Uso de anticonceptivos hormonales y depresión en mujeres adolescentes y jóvenes: una revisión de alcance / Hormonal contraceptive use and depression in adolescent and young women: a scoping review

Se ha señalado al uso de los métodos anticonceptivos hormonales como una de las posibles causas que explican el exceso de depresión en mujeres. Objetivo: Explorar la literatura sobre la asociación entre uso de anticoncepción hormonal y depresión en adolescentes y jóvenes. Método: Se llevó a cabo una revisión de alcance de la literatura identificando estudios empíricos cuantitativos enfocados en la asociación entre uso de anticonceptivos hormonales y depresión en mujeres entre 11 y 24 años, publicados entre enero de 2017 y septiembre de 2022 e indexadas en Web of Science y SCOPUS. Resultados: Se incluyeron 12 artículos que mostraron asociaciones positivas, negativas y no concluyentes o con resultados mixtos. Conclusiones: La relación entre el uso de anticonceptivos hormonales y depresión es compleja y multifacética. Los resultados presentados resaltan la necesidad de una investigación continua y más específica para comprender mejor las posibles asociaciones y proporcionar orientación clínica más precisa.

Abstract. The use of hormonal contraceptive methods has been pointed out as one of the possible causes that explain the excess of depression in women. Objective: To explore the literature on the association between the use of hormonal contraceptives and depression in adolescents and young women. Methods: We conducted a scoping review of the literature identifying quantitative empirical studies focused on the association between hormonal contraceptive use and depression in women aged 11-24 years, published between January 2017 and September 2022, and indexed in Web of Science and SCOPUS. Results: In total, 12 articles showing positive, negative, and inconclusive or mixed associations were included. Conclusions: The relationship between hormonal contraceptive use and depression is complex and multifaceted. The results presented highlight the need for continued and more specific research to better understand possible associations and provide more accurate clinical guidance.

The effects of hormonal contraceptive use on sleep in women: A systematic review and meta-analysis.

Hormonal contraceptives are some of the most widely used medications worldwide, but studies on their effects on sleep are contradictory, with some reporting a sleep-promoting effect, while others a sleep-inhibiting effect. Our objective was, therefore, to undertake a systematic review and meta-analysis of the literature on this subject to try to clarify their effects. A search was conducted in three databases (PubMed, Scopus and Web of Science). Only studies evaluating hormonal contraception use were considered eligible, and both objective and subjective sleep-related outcomes were considered. Individual effect size was calculated for each article, and meta-analyses were performed using a DerSimonian and Laird random effects method. The initial search identified 2076 articles, of which 13 met the criteria for the study after full text evaluation. A total of 33 meta-analyses were performed, three of them related to subjective measures and 30 considering data from polysomnography. The only statistically significant result between contraceptive users and non-contraceptive users was observed in respect of wake after sleep onset, which was 7 min shorter among contraceptive users (-7.12 [-12.80; -1.44]; I2  = 65%; p = 0.01). In conclusion, hormonal contraceptives are not associated with clinically relevant changes in sleep patterns in women.

The Effects of Hormonal Contraceptives on the Sleep of Women of Reproductive Age.

Research about the effects of hormonal contraceptives on sleep has been performed but is subjected to important levels of methodological heterogeneity. Hormonal contraceptives impact sleep, but the direction of this association is not clear. Most studies describe a negative sleep profile among contraceptive users, including increased sleepiness, insomnia symptoms, decreased sleep efficiency, and a reduced overall sleep quality. Hormonal intrauterine contraceptives are associated with less negative effects. More research on the field, especially randomized controlled trials, is needed to increase the level and certainty of evidence about the effects of hormonal contraceptives on sleep.

Hormonal Contraceptives and Post-fertilization Effects.

Hormonal contraceptives are widely used for birth control and therapeutic purposes. The mechanism of action proposed for these compounds can be found in several scientific journals published to date. The present work consists in a scoping review of a convenience sample of papers regarding the mechanisms of action of each of the three main classes of hormonal contraceptives available. Different parameters and biological consequences associated with their use were also reviewed. Based on these data, we evaluated the probability of embryo loss due to the use of hormonal contraceptives. Evidence indicates the probability of embryo loss due to post-fertilization effects.

