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PubMed1976

A current appraisal of side effects of oral contraceptives.

Oral contraception, although offering almost 100 per cent protection against pregnancy, is associated with many side effects which have resulted in much unnecessary adverse publicity. Such side effects, the majority of which are of annoying nature only, are due to the synthetic hormones used, and have resulted in many changes in formulation and in the withdrawal of several preparations. The types of preparations available are discussed and the side effects appraised from both the patient's and the physician's viewpoint.

Abnormalities, Drug-Induced↗
PubMed1985

Lymphocyte subsets in women on low dose oral contraceptives.

Oral contraceptive users have been reported to have a higher incidence of viral, bacterial and fungal infections. This study was undertaken to try to elucidate some of the mechanisms responsible for this increased susceptibility to infection. Peripheral blood lymphocytes were labelled with murine monoclonal antibodies directed against T cells and the various lymphocyte subsets: helper cells, suppressor/cytotoxic cells, or natural killer cells. The lymphocytes were then analyzed on a Coulter Electronics Epics V fluorescent activated cell sorter (FACS). A total of 27 control and 33 oral contraceptive users were studied. In comparison to the control group, there was no significant difference between the two groups in percentage or absolute numbers of total T cells, helper cells, suppressor/cytotoxic cells or natural killer cells. This study suggests that the increase in herpes virus, C. trachomonas, candida, and other infections in women taking oral contraceptives is not related to alterations in the numbers of T lymphocyte subsets or in levels of NK cells.

Contraceptives, Oral↗
PubMed1991

[Risk of breast cancer and oral contraceptives].

Oral contraceptive pills have been made available to women since the beginning of the 1960s. The pill (oral contraceptive pill, ovulation inhibitor) is the most sure of all contraceptive methods. With the beginning of applicating the pill, there had been fear of increasing breast cancer risk due to contained hormones. It is assumed that every third woman had ever taken oral contraceptive pills in her life. Yet, breast cancer incidence did not increase world-wide in an extent as would have been expected if the pill really were operating in a breast cancer promoting manner.

Breast Neoplasms↗
PubMed1999

Condom practices of urban teens using Norplant contraceptive implants, oral contraceptives, and condoms for contraception.

OBJECTIVES: The availability of long-acting hormonal birth control methods has created new contraceptive options for adolescents. The purpose of this study was to determine whether teens initiating these methods use condoms less frequently than teens using oral contraceptive pills or condoms alone and may therefore be at an increased risk of acquiring sexually transmitted infections. STUDY DESIGN: To investigate ongoing condom behavior in teens using levonorgestrel (Norplant) contraceptive implants, oral contraceptives, and condoms alone, we examined data from a 2-year prospective cohort study of 399 urban teens. The study consisted of 3 clinic-based cohorts of adolescent female contraceptive users: Norplant contraceptive implants (n = 200), oral contraceptives (n = 100), and condoms alone (n = 99). Data were collected at an admission interview and at 1- and 2-year follow-up from method continuers. RESULTS: Norplant contraceptive implant users were less likely than oral contraceptive or condom users to report condom use at last sex or consistent condom use at 1- and 2-year follow-up. The implant group showed a significant decrease in condom use from admission to 2 years after method initiation. The proportion of implant users self-reporting new sexually transmitted infections at 2-year follow-up, however, was not significantly greater than that of oral contraceptive or condom users. CONCLUSIONS: Our findings indicate that teen users of Norplant contraceptive implants are less likely to use condoms than teens who choose oral contraceptives but, probably because of differences in sexual behavior, are no more likely to self-report sexually transmitted infections. Our findings also indicate that teens who choose oral contraceptives and condoms do not use them consistently enough to avoid pregnancies or sexually transmitted infections.

Adolescent↗
PubMed1987

Plasma concentrations of vasopressin and a prostaglandin F2 alpha metabolite in women with primary dysmenorrhoea before and during treatment with a combined oral contraceptive.

Oral contraceptives reduce menstrual pain but the interaction with vasopressin and prostaglandin F2 alpha, two uterine stimulants related to the condition, is unknown. Ten women with a history of moderate to severe dysmenorrhoea were studied. Repeated blood samples were taken during a first menstrual cycle without treatment, during the first 21 days of a second cycle when they received an oral contraceptive (150 micrograms levonorgestrel and 30 micrograms ethynyloestradiol) and on the first or second day of the bleeding following hormonal withdrawal. Measurements were made of plasma concentrations of arginine vasopressin, 15-keto-13,14-dihydroprostaglandin F2 alpha, oestradiol-17 beta, progesterone, ethynyloestradiol, levonorgestrel, FSH, LH and prolactin, and serum osmolality was measured. Seven of the women rated their discomfort as moderate to severe on the first two menstruations, but as none or light at the withdrawal bleeding; with the rating scale for degree of pain that was used, this decrease in pain was significant (P less than 0.001). The plasma concentration of vasopressin in these seven women showed significant variation, with the highest concentrations being obtained at the beginning of the two painful menstruations (3.76 +/- 0.76 and 1.75 +/- 0.30 (S.E.M.) pmol/l) and at ovulation in the control cycle (1.91 +/- 0.58 pmol/l). During treatment the concentrations were consistently low, except on the first day of withdrawal bleeding (2.33 +/- 0.35 pmol/l). The concentrations of the prostaglandin F2 alpha metabolite showed less variation, but again the values at withdrawal bleeding (271 +/- 39 pmol/l) were not different from those obtained over the painful menstruations (255 +/- 24 and 217 +/- 25 pmol/l).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1972

The relation of growth hormone to altered carbohydrate metabolism in women taking oral contraceptives.

Oral glucose tolerance tests were performed on a group of women before and during oral contraceptive administration and the plasma glucose, insulin, and growth hormone levels were studied. A significant impairment of glucose tolerance and an altered insulin response were observed in women taking oral contraceptives. The women had higher plasma growth hormone levels in the fasting state but this is not of primary aetiological significance in the development of altered carbohydrate metabolism.

Adult↗
PubMed1990

Update on combination oral contraceptives.

Oral contraceptives in current use appear to be safe and effective. Studies found that early contraceptive pills, which had a high estrogen content, were associated with a number of serious side effects and long-term sequelae. Studies of the newer low-dose preparations demonstrate a much lower incidence of adverse effects. The beneficial effects of oral contraceptives in disease prevention are now widely recognized. The diversity of available formulations allows the physician to tailor therapy to the individual patient, maintaining contraceptive efficacy while minimizing adverse effects and long-term risks.

Contraceptives, Oral, Combined↗
PubMed2004

Jordanian Muslim women's intention to use oral contraceptives.

Oral contraceptives (OCs) are the second most popular method of contraception in Jordan; however, their use remains low compared with the intrauterine device. The purpose of this article is to report the effect of factors identified by The Theory of Planned Behavior (TPB) on Jordanian Muslim women's intention to use OCs. TPB was used to develop an investigator-developed instrument, the Intention to Use Oral Contraceptive Tool (IUOCT). The IUOCT measured attitude (general attitude and attitudinal beliefs), social norms and perceived behavioral control factors in a total of 83 women participants. A stepwise regression analysis was calculated using the IUOCT subscales as predictors of Jordanian Muslim women's intention to use OCs. The findings demonstrated that the attitude, specifically general attitude and positive beliefs, about OC use affect Jordanian Muslim women's intention to use OCs. However, the findings provide limited support for social norms and perceived behavioral control as factors influencing Jordanian Muslim women's intention to use OCs. The findings indicate that more attention should be devoted to health education programs on the benefits of using OCs rather than focusing only on correcting misinformation. Nursing implications and recommendations for future research are discussed.

Adult↗
PubMed1987

[Favorable concomitant effects and undesirable side effects of oral contraceptives].

Oral contraceptives can cause favourable or adverse unintended effects. Severe adverse side effects could be reduced by lowering the estrogen dose and lowering the dose and changing the structure of progestogens. So favourable side effects have gained in importance such as correcting disorders of the menstrual bleeding pattern, positive influence on functional ovarian cysts, benign breast diseases, the skin. Concerning the risk for neoplasm there is a certain protective effect against endometrial and ovarian cancer and no higher risk for breast cancer. Medically important adverse side effects on the cervix, the menstrual pattern, the liver and gallbladder, the central nervous system and psyche, or severe side effects like thromboembolic diseases are significantly reduced by dose reduced compounds containing newly developed progestogens. Interactions between oral contraceptives and other drugs are of little clinical significance.

Contraceptives, Oral↗
PubMed2006

Cerebral venous sinus thrombosis in users of four hormonal contraceptives: levonorgestrel-containing oral contraceptives, norgestimate-containing oral contraceptives, desogestrel-containing oral contraceptives and the contraceptive patch.

BACKGROUND: It has been suggested that the risk for cerebral venous sinus thrombosis (CVST) may be greater among users of the contraceptive patch than among users of oral contraceptives (OCs). METHODS: From the PharMetrics database, we identified women aged 15-44 years who filled at least one prescription for either the contraceptive patch or desogestrel-containing, norgestimate-containing or levonorgestrel-containing OCs to assess the risk of CVST. The person-time of current exposure to each study drug, as well as the incidence rates (IRs) and incidence rate ratios (IRRs) of CVST, was calculated. RESULTS: We identified over 1 million users of the four study drugs. There were five cases of CVST among current users of desogestrel, seven cases among current users of norgestimate, two cases among current users of levonorgestrel and none among current users of the contraceptive patch. The IRs per 100,000 woman-years were 2.7 [95% confidence interval (95% CI)=0.9-6.3], 1.6 (95% CI=0.7-3.3), 0.7 (95% CI=0.1-2.4) and 0.0 (95% CI=0.0-4.8), respectively, in users of desogestrel, norgestimate, levonorgestrel and the contraceptive patch. There were two women who had CVST while not currently taking a hormonal contraceptive (IR=0.4 per 100,000 woman-years; 95% CI=0.1-1.3). The IRRs were 4.0 (95% CI=0.7-42.4) for desogestrel-containing versus levonorgestrel-containing OCs, and 2.4 (95% CI=0.5-24.0) for norgestimate-containing versus levonorgestrel-containing OCs. The IRR for the patch could not be calculated. CONCLUSIONS: There is no evidence of an increased risk of CVST in users of the contraceptive patch compared to users of levonorgestrel-containing OCs.

Administration, Cutaneous↗
PubMed1991

[Psychosomatic aspects of oral contraception].

Oral contraceptive use is influenced by multiple emotional factors. Physiological and psychological effects are closely correlated. Contraception may assist women in pursuing important psychosocial goals, on the other hand, it may cause a number of problems. Many unconscious wishes or fears may interfere with the clear separation of sexuality from fertility. Ambivalence about pregnancy, neurotic personalities and problems in partner relationship may cause psychic conflicts with regard to contraception. Anxiety, side effects, misuse of contraceptives or problems in the relationship between doctor and patient may result. As a further development psychosomatic symptoms such as discomfort, nervousness, sleep disturbance, fatigue, nausea and sexual disorders may appear. The physician must take contradictory feelings of the patient into consideration, including her anxiety and her possible ambivalence with respect to pregnancy.

Contraceptives, Oral↗
PubMed1990

Gastrointestinal disease and oral contraception.

Oral contraceptive steroids play a major role in modern family planning. With the present tendency to decrease the doses of both estrogens and progestogens, any factor that reduces the bioavailability of the lower-dose preparations may have an impact on contraceptive protection. Although ethinyl estradiol, the most commonly used oral estrogen, is liable to an enterohepatic circulation as unchanged drug, the commonly used progestogens are not. At present, no convincing evidence exists in the human subject that disruption of the enterohepatic circulation by antibiotics or antacids does reduce contraceptive efficacy of the pill. Oral contraceptive steroids are mainly absorbed from the small bowel, and contraceptive efficacy depends on its absorptive capacity. Enhanced passage of gastrointestinal contents or impaired absorption may thus contribute to contraceptive failures in patients who have chronic inflammatory disease, diarrhea, ileostomy, or jejunoileal bypass.

Antacids↗
PubMed2002

Risk of Arterial Thrombosis in Relation to Oral Contraceptives (RATIO) study: oral contraceptives and the risk of ischemic stroke.

BACKGROUND AND PURPOSE: Epidemiological studies have shown an increased risk of venous thrombosis in women taking third-generation oral contraceptives, ie, those containing the progestogens desogestrel or gestodene. This study assesses the risk of ischemic stroke with several types of oral contraceptives. METHODS: A multicenter, population-based, case-control study was performed in 9 Dutch centers in women aged 18 to 49 years. Women with a first ischemic stroke were compared with control women without vascular diseases. The control subjects were recruited by random-digit dialing and were stratified by age, area of residence, and year of stroke. All patients and control subjects filled in a questionnaire about the use of oral contraceptives and risk factors for ischemic stroke. Odds ratios were adjusted for the stratification factors. RESULTS: Two hundred three women with an ischemic stroke and 925 control women were included. The risk of stroke in women using any type of oral contraceptives versus none was 2.3 (95% CI 1.6 to 3.3). Current users of first-generation oral contraceptives had an odds ratio of 1.7 (95% CI 0.7 to 4.4). Low-dose second-generation oral contraceptives increased the risk of stroke 2.4 times (95% CI 1.6 to 3.7), and third-generation oral contraceptives increased the risk of stroke 2.0 times (95% CI 1.2 to 3.5). The risk of stroke in women using third-generation oral contraceptives was not different from that in women using second-generation oral contraceptives (odds ratio 1.0, 95% CI 0.6 to 1.8). CONCLUSIONS: Third-generation oral contraceptives (containing desogestrel or gestodene) confer the same risk of first ischemic stroke as second-generation oral contraceptives (containing levonorgestrel).

Adolescent↗
PubMed2003

Markers for cardiovascular disease in monozygotic twins discordant for the use of third-generation oral contraceptives.

Oral contraceptives (OC) modulate the risk for developing cardiovascular (CV) diseases. The aim of this study was to determine whether the use of third-generation OC has an impact on markers of CV disease in genetically identical women. We performed an intrapair comparison in 27 monozygotic twin pairs, one of whom was taking third-generation OC, whereas the other was not using OC. Biometric parameters were ascertained and conventional and 24-h ambulatory blood pressure (BP) was recorded. A fasting blood sample was taken for the measurement of glucose, insulin, proinsulin, lipids, and insulin-like growth factor binding protein-1 (IGFBP-1). Insulin resistance and beta-cell function were calculated by homeostasis model assessment (HOMA). A 24-h urine sample for cortisol was obtained. Third-generation OC use increased 24-h ambulatory systolic and diastolic BP by 5.2 and 3.9 mmHg, respectively (both P=0.0003). There was no effect on glucose, insulin and proinsulin levels, and on HOMA parameters, but the IGFBP-1 levels were markedly raised (P=0.0009). The lipid profile showed a 34% increase in triglyceride levels (P < 0.0001), but also a 7% increase in HDL-cholesterol levels (P=0.037). Use of third-generation OC impacts on CV disease markers in young-adult genetically identical women. Some changes are beneficial (increased HDL-cholesterol), whereas others may be deleterious (increased BP and triglyceride levels) or have unknown effects at this time (increased IGFBP-1 levels).

Adult↗
PubMed1988

A twin study of the psychiatric side effects of oral contraceptives.

Oral contraceptive (ORC)-related depression and irritability are among the most commonly reported drug-induced psychiatric symptoms. To investigate the etiological role of genetic factors in ORC-related symptoms, we studied questionnaire responses in 715 monozygotic and 416 dizygotic volunteer twin pairs concordant for ORC usage. Biometrical genetic analysis indicated that the liability to ORC-related depression was clearly influenced by genetic but not familial-environmental factors. Similar, but less definitive, results were found for ORC-related irritability. Multivariate genetic analysis indicated that both the genetic and the individual-specific environmental factors that influenced the liability to ORC-related depression and irritability were largely distinct from those that influence baseline levels of psychiatric symptoms. Genes play an important etiological role in ORC-related psychiatric side effects. The genes that influence liability to these side effects appear to differ from those that are etiologically important in baseline psychiatric symptomatology.

Affect↗
PubMed1983

Effects on blood pressure of low dose oestrogen and progestagen only oral contraceptives.

Oral contraceptives containing at least 50 micrograms oestrogen and 1-4 mg progestagen can raise blood pressure [1,2]. However, there is controversy about the effect of lower doses of oestrogen [3-5] on blood pressure and especially the role of the progestagen component [6-9]. We describe the results of a prospective, controlled study of the effects on blood pressure of contraceptive preparations containing different types and dosages of oestrogen and of progestagen.

Adult↗