37.09 +/- 0.12 vs. 36.83 +/- 0.07 degrees C (LH), P < 0.01] and BT-treated [37. 19 +/- 0.05 vs. 36.88 +/- 0.12 degrees C (LH), P < 0.01] sites. The Tor threshold for sweating was similarly shifted (HH: 37.15 +/- 0.11 degrees C vs. LH: 36.94 +/- 0.11 degrees C, P < 0.01). A rightward shift in the relationship of heart rate to Tor was seen in HH. The sensitivities (slopes of the responses vs. Tor) did not differ statistically between phases. The similar threshold shifts at control and BT-treated sites suggest that the hormones shift the function of the active vasodilator system to higher internal temperatures. The similarity of the shifts among thermoregulatory effectors suggests a centrally mediated action of these hormones.

Adult↗

First time issue of oral hormonal contraception by nurses.

This study aimed to assess whether introducing the issue of first time oral hormonal contraception by nurses could expand the role of the family planning nurse and improve the service to the client group. Nurse acceptability of, and adherence to, the protocol were examined. Results indicate that with appropriate training the first time issue of oral hormonal contraception is a valuable skill in enhancing the nurses' role, reduces waiting time for clients and is acceptable to clients.

Attitude of Health Personnel↗

[Pharmacology of progestins used in oral hormonal contraceptive preparations].

OBJECTIVE: Review of the pharmacology of progestins used in combined oral contraceptives. DESIGN: Review article. SETTING: Department of Obstetrics and Gynaecology, General Teaching Hospital, Charles University, Prague. CONCLUSION: The author presents a review of pharmacology of progestins used in combined oral contraceptives. He compares important pharmacokinetic and pharmacodynamic properties of different progestins. The paper includes comparison of the influence of progestins on lipids, carbohydrates, steroid transport capacity and coagulation. The different pharmacology of progestins is an important factor in the process of pill selection.

Contraceptives, Oral, Hormonal↗

Cell proliferation in normal human breast ducts, fibroadenomas, and other ductal hyperplasias measured by nuclear labeling with tritiated thymidine. Effects of menstrual phase, age, and oral contraceptive hormones.

The proliferative rates of terminal duct cells were studied by tritiated thymidine labeling in vitro in 104 specimens of benign breast tissue from 92 women, The tritiated thymidine labeling index showed a cyclic pattern consistent with regulation by female sex hormones. It was low during the segment of the menstrual cycle encompassing days 2 through 15 (early cycle) and often was elevated during the segment encompassing days 16 through 1 (late cycle). The early cycle geometric mean index for morphologically normal terminal ducts was 0.19,and for ducts of fibroadenomas it was 0.77. The geomitric means for latecycle were 1.03 and 1.67 respectively. The difference for normal ducts between early and late cycles was highly significant (p less than 0.001). For both normal ducts and fibroadenomas the tritiated thymidine labeling index correlated negatively with the age of the patient, and the higher index value of fibroadenoma ducts relative to normal ducts was entirely accounted for by the younger mean age of the fibroadenoma patients. Oral use of contraceptive hormones could not be shown to change the index in either normal ducts or fibroadenoma ducts. Based on a postulated duration of DNA synthesis of 12 hours, the mean turnover time of the cells of normal terminal ducts would be approximately 22 days for 20 year old women with regular menstrual cycles, and would increase to 147 day at age 40. The mean potential doubling times of fibroadenomas would be approximately 33 days. The index values of other benign ductal proliferative lesions of the breast were similar to those of fibroadenomas and normal terminal ducts.

Adenofibroma↗

A comparative analysis of the modification of sexual desire of users of oral hormonal contraceptives and intrauterine contraceptive devices.

OBJECTIVE: To compare the influence of oral hormonal contraceptives (OCs) and the use of intrauterine contraceptive devices (IUDs) on the modification of sexual desire. MATERIALS AND METHODS: A prospective observational study of 1073 women using OCs or an IUD at the Family Planning Center 'Marina Alta' in Alicante, Spain. In order to evaluate the relative risk regarding the decrease in libido attributed to each contraceptive method, a logistic regression analysis was undertaken which considered the factors of age adjustment, level of studies, family planning information, relationship with partner, age when sexual relationships were initiated, parity, contraceptive method previously used and the duration of use of the contraceptive method. RESULTS: No differences in the decrease of sexual desire were observed between the use of the OC and IUD (odds ratio (OR) 1.32; 95% confidence interval (CI) 0.70-2.49), yet differences were noted, however, in relation to age (OR 1.05; 95% CI 1.01-1.10). Although these differences were not statistically significant, a high level of awareness regarding family planning was shown to increase sexual desire when compared to a lower level of information on this subject (OR 0.64; 95% CI 0.41-1.01). Sexual desire was seen to decrease if the quality of the relationship with the partner was average (OR 2.24; 95% CI 1.36-3.69) or poor (OR 4.69; 95% CI 1.93-11.4). Nulliparous women showed a greater decrease in sexual desire in relation to women who had already given birth (OR 1.57; 95% CI 1.00-2.47). Sexual desire was greater if the contraceptive method had already been in use for 6-12 months (OR 0.41; 95% CI 0.17-0.98). CONCLUSIONS: Sexual desire does not vary in relation to the use of OCs or IUDs, yet it does decrease with age, in nulliparous women and in those with an average or poor relationship with their partner. Furthermore, sexual desire shows an increase between the first 6 and 12 months of contraceptive treatment.

Adolescent↗