Influência do anticoncepcional hormonal oral no surgimento da trombose venosa profunda / Influence of oral hormonal contraceptives on the emergence of deep vein thrombosis / Influencia de los anticonceptivos hormonales orales en la aparición de trombosis venosa profunda

Objetivo: Descrever a ação dos anticoncepcionais orais no organismo feminino, relatando os fatores que desencadeiam a trombose venosa profunda. Método: Tratase de uma revisão bibliográfica de caráter qualitativo, onde foram selecionados 11 artigos de maior relevância para compormos a pesquisa. Resultado: A análise dos artigos selecionados mostrou que os anticoncepcionais orais possuem ligação com a ocorrência de eventos trombóticos. Os contraceptivos são compostos por um combinado de hormônios que influenciam diretamente no surgimento da trombose venosa profunda. Conclusão: Os anticoncepcionais orais exercem influência no surgimento de trombose venosa profunda pois podem causar alterações no equilíbrio hemostático. Para a utilização desses medicamentos, é necessário responsabilidade e acompanhamento de um especialista, em após uma criteriosa avaliação, será selecionado o anticoncepcional mais adequado.

Objective: To describe the action of oral contraceptives in the female body, reporting the factors that trigger deep vein thrombosis. Method: This is a bibliographical review of a qualitative nature, where 11 articles of greatest relevance were selected to compose the research. Results: The analysis of the selected articles showed that oral contraceptives are linked to the occurrence of thrombotic events. Contraceptives are composed of a combination of hormones that directly influence the onset of deep vein thrombosis. Conclusion: Oral contraceptives influence the development of deep vein thrombosis as they can cause changes in homostatic balance. For the use of these drugs, it is necessary to be responsible and supervised by a specialist, and after a careful evaluation, the most suitable contraceptive will be selected.

Objetivo: Describir la acción de los anticonceptivos orales en el organismo femenino, informando los factores desencadenantes de la trombosis venosa profunda. Método: Se trata de una revisión bibliográfica de carácter cualitativo, donde se seleccionaron 11 artículos de mayor relevancia para componer la investigación. Resultados: El análisis de los artículos seleccionados mostró que los anticonceptivos orales están relacionados con la aparición de eventos trombóticos. Los anticonceptivos están compuestos por una combinación de hormonas que influyen directamente en la aparición de trombosis venosa profunda. Conclusión: Los anticonceptivos orales influyen en el desarrollo de la trombosis venosa profunda ya que pueden provocar cambios en el equilibrio homostático. Para el uso de estos medicamentos es necesario ser responsable y supervisado por un especialista, y luego de una cuidadosa evaluación, se seleccionará el anticonceptivo más adecuado.

Analysis of the Role of Female Hormones During Infection by COVID-19.

Women have metabolic, immunological, and genetic variables that ensure more protection from coronavirus infection. However, the indication of treatment for several pathologies and contraception is determined by hormones that have adverse effects and raise doubts about their use during the COVID-19 pandemic. Therefore, the present study searches women specificities and the relation between female sexual hormones and COVID-19, and reports the main recommendations in this background. To this end, a review of the literature was conducted in the main databases, auxiliary data sources, and official websites. Therefore, considering the hypercoagulability status of COVID-19, the debate about the use of contraceptives due to the relative risk of thromboembolic effects that they impose arises. However, the current available evidence, as well as the recommendations of main health organs around the world, demonstrate that the use of hormonal contraceptives must be maintained during the pandemic.

As mulheres possuem variáveis metabólicas, imunológicas e genéticas que conferem maior proteção à infecção pelo coronavírus. Todavia, a indicação de tratamento para certas patologias e para a contracepção é determinada por hormônios que possuem efeitos adversos e levantam dúvidas quanto ao seu uso durante a pandemia da COVID-19. Desta forma, o presente estudo busca investigar as especificidades da mulher e a relação dos hormônios sexuais femininos com a COVID-19, assim como relatar as principais recomendações neste contexto. Para isso, realizou-se uma revisão da literatura nas principais bases de dados, fontes auxiliares de dados e sites oficiais. Portanto, considerando o estado hipercoagulável da COVID-19, surge o debate quanto à utilização de contraceptivos pelo seu risco relativo de efeitos tromboembólicos. No entanto, as atuais evidências disponíveis, assim como as recomendações dos principais órgãos de saúde do mundo, demonstraram que o uso de contraceptivos hormonais deve ser mantido durante a pandemia.

