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.

Combined oral contraceptives in improving quality of young women’s lives

2019 ◽  
Vol 1 (1) ◽  
pp. 15-18
Author(s):  
A. L. Tikhomirov ◽  
T. A. Yudina ◽  
D. I. Burchakov
Keyword(s):  
Side Effects ◽  
Oral Contraceptives ◽  
Hormonal Contraception ◽  
Hormonal Contraceptive ◽  
Combined Oral Contraceptives ◽  
Distinctive Features ◽  
Women's Lives ◽  
Combined Hormonal Contraceptive

Compliance with the use of combined hormonal contraceptive drugs containing drospirenone is presented. The use of such drugs enhances the use of hormonal contraception. The distinctive features of the drugs are considered: reliable contraception, reduced severity of side effects, additional positive preventive and curative effects.

The influence of the body mass index (BMI) on selected parameters of the coagulation system in patients with disorders of the balance system taking oral contraceptives

2016 ◽  
Vol 70 (4) ◽  
pp. 28-34 ◽  
Author(s):  
Marzena Bielińska ◽  
Joanna Urbaniak ◽  
Krzysztof Kuśmierczyk ◽  
Jurek Olszewski ◽  
Piotr Pietkiewicz
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Oral Contraceptives ◽  
Hormonal Contraception ◽  
The Body ◽  
Coagulation System ◽  
Hormonal Contraceptives ◽  
Study Group ◽  
Balance System ◽  
Estradiol Concentration

Introduction: The objective of the paper is to evaluate the influence of the body mass index (BMI) on selected parameters of the coagulation system in patients with disorders of the balance system taking oral contraceptives. Material and methods: 105 young women participated in the study who were divided into 2 groups. Group I: 52 women disorders of the balance system taking hormonal contraceptives for at least 2 months, between the age of 20–49; Group II: 53 women with no disorders of the balance system taking hormonal contraceptives for at least 2 months, between the age of 18–40. Patients entering the study underwent full otoneurological examination, detailed laryngological assessment and the examination of selected parameters of the hemostasis system, including the evaluation of fibrinogen and D-dimer levels, APTT and PT, estradiol and progesterone concentrations in the blood serum and evaluation of the body mass index (BMI). Results: Central vertigo was the most common type of vertigo in the study group (59,6% of cases). Other vertigo types in this group included compensated vertigo of mixed origin (36,6% of cases) and peripheral vertigo (only 3,8% of cases), which indicates that 40.4% of the cases suffer from damage to the labyrinth. The analysis of the concentration of estradiol in the blood serum revealed, after consideration of a menstrual cycle phase, that estradiol concentration exceeded normative values significantly more often in the study group than in the control group and that estradiol concentration was significantly less frequently below the norm in the study group; the difference was statistically significant (p=0,048). The body mass index (BMI) of women participating in the study significantly correlated with the concentration of D-dimers only in the study group (p=0,35 vs p=0,012). Conclusions: Evaluating the body mass index before administering hormonal contraception can be useful to eliminate other risk factors for thromboembolism. In order to prevent potential thromboembolism episodes, administering hormonal contraception only after lowering the body mass index may also be worth considering.

scholarly journals Cerebral venous thrombosis related to the use of combined oral contraceptives

2021 ◽  
Author(s):  
Amanda Mendes Clemente Vilella ◽  
Letícia Luísa Mattos
Keyword(s):  
Venous Thrombosis ◽  
Oral Contraceptives ◽  
Cerebral Venous Thrombosis ◽  
Polycystic Ovary ◽  
Sinus Thrombosis ◽  
Rare Condition ◽  
Signs And Symptoms ◽  
Reproductive Age ◽  
Combined Oral Contraceptives ◽  
Menstrual Dysfunction

Background: Cerebral venous thrombosis (CVT) is a rare condition (less than 1% of stroke). It occurs in the younger population (less than 50 years old), 3 times more common in women, especially those of reproductive age. Objectives and methodology: Narrative review to correlate CVT with the use of combined oral contraceptives (ACO). The following databases were used: Pubmed, Scielo and Medline. Results: A systematic review had 11 studies included showing that the use of OAC increases the chances of developing CVST (central venous sinus thrombosis). Among the 9 studies that reported odds ratios, the combined probability of developing CVST in women of reproductive age who use OAC was 7.59 times the probability of developing CVST compared to those who do not take oral contraceptives (OR = 7.59, 95 CI % 3.82-15.09). A retrospective study of 37 female adolescents was diagnosed with CVT, 22 (59%) of whom used OAC and the remaining 15 had other etiological factors. The data indicate that adolescents using OAC to treat hirsutism, menstrual dysfunction or polycystic ovary syndrome may also have some risk factors for thrombosis, such as hereditary coagulopathy. The coexistence of these diseases mentioned with the use of OCA can increase the risk of CVT. Conclusions: The two main studies analyzed concluded the association between the use of ACO and cases of CVT in women. It’s necessary to be attentive to suggestive signs and symptoms in this population, as they are common to other pathologies, making the diagnosis of CVT difficult.

