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1.
Physiol Rep ; 10(9): e15267, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35510324

RESUMO

Oral contraceptives (OC) are associated with increased risk of hypertension and elevated blood pressure (BP). Whether non-oral hormonal contraceptives have similar associations is unknown. We sought to investigate the effect of non-oral hormonal contraceptive (NOHC) use on the risk of hypertension and changes in BP, compared to non-hormonal contraceptive and OC use. We searched bibliographic databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials) until August 2020. Studies reporting risk of hypertension or changes in systolic and diastolic BP with NOHC use compared with either non-hormonal contraceptive or OC use. Abstract screening, full-text review, data extraction, and quality assessment were completed in duplicate. For studies reporting dichotomous outcomes, we reported results as relative risk with 95% confidence intervals (CI). A random-effects model was used to estimate pooled weighted mean difference and 95% CI of change in BP. Twenty-five studies were included. A lower incidence of hypertension was observed with injectable contraceptive use compared to non-hormonal contraceptive and OC use, although it was unclear if this was statistically significant. Compared to non-hormonal contraceptive use, injectable contraceptive use was associated with increased BP (SBP: 3.24 mmHg, 95%CI 2.49 to 3.98 mmHg; DBP: 3.15 mmHg, 95%CI 0.09 to 6.20 mmHg), the hormonal intra-uterine device use was associated with reduced BP (SBP: -4.50 mmHg, 95%CI -8.44 to -0.57 mmHg; DBP: -7.48 mmHg, 95% -14.90 to -0.05 mmHg), and the vaginal ring was associated with reduced diastolic BP (-3.90 mmHg, 95%CI -6.67 to -1.13 mmHg). Compared to OC use, the injectable contraceptive use was associated with increased diastolic BP (2.38 mmHg, 95%CI 0.39 to 4.38 mmHg). NOHC use is associated with changes in BP which differ by type and route of administration. Given the strong association between incremental increases in BP and cardiovascular risk, prospective studies are required.


Assuntos
Anticoncepcionais Orais , Hipertensão , Pressão Sanguínea , Anticoncepcionais Orais/efeitos adversos , Feminino , Humanos , Hipertensão/induzido quimicamente , Hipertensão/epidemiologia , Estudos Prospectivos , Sístole
2.
Front Endocrinol (Lausanne) ; 13: 817825, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35528016

RESUMO

Fluctuating ovarian hormones have been shown to affect decision-making processes in women. While emerging evidence suggests effects of endogenous ovarian hormones such as estradiol and progesterone on value-based decision-making in women, the impact of exogenous synthetic hormones, as in most oral contraceptives, is not clear. In a between-subjects design, we assessed measures of value-based decision-making in three groups of women aged 18 to 29 years, during (1) active oral contraceptive intake (N = 22), (2) the early follicular phase of the natural menstrual cycle (N = 20), and (3) the periovulatory phase of the natural menstrual cycle (N = 20). Estradiol, progesterone, testosterone, and sex-hormone binding globulin levels were assessed in all groups via blood samples. We used a test battery which measured different facets of value-based decision-making: delay discounting, risk-aversion, risk-seeking, and loss aversion. While hormonal levels did show the expected patterns for the three groups, there were no differences in value-based decision-making parameters. Consequently, Bayes factors showed conclusive evidence in support of the null hypothesis. We conclude that women on oral contraceptives show no differences in value-based decision-making compared to the early follicular and periovulatory natural menstrual cycle phases.


Assuntos
Anticoncepcionais Orais , Progesterona , Teorema de Bayes , Anticoncepcionais Orais/farmacologia , Estradiol , Feminino , Humanos , Ciclo Menstrual
3.
J Med Microbiol ; 71(4)2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35452382

RESUMO

Introduction. Evidence has linked exogenous and endogenous sex hormones with the human microbiome.Hypothesis/Gap statement. The longitudinal effects of oral contraceptives (OC) on the human gut microbiome have not previously been studied.Aim. We sought to examine the longitudinal impact of OC use on the taxonomic composition and metabolic functions of the gut microbiota and endogenous sex steroid hormones after initiation of OC use.Methodology. We recruited ten healthy women who provided blood and stool samples prior to OC use, 1 month and 6 months after starting OC. We measured serum levels of sex hormones, including estradiol, progesterone, sex hormone-binding globulin (SHBG), and total testosterone. Shotgun metagenomic sequencing was performed on DNA extracted from faecal samples. Species and metabolic pathway abundances were determined using MetaPhlAn2 and HUMAnN2. Multivariate association with linear models was used to identify microbial species and metabolic pathways associated with OC use and endogenous levels of sex hormones.Results. The percentage variance of the microbial community explained by individual factors ranged from 9.9 % for age to 2.7 % for time since initiation of OC use. We observed no changes in the diversity or composition of the gut microbiome following OC initiation. However, the relative abundance of the biosynthesis pathways of peptidoglycan, amino acids (lysine, threonine, methionine, and tryptophan), and the NAD salvage pathway increased after OC initiation. In addition, serum levels of estradiol and SHBG were positively associated with Eubacterium ramulus, a flavonoid-degrading bacterium. Similarly, microbes involving biosynthesis of l-lysine, l-threonine, and l-methionine were significantly associated with lower estradiol, SHBG, and higher levels of total testosterone.Conclusion. Our study provides the first piece of evidence supporting the association between exogenous and endogenous sex hormones and gut microbiome composition and function.