Analysis of the Role of Female Hormones During Infection by COVID-19 / Análise do papel dos hormônios femininos durante a infecção por COVID-19

Abstract Women have metabolic, immunological, and genetic variables that ensure more protection from coronavirus infection. However, the indication of treatment for several pathologies and contraception is determined by hormones that have adverse effects and raise doubts about their use during the COVID-19 pandemic. Therefore, the present study searches women specificities and the relation between female sexual hormones and COVID-19, and reports the main recommendations in this background. To this end, a review of the literature was conducted in the main databases, auxiliary data sources, and official websites. Therefore, considering the hypercoagulability status of COVID-19, the debate about the use of contraceptives due to the relative risk of thromboembolic effects that they impose arises. However, the current available evidence, as well as the recommendations of main health organs around the world, demonstrate that the use of hormonal contraceptives must be maintained during the pandemic.

Resumo As mulheres possuem variáveis metabólicas, imunológicas e genéticas que conferem maior proteção à infecção pelo coronavírus. Todavia, a indicação de tratamento para certas patologias e para a contracepção é determinada por hormônios que possuem efeitos adversos e levantam dúvidas quanto ao seu uso durante a pandemia da COVID-19. Desta forma, o presente estudo busca investigar as especificidades da mulher e a relação dos hormônios sexuais femininos com a COVID-19, assim como relatar as principais recomendações neste contexto. Para isso, realizou-se uma revisão da literatura nas principais bases de dados, fontes auxiliares de dados e sites oficiais. Portanto, considerando o estado hipercoagulável da COVID-19, surge o debate quanto à utilização de contraceptivos pelo seu risco relativo de efeitos tromboembólicos. No entanto, as atuais evidências disponíveis, assim como as recomendações dos principais órgãos de saúde do mundo, demonstraram que o uso de contraceptivos hormonais deve ser mantido durante a pandemia.

[Contraceptive discontinuities in the use of oral and injectable hormonal contraceptives, and male condoms]. / Descontinuidades contraceptivas no uso do contraceptivo hormonal oral, injetável e do preservativo masculino.

The study aimed to estimate the total contraceptive discontinuity rates in the use of oral and injectable hormonal contraceptives, and male condoms and dropout rates due to switches to more effective and less effective methods. Data on 2,051 women, users of primary healthcare services in three Brazilian state capitals, were collected using the contraceptive calendar. The results showed that 24.5% of users of oral hormonal contraceptives, 33.5% of users of injectables, and 39% of users of male condoms had discontinued the respective method after 12 months of use, independently of the reason, and that the rates varied little between the capitals but did depend on the method. The main reason for discontinuing use of the contraceptive method was the desire to become pregnant (20.8%). Conception while using the method was reported by 20% of the women, a proportion that reached 25.7% in users of male condoms. After 12 months with the method, the dropout rate for reasons related to the contraceptive method was 11.4% in users of injectables; 15.9% of users of male condoms switched to a more effective method; and 16.3% of users of injectables switched to a less effective method. Contraceptive discontinuity rates were high and varied according to the contraceptive method.

O objetivo foi estimar as taxas de descontinuidade total no uso do contraceptivo hormonal oral, injetável e do preservativo masculino, bem como verificar as taxas de interrupção por abandono e por troca para método mais eficaz e menos eficaz. Dados de 2.051 mulheres usuárias de unidades básicas de saúde de três capitais brasileiras foram coletados por meio do calendário contraceptivo. Os resultados mostraram que 24,5% das usuárias do contraceptivo hormonal oral, 33,5% das usuárias de contraceptivo hormonal injetável e 39% das usuárias do preservativo masculino haviam descontinuado o uso do método até 12 meses de uso, independentemente da razão. Houve pouca variação nas taxas entre capitais, mas não no método utilizado. A principal razão para descontinuar o uso do método contraceptivo foi por querer engravidar (20,8%). Um total de 20% das mulheres engravidou enquanto usava algum método, e essa proporção alcançou 25,7% entre usuárias do preservativo masculino. Ressalta-se que, após 12 meses de uso, a taxa de abandono por razões relacionadas ao método contraceptivo foi de 11,4% entre usuárias do injetável. A taxa de troca para método mais eficaz foi de 15,9% entre usuárias do preservativo masculino, e a taxa de troca para método menos eficaz foi de 16,3% entre usuárias do contraceptivo hormonal injetável. As taxas de descontinuidade contraceptiva foram altas e variaram conforme o tipo de método contraceptivo utilizado.

