The state of hormonal contraception today: benefits and risks of hormonal contraceptives: combined estrogen and progestin contraceptives

SummaryThe risk of thromboembolic events (TE) is increased by acquired or inherited thrombo -philias (IT). We know that some hormonal contraceptives also increase the risk of thrombosis, thus, the use of such contraceptives are discussed as contraindications in women with IT. TEs are infrequent events in children and adolescents and in the majority of cases are associated with secondary complications from underlying chronic illness. Although adolescents are not typically considered to be at high-risk for TE, this cohort is frequently using hormonal contraception, leading to an increased risk in cases with unknown IT. The risk of TE with pregnancy alone is higher than associated with combined hormonal contra -ception. Progestin-only methods have not been found to increase the risk of TE with only moderate changes of coagulation proteins compared to normal reference values. Conclusion: Thrombophilic women are good candidates for progestin-only contraceptive methods.

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Hormonal contraception as a method of social adaptation of women in modern society

GYNECOLOGY ◽

10.26442/20795696.2019.3.190593 ◽

2019 ◽

Vol 21 (3) ◽

pp. 17-21

Author(s):

Tatyana Yu Pestrikova ◽

Elena A Yurasova ◽

Igor V Yurasov ◽

Tamara D Kovaleva

Keyword(s):

Ethinyl Estradiol ◽

Hormonal Contraception ◽

Modern Society ◽

Well Being ◽

Social Adaptation ◽

Female Employment ◽

Hormonal Contraceptives ◽

Aim Analysis ◽

Positive Effects ◽

Chlormadinone Acetate

Relevance. Currently, women make up more than 40% of the global workforce and more than half of students studying at universities around the world. Women's education, especially at a high level, tends to increase female employment. The mismatch of the style and rhythm of modern life with a genetically determined and working millennium reproductive program requires the choice of a specific approach to social adaptation. Aim. Analysis of literary sources on the use of hormonal contraception as a method of social adaptation. Materials and methods. To write this review, domestic and foreign publications were searched in Russian and international search systems (PubMed, eLibrary, etc.) for the last 2-10 years. The review included articles from peer-reviewed literature. Results. The review describes the features of modern hormonal contraceptives. Their non-contraceptive effects are presented. The individual non-contraceptive effects of a combined oral contraceptive containing 30 mg of ethinyl estradiol and 2 mg of chlormadinone acetate were determined. It has been established that the use of this contraceptive helps to improve the well-being and mood of patients, which allows you to actively use this contraceptive in routine clinical practice with premenstrual syndrome, dysmenorrhea, without the use of analgesics. Conclusions. The numerous positive effects of ethinyl estradiol and chlormadinone acetate allow the use of the drug as a means to increase social adaptation, and, consequently, improve the quality of life.

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Market Diffusion of Extended Cycle Hormonal Contraceptives

INNOVATIONS in pharmacy ◽

10.24926/iip.v3i3.271 ◽

2012 ◽

Vol 3 (3) ◽

Author(s):

Megen Leeds Schumacher ◽

Ashley Cetola Pettia ◽

Albert I Wertheimer

Keyword(s):

Hormonal Contraception ◽

Target Population ◽

Hormonal Contraceptive ◽

The United States ◽

Hormonal Contraceptives ◽

Original Research ◽

Main Concern ◽

Novel Approach ◽

Market Diffusion ◽

Extended Cycle

Background: Extended cycle hormonal contraceptives (e.g. Seasonale, Seasonique) when introduced in 2003 were considered a very novel approach to contraception. The idea of manipulating the menstrual cycle so that women would experience just four menstruations a year was radical and was assumed to be responsible for the slow acceptance rate among the general public. Objective: This report analyzes two different aspects of the acceptance of this unique idea in the population. The first was the level of usage of extended cycle hormonal contraceptives in the general population, which was measured by a review of sales figures over time in the United States. The second was an examination of market diffusion as it relates to consumer perceptions regarding the characteristics of these products. Methods: To determine the degree of usage of extended cycle hormonal contraceptives the yearly sales, in terms of units sold, were compared with that of other leading methods of hormonal contraception. Along with the data, survey answers were obtained from 65 women who volunteered to participate in the study. Participants were selected randomly to represent the target population to assess the level of awareness about the benefits, risks, and any other concerns regarding the use of extended cycle hormonal contraceptives. Results: The yearly sales data of units sold showed a definitive increase in the sales of extended cycle hormonal contraceptives since their release on the market. The survey results showed an overwhelming awareness in the study population about the extended regimen. However, only about half of the women in the survey group were aware of its benefits. The main concern reported was the perceived significant side effect profile. Conclusion: Though awareness about the extended cycle hormonal contraception regimen was widespread, the survey population was not well informed about the advantages and the disadvantages regarding the degree of severity of side effects. To address these knowledge deficits, these aspects should be the focus when distributing information about extended cycle hormonal contraceptive regimens. This may boost the use of a potentially advantageous contraceptive regimen by a population who would derive benefit from its usage. Type: Original Research