Assuntos
Microbioma Gastrointestinal , Pré-Escolar , Anticoncepcionais Orais/farmacologia , Estradiol , Feminino , Hormônios Esteroides Gonadais , Humanos , Testosterona
4.
BMJ Open ; 12(4): e055325, 2022 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-35414552

RESUMO

OBJECTIVES: To assess the pattern of contraceptive use and its determinants, knowledge regarding contraceptives including oral contraceptive pills and fertility intentions among tribal women in the reproductive age group. DESIGN: Community-based cross-sectional study. SETTING: Community development blocks in a predominantly tribal district of Wayanad in Kerala, India. PARTICIPANTS: Women in the reproductive age group (15-49 years) from the tribal groups in the district numbering 2495. OUTCOME MEASURES: PRIMARY: Prevalence of contraceptive use and its determinants. SECONDARY: Knowledge regarding contraceptives in general, oral contraceptives and fertility intentions. RESULTS: The mean age of the study participants was 30.8 years (SD=9.8) and belonged to various tribal groups such as Paniya (59.2%), Kurichiyar (13.6%) and Adiya (10.9%). Current use of contraceptive was reported by about a fourth, 658 (26.4%) (95% CI 27.9 to 24.9) of women. Following logistic regression, belonging to Paniya tribe (adjusted OR (aOR) 2.67, 95% CI 1.49 to 4.77; p<0.001) and age at menarche >13 years (aOR 1.69, 95% CI 1.14 to 2.52; p<0.009) had significantly higher use of contraceptives whereas social vulnerability as indicated by staying in a kutcha house had a lesser likelihood of use of contraceptive (aOR 0.55, 95% CI 0.31 to 0.95; p<0.03). Oral contraceptive use was low (4.8%) among this population and no abuse was observed.Less than half (47%) of the respondents had an above average knowledge on contraception. Multivariable logistic regression indicated that above average knowledge was 2.2 times more likely with higher education (95% CI 1.2 to 3.9), lesser among those who desired more than two children (aOR 0.59; 95% CI 0.38 to 0.94; p<0.02).Two children per family was the preferred choice for 1060 (42.5%) women. No gender bias in favour of the male child was observed. CONCLUSION: Awareness and use of contraceptives are poor though the fertility is not commensurately high. Along with developing targeted responses to contraceptive use among Indigenous people with indigenous data, awareness also requires attention. Ethnographic studies are also necessary to determine the differences in contraceptive use including traditional methods among the various Indigenous groups.


Assuntos
Comportamento Contraceptivo , Intenção , Adolescente , Adulto , Criança , Anticoncepção/métodos , Anticoncepcionais Orais/uso terapêutico , Estudos Transversais , Serviços de Planejamento Familiar , Feminino , Fertilidade , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
5.
Front Endocrinol (Lausanne) ; 13: 799675, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35360055