El objetivo fue estimar las tasas de discontinuidad contraceptiva totales en el uso del contraceptivo hormonal oral o inyectable y del preservativo masculino, así como por abandono, cambio por un método más eficaz o menos eficaz. Se recogieron datos de 2.051 mujeres usuarias de unidades básicas de salud de tres capitales brasileñas mediante el calendario contraceptivo. Los resultados expusieron que un 24,5% de las usuarias del contraceptivo hormonal oral, un 33,5% de las usuarias de inyectables y un 39% de las usuarias del preservativo masculino habían discontinuado el uso del método tras 12 meses de uso, independientemente de la razón, siendo que las tasas poco variaron entre las capitales, pero sí dependiendo del método utilizado. La principal razón para interrumpir el uso del método contraceptivo fue querer quedarse embarazada (20,8%). Quedarse embarazada mientras se usaba el método fue informado por un 20% de las mujeres, proporción que alcanza un 25,7% entre usuarias del preservativo masculino. Se resalta que, tras 12 meses de uso del método, la tasa de abandono por razones relacionadas con el método contraceptivo fue un 11,4% entre usuarias de los inyectables; la tasa de cambio hacia un método más eficaz fue 15,9% entre usuarias del preservativo masculino; y la tasa de cambio por un método menos eficaz fue 16,3% entre usuarias de los inyectables. Las tasas de discontinuidad contraceptiva fueron altas y variaron según el tipo de método contraceptivo utilizado.

Efeitos do exercício físico sobre o perfil lipídico e inflamatório de mulheres jovens em uso de contraceptivo oral combinado: protocolo de um estudo sequencial cruzado / Effects of physical exercise on the lipid and inflammatory profile of young women using combined oral contraceptives: protocol of a crosssectional study

INTRODUÇÃO: O uso de contraceptivos orais combinados (COC) trata-se de um fator de risco para a doença aterosclerótica por comprometer o perfil lipídico e inflamatório, podendo o exercício físico minimizar essas condições. OBJETIVO: Testar a hipótese de que exercício físico pode modificar o perfil lipídico e inflamatório de mulheres em uso COC. MÉTODOS: Protocolo de um estudo sequencial cruzado com mulheres de 20 e 30 anos, irregularmente ativas, em uso de COC há pelo menos 6 meses. Realizouse uma avaliação físico-clínica (AFC) nas participantes com medidas antropométricas, VO2máx. indireto e análise do perfil lipídico e inflamatório. Na sequência separou-se as participantes em 2 grupos: O grupo intervenção inicial (GII) que iniciou praticando exercícios intervalados de alta intensidade por 2 meses, e o grupo intervenção posterior (GIP), que seguiu irregularmente ativo pelo mesmo período. Em seguida o GII e o GIP alternariam suas condições por mais 2 meses, totalizando 4 meses de acompanhamento e 3 AFC, realizadas no início, após 2 meses e ao final do estudo. As informações colhidas foram divididas em 3 momentos: Momento inicial (MI), momento pós exercício (MPE) e pós inatividade (MPI).

INTRODUCTION: The use of combined oral contraceptives (COC) is a risk factor for atherosclerotic disease because it compromises the lipid and inflammatory profile, and physical exercise can minimize these conditions. OBJECTIVE: To test the hypothesis that high intensity interval physical exercise promotes changes in the lipid and inflammatory profile of women who are irregularly active using COC. METHODS: Protocol of a crosssectional study with women of 20 and 30 years, irregularly active, using COC for at least 6 months. A physicalclinical assessment (AFC) was performed on the participants with anthropometric measurements, VO2max. analysis and analysis of the lipid and inflammatory profile. Afterwards, the participants were divided into 2 groups: the initial intervention group (GII) that started practicing high intensity interval exercises for 2 months, and the posterior intervention group (GIP), which remained irregularly active for the same period. Then the GII and GIP would alternate their conditions for another 2 months, totaling 4 months of follow-up and 3 AFC, performed at the beginning, after 2 months and at the end of the study. The information collected was divided into 3 moments: Initial moment (MI), post-exercise moment (MPE) and post-inactivity (MPI).

Manejo conservador de retención de productos de la concepción con anticonceptivos orales combinados / Conservative Management of Retained Products of Conception with Combined Oral Contraceptives. Case Report