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Risk Factors of Body Mass Index (BMI), Age of Menarche, Parity and Hormonal Contraception of Genu Osteoarthritis in Female Patients

Folia Medica Indonesiana ◽

10.20473/fmi.v57i2.23029 ◽

2021 ◽

Vol 57 (2) ◽

pp. 104

Author(s):

Alisiya Alisiya ◽

Sulistiawati Sulistiawati ◽

Patricia Maria Kurniawati ◽

RR Indrayuni Lukitra Wardhani

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Hormonal Contraception ◽

Hormonal Contraceptive ◽

Hormonal Contraceptives ◽

Control Group ◽

Case Group ◽

Control Approach ◽

Female Patients ◽

Age Of Menarche

Osteoarthritis (OA) is a degenerative disease related to joint cartilage and commonly occurs in the knee joint. The 2013 National Survey recorded the prevalence of joint diseases in East Java was 26.9%. OA affected more women than men due to the estrogen and caused disabilities in many women. This study aimed to find the relationship between Body Mass Index (BMI), age of menarche, parity, and the use of hormonal contraceptives against OA in genu at Universitas Airlangga Hospital, Surabaya. This was an analytic observational study with a case-control approach. Data collection was carried out through a short interview using a questionnaire. The sample size was calculated using a formula and found that the study required 42 patients with OA in the case group and 42 patients without OA in the control group. The case group was dominated by patients with 56-60 years old age (62.1%), BMI 23-24.9 kg/m2 (58.7%), menarche age 12-13 years (53.6%), multiparous (52.6%), having contraception pill usage history (62.3%) particularly using combination pills (60.5%) with a mean duration of use > 1 year (56.8%). There was a relationship between BMI and type of hormonal contraceptive used against genu OA in female patients at Universitas Airlangga Hospital Surabaya.

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Combined hormonal contraception and risk of venous thromboembolism within the first year following pregnancy

Thrombosis and Haemostasis ◽

10.1160/th13-09-0797 ◽

2014 ◽

Vol 112 (07) ◽

pp. 73-78 ◽

Cited By ~ 1

Author(s):

Thomas Bergholt ◽

Anne Nielsen ◽

Michael J. Paidas ◽

Ellen Christine L. Løkkegaard ◽

Jesper Petersen

Keyword(s):

Venous Thromboembolism ◽

Hormonal Contraception ◽

Hormonal Contraceptives ◽

First Year ◽

The Difference ◽

Combined Hormonal Contraception ◽

One Year ◽

First Time ◽

Combined Hormonal Contraceptives

SummaryEstimating the risk of venous thromboembolism (VTE) associated with combined hormonal contraceptives following early terminated pregnancies or birth, a Danish nationwide retrospective cohort observing a one-year follow-up was defined using three unique registries. All Danish women with confirmed pregnancies aged 15–49 during the period of 1995–2009 were included. The main outcomes were relative and absolute risks of first time venous thromboembolism in users as well as non-users of combined hormonal contraceptives. In 985,569 person-years, 598 venous thromboembolisms were recorded. After early terminated pregnancies and births, respectively, 113 and 485 events occurred in 212,552 and 773,017 person-years. After early terminated pregnancies, the crude VTE incidence ratios were similar, and the numbers needed to harm were equal between groups that did or did not use combined hormonal contraceptives throughout the follow-up year. After childbirth, individuals that used combined hormonal contraceptives were more likely than non-users to experience VTE depicted by crude incidence ratios; however, the difference was only significant after 14 weeks. This implied that the numbers needed to harm were lower for those that used compared to those that did not use combined oral contraceptives in the initial 14 weeks postpartum. In conclusion, the use of combined hormonal contraceptives after early terminated pregnancies was not detrimental, but during the puerperal period, they should be used with caution.