RESUMO

Background: Hormonal contraceptive (HC) use has been associated with an increased risk of developing a depressive episode. This might be related to HC's effect on the serotonergic brain system as suggested by recent cross-sectional data from our group, which show that healthy oral contraceptive (OC) users relative to non-users have lower cerebral serotonin 4 receptor (5-HT4R) levels. Here, we determine if cerebral 5-HT4R binding differs between HC non-users, OC users, and hormonal intrauterine device (HIUD) users among women with an untreated depressive episode. Also, we test if antidepressant drug treatment response and its association with pre-treatment 5-HT4R binding depends on HC status. Methods: [11C]-SB207145 Positron Emission Tomography imaging data from the NeuroPharm-NP1 Study (NCT02869035) were available from 59 depressed premenopausal women, of which 26 used OCs and 10 used HIUDs. The participants were treated with escitalopram. Treatment response was measured as the relative change in the Hamilton Depression Rating Scale 6 items (rΔHAMD6) from baseline to week eight. Latent variable models were used to evaluate the association between global 5-HT4R binding and OC and HIUD use as well as rΔHAMD6. Results: We found no evidence of a difference in global 5-HT4R binding between depressed HC users and non-users (p≥0.51). A significant crossover interaction (p=0.02) was observed between non-users and OC users in the association between baseline global 5-HT4R binding and week eight rΔHAMD6; OC users had 3-4% lower binding compared to non-users for every 10% percent less improvement in HAMD6. Within the groups, we observed a trend towards a positive association in non-users (padj=0.10) and a negative association in OC users (padj=0.07). We found no strong evidence of a difference in treatment response between the groups (p=0.13). Conclusions: We found no difference in 5-HT4R binding between HC users vs. non-users in depressed women, however, it seemed that 5-HT4R settings differed qualitatively in their relation to antidepressant drug treatment response between OC users and non-users. From this we speculate that depressed OC users constitutes a special serotonin subtype of depression, which might have implications for antidepressant drug treatment response.


Assuntos
Antidepressivos , Encéfalo , Antidepressivos/uso terapêutico , Anticoncepcionais Orais , Estudos Transversais , Feminino , Humanos , Transmissão Sináptica
6.
Clin Nutr ESPEN ; 48: 247-252, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35331498

RESUMO

BACKGROUND: Energy restriction promoted by hypocaloric diets is one of the most studied interventions to achieve weight loss. However, there are many factors which may influence the weight loss process. Hormonal contraception is an important factor to be investigated. PURPOSE: To evaluate the effect of oral contraceptive use on weight loss following 500-kcal reduction diet intervention for 1-month. METHODS: We conducted a single-blind controlled study in which 19 healthy women aged 18-25 years were divided into oral contraceptive use group (COC, n = 9) or no hormonal contraception use group (NHC, n = 10). Anthropometric measurements were assessed at baseline and after 4 weeks of intervention. RESULTS: Both COC and NHC groups achieved significant body weight, body fat, and lean body mass loss following 4 weeks of caloric restriction diet intervention. COC group lost more weight (2.87 kg) than NHC group (1.36 kg) (p < 0.001). CONCLUSION: In a month's time, daily reduction of 500-kcal resulted in reduction of body weight and body fat. COC group lost more weight than NHC group. Given the limitations of the study, these data should be interpreted with caution. More studies are necessary to verify the effects of oral contraceptive use on weight loss.


Assuntos
Restrição Calórica , Obesidade , Adolescente , Adulto , Composição Corporal , Anticoncepcionais Orais/farmacologia , Feminino , Humanos , Método Simples-Cego , Perda de Peso , Adulto Jovem
7.
FEMINA ; 50(3): 171-177, 20220331. tab
Artigo em Português | LILACS | ID: biblio-1367570

RESUMO

Objetivo: Investigar o conhecimento das adolescentes atendidas no Ambulatório de Ginecologia sobre os métodos contraceptivos. Métodos: Foi realizado um estudo quantitativo de corte transversal com adolescentes do sexo feminino, acompanhadas no Serviço de Ginecologia. A seleção foi por ordem de chegada mediante agendamento prévio. Após consulta médica, foi aplicado um questionário anônimo e estruturado sobre: características sociodemográficas; antecedentes ginecológicos; conhecimento do uso correto e indicação dos métodos contraceptivos. As variáveis foram analisadas pela estatística descritiva com medidas de tendência central e variabilidade. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa. Resultados: A população estudada foi composta por adolescentes com média de idade de 15,80 anos (+/- 1,3), 48,0% de etnia/cor parda, 84,0% frequentavam a escola pública e 56,0% cursavam o ensino médio. A maioria possuía conhecimento insuficiente/ausência de conhecimento e 80,0% tinham informações sobre contracepção que não envolveu a participação de um profissional de saúde, apesar de eles indicarem o uso dos métodos para a maioria dessas jovens (75,0%). A combinação do preservativo masculino e anticoncepcional oral foi referida em 25,0% das adolescentes. Conclusão: A maioria das adolescentes possuía conhecimento insuficiente/ausente sobre métodos contraceptivos, o que parece contribuir para o uso inconsistente deles. A maior prevalência do uso do preservativo masculino e do anticoncepcional oral associada à baixa participação dos profissionais de saúde como fonte de informação para o uso correto dos métodos ratifica a necessidade de políticas públicas sobre educação sexual para que as adolescentes exerçam sua sexualidade com responsabilidade e segurança.(AU)


