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At least 343 records · Page 19Linked to original sources
PubMed1989

Epidemiologic studies of oral contraception.

Epidemiologic studies of oral contraception are of two main types: case-control and cohort. The best known cohort studies are the Royal College of General Practitioners' study and the Oxford-Family Planning Association study, both of which have been conducted in the United Kingdom. Combination oral contraceptives--both the older, higher-dose type, and the newer, lower-dose type--are highly effective if used properly. Noncontraceptive benefits of combination oral contraceptives include protective effects against menstrual disorders, anemia, benign breast disease, functional ovarian cysts, ovarian cancer, endometrial cancer, pelvic inflammatory disease, and uterine fibroids. Adverse effects include various cardiovascular problems, liver tumors, and the temporary impairment of fertility after stopping use, especially in older, nulliparous women. Effects, if any, on breast cancer and cervical cancer are still under evaluation. The often quoted cardiovascular risks of combination oral contraceptives are derived from studies of the older, higher-dose pills used in an outmoded way. There is evidence that modern pills, used by properly selected young women who are subsequently kept under surveillance, carry a minimal cardiovascular risk. A national study is currently in progress in the United Kingdom to try to confirm this.

Adult↗
PubMed2001

Over-the-counter use of oral contraceptives in Kuwait.

Oral contraceptive pills (OCPs) are available over-the-counter (OTC) in Kuwait, and constitute a leading method for spacing and limiting children. Data from a nationally representative survey of Kuwaiti women are used to examine OTC use of OCPs. One-fourth of the women initiated use without consulting a doctor, and 50% bought OCPs from the pharmacy. No socioeconomic or demographic differences were found between those who consulted a physician, implying that women of different background have similar accessibility to the physician. Using multivariate analysis, the odds of consulting a physician were found to be significantly lower for women who first bought OCPs directly from the commercial pharmacy. The duration of first time OCP use did not differ according to physician consultation. It is concluded that OTC availability of OCPs has many advantages and prevents unwanted pregnancy. However, there is a need for better packaging and instructions that would enable high-risk women to identify themselves and to use OCPs under physician supervision.

Contraceptives, Oral↗
PubMed2000

Oral contraceptives and thrombosis.

Oral contraceptives (OCs) are used by many millions of healthy young women. Their ease of use and efficacy against unwanted pregnancy has made them an indispensable part of modern society. Despite various changes in formulation, they are clearly associated with an increased risk of venous thromboembolism (VTE). Case-control and prospective studies have developed a range of relative risks of VTE, but the important issue is the impact of VTE relative to perceived benefits of the OC. This involves societal as well as medical judgment. The development of third-generation OCs has led to considerable concerns that these newer preparations may be associated with additional thrombotic risks over and above those of the traditional second-generation preparations. The paradoxical effect, that a change in progestogen in the combined OC could lead to increased VTE, could be explained by the induction of activated protein C resistance. In a society that is less prepared to accept unwanted side effects from medications, it is recommended that increased attention be given to patient selection, and possibly the incorporation into this process of some of the more recently discovered hypercoagulability markers.

Blood Coagulation Tests↗
PubMed1988

Oral contraceptives and hypertension.

Oral contraceptives result in a mild elevation of blood pressure in most women and overt hypertension in about 5%. Both estrogen and progestogen are responsible for the blood pressure effect, but the mechanism is as yet unknown. The risk of cardiovascular complications is found primarily in women over 35 years of age and in those who smoke. Preparations with an estrogen content of 30 g and a progestogen content of 1 mg or less appear to be safe.

Animals↗
PubMedDate not supplied

Ovarian consequences of the transient interruption of combined oral contraceptives.

The combined oral contraceptive pill is an efficient means of contraception. It acts at different levels of the genital tract. Despite its efficiency, it is universally suggested that patients take the pill at regular daily intervals. Little attention has been given to the question of what happens if you miss the pill one day or more. A study was undertaken to evaluate the consequences of pill misses at different times of the cycle. Forty-seven young, healthy, normally menstruating patients voluntarily enrolled. All were given Cilest (ethinyl estradiol 35 micrograms and norgestimate 250 mg, Cilag France) for 21 days without any misses. Then, after a 7-day interval, they were prescribed one (group 1), two (group 2), three (group 3) or four days of pill misses, to occur respectively on day 1 (group a), 6 (group b), 12 (group c) or 18 (group d) of a new 21 day cycle; supplementary contraceptive means were recommended. Four patients had no miss prescribed and served as controls. Ovarian function was evaluated with daily estrogen measurements (E1 + E2 enzymatic dosage, BioMérieux, France) and ultrasound examinations. When required, because of significant increase in estrogen or because of follicular growth detected on ultrasound, LH and progesterone were measured. None of the patients experienced a normal ovulation. Four patients (1 control, 1 from group 2a, and 2 from group 3a) had a significant increase in estrogen levels and had a follicular image on ultrasounds. One of them (group 3a) had a follicular rupture, but none had a LH surge or increase in progesterone.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Ovarian consequences of the transient interruption of combined oral contraceptives.