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Oncological issues of hormonal contraception and hormone replacement therapy

Journal of obstetrics and women s diseases ◽

10.17816/jowd95658 ◽

2021 ◽

Vol 50 (4) ◽

pp. 83-89

Author(s):

A. F. Urmancheeva ◽

G. F. Kutusheva

Keyword(s):

Replacement Therapy ◽

Hormone Replacement ◽

Hormonal Contraception ◽

Epidemiological Studies ◽

Hormonal Contraceptives ◽

Ovarian Cancer Risk ◽

Considerable Decrease ◽

Female Population ◽

Clinical Investigations ◽

Oncologic Patients

The article gives critical analysis of numerous epidemiological studies touching upon the problems of carcinogenesis while using hormonal contraception and hormonal replacement therapy and also the expediency of HRT as to oncologic patients after radical treatment.The materials presented testify to relative carcinogenous safety of hormonal contraceptives as to the majority of tumors and even considerable decrease of endometrial and ovarian cancer risk; but some investigations point to the increase о f breast cancer in case о f prolonged application о f hormonal preparations.The results оf the analysis show that HR Tmay be recommended among female population providing active screening, especially of mammary glands and endometrium. Besides that, hormonal preparations are not excluded for rehabilitation of some oncologic patients underthorough monitoring. Yet, there exists burning necessity of continuing cooperated scientific and clinical investigations forfurther studying oncologic aspects of hormonal contraception and HRT.

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0830 Hormonal Contraceptive Use and Sleep: A Systematic Review and Meta-Analysis

SLEEP ◽

10.1093/sleep/zsaa056.826 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A316-A316

Author(s):

A G Bezerra ◽

G Pires ◽

M L Andersen ◽

S Tufik ◽

H Hachul

Keyword(s):

Systematic Review ◽

Effect Size ◽

Full Text ◽

Contraceptive Use ◽

Total Sleep Time ◽

Meta Analysis ◽

Hormonal Contraception ◽

Sleep Time ◽

Hormonal Contraceptives ◽

Bibliographic Search

Abstract Introduction The effects of hormonal contraceptives on sleep has been matter of debate in current literature. While some articles observed a sleep promoting effect and reduced sleep disordered breathing, others have failed to detect any result or even detected a worse sleep pattern in women using hormonal contraception. As the literature has been growing on this field, a systematic review is necessary to gather and compare all the studies in a comprehensive way. Methods A bibliographic search was conducted in Pubmed, Scopus and Web of Science. Studies were selected first based on titles and abstracts, followed by full text analysis and data extraction. Only original studies evaluating women using hormonal contraception were considered eligible. Both objective and subjective sleep-related outcomes were extracted for analyzes. Individual effect size for each articles was calculated using regular or standardized mean differences and meta-analyses were conducted using a DerSimonian and Laird random effects model. Results After the bibliographic search, 1787 non-duplicated articles were included in our initial data screening. Articles sample was reduced to 114 records after abstract screening and to ten studies after full text analyses. The following sleep outcomes were eligible for meta-analysis: Pittsburgh Sleep Quality Index (PSQI - 3 studies), total time in bed (4), subjective total sleep time (4), objective total sleep time (3), sleep latency (6), sleep efficiency (6). None of them resulted in statistically significant effects of contraceptive use and the effect size ± 95% interval of confidence overlapped the zero value. Conclusion Hormonal contraceptives is not associated to any alteration in sleep patterns in women. This conclusion should be restricted to a general framework, since our sample does not allowed stratified analyses. Future studies should consider the effect of specific hormonal composition (ex.: combined vs. progestogen-only contraceptives) and administration route (contraceptive pills vs. levonorgestrel intrauterine device). Support AFIP, CAPES, CNPq

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Non-contraceptive benefits of hormonal contraception

Journal of Prescribing Practice ◽

10.12968/jprp.2019.1.8.394 ◽

2019 ◽

Vol 1 (8) ◽

pp. 394-399

Author(s):