Objetivo: presentar el caso de una paciente con retención de productos de la concepción (RPC) después de aborto médico, tratada con anticonceptivos orales combinados (ACOC), y efectuar revisión de la literatura. Caso Clínico: paciente de 37 años, con sangrado genital escaso y leve dolor pélvico, quien tuvo aborto provocado con misoprostol cuatro días antes, acude sin signos de infección, con endometrio mixto de 18,5 mm. Durante seis semanas de seguimiento persiste sangrado y endometrio mixto engrosado, con disminución lenta de la gonadotrofina corionica humana (GCH); se sospecha RPC, se suministra ciclo de ACOC y al terminarlos expulsa completamente el tejido retenido. Metodología: búsqueda bibliográfica en bases de datos Google Scholar, Science Direct, RIMA, PubMed. Revisión de literatura: la RPC se presenta después de parto o aborto (más frecuente). Criterios diagnósticos: sangrado persistente, hallazgos ecográficos y medición de GCH. Diagnóstico diferencial: enfermedad trofoblastica gestacional y malformaciones arteriovenosas uterinas. Es factible el manejo conservador, con bajas tasas de infección o procedimientos quirúrgicos. Ante la evolución prolongada, presencia de signos de infección o hemorragia importante, se impone la evacuación quirúrgica, tradicionalmente con dilatación y legrado, y más recientemente resección histeroscópica. La bibliografía reciente sugiere el uso de ACOC como manejo médico. En nuestro caso, la paciente tomó un ciclo de ACOC y al terminarlos presentó expulsión de los restos retenidos. Conclusiones: el manejo conservador de la RPC con ACOC surge como una opción en casos seleccionados; son necesarios estudios controlados para definir su utilidad..Au

Objective: to report the case of a patient with retained products of conception (RPC) after a medical abortion, successfully treated with combined oral contraceptives (COCs), and to review the literature. Clinical case: a 37-year-old patient, with little genital bleeding and slight pelvic pain, who had had a misoprostol-induced abortion four days before consulting, she attended without signs of infection, with a thikened 18.5 mm mixed endometrium. After six weeks follow-up genital bleeding and thickened mixed endometrium persist, with a slow decrease in human chorionic gonadotropin (HCG), RPC is suspected, and a COC cycle is administered, when finished, she completely expelled the retained tissue. Methodology: Google Scholar, Science Direct, RIMA and PubMed databases were searched. Literature review: RPC occurs after delivery or abortion (more frequent), diagnostic criteria: persistent bleeding, ultrasound findings and HCG measurement; the differential diagnosis includes gestational trophoblastic disease and uterine arteriovenous malformations. Conservative management is feasible, with low rates of infection or surgical procedures, however, in case of prolonged evolution, evident signs of infection or significant bleeding, surgical evacuation is required, traditionally with dilation and curettage, and more recently hysteroscopic resection. Novel bibliography suggests the use of ACOC as medical management. In our case, the patient took a cycle of COC and at the end she expelled the retained remains. Conclusions: conservative management of RPC with COC arises as an option in selected cases, controlled trails are needed to define its usefulness..Au

Descontinuidades contraceptivas no uso do contraceptivo hormonal oral, injetável e do preservativo masculino / Contraceptive discontinuities in the use of oral and injectable hormonal contraceptives, and male condoms / Discontinuidades contraceptivas en el uso del anticonceptivo hormonal oral o inyectable y del preservativo masculino

O objetivo foi estimar as taxas de descontinuidade total no uso do contraceptivo hormonal oral, injetável e do preservativo masculino, bem como verificar as taxas de interrupção por abandono e por troca para método mais eficaz e menos eficaz. Dados de 2.051 mulheres usuárias de unidades básicas de saúde de três capitais brasileiras foram coletados por meio do calendário contraceptivo. Os resultados mostraram que 24,5% das usuárias do contraceptivo hormonal oral, 33,5% das usuárias de contraceptivo hormonal injetável e 39% das usuárias do preservativo masculino haviam descontinuado o uso do método até 12 meses de uso, independentemente da razão. Houve pouca variação nas taxas entre capitais, mas não no método utilizado. A principal razão para descontinuar o uso do método contraceptivo foi por querer engravidar (20,8%). Um total de 20% das mulheres engravidou enquanto usava algum método, e essa proporção alcançou 25,7% entre usuárias do preservativo masculino. Ressalta-se que, após 12 meses de uso, a taxa de abandono por razões relacionadas ao método contraceptivo foi de 11,4% entre usuárias do injetável. A taxa de troca para método mais eficaz foi de 15,9% entre usuárias do preservativo masculino, e a taxa de troca para método menos eficaz foi de 16,3% entre usuárias do contraceptivo hormonal injetável. As taxas de descontinuidade contraceptiva foram altas e variaram conforme o tipo de método contraceptivo utilizado.

