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1.
Eur J Epidemiol ; 35(9): 871-878, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32767022

RESUMO

There are conflicting finds in the literature regarding the association of female estrogen status and the incidence of Parkinson's disease (PD). We aimed to investigate whether female reproductive factors are associated with PD. Using the Korean National Health Insurance System database, 4,729,546 postmenopausal women without PD were identified. The new incidence of PD was defined as subjects with an ICD-10 code for PD (G20) and with a rare intractable disease registration code for PD (V124). The Cox proportional hazard models were used to evaluate the associations of various reproductive factors with incidence of PD. During the median follow-up of 5.84 years, 20,816 individuals were diagnosed with PD. An increased risk of PD was observed in subjects with a later age at menarche (≥ 17 years) compared with reference subjects (13 years ≤ age at menarche ≤ 14 years) (adjusted hazard ratio, aHR 1.10, 95% confidence interval, CI 1.05-1.16). As age at menopause increased, risk of PD decreased (P for trend 0.019). Consistently, decreased risk of PD was observed (aHR 0.91, 95% CI 0.85-0.96) in subjects with longer duration of fertility (≥ 40 years of age) compared with shorter duration of fertility (< 30 years of age). Hormone replacement therapy and oral contraceptives independently increased the risk of PD by 17% and 7%, respectively. Female reproductive factors are independent risk factors for PD, with higher risk associated with shorter lifetime exposure to endogenous estrogen.


Assuntos
Anticoncepcionais Orais/efeitos adversos , Terapia de Reposição Hormonal/efeitos adversos , Menarca , Menopausa , Doença de Parkinson/epidemiologia , História Reprodutiva , Adulto , Idoso , Estudos de Coortes , Anticoncepcionais Orais/administração & dosagem , Feminino , Terapia de Reposição Hormonal/métodos , Humanos , Incidência , Pessoa de Meia-Idade , Doença de Parkinson/etiologia , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo
2.
BMC Womens Health ; 20(1): 136, 2020 06 29.
Artigo em Inglês | MEDLINE | ID: mdl-32600463

RESUMO

BACKGROUND: Little is known about how the menstrual cycle affects gastrointestinal function and self-reported stress in young, healthy women taking oral contraceptives (OC). This study prospectively characterized gastrointestinal function and symptoms on each day throughout the menstrual cycle. METHODS: Healthy women aged 18-35 years (n = 78) who took OC participated in the 5-week observational study. Stool frequency, self-reported stress, stool form measured by the Bristol Stool Form Scale (BSFS), and gastrointestinal symptoms measured by a modified version of the Gastrointestinal Symptom Rating Scale (GSRS) were assessed daily. GSRS scores were reported (1 = no discomfort at all, 7 = very severe discomfort) and were averaged for individual syndrome scores or summed for the total score. The validated, weekly version of the GSRS was completed at two time points to reflect menstruation and 1 week prior to menstruation (n = 72). Outcomes were analyzed in linear mixed models with the Dunnett's post hoc test against day 1 of menstrual bleeding or with nonparametric tests. RESULTS: Daily stress (P = 0.0018), BSFS score (P = 0.0493), stool frequency (P = 0.0241), abdominal pain (P < 0.0001), diarrhea (P = 0.0022), constipation (P = 0.0446), reflux (P = 0.0193), and indigestion (P < 0.0001) all varied significantly by the day of the menstrual cycle. Dunnett's post hoc tests showed that scores (mean ± SEM) on the first day of bleeding (day 1) for daily abdominal pain (2.6 ± 0.2), diarrhea (1.7 ± 0.1), and indigestion (2.1 ± 0.2) symptoms were higher than scores on all other days of the menstrual cycle (P < 0.05) with scores not on day 1 falling under 1.5, or between no discomfort at all and slight discomfort. Reflux, stool frequency, BSFS, self-reported stress, and constipation were higher on day 1 (P < 0.05) than on 12, 8, 6, 4, and 2 other days of the menstrual cycle, respectively. The median (IQR) GSRS score was higher during the week of menstruation than the week prior to menstruation for diarrhea [1.50 (1.00-2.33) vs 1.33 (1.00-2.00), P = 0.002] and abdominal pain [2.00 (1.33-2.67) vs 1.67 (1.33-2.33), P = 0.011] syndrome scores. CONCLUSION: Bowel habits appear to vary across the menstrual cycle and suggest more gastrointestinal discomfort on day 1 of menstrual bleeding in healthy women taking OC. Future interventional studies could identify ways to improve gastrointestinal symptoms in healthy women during menstruation.