Michelle Cooper ◽

Katie Boog

Keyword(s):

Polycystic Ovary Syndrome ◽

Premenstrual Syndrome ◽

Polycystic Ovary ◽

Hormonal Contraception ◽

Hormonal Contraceptives ◽

Primary Role ◽

Menstrual Pain ◽

Ovary Syndrome ◽

Risk Of Cancer

Beyond their primary role of preventing pregnancy, hormonal contraceptives provide a number of non-contraceptive benefits including a reduction in menstrual pain and bleeding, improvement in acne and a decrease in the lifetime risk of cancer of the ovaries and endometrium. They are also widely used in the management of a number of gynaecological conditions including endometriosis, premenstrual syndrome and polycystic ovary syndrome. Although the risks may outweigh the benefits when a method is used solely for contraception, the risk-benefit profile may change when it is also used for a medical indication. Potential non-contraceptive benefits should be discussed with all women when considering the most appropriate form of contraception to suit their needs.

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Association between contemporary hormonal contraception and ovarian cancer in women of reproductive age in Denmark: prospective, nationwide cohort study

BMJ ◽

10.1136/bmj.k3609 ◽

2018 ◽

pp. k3609 ◽

Cited By ~ 14

Author(s):

Lisa Iversen ◽

Shona Fielding ◽

Øjvind Lidegaard ◽

Lina S Mørch ◽

Charlotte W Skovlund ◽

...

Keyword(s):

Ovarian Cancer ◽

Relative Risk ◽

Hormonal Contraception ◽

Reproductive Age ◽

Hormonal Contraceptives ◽

Ovarian Cancer Risk ◽

Women Of Reproductive Age ◽

Ovarian Cancers ◽

Study Population ◽

Combined Hormonal Contraceptives

AbstractObjectivesTo investigate the association between contemporary combined hormonal contraceptives (including progestogen types in combined preparations and all progestogen-only products) and overall and specific types of ovarian cancer.DesignProspective, nationwide cohort study.SettingDenmark, 1995-2014.ParticipantsAll women aged 15-49 years during 1995-2014 were eligible. Women were excluded if they immigrated after 1995, had cancer (except non-melanoma skin cancer), had venous thrombosis, or were treated for infertility before entry (final study population included 1 879 227 women). Women were categorised as never users (no record of being dispensed hormonal contraception), current or recent users (≤1 year after stopping use), or former users (>1 year after stopping use) of different hormonal contraceptives.Main outcome measuresPoisson regression was used to calculate relative risk of ovarian cancer among users of any contemporary combined hormonal contraceptives and by progestogen type in combined preparations and all progestogen-only products, including non-oral preparations. Separate analyses examined women followed up to their first contraception type switch and those with full contraceptive histories. Duration, time since last use, and tumour histology were examined and the population prevented fraction were calculated.ResultsDuring 21.4 million person years, 1249 incident ovarian cancers occurred. Among ever users of hormonal contraception, 478 ovarian cancers were recorded over 13 344 531 person years. Never users had 771 ovarian cancers during 8 150 250 person years. Compared with never users, reduced risks of ovarian cancer occurred with current or recent use and former use of any hormonal contraception (relative risk 0.58 (95% confidence interval 0.49 to 0.68) and 0.77 (0.66 to 0.91), respectively). Relative risks among current or recent users decreased with increasing duration (from 0.82 (0.59 to 1.12) with ≤1 year use to 0.26 (0.16 to 0.43) with >10 years’ use; P<0.001 for trend). Similar results were achieved among women followed up to their first switch in contraceptive type. Little evidence of major differences in risk estimates by tumour type or progestogen content of combined oral contraceptives was seen. Use of progestogen-only products were not associated with ovarian cancer risk. Among ever users of hormonal contraception, the reduction in the age standardised absolute rate of ovarian cancer was 3.2 per 100 000 person years. Based on the relative risk for the never use versus ever use categories of hormonal contraception (0.66), the population prevented fraction was estimated to be 21%—that is, use of hormonal contraception prevented 21% of ovarian cancers in the study population.ConclusionsUse of contemporary combined hormonal contraceptives is associated with a reduction in ovarian cancer risk in women of reproductive age—an effect related to duration of use, which diminishes after stopping use. These data suggest no protective effect from progestogen-only products.

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