The study aimed to estimate the total contraceptive discontinuity rates in the use of oral and injectable hormonal contraceptives, and male condoms and dropout rates due to switches to more effective and less effective methods. Data on 2,051 women, users of primary healthcare services in three Brazilian state capitals, were collected using the contraceptive calendar. The results showed that 24.5% of users of oral hormonal contraceptives, 33.5% of users of injectables, and 39% of users of male condoms had discontinued the respective method after 12 months of use, independently of the reason, and that the rates varied little between the capitals but did depend on the method. The main reason for discontinuing use of the contraceptive method was the desire to become pregnant (20.8%). Conception while using the method was reported by 20% of the women, a proportion that reached 25.7% in users of male condoms. After 12 months with the method, the dropout rate for reasons related to the contraceptive method was 11.4% in users of injectables; 15.9% of users of male condoms switched to a more effective method; and 16.3% of users of injectables switched to a less effective method. Contraceptive discontinuity rates were high and varied according to the contraceptive method.

El objetivo fue estimar las tasas de discontinuidad contraceptiva totales en el uso del contraceptivo hormonal oral o inyectable y del preservativo masculino, así como por abandono, cambio por un método más eficaz o menos eficaz. Se recogieron datos de 2.051 mujeres usuarias de unidades básicas de salud de tres capitales brasileñas mediante el calendario contraceptivo. Los resultados expusieron que un 24,5% de las usuarias del contraceptivo hormonal oral, un 33,5% de las usuarias de inyectables y un 39% de las usuarias del preservativo masculino habían discontinuado el uso del método tras 12 meses de uso, independientemente de la razón, siendo que las tasas poco variaron entre las capitales, pero sí dependiendo del método utilizado. La principal razón para interrumpir el uso del método contraceptivo fue querer quedarse embarazada (20,8%). Quedarse embarazada mientras se usaba el método fue informado por un 20% de las mujeres, proporción que alcanza un 25,7% entre usuarias del preservativo masculino. Se resalta que, tras 12 meses de uso del método, la tasa de abandono por razones relacionadas con el método contraceptivo fue un 11,4% entre usuarias de los inyectables; la tasa de cambio hacia un método más eficaz fue 15,9% entre usuarias del preservativo masculino; y la tasa de cambio por un método menos eficaz fue 16,3% entre usuarias de los inyectables. Las tasas de discontinuidad contraceptiva fueron altas y variaron según el tipo de método contraceptivo utilizado.

Luteotropic effects of human chorionic gonadotropin administered 7.5 days after synchronous estrous induction in Morada Nova ewes.

This study was conducted in ewes to assess effects of human chorionic gonadotropin (hCG) administration after imposing an estrous induction treatment regimen. Ewes (n = 115) were treated with a 60 mg medroxyprogesterone-intravaginal-sponge for 6 d plus 200 IU of equine chorionic gonadotropin (eCG) im and 37.5 µg d-cloprostenol im 36 h before sponge removal (Day 0). After natural mating, ewes having at least one corpus luteum (CL; n = 108) were administered either 1 mL of saline (G-Control; n = 53) or 300 IU of hCG (G-hCG; n = 55) on Day 7.5 after sponge removal (Day 0). Ovarian ultrasonography and blood collection were performed on Days 7.5, 13.5, 17.5, 21.5, and 30.5. Accessory CL (aCL) were observed in 81.5 % (G-hCG) and 0.0 % (G-Control) of ewes (P = 0.0001). Diameter, area, and volume of luteal tissue were greater (P < 0.05) in G-hCG from Day 13.5 to 30.5. Progesterone (P4) concentrations were greater (P < 0.05) on Days 13.5, 17.5, 21.5 and 30.5 for ewes of the G-hCG group. Pregnancy percentage was similar (P = 0.25) between groups [47.1 % (G-control) compared with 60.0 % (G-hCG)], although total number of lambs produced by estrous synchronized ewes was greater (P = 0.005) in ewes of the G-hCG group (90.9 % compared with 66.0 %). In conclusion, hCG administration 7.5 days after sponge removal from Morada Nova ewes during the non-breeding season is an effective treatment to induce aCL formation, improve luteal tissue biometry and P4 concentrations, and to enhance the total number of lambs born.

Hormonal contraceptive use and subjective sleep reports in women: An online survey.