Assuntos
Anticoncepcionais Orais/efeitos adversos , Defecação/fisiologia , Trânsito Gastrointestinal/fisiologia , Ciclo Menstrual/fisiologia , Menstruação/fisiologia , Adolescente , Adulto , Anticoncepcionais Orais/administração & dosagem , Fezes , Feminino , Gastroenteropatias , Humanos , Estudos Prospectivos , Adulto Jovem
3.
Arch Gynecol Obstet ; 301(4): 875-884, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32140806

RESUMO

PURPOSE: BRCA mutation carriers have an increased risk of developing breast or ovarian cancer. Oral contraception (OC) is known to increase breast cancer and reduce ovarian cancer risk in the general population. This review analyses the published data on OC and risk of cancer in BRCA mutation carriers. METHODS: We included all relevant articles published in English from 1995 to 2018. Literature was identified through a search on PubMed and Cochrane Library. RESULTS: We included four meta-analyses, one review, one case-control study and one retrospective cohort study on the association between ovarian cancer and OC in BRCA mutation carriers. All report a risk reduction for the OC users and several also describe an inverse correlation with duration of use. Regarding breast cancer, we included four meta-analyses, one review, one case-control study, two case-only studies, one prospective and one retrospective cohort study. Some studies report a risk elevation, while others did not find an association between OC use and breast cancer in BRCA mutation carriers. In other studies, the association was limited to early-onset breast cancer and/or associated with young age at first start of OC. CONCLUSION: Oral contraception leads to a risk reduction of ovarian cancer also in BRCA mutation carriers. An increase in breast cancer risk due to OC cannot be excluded. Women with BRCA mutation who consider OC use have to be informed about possible increase in breast cancer risk and alternative contraceptive methods. OC should not be used for the prevention of ovarian cancer in this population.


Assuntos
Neoplasias da Mama/induzido quimicamente , Anticoncepcionais Orais/efeitos adversos , Neoplasias Ovarianas/induzido quimicamente , Adulto , Neoplasias da Mama/genética , Estudos de Casos e Controles , Feminino , Humanos , Mutação , Neoplasias Ovarianas/genética , Estudos Prospectivos , Estudos Retrospectivos
4.
Exp Mol Pathol ; 114: 104414, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32165089

RESUMO

The Growth arrest specific 8 (GAS8) and its anti-sense transcript (GAS8-AS1) are located in a genomic region that is frequently mutated in breast cancer. These transcripts have established tumor suppressor effects in some human malignancies. In the current investigation, we aimed at identification of the role of GAS8 and GAS8-AS1 in breast cancer. We measured gene expression of GAS8 and GAS8-AS1 in paired tumoral and non-tumoral tissues obtained from 88 breast cancer patients by means of real time PCR. No significant differences were identified in expressions of GAS8 and GAS8-AS1 in tumoral samples compared with non-tumoral tissues (Fold changes = 1.53 and 1.71; P values = .28 and 0.14 respectively). Transcript levels of GAS8-AS1 was significantly correlated with estrogen receptor (ER) status (P = .01). Expression of GAS8 gene was associated with history of oral contraceptive use (P = .04). The similar expressions of GAS8 and GAS8-AS1 genes in tumoral and non-tumoral tissues of breast in spite of previous reports regarding their fundamental tumor suppressor roles in other tissues show that these genes are not involved in the pathogenesis of breast cancer. So, these genes have distinct roles in diverse tissues.