Objective: Evaluate the knowledge of adolescents seen in the Gynecology Outpatient Clinic for Children and Youth. Methods: A quantitative transverse study was carried out with thems, regularly seen at the Gynecology Outpatient Clinic for Children and Youth. We selected participants by arrival order. After having their appointment done, we applied an anonymous and structured questionnaire containing questions regarding sociodemographics characteristics, past gynaecological history and knowledge, correct use and indications of contraceptives methods. Those variables were analysed using descriptive statistics such as central tendency and variability. The research was approved by the Ethics in Research Committee. Results: The population studied was composed of adolescents with an average age of 15.8 years (+/- 1.3), 48.0% of ethnicity/brown colour, 84.0% attended public school and 56.0% were in high school. Most of them had insufficient knowledge/lack of knowledge and 80.0% had information about contraception that did not involve the participation of a health professional, however health professionals had suggested a method of contraception for most of these young women (75.0%). The combination of male condoms and oral contraceptives were reported by 25.0% of adolescents. Conclusion: That most of the adolescents had insufficient/absent knowledge about contraceptive methods which seems to contribute to their inconsistent use. The high prevalence of the use of male condoms and oral contraceptives found in this study and low participation of health professionals as a source of information for the correct use of methods ratify the need for public policies on sex education for adolescents enjoy their sexuality responsibly and safely.(AU)


Assuntos
Humanos , Feminino , Adolescente , Gravidez na Adolescência/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Anticoncepção/métodos , Saúde do Adolescente/estatística & dados numéricos , Brasil/epidemiologia , Estudos Transversais , Preservativos , Anticoncepcionais Orais , Comunicação em Saúde
8.
Drugs Today (Barc) ; 58(1): 1-8, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35107089

RESUMO

Estetrol (E4) is a natural human estrogen produced during human pregnancy in the fetal liver with a unique mechanism of action that displays tissue-selective activity, and behaves as a natural selective estrogen receptor modulator. E4 acts as an estrogen agonist on the vagina, the uterus and the endometrium, and also shows bone-sparing activity. Its mechanism of action results in neutral impact on endocrine, metabolic and hemostatic parameters, compared with other oral contraceptives. In 2021, Health Canada approved the combination 15 mg E4/3 mg drospirenone (DRSP), the first and only combined oral contraceptive based on the native estrogen E4, which has been synthesized from plant-based sources. Shortly afterwards, the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA) also approved the combination 14.2 mg E4/3 mg DRSP as a female contraceptive.


Assuntos
Estetrol , Androstenos/efeitos adversos , Anticoncepcionais Orais , Estetrol/efeitos adversos , Estrogênios , Feminino , Humanos , Estados Unidos
9.
Am J Mens Health ; 16(1): 15579883221074855, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35135388

RESUMO

Community pharmacists play a crucial role in providing comprehensive patient education regarding contraception methods. This study aims to investigate Jordanian pharmacists' knowledge and perceptions toward male oral contraceptive pills (OCPs). A mixed-explanatory sequential method was divided into two phases. The first was a self-administered electronic survey that was distributed to community pharmacists/trainees in Jordan. The second phase was carried out through online semi-structured in-depth interviews targeting the maximum variation purposive sample of community pharmacists. A total of 158 (response rate 98%) questionnaires were included in the analysis. The majority of the participants were female (n = 118, 74.2%). In terms of knowledge, only 25% of participants acknowledged the presence of male OCPs and almost half were uncertain about the mechanism of action and the possible uses. The findings of the interviews confirmed a relatively negative perception toward male OCPs and the identified barriers to male OCPs were cultural norms, side effects, and poor compliance. It is argued that there is a negative perception toward male OCPs due to the majority of pharmacists not believing such products will be successful in Jordan. Once these pills are approved for their effectiveness and safety, men may need further education and encouragement to take an active role in family planning along with their partners.


Assuntos
Anticoncepcionais Masculinos , Farmacêuticos , Atitude do Pessoal de Saúde , Anticoncepcionais Orais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Percepção , Inquéritos e Questionários
11.
Gynecol Oncol ; 164(3): 514-521, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35063280