The combined oral contraceptive pill is an efficient means of contraception. It acts at different levels of the genital tract. Despite its efficiency, it is universally suggested that patients take the pill at regular daily intervals. Little attention has been given to the question of what happens if you miss the pill one day or more. A study was undertaken to evaluate the consequences of pill misses at different times of the cycle. Forty-seven young, healthy, normally menstruating patients voluntarily enrolled. All were given Cilest (ethinyl estradiol 35 micrograms and norgestimate 250 mg, Cilag France) for 21 days without any misses. Then, after a 7-day interval, they were prescribed one (group 1), two (group 2), three (group 3) or four days of pill misses, to occur respectively on day 1 (group a), 6 (group b), 12 (group c) or 18 (group d) of a new 21 day cycle; supplementary contraceptive means were recommended. Four patients had no miss prescribed and served as controls. Ovarian function was evaluated with daily estrogen measurements (E1 + E2 enzymatic dosage, BioMérieux, France) and ultrasound examinations. When required, because of significant increase in estrogen or because of follicular growth detected on ultrasound, LH and progesterone were measured. None of the patients experienced a normal ovulation. Four patients (1 control, 1 from group 2a, and 2 from group 3a) had a significant increase in estrogen levels and had a follicular image on ultrasounds. One of them (group 3a) had a follicular rupture, but none had a LH surge or increase in progesterone.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2006

[Oral contraceptives and cancer].

Oral contraceptives (OC) convey a protection against ovarian, endometrial and perhaps colorectal cancer. However, OC use is associated with excess risk of breast (current or recent use only), cervical and liver cancer. Benefits and risks of OC use on cancer were reviewed in 2005 by a Working Group at the International Agency for Research on Cancer, which concluded that combined OCs are carcinogenic to humans, based on an increased risk for hepatocellular carcinoma, cervical and (for current use only) breast cancers. The Working Group also concluded that there is conclusive evidence that OCs have a protective effect against cancers of the ovary and endometrium.

Breast Neoplasms↗
PubMed1990

[The frequency of miscarriages in the users of oral contraception].

Overuse of oral contraceptives (OC) is currently raising medical problems due to this medication's side effects on the immune system of future mothers. The high rate of miscarriages recorded among OC users is only one facet of the immune disorders often found in these women. This article emphasizes the precautions that should be taken with such medications in teen-agers. If the pregnancy is accompanied with an immune dysfunction exposing the future mother to subsequent infections, this will occur in patients weakened by OC, and will result in troublesome immune disorders. Therefore the notion of OC and miscarriage in pregnant women must lead to consider these as high at risk patients.

Abortion, Induced↗
PubMed2006

Biphasic versus monophasic oral contraceptives for contraception.

BACKGROUND: Side effects caused by oral contraceptives discourage compliance with, and continuation of, oral contraceptives. Three approaches have been used to decrease these adverse effects: reduction of steroid dose, development of new steroids, and new formulas and schedules of administration. The third strategy led to the biphasic oral contraceptive pill. OBJECTIVES: To compare biphasic with monophasic oral contraceptives in terms of efficacy, cycle control, and discontinuation due to side effects. Our a priori hypotheses were: (a) biphasic oral contraceptives are less effective than monophasic oral contraceptives in preventing pregnancy; (b) biphasic oral contraceptives cause more side effects, give poorer cycle control, and have lower continuation rates. SEARCH STRATEGY: We searched the computerized databases MEDLINE, EMBASE, POPLINE, LILACS and CENTRAL. In addition, we searched the reference lists of all potentially relevant articles and book chapters. We also contacted the authors of relevant studies and pharmaceutical companies in Europe and the USA. SELECTION CRITERIA: We included randomized controlled trials comparing any biphasic with any monophasic oral contraceptive when used to prevent pregnancy. DATA COLLECTION AND ANALYSIS: We examined the studies found during the various literature searches for possible inclusion and assessed their methodology using Cochrane guidelines. We contacted the authors of all included studies and possibly randomized studies for supplemental information about methodology and outcome. We entered the data into RevMan, and calculated Peto odds ratios for the incidence of intermenstrual bleeding, absence of withdrawal bleeding, and study discontinuation due to intermenstrual bleeding. MAIN RESULTS: Only one trial of limited quality compared a biphasic and monophasic preparation. Percival-Smith 1990 examined 533 user cycles of a biphasic pill (500 microg norethindrone/35 microg ethinyl estradiol for 10 days, followed by 1000 microg norethindrone/35 microg ethinyl estradiol for 11 days; Ortho 10/11) and 481 user cycles of a monophasic contraceptive pill (1500 microg norethindrone acetate/30 microg ethinyl estradiol daily; Loestrin). The study found no significant differences in intermenstrual bleeding, amenorrhea and study discontinuation due to intermenstrual bleeding between the biphasic and monophasic oral contraceptive pills. AUTHORS' CONCLUSIONS: Conclusions are limited by the identification of only one trial, the methodological shortcomings of that trial, and the absence of data on accidental pregnancies. However, the trial found no important differences in bleeding patterns between the biphasic and monophasic preparations studied. Since no clear rationale exists for biphasic pills and since extensive evidence is available for monophasic pills, the latter are preferred.

Chemistry, Pharmaceutical↗