Unintended pregnancy in users of nomegestrol acetate and 17β-oestradiol (NOMAC-E2) compared with levonorgestrel-containing combined oral contraceptives: final results from the PRO-E2 study

Objective The effect of combined oral contraceptives (COCs) on female sexuality has long been a matter of discussion, but placebo-controlled studies are lacking. Thus, the aim of the present study was to investigate if an oestradiol-containing COC influences sexual function. Design Investigator-initiated, randomised, double-blinded, placebo-controlled clinical trial where 202 healthy women were randomised to a combined oral contraceptive (1.5 mg oestradiol and 2.5 mg nomegestrol acetate) or placebo for three treatment cycles. Methods Sexual function at baseline and during the last week of the final treatment cycle was evaluated by the McCoy Female Sexuality Questionnaire. Serum and hair testosterone levels were assessed at the same time points. Results Compared to placebo, COC use was associated with a small decrease in sexual interest (COC median change score: −2.0; interquartile range (IQR): −5.0 to 0.5 vs placebo: −1.0; IQR: −3.0 to 2.0, P = 0.019), which remained following adjustment for change in self-rated depressive symptoms (B = −0.80 ± 0.30, Wald = 7.08, P = 0.008). However, the proportion of women who reported a clinically relevant deterioration in sexual interest did not differ between COC or placebo users (COC 18 (22.2%) vs placebo 16 (17.8%), P = 0.47). Change in other measured aspects of sexual function as well as total score of sexual function did not differ between the two treatments. Conclusions This study suggests that use of oestradiol-based COCs is associated with reduced sexual interest. However, the changes are minute, and probably not of clinical relevance.

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Platelet Adhesiveness in Symptomatic Women Taking Oral Contraceptives

Thrombosis and Haemostasis ◽

10.1055/s-0038-1653695 ◽

1971 ◽

Vol 26 (03) ◽

pp. 426-430 ◽

Cited By ~ 3

Author(s):

T. F Zuck ◽

J. J Bergin ◽

Jane M. Raymond ◽

W. R Dwyre ◽

D. G Corby

Keyword(s):

Oral Contraceptives ◽

Platelet Adhesiveness ◽

Combined Oral Contraceptives ◽

Increased Risk ◽

Normal Women ◽

Asymptomatic Women

SummaryPlatelet adhesiveness to glass was determined in several groups of women. Increases were found in women developing thrombovascular symptoms while taking combined oral contraceptives, compared to both normal women and asymptomatic users of oral contraceptives. Despite this increase, overlap of the groups did not permit discrimination between symptomatic and asymptomatic women. However, it is possible, that in concert with other coagulation changes, platelet adhesiveness to glass may prove adjunctive in defining women at increased risk of developing thrombovascular symptoms while taking oral contraceptives, and further define the mechanism of the increased risk.

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Faculty Opinions recommendation of Effect of progestogens and combined oral contraceptives on nerve fibers in peritoneal endometriosis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1147544.628360 ◽

2009 ◽

Author(s):

Moamar Al-Jefout

Keyword(s):

Oral Contraceptives ◽

Nerve Fibers ◽

Combined Oral Contraceptives ◽

Peritoneal Endometriosis

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Faculty Opinions recommendation of Effects of combined oral contraceptives, depot medroxyprogesterone acetate and the levonorgestrel-releasing intrauterine system on the vaginal microbiome.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.727748411.793536806 ◽

2017 ◽

Author(s):

Phillip Hay

Keyword(s):

Oral Contraceptives ◽

Medroxyprogesterone Acetate ◽

Vaginal Microbiome ◽

Combined Oral Contraceptives ◽

Depot Medroxyprogesterone Acetate

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HAEMOSTATIC CHANGES INDUCED BY TWO LOW DOSE TRIPHASIC ORAL CONTRACEPTIVES

10.1055/s-0038-1643825 ◽

1987 ◽

Author(s):

S J Machin ◽

I J Mackie ◽

K Walshe ◽

M D Gillmer

Keyword(s):

Oral Contraceptives ◽

Protein C ◽

Low Dose ◽

Factor Vii ◽

Cycle Period ◽

Factor Xii ◽

Factor X ◽

Combined Oral Contraceptives ◽

First Time ◽

Protein C Activity

The haemostatic system was investigated in 26 women taking cyclically administered triphasic combined oral contraceptives for the first time during their first six cycles. Fourteen women received Logynon (mean dose 32.4μg ethinyloestradiol, 92pg progestagen) and 12 received SHD 415G (Schering) which contains a mean dosage of 32.4μg ethinyloestradiol and 78pg gestodene, a recently developed progesterone. The Logynon group showed a significant increase (p<0.005) in fibrinogen (pre-mean 284.4 g/1; after 1 cycle 347.3 g/1, after 6 cycles 318.6 g/1) , factor VII (65.8 u/1 to 73.9 u/1 to 83.2 u/1), factor XII (1.74 u/1 to 2.41 u/1, to 2.25 u/1), plasminogen (100.9 u/1 to 135.1 u/1 to 126.3 u/1); decrease in ATIII (115.9 u/1 to 103.1 u/1 to 93.4 u/1) but no significant change in factor X (98.4 u/1 to 108.9 u/1 to 102.4) or protein C (0.85 u/1 to 0.88 u/1 to 0.94 u/1) activity. The SHD 415G group showed similar changes with an increase in fibrinogen (247.9 g/1 to 330.8 g/1 to 373 .1 g/1), factor VII (63.1 u/1 to 73.1 u/1 to 90.3 u/1, factor X (98.3 u/1 to 112.0 u/1 to 124.4 u/1), factor XII (1.46 u/1, to 1.93 u/1, to 2.03 u/1), plasminogen (110.8 u/1 to 125.4 u/1 to 136.7 u/1); decrease in ATIII (113.1 u/1 to 96.3 u/1 to 89.7 u/1), but no change in protein C (0.84 u/1 to - 0.78 u/1 to 0.85 u/1) activity. These changes were apparent after the first cycle of therapy and the differences were maintained over the six cycle period. There was no increase in protein C activity despite changes in the other vitamin K dependent proteins factors VII and X. Both low oestrogen dose triphasic pills caused similar prothrombotic changes which were not modified by the new progesterone, gestodene.

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