Hormonal Contraception in Women of Older Reproductive Age

2008 ◽  
Vol 358 (12) ◽  
pp. 1262-1270 ◽  
Author(s):  
Andrew M. Kaunitz
Keyword(s):  
Hormonal Contraception ◽  
Reproductive Age

Folate contraception and clinical practice

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 101-107
Author(s):  
Vera N. Prilepskaya ◽  
Lana L. Bostandzhian
Keyword(s):  
Oral Contraceptives ◽  
Hormonal Contraception ◽  
The Body ◽  
Reproductive Age ◽  
Folate Supplementation ◽  
Combined Oral Contraceptives ◽  
Dosage Regimens ◽  
Gynecological Diseases ◽  
Unwanted Pregnancies ◽  
Fetal Malformations

Since the first pill, there has been a significant evolution of hormonal contraception: low- and micro-dose drugs have appeared, drugs with components as close as possible to endogenous hormones have been developed, new dosage regimens and routes of contraceptive administration have been created. Modern combined oral contraceptives are not only used to prevent unwanted pregnancies, but are also widely used to treat a number of gynecological and non-gynecological diseases. In recent years, two new combined oral contraceptives with folate supplementation have been developed. The main purpose of adding folate to contraceptives is the prevention of fetal malformations, which is ensured by an increase in the level of folate in the body of women of reproductive age against the background of contraception and after its withdrawal.

scholarly journals The Impact of the COVID-19 Pandemic on Women’s Reproductive Health

2021 ◽  
Vol 12 ◽  
Author(s):  
Phelan Niamh ◽  
Lucy Ann Behan ◽  
Lisa Owens
Keyword(s):  
Reproductive Health ◽  
Cycle Length ◽  
Home Schooling ◽  
Hormonal Contraception ◽  
Median Number ◽  
Reproductive Age ◽  
Poor Sleep ◽  
Women’S Reproductive Health ◽  
Women's Reproductive Health ◽  
The Impact

BackgroundThe COVID-19 pandemic has profoundly affected the lives of the global population. It is known that periods of stress and psychological distress can affect women’s menstrual cycles. We therefore performed an observational study of women’s reproductive health over the course of the pandemic thus far.Materials and MethodsAn anonymous digital survey was shared by the authors via social media in September 2020. All women of reproductive age were invited to complete the survey.Results1031 women completed the survey. Mean age was 36.7 ± 6.6 years (range, 15–54). 693/70% reported recording their cycles using an app or diary. 233/23% were using hormonal contraception. 441/46% reported a change in their menstrual cycle since the beginning of the pandemic. 483/53% reported worsening premenstrual symptoms, 100/18% reported new menorrhagia (p = 0.003) and 173/30% new dysmenorrhea (p < 0.0001) compared to before the pandemic. 72/9% reported missed periods who not previously missed periods (p = 0.003) and the median number of missed periods was 2 (1–3). 17/21% of those who “occasionally” missed periods pre-pandemic missed periods “often” during pandemic. 467/45% reported a reduced libido. There was no change in the median cycle length (28 days) or days of bleeding (5) but there was a wider variability of cycle length (p = 0.01) and a 1 day median decrease in the minimum (p < 0.0001) and maximum (p = 0.009) cycle length. Women reported a median 2 kg increase in self-reported weight and a 30-min increase in median weekly exercise. 517/50% of women stated that their diet was worse and 232/23% that it was better than before the pandemic. 407/40% reported working more and 169/16% were working less. Women related a significant increase in low mood (p < 0.0001), poor appetite (p < 0.0001), binge eating (p < 0.0001), poor concentration (p < 0.0001), anxiety (p < 0.0001), poor sleep (p < 0.0001), loneliness (p < 0.0001) and excess alcohol use (p < 0.0001). Specific stressors reported included work stress (499/48%), difficulty accessing healthcare (254/25%), change in financial (201/19%) situation, difficulties with home schooling (191/19%) or childcare (99/10%), family or partner conflict (170/16%), family illness or bereavement (156/15%).ConclusionsThe COVID-19 pandemic has significantly impacted the reproductive health of women. The long term health implications of this are yet to be determined and future studies should address this.

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

BMJ ◽  
2018 ◽  
pp. k3609 ◽  
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.

scholarly journals PENGGUNAAN KONTRASEPSI HORMONAL DAN OBESITAS PADA WANITA USIA SUBUR DI INDONESIA: ANALISIS DATA IFLS 5 TAHUN 2014

2020 ◽  
Vol 10 (2) ◽  
pp. 101-110
Author(s):  
Yusri Kartika ◽  
Sudarto Ronoatmodjo
Keyword(s):  
Contraceptive Use ◽  
Cox Regression ◽  
Hormonal Contraception ◽  
Hormonal Contraceptive ◽  
Reproductive Age ◽  
Hormonal Contraceptives ◽  
Bivariate Analysis ◽  
P Value ◽  
Cross Sectional ◽  
Reproductive Age Women

Abstract Background: Prevalence of obesity in adult females in Indonesia is 32,9% in 2013. Hormonal contraceptives (pills, injections and implants) are widely used by reproductive-age women in Indonesia, and the prevalence is 45%. Objective: The aim of this study is to identify whether reproductive-age women who use hormonal contraceptives are at risk of developing obesity compared to WUS who do not use hormonal contraceptives. Method: The design of this study is a cross sectional study using secondary data (5th Indonesia Family Life Survey, and the sample is reproductive-age women (15-49 years old) consisting of 6045 respondents. The variables of this study are obesity, hormonal contraceptive use, age, education, occupation, and duration of contraceptive use. Data were analysed by using Cox Regression. Result: The results of bivariate analysis showed that hormonal contaceptive use, age, education, occupation, and duration of contraceptive use were associated with obesity among reproductive-age womenand statistically significant (P-Value <0,05). Multivariate analysis showed that hormonal contraceptive use did not increase the risk of obesity among reproductive-age women in Indonesia (PR 0.939; CI 95% 0.869 - 1.013). Conclusion: The use of hormonal contraception did not increase the risk of obesity among reproductive-age women. Key words: Hormonal Contraception; Obesity; Reproductive Age-Women Abstrak Latar belakang : Prevalensi obesitas pada perempuan dewasa di Indonesia sebesar 32,9 persen pada tahun 2013. Kontrasepsi hormonal (pil, suntikan dan implan) merupakan jenis kontrasepsi yang paling banyak digunakan oleh wanita usia subur (WUS) di Indonesia, dengan prevalensi sebesar 45%. Tujuan : untuk mengetahui apakah wanita usia subur (WUS) yang menggunakan kontrasepsi hormonal berisiko mengalami obesitas dibandingkan WUS yang tidak menggunakan kontrasepsi hormonal.  Metode : Desain penelitian ini adalah studi cross- sectional dengan menggunakan data sekunder IFLS 5 tahun 2014. Sampel adalah WUS (15-49 tahun) sebanyak 6.045 responden. Variabel dalam penilitian ini adalah obesitas pada WUS, penggunaan kontrasepsi hormonal, umur, pendidikan, pekerjaan, serta lama penggunaan kontrasepsi. Analisis data yang digunakan adalah Cox Regression. Hasil : Hasil analisis bivariat menunjukkan bahwa variabel penggunaan kontrasepsi hormonal, umur, pendidikan dan status pekerjaan, serta  lama penggunaan kontrasepsi berhubungan dengan obesitas pada WUS (p-value <0,05). Analisis multivariat menunjukkan bahwa penggunaan kontrasepsi hormonal tidak meningkatkan risiko obesitas secara bermakna pada WUS di Indonesia (PR 0,939; CI 95% 0,869 – 1,013). Kesimpulan: Penggunaan kontrasepsi hormonal tidak meningkatkan risiko WUS untuk mengalami obesitas.   Kata kunci: Kontrasepsi Hormonal; Obesitas; Wanita Usia Subur

scholarly journals Promotion of reproductive and metabolic health - current trends in the treatment and prevention of polycystic ovary syndrome in different periods of life

2021 ◽  
Vol 47 (3) ◽  
pp. 130-149
Author(s):  
Joanna Smyczyńska
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Diagnostic Criteria ◽  
Polycystic Ovary ◽  
Hormonal Contraception ◽  
Reproductive Age ◽  
Metabolic Effects ◽  
Adult Women ◽  
Ovary Syndrome ◽  
Treatment And Prevention

Polycystic ovary syndrome (PCOS) is one of the most common hormonal disorders and causes of infertility in women in reproductive age. Diagnostic criteria of PCOS in adult women include: ovulation disorders, hyperandrogenism and  polycystic ovaries. According to most recommendations, 2 out of these 3 criteria are confirm the diagnosis of PCOS. In girls during puberty and in the first years after menarche, different diagnostic criteria of menstrual disorders should be taken into account (variable length of menstrual cycles, monophasic cycles) and the limited usefulness of ultrasound examination for PCOS diagnosis within 8 years after menarche. Fairly extensive differential diagnosis is also necessary, especially – exclusion of adrenal hyperandrogenism. Moreover, the diagnostic criteria of PCOS do not take into account the metabolic disorders found in most patients (obesity, insulin resistance, type 2 diabetes), which should be diagnosed as early as possible and treated appropriately. This is especially true for teenagers, in whom the unequivocal diagnosis of PCOS or its exclusion may be very difficult. Current recommendations regard hormonal contraception as the first-line therapy in PCOS, in both adult women and adolescents. Together with its beneficial effect on the reduction of hyperandrogenism and obtaining regular bleeding (which in fact are not menstruations), the unfavorable metabolic effects of hormonal contraception are emphasized, as well as the inadequacy of its use if it is expected to achieve or restore ovulation and fertility. The latest reports indicate the legitimacy of treatment aimed at correcting disorders of carbohydrate metabolism and its greater effectiveness compared to the use of oral contraceptives in both adult women and girls with PCOS. In the pharmacotherapy of insulin resistance, metformin is of fundamental importance, the use of pioglitazone, GLP-1 receptor agonists or inositols is also proposed. Adequate lifestyle and dietary modification are of major importance in the treatment and prevention of PCOS. The mechanisms of "inheritance" of PCOS and insulin resistance with the participation of epigenetic modifications are still better understood, taking into account the effects of exposure to androgen excess in utero, intrauterine growth retardation, and maternal obesity and hyperalimentation. This creates new possibilities for PCOS prophylaxis.

scholarly journals Menstrual cycle and gynecologic pathology in menstrual-related migraine

2021 ◽  
Vol 13 (4) ◽  
pp. 12-17
Author(s):  
E. A. Kiryanova ◽  
G. R. Tabeeva
Keyword(s):  
Menstrual Cycle ◽  
Cycle Length ◽  
Hormonal Contraception ◽  
Reproductive Age ◽  
Patient Evaluation ◽  
Women Of Reproductive Age ◽  
Endometrial Polyps ◽  
Leading Role ◽  
Prospective Comparative Study ◽  
Group 2

Migraine is the first most frequent cause of disability among women of reproductive age globally, and up to 60% of patients note the association of headache attacks with menstruation.Objective: to determine the features of menstrual cycle and gynecologic pathology in women with menstrual-related migraine (MRM).Patients and methods. A prospective comparative study included 69 women of reproductive age with a migraine diagnosis who did not receive hormonal contraception. Depending on the association of migraine attacks with menstruation (according to headache diaries), the patients were divided into two groups: the 1st group consisted of 44 patients with MRM; group 2 — 25 patients with non-menstrual migraine (without the association of attacks with menstruation).Results and discussion. Patients with MRM had heavier menstrual bleeding, longer menstruations (more than six days), abnormal menstrual cycle length and regularity, dysmenorrhea. In addition, the obtained data indicate a comorbid estrogen-associated gynecological pathology (endometriosis, adenomyosis, endometrial polyps, myoma) in MRM.Conclusion. Presumably, the hypothalamic-pituitary-ovarian axis dysfunction plays the leading role in the MRM. It presents with menstrual cycle abnormalities and increased presence of estrogen-associated gynecological pathology, which should be considered during patient evaluation and suggesting recommendations.

scholarly journals Side effects and the need for secrecy: characterising discontinuation of modern contraception and its causes in Ethiopia using mixed methods

2017 ◽  
Author(s):  
Alexandra Alvergne ◽  
Rose Stevens ◽  
Eshetu Gurmu
Keyword(s):  
Mixed Methods ◽  
Side Effects ◽  
Health Professionals ◽  
Contraceptive Use ◽  
Hormonal Contraception ◽  
Reproductive Age ◽  
Structured Interviews ◽  
Main Hypothesis ◽  
Major Barrier ◽  
Contraceptive Discontinuation

AbstractBackgroundContraceptive discontinuation is a major barrier to reducing global unmet needs for family planning, but the reasons why women discontinue contraception are poorly understood. Here we use data from Ethiopia to investigate (i) the magnitude of contraceptive discontinuation in 2005-2011, (ii) how the risk of discontinuation varies with method type and education level and (iii) the barriers to continuation. Our main hypothesis is that contraceptive discontinuation is driven by the experience of physiological side-effects associated with the use of hormonal contraception, rather than a lack of education.MethodsWe used a mixed methods explanatory sequential design to explain the quantitative results in more details through the qualitative data. First, we analysed quantitative data from the 2011 Ethiopian Demographic and Health Survey to study patterns of contraceptive discontinuation and method choice using multilevel multiprocess models. Second, we conducted semi-structured interviews and focus group discussions in the 3 most populated regions of Ethiopia with individuals of reproductive age and health professionals.ResultsThe analysis of EDHS data shows that the rate of discontinuation has not reduced in the period 2005-2011 and remains high. Discontinuation mainly takes the form of abandonment, and is a function of method type and wealth but not of educational level. Interviews with women and health professionals reveal that the experience of debilitating physiological side effects, the need for secrecy and poverty are important barriers to continuation.ConclusionsOur findings together suggest that physiological and social side-effects of contraceptive use, not education, are the root causes of contraceptive discontinuation in Ethiopia. We argue that to tackle discontinuation due to side-effects, dispelling misconceptions through educating women is not addressing the root causes of discontinuation, and that priority should be given to both engaging men and questioning the appropriateness of medical technology to the physiology of Ethiopian women, especially those living in poverty.

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