RESUMO

Background BRCA1 and BRCA2 (BRCA) mutation carriers face a high lifetime risk of developing ovarian cancer. Oral contraceptives are protective in this population; however, the impact of other types of contraception (e.g. intrauterine devices, implants, injections) is unknown. We undertook a matched case-control study to evaluate the relationship between type of contraception and risk of ovarian cancer among women with BRCA mutations. Methods A total of 1733 matched pairs were included in this analysis. Women were matched according to year of birth, date of study entry, country of residence, BRCA mutation type and history of breast cancer. Detailed information on hormonal, reproductive and lifestyle exposures were collected from a routinely administered questionnaire. Conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) associated with each contraceptive exposure. Results Ever use of any contraceptive was significantly associated with reduced risk of ovarian cancer (OR = 0.62; 95% CI 0.52-0.75; P < 0.0001), which was driven by significant inverse associations with oral contraceptives (OR = 0.66; 95% CI 0.54-0.79; P < 0.0001) and contraceptive implants (OR = 0.30; 95% CI 0.12-0.73; P = 0.008). We observed a similar effect with use of injections (OR = 0.37; 95% CI 0.10-1.38; P = 0.14), but this did not achieve significance. No significant associations were observed between patterns of intrauterine device use and risk of ovarian cancer. Conclusions These findings support a protective effect of oral contraceptives and implants on risk of ovarian cancer among women with BRCA mutations. The possible protective effect of injections requires further evaluation.


Assuntos
Neoplasias da Mama , Neoplasias Ovarianas , Proteína BRCA1/genética , Proteína BRCA2/genética , Neoplasias da Mama/genética , Carcinoma Epitelial do Ovário , Estudos de Casos e Controles , Anticoncepcionais Orais/uso terapêutico , Feminino , Heterozigoto , Humanos , Mutação , Neoplasias Ovarianas/etiologia , Neoplasias Ovarianas/genética , Fatores de Risco
12.
Acta Neurol Scand ; 145(5): 565-570, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35089604

RESUMO

OBJECTIVE: Uncertainty exists for the absolute risk of ischemic and hemorrhagic stroke in users of oral contraceptives (OCs). Estimates greatly vary between countries. In Denmark, absolute risk of ischemic stroke (IS) is estimated to be 21 per 100,000 person-years. Risk of cerebral hemorrhage (CH) is unknown. Using the Danish Stroke Registry, we investigated absolute risk of IS and CH in users of OC. MATERIAL AND METHODS: For the Danish female population aged 15-49 years during 2003-2011, we obtained information on hospital admission for IS and CH and current use of OC from Danish nationwide registries. We defined current use of OC as redeeming at least two OC prescriptions within the previous year. RESULTS: The Danish female population years 2003-2011 consisted mean of 1,246,142 women per year. Of these, 29.6% were OC users. In the study period, OC users had 291 IS and 14 CH. Absolute risk of IS in OC users was 8.8 per 100,000 person-years and of CH it was 0.4 per 100,000 person-years. CONCLUSIONS: In OC users, absolute risk of IS was 8.8 per 100,000 person-years. This is more than half that of the risk previously assumed in Denmark. Risk of CH in OC users was very low and 0.4 per 100,000 person-years.


Assuntos
Anticoncepcionais Orais , AVC Hemorrágico , Adolescente , Adulto , Estudos de Casos e Controles , Anticoncepcionais Orais/efeitos adversos , Dinamarca/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
13.
Int J Clin Pharmacol Ther ; 60(4): 167-175, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35006073

RESUMO

AIM: The aim of this study was to analyze the association between widely used contraceptive methods and the manifestation of lower urinary tract infections (LUTI) in patients treated in gynecological practices in Germany. MATERIALS AND METHODS: This study was based on IQVIA Disease Analyzer database and includes a total of 133,638 females aged between 16 and 50 years who received an initial diagnosis of LUTI including cystitis (ICD-10: N39.0, N30.0) between January 2011 and December 2020 (index date). 1 : 1 matching of LUTI cases to non-LUTI controls was used to investigate the association between predefined criteria and LUTI. A greedy nearest neighbor propensity score method was used to balance cases and controls with respect to age, pregnancy, visit frequency during the observation period, and comorbidities including cancer, diabetes mellitus, and urolithiasis. Univariate logistic regression models were used to assess the association between contraceptive prescriptions and LUTI. RESULTS: The general use of any contraceptive method was negatively associated with subsequent LUTI. Injectable contraceptives and pills were negatively associated with LUTI manifestation. There was a significant negative association between monophasic preparations containing < 50 µg estrogen, triphasic preparations, and progestogen-only preparations and LUTI. By contrast, we found a significant positive association between emergency contraceptives and LUTI. CONCLUSION: The general application of birth control methods as well as the use of injectable contraceptives and oral contraceptives were negatively associated with LUTI manifestation. In contrast to other birth control methods, the intake of emergency contraception was positively associated with a manifestation of LUTI.


Assuntos
Anticoncepcionais Orais , Infecções Urinárias , Adolescente , Adulto , Estudos de Casos e Controles , Anticoncepção/efeitos adversos , Anticoncepcionais Orais/efeitos adversos , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Gravidez , Infecções Urinárias/induzido quimicamente , Infecções Urinárias/diagnóstico , Infecções Urinárias/epidemiologia , Adulto Jovem
14.
Diabetes Metab Syndr ; 16(2): 102408, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35093686

RESUMO

BACKGROUND AND AIMS: The contraceptive use is 56% and prevalence of metabolic syndrome (MetS) is 30% in Iran. The aim of this study investigates relationship between oral contraceptive pills (OCP) use and MetS in women in the cohort population of Fasa city. METHODS: In a cross-sectional study, 5489 women aged 35-70 years were studied for 5 years in the Sheshdeh area in 2016. MetS were calculated using adult treatment panel III (ATP III) and international diabetes federation (IDF) methods. The odds ratio (OR) with a 95% confidence interval (CI) was reported. Linear regression was used to eliminate the confounding effect. RESULTS: The OR of developing MetS in the OCP recipients was estimated as higher than the non-recipients. The OR of developing MetS using IDF criteria in OCP recipients was (OR = 0.896,95% CI:0.800-1.004). that increased to (OR = 1.230,95% CI:1.084-1.395) after adjusting for confounding variables. Also, the odds ratio using ATP (III) criteria was (OR = 0.900,95% CI:0.804-1.009). that increased to (OR = 1.245,95% CI:1.098-1.413) after adjusting for confounding variables. Also, the OR of developing MetS in OCP recipients decreased with increasing the number of MetS components from 1.199 to 0.812,95% CI:0.771-1.864,0.467-1.413, but after adjustment, increased from 1.151 to 1.747,95% CI:0.733-1.805,0.815-3.746. CONCLUSION: The results of the present study showed that the OR of developing MetS in OCP recipients using both IDF and ATP (III) methods was higher after adjusting by confounder effects so it is recommended monitoring by physicians.


Assuntos
Síndrome Metabólica , Adulto , Idoso , Estudos de Coortes , Anticoncepcionais Orais/efeitos adversos , Estudos Transversais , Feminino , Humanos , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco
15.
BMC Public Health ; 22(1): 27, 2022 01 06.
Artigo em Inglês | MEDLINE | ID: mdl-34991554

RESUMO

BACKGROUND: There is little evidence as to whether the use of oral contraceptives(OC) during the fertile years affects the development of postmenopausal hypertension. This study aimed to evaluate the association between past use of OC and development of hypertension in postmenopausal women. METHODS: This was a cross-sectional study conducted using data from the Fifth Korea National Health and Nutrition Examination Survey of postmenopausal women. Subjects were classified into three groups based on past OC use duration: nonusers, short-term users(0-30 months), and long-term users(≥ 30 months). We evaluated the development of hypertension in women after menopause. A multivariable logistic regression model was used to identify the association between the use of OC during the fertile years and the prevalence of hypertension after menopause following adjustment for potential confounding factors. RESULTS: Of the 3,386 postmenopausal women, 2,713 were nonusers of OC, 489 were short-term users, and 184 were long-term users. Women who had used OC for 30 months or more had a significantly greater prevalence of hypertension after menopause than those who had never taken OC. The association between taking OC for 30 months or more during the fertile years and the prevalence of hypertension after menopause was significant following adjustment for potential confounding factors (adjusted OR:1.75; 95%CI:1.12-2.74). CONCLUSION: This study identified an association between past OC use and an increased prevalence of hypertension in postmenopausal women. Our results suggest that long-term use of OC during the fertile years can be an important risk factor for subsequent hypertension after menopause.


Assuntos
Hipertensão , Pós-Menopausa , Anticoncepcionais Orais/efeitos adversos , Estudos Transversais , Feminino , Humanos , Hipertensão/epidemiologia , Inquéritos Nutricionais , Prevalência , República da Coreia/epidemiologia
16.
J Epidemiol ; 32(3): 117-124, 2022 03 05.
Artigo em Inglês | MEDLINE | ID: mdl-33132283

RESUMO

BACKGROUND: There have been few community-based epidemiological studies in which the prevalence of exogenous hormone use, including the use of oral contraceptives (OCs) and hormone replacement therapy (HRT), has been accurately assessed in Japan. METHODS: We have been conducting repeated surveys of participants in the Japan Nurses' Health Study (JNHS), as a nationwide prospective cohort study, since 2001. We determined the prevalence of exogenous hormone use at baseline and during a 10-year follow-up period. A total of 15,019 female nurses participated in the JNHS follow-up cohort. We determined the prevalence of OC use in 14,839 women <60 years of age at baseline and the prevalence of HRT use in 7,915 women, excluding premenopausal women, at the last time they answered a questionnaire. The duration of HRT use was estimated using the Kaplan-Meier method. RESULTS: Six percent of the participants used OCs. The proportion of HRT users who stopped HRT before the baseline survey, the proportion of women using HRT during the follow-up period, and the proportion of all of the participants who had used HRT were 3.2%, 10.6%, and 13.8%, respectively. The median duration of HRT use was 2 years. CONCLUSIONS: The lifetime prevalences of exogenous hormone use during this prospective study conducted in Japanese nurses were 6.0% for OCs and 13.8% for HRT. The information obtained in this study will be useful for clarification of the association between exogenous estrogen exposure and estrogen-related diseases as future research.


Assuntos
Anticoncepcionais Orais , Enfermeiras e Enfermeiros , Terapia de Reposição de Estrogênios/efeitos adversos , Feminino , Terapia de Reposição Hormonal , Humanos , Japão/epidemiologia , Prevalência , Estudos Prospectivos
17.
Int J Pharm Pract ; 30(1): 45-51, 2022 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-34718596

RESUMO

OBJECTIVES: To examine the extent of Lebanese pharmacists' knowledge about oral contraceptives (OCs), the characteristics influencing their knowledge and the factors that may predict their counselling practices. METHODS: A cross-sectional descriptive study was conducted between January and June 2020 in which a random sample of community pharmacists in Lebanon was asked to complete a self-administered questionnaire. The survey was divided into three sections including demographic information, pharmacists' knowledge and counselling practices, and their perceptions about OCs. KEY FINDINGS: Of the 300 pharmacists invited to participate, 240 (80%) responded. The majority of the pharmacists (255; 85%) had satisfactory general knowledge about the indications, side effects, contraindications and drug interactions of OCs. However, only 173 (57.5%) participants had satisfactory knowledge about the proper use of OCs. Older pharmacists and those who have been in practice for more than 10 years achieved lower knowledge scores; however, those with postgraduate degrees had significantly higher scores. Pharmacists with a postgraduate degree and male pharmacists were less likely to counsel patients compared with their counterparts. Conversely, pharmacists with postgraduate OC training and those who had a private area for consultation presented better counselling practices. CONCLUSIONS: More than half of the participating pharmacists appeared to have satisfactory knowledge about OCs and their proper use; however, limited counselling and key misconceptions were observed in this study.


Assuntos
Serviços Comunitários de Farmácia , Farmacêuticos , Anticoncepcionais Orais , Aconselhamento , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino
18.
J Clin Endocrinol Metab ; 107(4): e1402-e1412, 2022 03 24.
Artigo em Inglês | MEDLINE | ID: mdl-34865056

RESUMO

CONTEXT: No prospective epidemiologic studies have examined associations between use of oral contraceptives (OCs) or menopausal hormone therapy (MHT) and risk of pituitary adenoma in women. OBJECTIVE: Our aim was to determine the association between use of OC and MHT and risk of pituitary adenoma in two separate datasets. METHODS: We evaluated the association of OC/MHT with risk of pituitary adenoma in the Nurses' Health Study and Nurses' Health Study II by computing multivariable-adjusted hazard ratios (MVHR) of pituitary adenoma by OC/MHT use using Cox proportional hazards models. Simultaneously, we carried out a matched case-control study using an institutional data repository to compute multivariable-adjusted odds ratios (MVOR) of pituitary adenoma by OC/MHT use. RESULTS: In the cohort analysis, during 6 668 019 person-years, 331 participants reported a diagnosis of pituitary adenoma. Compared to never-users, neither past (MVHR = 1.05; 95% CI, 0.80-1.36) nor current OC use (MVHR = 0.72; 95% CI, 0.40-1.32) was associated with risk. For MHT, compared to never-users, both past (MVHR = 2.00; 95% CI, 1.50-2.68) and current use (MVHR = 1.80; 95% CI, 1.27-2.55) were associated with pituitary adenoma risk, as was longer duration (MVHR = 2.06; 95% CI, 1.42-2.99 comparing more than 5 years of use to never, P trend = .002). Results were similar in lagged analyses, when stratified by body mass index, and among those with recent health care use. In the case-control analysis, we included 5469 cases. Risk of pituitary adenoma was increased with ever use of MHT (MVOR = 1.57; 95% CI, 1.35-1.83) and OC (MVOR = 1.27; 95% CI, 1.14-1.42) compared to never. CONCLUSION: Compared to never use, current and past MHT use and longer duration of MHT use were positively associated with higher risk of pituitary adenoma in 2 independent data sets. OC use was not associated with risk in the prospective cohort analysis and was associated with only mildly increased risk in the case-control analysis.


Assuntos
Adenoma , Neoplasias Hipofisárias , Adenoma/induzido quimicamente , Adenoma/epidemiologia , Estudos de Casos e Controles , Estudos de Coortes , Anticoncepcionais Orais/efeitos adversos , Feminino , Humanos , Menopausa , Neoplasias Hipofisárias/epidemiologia , Estudos Prospectivos , Fatores de Risco
19.
Cancer Epidemiol Biomarkers Prev ; 31(2): 436-442, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34862209

RESUMO

BACKGROUND: We investigated the associations of oral contraceptives (OC) with percent breast density (PD), absolute dense area (DA), nondense area (NDA), and a novel image intensity variation (V) measure in premenopausal women. METHODS: This study included 1,233 controls from a nested case-control study within Nurses' Health Study II cohort. Information on OCs was collected in 1989 and updated biennially. OC use was defined from the questionnaire closest to the mammogram date. PD, DA, and NDA were measured from digitized film mammograms using a computer-assisted thresholding technique; the V measure was obtained with a previously developed algorithm measuring the SD of pixel values in the eroded breast region. Generalized linear regression was used to assess associations between OCs and density measures (square root-transformed PD, DA, and NDA, and -untransformed V). RESULTS: OC use was not associated with PD [current vs. never: ß = -0.06; 95% confidence interval (CI), -0.37-0.24; past vs. never: ß = 0.10; 95% CI, -0.09-0.29], DA (current vs. never: ß = -0.20; 95% CI -0.59-0.18; past vs. never: ß = 0.13; 95% CI, -0.12-0.39), and NDA (current vs. never: ß = -0.19; 95% CI, -0.56-0.18; past vs. never: ß = -0.01; 95% CI, -0.28-0.25). Women with younger age at initiation had significantly greater V-measure (<20 years vs. never: ß = 26.88; 95% CI, 3.18-50.58; 20-24 years vs. never: ß = 20.23; 95% CI, -4.24-44.71; 25-29 years vs. never: ß = 2.61; 95% CI -29.00-34.23; ≥30 years vs. never: ß = 0.28; 95% CI, -34.16-34.72, P trend = 0.03). CONCLUSIONS: Our findings suggest that an earlier age at first OC use was associated with significantly greater V. IMPACT: These findings could guide decisions about the age for OC initiation.


Assuntos
Densidade da Mama/efeitos dos fármacos , Mama/patologia , Anticoncepcionais Orais/efeitos adversos , Pré-Menopausa , Adulto , Estudos de Casos e Controles , Anticoncepcionais Orais/administração & dosagem , Feminino , Humanos , Mamografia/estatística & dados numéricos , Pessoa de Meia-Idade , Estudos Prospectivos
20.
Mult Scler ; 28(6): 950-957, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34841948

RESUMO

OBJECTIVE: To evaluate whether oral contraceptive (OC) use is associated with the risk of a second attack and disability accrual in women with a clinically isolated syndrome (CIS) and early multiple sclerosis (MS). METHODS: Reproductive information from women included in the Barcelona CIS prospective cohort was collected through a self-reported cross-sectional survey. We examined the relationship of OC exposure with the risk of a second attack and confirmed Expanded Disability Status Scale of 3.0 using multivariate Cox regression models, adjusted by age, topography of CIS, oligoclonal bands, baseline brain T2 lesions, body size at menarche, smoking, and disease-modifying treatment (DMT). OC and DMT exposures were considered as time-varying variables. Findings were confirmed with sensitivity analyses using propensity score models. RESULTS: A total of 495 women were included, 389 (78.6%) referred to ever use OC and 341 (68.9%) started OC before the CIS. Exposure to OC was not associated with a second attack (adjusted hazard ratio (aHR) = 0.73, 95% confidence interval (CI) = 0.33-1.61) or disability accrual (aHR = 0.81, 95% CI = 0.17-3.76). Sensitivity analyses confirmed these results. CONCLUSION: OC use does not modify the risk of second attack or disability accrual in patients with CIS and early MS, once considered as a time-dependent exposure and adjusted by other potential confounders.


Assuntos
Doenças Desmielinizantes , Esclerose Múltipla , Anticoncepcionais Orais , Estudos Transversais , Doenças Desmielinizantes/induzido quimicamente , Progressão da Doença , Feminino , Humanos , Masculino , Esclerose Múltipla/tratamento farmacológico , Esclerose Múltipla/epidemiologia , Estudos Prospectivos
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