Assuntos
Neoplasias da Mama/genética , Proteínas do Citoesqueleto/genética , Proteínas de Neoplasias/genética , RNA Longo não Codificante/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/patologia , Linhagem Celular Tumoral , Anticoncepcionais Orais/efeitos adversos , Feminino , Regulação Neoplásica da Expressão Gênica/genética , Humanos , Pessoa de Meia-Idade
5.
Rev. Hosp. Ital. B. Aires (2004) ; 40(1): 34-38, mar. 2020. tab
Artigo em Espanhol | LILACS | ID: biblio-1102292

RESUMO

Las mujeres han sido tratadas por décadas con testosterona intentando aliviar una gran variedad de síntomas con riesgos y beneficios inciertos. En la mayoría de los países, la testosterona se prescribe "off-label", de modo que las mujeres están utilizando compuestos y dosis ideadas para tratamientos en hombres. En este sentido, varias sociedades médicas de distintos continentes adoptaron recientemente por consenso una toma de posición sobre los beneficios y potenciales riesgos de la terapia con testosterona en la mujer, explorar las áreas de incertidumbre e identificar prácticas de prescripción con potencial de causar daño. Las recomendaciones con respecto a los beneficios y riesgos de la terapia con testosterona se basan en los resultados de ensayos clínicos controlados con placebo de al menos 12 semanas de duración. A continuación se comentan las recomendaciones. (AU)


There are currently no clear established indications for testosterone replacement therapy for women. Nonetheless, clinicians have been treating women with testosterone to alleviate a variety of symptoms for decades with uncertainty regarding its benefits and risks. In most countries, testosterone therapy is prescribed off-label, which means that women are using testosterone formulations or compounds approved for men with a modified dose for women. Due to these issues, there was a need for a global Consensus Position Statement on testosterone therapy for women based on the available evidence from placebo randomized controlled trials (RCTs). This Position Statement was developed to inform health care professionals about the benefits and potential risks of testosterone therapy intended for women. The aim of the Consensus was to provide clear guidance as to which women might benefit from testosterone therapy; to identify symptoms, signs, and certain conditions for which the evidence does not support the prescription of testosterone; to explore areas of uncertainty, and to identify any prescribing practices that have the potential to cause harm. (AU)


Assuntos
Humanos , Feminino , Idoso , Testosterona/uso terapêutico , Pós-Menopausa/efeitos dos fármacos , Depressores do Apetite/efeitos adversos , Fenitoína/efeitos adversos , Placebos/administração & dosagem , Psicotrópicos/efeitos adversos , Tamoxifeno/efeitos adversos , Testosterona/administração & dosagem , Testosterona/análise , Testosterona/efeitos adversos , Testosterona/farmacologia , Fármacos Cardiovasculares/efeitos adversos , Indometacina/efeitos adversos , Hormônio Liberador de Gonadotropina/efeitos adversos , Pós-Menopausa/fisiologia , Ensaios Clínicos Controlados como Assunto , Antagonistas Colinérgicos/efeitos adversos , Anticoncepcionais Orais/efeitos adversos , Disfunções Sexuais Psicogênicas/etiologia , Disfunções Sexuais Psicogênicas/terapia , Danazol/efeitos adversos , Consenso , Inibidores da Aromatase/efeitos adversos , Uso Off-Label , Inibidores do Fator Xa/efeitos adversos , Anfetaminas/efeitos adversos , Antagonistas dos Receptores Histamínicos/efeitos adversos , Antagonistas de Androgênios/efeitos adversos , Androgênios/fisiologia , Cetoconazol/efeitos adversos , Entorpecentes/efeitos adversos
6.
Rehabilitación (Madr., Ed. impr.) ; 54(1): 63-67, ene.-mar. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-196641

RESUMO

La osteonecrosis múltiple se define como la presencia de osteonecrosis en 3 o más territorios óseos. