scholarly journals Anticoncepcionais hormonais: interações que podem comprometer sua eficácia / Hormonal contraceptives: interactions that can Commit your effectiveness

2021 ◽  
Vol 4 (6) ◽  
pp. 27708-27720
Author(s):  
Fabrícia Morgana Teixeira De Lima ◽  
Hemilly Alanna da Silva Lima ◽  
Odair Alves Da Silva
2009 ◽  
Vol 29 (02) ◽  
pp. 193-196 ◽  
Author(s):  
H. Rott ◽  
A. Kruempel ◽  
G. Kappert ◽  
U. Nowak-Göttl ◽  
S. Halimeh

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.


GYNECOLOGY ◽  
2019 ◽  
Vol 21 (3) ◽  
pp. 17-21
Author(s):  
Tatyana Yu Pestrikova ◽  
Elena A Yurasova ◽  
Igor V Yurasov ◽  
Tamara D Kovaleva

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Micaele Maria Lopes Castro ◽  
Maria Karolina Martins Ferreira ◽  
Iasmin Encaua Essashika Prazeres ◽  
Paula Beatriz de Oliveira Nunes ◽  
Marcela Baraúna Magno ◽  
...  

Abstract Background Previous studies indicated an impact of hormonal contraceptive use on oral health. This systematic review aimed to investigate the evidence supporting the impact of the use of hormonal contraceptives and periodontal diseases. Methods This study is based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and based on the PECO acrostic. Inclusion criteria comprised observational studies including women (P), which evaluated hormonal contraceptive users (E) and hormonal contraceptive non-users (C), to verify the association between this hormonal therapy and the periodontal diseases (O). Searches were performed on 5 databases: PubMed, Scopus, Web of Science, Cochrane Library, LILACS and grey literature (OpenGrey and Google Scholar). After the selection process, the included studies were evaluated qualitatively. Moreover, quantitative data were analyzed in two meta-analyses for clinical attachment loss (CAL) and probing depth (PD). Finally, the level of certainty was measured with the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) tool between periodontal clinical parameters. Results 18 articles were eligible for the qualitative synthesis and 7 of them were selected for quantitative analysis. Hence, 15 of the eligible articles reported an association between the use of hormonal contraceptives and severity of periodontal disease. However, 6 articles demonstrated high risk of bias and were excluded from quantitative synthesis. The meta-analysis showed a statistically significant difference for CAL (MD 0.24 [0.09, 0.40]; p = 0.002), but in PD (MD 0.05 [− 0.05, 0.15]; p = 0.33) such difference was not identified. A very low level of evidence was found between the clinical parameters. Conclusions The use of hormonal contraceptives may be associated to severity of periodontal diseases. However, the quantitative analysis points to an inconclusive outcome due to the high level of heterogeneity. The association is biologically plausible, however additional studies are warranted to better elucidate the clinical significance of this possible association.


Thorax ◽  
2001 ◽  
Vol 56 (8) ◽  
pp. 613-616
Author(s):  
P Lange ◽  
J Parner ◽  
E Prescott ◽  
C Suppli Ulrik ◽  
J Vestbo

BACKGROUNDRecent evidence suggests a role for hormonal factors in the aetiology of asthma.METHODSData from a large study of women selected from the general population were used to relate treatment with oral hormonal contraceptives (OCP) and postmenopausal hormone replacement therapy (HRT) to the following asthma indicators: self-reported asthma, wheezing, cough at exertion, and use of medication for asthma. The study sample comprised 1536 premenopausal and 3016 postmenopausal women who participated in the third round of the Copenhagen City Heart Study in 1991–4. A total of 377 women were taking OCP (24.5% of premenopausal women) and 458 were on HRT (15.2% of postmenopausal women).RESULTSIn premenopausal women 4.8% reported having asthma. The prevalence of self-reported asthma, wheeze, use of asthma medication, and cough at exertion was not significantly related to use of OCP. In postmenopausal women the prevalence of self-reported asthma was 6.2%. A weak but consistent association was observed between HRT and self-reported asthma (OR 1.42 (95% CI 0.95 to 2.12)), wheeze (OR 1.29 (95% CI 1.02 to 1.64)), cough at exertion (OR 1.34 (95% CI 1.01 to 1.77)), and use of asthma medication (OR 1.45 (95% CI 0.97 to 2.18)).CONCLUSIONSIn this study of the general population no relationship was found between the use of OCP and asthma. Although an association was observed between HRT and asthma and asthma-like symptoms, this was relatively weak and it is concluded that there is no necessity to change present prescription practice.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 853.2-854
Author(s):  
M. Clowse ◽  
J. LI ◽  
M. Birru Talabi ◽  
A. Eudy ◽  
G. Schmajuk

Background:Several of the most commonly prescribed medications for women with rheumatic disease are teratogens, posing a risk for pregnancy loss and birth defects if taken in pregnancy. To prevent these life-altering complications, it is important that all women taking teratogenic medications avoid pregnancy through abstinence or contraception.Objectives:We sought to understand the accessibility to contraceptive data within the RISE Registry and to test whether, compared to other women, those prescribed a teratogen would be more likely to have documentation of contraceptive.Methods:Data were derived from Rheumatology Informatics System for Effectiveness (RISE), a national EHR-enabled rheumatology registry that passively collects data on all patients seen by participating practices. As of 2018, RISE held validated data from 1,113 clinicians in 226 practices, representing an estimated 32% of the U.S. clinical rheumatology workforce. Female patients between the ages 18-45 with an anti-rheumatic medication prescribed within the RISE system in 2018 were stratified into one of 3 groups: 1) Any teratogen (methotrexate, mycophenolate, mycophenolic acid, cyclophosphamide, leflunomide, thalidomide, lenalidomide); 2) Only pregnancy-compatible medications (hydroxychloroquine, azathioprine, or a TNF-α inhibitors [TNFi]); and 3) Any medication with unknown teratogenicity (non-TNF biologics and new small molecule medications). We identified the most recent contraceptive medication or device reported in 2018 using structured fields in the EHR. Contraceptive effectiveness was classified as ‘highly effective’ (IUD, Nexplanon, and surgical) and ‘effective’ (oral contraceptives, depo-provera, patch, ring), and unknown (type not reported). Statistical significance was assessed using Stata SE 15.1.Results:In 2018, 110,359 women between the ages of 18-45 were prescribed an anti-rheumatic medication within the RISE Registry. Of these, 11,569 (10.5%) had a contraceptive documented at the last visit. The frequency of contraception documentation varied between practices, ranging from 0% to 28.7% (median 9.2%).Contraception was documented slightly less often in women receiving teratogens (9.8%) compared to women receiving only pregnancy-compatible medications (10.4%, p=0.04) and medications with unknown pregnancy risks (10.0%, p=0.67).The frequency of contraceptive documentation in women prescribed a teratogen varied significantly by race with white women having the highest rate (11.0%) compared to African-American women (7.4%, p<0.001), Hispanic women (5.5%, p<0.001), and Asian women (8.4%, p=0.08).The type of contraceptive documented did not vary significantly between medication group. Highly effective contraception was rarely documented (1.4-1.6%) and moderately-effective hormonal contraceptives were more frequently documented (6.3-8.2%).Conclusion:This study is limited to the analysis of structured fields within the RISE Registry, thereby missing contraceptive documentation within the clinician notes. Increased uniformity in documentation and/or analysis of visit notes will be essential to use the RISE Registry to study the implementation of published contraceptive guidelines. While the documentation of contraception identified in this analysis of the RISE Registry likely under-estimates actual contraceptive use, it reveals important gaps in care. Contrary to what was expected, women prescribed a teratogen were not more likely than other women to have a documented contraceptive. Additionally, important racial disparities in contraception documentation suggest that rheumatologists may not addressing reproductive health needs equally across patient populations.Acknowledgments Disclaimer:This data was supported by the ACR’s RISE Registry. However, the views expressed represent those of the authors, not necessarily those of the ACRDisclosure of Interests:Megan Clowse Grant/research support from: GSK, Pfizer, Consultant of: UCB, Astra-Zeneca, Speakers bureau: UCB, Jing Li: None declared, Mehret Birru Talabi: None declared, Amanda Eudy: None declared, Gabriela Schmajuk Grant/research support from: Pfizer


2021 ◽  
pp. 239698732110195
Author(s):  
P Correia ◽  
S Machado ◽  
I Meyer ◽  
M Amiguet ◽  
A Eskandari ◽  
...  

Introduction Systemic contraceptives increase the risk of ischemic stroke but little is known about the characteristics, mechanisms and long-term outcome post stroke of patients on hormonal contraception. We sought to To assess characteristics and outcome of acute ischemic stroke (AIS) in young women using systemic hormonal contraceptives (SHC) and compare them to strokes in non-contraceptive users. Patients and methods Using the Acute STroke Registry and Analysis of Lausanne (ASTRAL), we analyzed demographics, risk factors, clinical, radiological and treatment data of consecutive female patients of <50 years between 2003 to 2015. We compared groups with and without SHC in a logistic regression analysis. Results Of the 179 female patients of <50 years during the observation period, 57 (39.6%) used SHC, 71.9% of whom, a combined oral contraceptive pill. On logistic regression contraceptive users were significantly younger but had comparable stroke severity. They had less migraine with aura and tobacco use, and more hyperlipidaemia. Also, contraceptive users had significantly less intra and extracranial stenosis and occlusion on arterial imaging, but more focal hypoperfusion on CT-perfusion. Undetermined mechanism of stroke was more frequent with SHC users, whereas rare mechanisms were more frequent in non-users. The contraceptive user group had a more favourable adjusted 12-month outcome with significantly fewer ischemic recurrences after stopping systemic contraception in all. Conclusion Contraceptive users with ischemic strokes are younger and have lesser tobacco use and migraine with aura and more hyperlipidemia. Their stroke mechanism is more often undetermined using a standardised work-up, and their adjusted long-term outcome is more favourable with less stroke recurrence.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hankiz Dolan ◽  
Mu Li ◽  
Deborah Bateson ◽  
Rachel Thompson ◽  
Chun Wah Michael Tam ◽  
...  

Abstract Background In Australia, ethnic Chinese people are one of the largest, youngest and fastest growing overseas-born groups. Yet, little is known about their perceptions of contraceptive methods and their experiences with choosing one. Decisions about contraceptive methods are preference sensitive. Understanding the influencing factors of Chinese migrant women’s contraceptive method choice and practices will help cater to their decision-making needs in a culturally sensitive and responsive way. Methods A qualitative study design underpinned by critical realism approach was used to explore Chinese migrant women’s perceptions and experiences of choosing contraceptive methods. Semi-structured interviews were conducted with 22 women who self-identified as being ethnically Chinese and had been living in Australia for no more than 10 years. The interview guide was adapted from the Ottawa Decision Support Framework. Majority of the interviews were conducted in Mandarin Chinese. Transcribed data was analysed using thematic analysis method. Results Four major themes were identified, including: ‘every medicine is part poison: hormonal contraceptives cause harm to the body’; ‘intrauterine device, a device used in the past for married women’; ‘it takes two (or one) to decide, depending on the relationship dynamics and contraception preferences’; and ‘it is not necessary to seek medical advice in choosing contraceptive methods’. Conclusions Our findings suggest that Chinese migrant women’s perceptions and experiences of choosing contraceptive methods are influenced by complex personal, cultural, societal and inter-relational factors. Chinese migrant women were cautious of using hormonal methods due to fears of side-effects, including reduced or absent menstrual bleeding. Women were also reluctant to consider intrauterine devices as options due to associating them with past experiences of other women and themselves and also fears of potential complications. There was a reluctant attitude towards seeking medical advice regarding contraception due to beliefs that needing to use contraception is not an illness requiring treatment. Such findings are likely to be useful in increasing healthcare professionals’ and policy makers’ understanding of Chinese migrant women’s contraceptive method preferences, beliefs and behaviours. They also help to develop culturally and linguistically sensitive strategies, which goes beyond the provision of contraceptive counselling, in assisting Chinese migrant women’s decision-making needs.


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