Female sexual hormones have known hypnogenic effects and the use of hormonal replacement therapy in postmenopausal women leads to improvement in sleep quality. However, the effects of hormonal contraceptives in women of reproductive age are still scarcely understood. This study sought to evaluate the impact of hormonal contraceptive use on subjective self-reports of sleep through a web-based cross-sectional survey. A total of 2,055 women between 18 and 40 years old participated by answering an online questionnaire evaluating hormonal contraceptive use, sleep-related characteristics and related features. Sleep assessment tools comprised the Epworth Sleepiness Scale (ESS) and the Insomnia Severity Index (ISI). Statistical comparisons were performed between hormonal contraceptive users and those who reported no current use. Analyses were repeated to compare users of combined contraceptives with users of progestagens only, as well as to compare users of different generations of contraceptives. Among the total sample, 1,286 participants met the inclusion criteria (918 of them were currently taking a hormonal contraceptive). Contraceptive users reported more frequent sleep complaints and had higher scores on ESS and ISI, which means increased excessive daytime sleepiness and more insomnia symptoms. Women using progestagen-only therapies reported lower total sleep duration compared with combined therapy. Users of third-generation contraceptives showed lower total sleep time and higher ISI score when compared with non-users. In conclusion, contraceptive users have more insomnia symptoms and increased excessive daytime sleepiness when compared with women who do not use any hormonal contraceptive method, and progestagen-only therapy was associated with lower sleep duration.

Availability of pharmacist prescription of contraception in rural areas of Oregon and New Mexico.

OBJECTIVE: To determine the availability of pharmacist prescribing of hormonal contraception in rural areas of two states. STUDY DESIGN: Cross-sectional survey. RESULTS: Overall, 42% of pharmacies prescribed contraception (Oregon: 46% and New Mexico 19%). A similar proportion of rural pharmacies reported offering pharmacist prescription of 37 contraception as urban locations (39% vs 46%, p = 0.26). Nearly 53% of rural and 45% of urban pharmacies report billing women, rather than insurance, directly for the cost of the pharmacist consultation. Over 80% of pharmacists in both rural and urban locations did not know if Medicaid covered the cost. CONCLUSION: Pharmacists in rural areas are as willing as their urban counterparts to prescribe hormonal contraception. Financial barriers remain a concern.

One-year adolescent bone mineral density and bone formation marker changes through the use or lack of use of combined hormonal contraceptives / Alterações na densidade mineral óssea e nos marcadores de formação óssea em adolescentes usuárias ou não de contraceptivos hormonais orais combinados por período de um ano

Abstract Objective: The objective of this study was to evaluate the effects of two low-dose combined oral contraceptives on bone metabolism in adolescents for one year. Methods: This was a quasi-experimental study. The adolescents were divided into three groups: oral contraceptives 1 (n = 42) (20 µg EE/150 µg desogestrel), oral contraceptives 2 (n = 66) (30 µg EE/3 mg drospirenone), and a control group (n = 70). Adolescents underwent anthropometric assessment and densitometry (dual-energy X-ray). Bone age and bone formation markers (osteocalcin and bone alkaline phosphatase) were evaluated. The oral contraceptives users were evaluated again after 12 months. Linear regression analysis was used to indirectly study the effect of each additional year of chronological age on anthropometric and densitometric variables as well as on bone markers in the control group. Results: At study entry, no significant differences were observed between the oral contraceptives 1, oral contraceptives 2, and controls in the analyzed variables. Linear regression analysis showed an increase in bone mineral density and bone mineral content for each additional year. There was a significant reduction in bone alkaline phosphatase levels; no significant difference was observed for osteocalcin in control individuals. Comparison of dual-energy X-ray variables at baseline and after one year showed no significant differences in the oral contraceptives 1 or oral contraceptives 2 groups. A significant reduction in bone alkaline phosphatase and osteocalcin levels was observed in both the oral contraceptives 1 and oral contraceptives 2 groups. Conclusion: Adolescent women gain peak bone mass during this phase of life. Two low-dose combined oral hormonal contraceptives were associated with lower bone gain and lower bone formation markers than in untreated controls.

Resumo: Objetivo: O objetivo deste estudo foi avaliar os efeitos de dois contraceptivos orais combinados de baixa dosagem por um ano sobre o metabolismo ósseo em adolescentes. Métodos: Este foi um estudo quase experimental. As adolescentes foram divididas em três grupos: contraceptivos orais 1 (n = 42) (20 µg de EE/150 µg de desogestrel), contraceptivos orais 2 (n = 66) (30 µg EE/3 mg de drospirenona) e grupo controle (n = 70). As adolescentes foram submetidas à avaliação antropométrica e densitometria (raio-X de dupla energia). Foram avaliados a idade óssea e os marcadores de formação óssea (osteocalcina e fosfatase alcalina óssea). As usuárias de contraceptivos orais foram novamente avaliadas após 12 meses. A análise de regressão linear foi utilizada para estudar, indiretamente, o efeito de cada ano adicional da idade cronológica sobre as variáveis antropométricas e densitométricas e sobre os marcadores ósseos no grupo de controle. Resultados: No início do estudo, não foram observadas diferenças significativas nas variáveis analisadas entre as usuárias de contraceptivos orais 1, contraceptivos orais 2 e o grupo controle. A análise de regressão linear mostrou um aumento na densidade mineral óssea e no conteúdo mineral ósseo para cada ano adicional. Houve uma redução significativa nos níveis de fosfatase alcalina óssea e não foi observada diferença significativa para osteocalcina nos indivíduos controles. A comparação das variáveis do raio-X de dupla energia no início e após um ano não mostrou diferença significativa no grupo de contraceptivos orais 1 ou contraceptivos orais 2. Foi observada uma redução significativa nos níveis de fosfatase alcalina óssea e osteocalcina nos dois grupos contraceptivos orais 1 e contraceptivos orais 2. Conclusão: As adolescentes atingiram o pico de massa óssea durante essa fase da vida. Duas formulações de contraceptivos hormonais orais de baixa dosagem, após um ano de uso, se associaram a menor incremento na densidade mineral óssea e menor concentração de marcadores de formação óssea quando confrontados com resultados de adolescentes não usuárias de contraceptivos.

Hemopneumotórax recorrente: descrição da síndrome da endometriose torácica / Recurrent hemopneumothorax: thoracic endometriosis syndrome description

A endometriose torácica é uma forma de endometriose extrapélvica encontrada em tecidos pulmonares ou na pleura. Caracteriza- se clinicamente pela presença de pneumotórax catamenial, hemotórax catamenial, hemoptise e nódulos pulmonares. O pneumotórax catamenial é a manifestação mais frequente, sendo caracterizado pelo acúmulo recorrente de ar na cavidade torácica durante o período menstrual. Ocorre, geralmente, no hemitórax direito e possui maior incidência na faixa etária dos 30 aos 40 anos de idade. Nosso objetivo é descrever um caso de derrame pleural hemorrágico recorrente e pneumotórax espontâneo correlacionados ao período menstrual em paciente de 34 anos. (AU)

Thoracic endometriosis is a form of extrapelvic endometriosis found in pulmonary tissue or the pleura. Clinically, it is characterized by the presence of catamenial pneumothorax, catamenial hemothorax, hemoptysis, and pulmonary nodules. The most frequent clinical presentation is catamenial pneumothorax, which is typified by a recurrent collection of air in the thoracic cavity occurring in conjunction with menstrual periods. It occurs more commonly on the right side and its highest incidence is between 30 and 40 years of age. Our objective is to describe a case of recurrent hemorrhagic pleural effusion and spontaneous pneumothorax correlated to the menstrual period in a 34-year-old patient. (AU)

Hormonal oral contraceptive influence on isolation, Characterization and cryopreservation of mesenchymal stem cells from menstrual fluid.

The purpose of the study was to evaluate whether the intake of hormonal oral contraceptive influences the viability of mesenchymal stem cell. Sixteen healthy female volunteers with regular menstrual cycles were invited to participate. Menstrual fluid was collected on the day of maximum flux, and collected cells were analyzed by a 'minimal standard' for MSC characterization: plastic adherence, trilineage (adipogenic, osteogenic, chondrogenic) in vitro differentiation and a minimalistic panel of markers assessed by flow cytometry (CD731, CD901, CD1051, CD34-, CD45-) using monoclonal antibodies. The participants were divided into two groups: Group 1 - no hormonal contraceptive use; Group 2 - hormonal oral contraceptive use. The median of the menstrual fluid volume was 5.0 and the median number of cells was 5.2 × 106. Median of cell viability was 89.3%. After culture, mesenchymal stem cells increased from 0.031% of the total cells to 96.9%. The cells formed clusters and reached confluence after 15-21 days of culture in the first passage. In the second passage, clusters and the confluence were observed after 3 days of culture. No difference was observed between the groups. Our data suggest that oral hormonal contraceptive intake maintains the viability of mesenchymal stem cells from menstrual fluid.

Hormonal contraception and risk of breast cancer: a critical look.

Today health professionals are not only required to know medicine, but scientific reading, interpretation, and communication of new data. The new information about contraception and hormonal therapies must be analyzed by gynecologists to determine whether or not the new data are applicable to their patients and if it has an impact on their health. Recently a new study of hormonal contraceptives and the risk of breast cancer was published. In this study, the investigators found an elevation of the relative risk of breast cancers on the users versus the nonusers of hormonal contraception. After analyzing the publication and other data available, it is our opinion that it is a very low increase of the risk and its impact should be evaluated case by case, not forgetting to take into account the numerous beneficial effects that hormonal contraception have.