Diagnosis and management of patients with hyperandrogenism in early reproductive age

2021 ◽  
Vol 20 (5) ◽  
pp. 124-130
Author(s):  
E.P. Khashchenko ◽  
◽  
O.I. .Lisitsyna ◽  
E.V. Uvarova ◽  
◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Congenital Adrenal Hyperplasia ◽  
Oral Contraceptives ◽  
Clinical Symptoms ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Adrenal Hyperplasia ◽  
Ovary Syndrome ◽  
Combined Oral Contraceptives ◽  
Diagnosis And Management

Hyperandrogenism is characterized by the presence of clinical symptoms and / or biochemical parameters of high androgen levels. Dermopathy and particularly acne and hirsutism are regarded as the main clinical markers of hyperandrogenism. Cosmetic problems associated with hyperandrogenism are often the reason for young woman to seek medical attention. Body hair growth in atypical areas, acne and trophic skin changes have a significant effect on the emotional state, provoke a sense of imperfection and loss of attractiveness, and reduce the quality of life. Concomitant menstrual disorders (up to 50–75%) complicate the patient’s state and determine an increased risk of gynecological disorders in the future. The causes of hyperandrogenism in early reproductive age can be varied: from more common physiological hyperandrogenism in adolescence, idiopathic hyperandrogenism, polycystic ovary syndrome (PCOS) and the atypical form of congenital adrenal hyperplasia to less common hyperthecosis, acromegaly, hyperprolactinemia, hypothyroidism, Cushing’s disease, and androgen-secreting tumors. The diagnostic search should begin with assessing complaints and clinical symptoms, and a complete physical examination. To confirm biochemical hyperandrogenism, total and free testosterone, and free androgen index are evaluated. Additional methods of examination are used to clarify the diagnosis. Treatment is prescribed in accordance with the established diagnosis. Androgen-secreting tumors require surgical intervention. Other causes of hyperandrogenism are usually treated with medication. According to current recommendations, combined oral contraceptives are the first-line therapy for the most common conditions accompanied by hyperandrogenism (hirsutism, acne vulgaris, PCOS) in early reproductive age. A clinical solution may be a combined administration of microdoses of ethinylestradiol (20 μg) and drospirenone (3 mg), progestagen with antiandrogenic property in the mode 24 + 4 (for instance: Dimia). This article presents clinical cases of diagnosis and management tactics for patients of early reproductive age with hyperandrogenism. Conclusion. The differential diagnosis of physiological and pathological conditions accompanied by hyperandrogenism is one of the current challenges for obstetrician-gynecologist. A properly developed algorithm of examination, interpretation of its results, therapy and prevention of complications are of great importance. Key words: acne, alopecia acreata, congenital adrenal hyperplasia, hyperandrogenism, hirsutism, girls, drospirenone, combined oral contraceptives, contraception, adolescents, early reproductive age, polycystic ovary syndrome, ethinylestradiol

scholarly journals Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review

BMJ ◽  
2020 ◽  
pp. m3502 ◽  
Author(s):  
Kelvin Okoth ◽  
Joht Singh Chandan ◽  
Tom Marshall ◽  
Shakila Thangaratinam ◽  
G Neil Thomas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Preterm Birth ◽  
Gestational Diabetes ◽  
Polycystic Ovary Syndrome ◽  
Oral Contraceptives ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Ovary Syndrome ◽  
Combined Oral Contraceptives

Abstract Objective To consolidate evidence from systematic reviews and meta-analyses investigating the association between reproductive factors in women of reproductive age and their subsequent risk of cardiovascular disease. Design Umbrella review. Data sources Medline, Embase, and Cochrane databases for systematic reviews and meta-analyses from inception until 31 August 2019. Review methods Two independent reviewers undertook screening, data extraction, and quality appraisal. The population was women of reproductive age. Exposures were fertility related factors and adverse pregnancy outcomes. Outcome was cardiovascular diseases in women, including ischaemic heart disease, heart failure, peripheral arterial disease, and stroke. Results 32 reviews were included, evaluating multiple risk factors over an average follow-up period of 7-10 years. All except three reviews were of moderate quality. A narrative evidence synthesis with forest plots and tabular presentations was performed. Associations for composite cardiovascular disease were: twofold for pre-eclampsia, stillbirth, and preterm birth; 1.5-1.9-fold for gestational hypertension, placental abruption, gestational diabetes, and premature ovarian insufficiency; and less than 1.5-fold for early menarche, polycystic ovary syndrome, ever parity, and early menopause. A longer length of breastfeeding was associated with a reduced risk of cardiovascular disease. The associations for ischaemic heart disease were twofold or greater for pre-eclampsia, recurrent pre-eclampsia, gestational diabetes, and preterm birth; 1.5-1.9-fold for current use of combined oral contraceptives (oestrogen and progesterone), recurrent miscarriage, premature ovarian insufficiency, and early menopause; and less than 1.5-fold for miscarriage, polycystic ovary syndrome, and menopausal symptoms. For stroke outcomes, the associations were twofold or more for current use of any oral contraceptive (combined oral contraceptives or progesterone only pill), pre-eclampsia, and recurrent pre-eclampsia; 1.5-1.9-fold for current use of combined oral contraceptives, gestational diabetes, and preterm birth; and less than 1.5-fold for polycystic ovary syndrome. The association for heart failure was fourfold for pre-eclampsia. No association was found between cardiovascular disease outcomes and current use of progesterone only contraceptives, use of non-oral hormonal contraceptive agents, or fertility treatment. Conclusions From menarche to menopause, reproductive factors were associated with cardiovascular disease in women. In this review, presenting absolute numbers on the scale of the problem was not feasible; however, if these associations are causal, they could account for a large proportion of unexplained risk of cardiovascular disease in women, and the risk might be modifiable. Identifying reproductive risk factors at an early stage in the life of women might facilitate the initiation of strategies to modify potential risks. Policy makers should consider incorporating reproductive risk factors as part of the assessment of cardiovascular risk in clinical guidelines. Systematic review registration PROSPERO CRD42019120076.

scholarly journals Risks of venous thromboembolic complications in related to combined oral contraceptives

2022 ◽  
Vol 15 (6) ◽  
pp. 777-787
Author(s):  
K. A. Gabelova ◽  
N. A. Shabanova ◽  
V. F. Bezhenar ◽  
E. E. Zvartau ◽  
Yu. A. Akishina
Keyword(s):  
Oral Contraceptives ◽  
Unwanted Pregnancy ◽  
Hormonal Contraception ◽  
Vena Cava ◽  
Thromboembolic Complications ◽  
Combined Oral Contraceptives ◽  
Increased Risk ◽  
Venous Thromboembolic ◽  
Reversible Method ◽  
Thrombotic Complications

Hormonal contraception is the most popular and effective reversible method for preventing unwanted pregnancy exerting multiple prophylactic and therapeutic effect along with contraceptive activity. The main adverse coupled to combined oral contraceptives (COCs) is its impact on the hemostasis and increased risk of venous thromboembolic complications. A great evolutionary path has been travelled after beginning application of hormonal contraception to reduce dose of its estrogen component and improving quality of gestagen component. Nevertheless, thrombotic complications related to COCs use still remain a pressing issue not only due to disease severity and high mortality rate from pulmonary embolism (PE), but also due to the difficulties in its timely diagnostics. Here we describe a clinical case of a 19-year-old patient suffering from vena cava inferior thrombosis complicated by PE after using COCs.

scholarly journals Effect of combined oral contraceptives conaining drospirenone + ethinylestradiol on the mammary gland condition in women of reproductive age

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Vladislava Novikova ◽  
Vadim Khorolsky ◽  
Natalia Strelnikova ◽  
Galina Makarenko ◽  
Susanna Gasparyan ◽  
...  
Keyword(s):  
Mammary Gland ◽  
Oral Contraceptives ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Combined Oral Contraceptives

scholarly journals Hemostasis in women with obesity and metabolic syndrome

2021 ◽  
Vol 5 (9) ◽  
pp. 598-604
Author(s):  
I.A. Kuzina ◽  
◽  
E.V. Goncharova ◽  
N.S. Martirosyan ◽  
M.E. Telnova ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Venous Thromboembolism ◽  
Oral Contraceptives ◽  
Reproductive Age ◽  
Morbidity And Mortality ◽  
Glucose Metabolism Disorders ◽  
Clinical Issue ◽  
Combined Oral Contraceptives ◽  
Cardiovascular Morbidity And Mortality ◽  
Hemostatic Disorders

To date, obesity is a global epidemic that resulted in increased morbidity and mortality, including those associated with thrombotic conditions. Metabolic syndrome (MS) is characterized by abdominal obesity, glucose metabolism disorders, hypertension, and dyslipidemia. Patients with MS have higher risks of thrombosis and cardiovascular events. Hemostatic disorders in women with obesity and MS are an important clinical issue. Hemostatic abnormalities in these patients (hypercoagulation, hypofibrinolysis, platelet dysfunctions) increase the risk of cardiovascular morbidity and mortality and venous thromboembolism (VTE). Combined oral contraceptives (COCs) increase VTE risk in women with obesity. During pregnancy and postnatal period, obesity is one of the most common causes of VTE. In postmenopause, obesity and MS, and COCs prescribed as menopausal hormone therapy require close attention in controlling hemostatic parameters. This paper reviews significant hemostatic abnormalities in obesity and MS and discusses the role of these conditions in developing hemostatic disorders and VTE in women of reproductive age and postmenopause. KEYWORDS: obesity, metabolic syndrome, hemostasis, combined oral contraceptives, pregnancy, postmenopause, venous thromboembolism. FOR CITATION: Kuzina I.A., Goncharova E.V., Martirosyan N.S. et al. Hemostasis in women with obesity and metabolic syndrome. Russian Medical Inquiry. 2021;5(9):598–604 (in Russ.). DOI: 10.32364/2587-6821-2021-5-9-598-604.

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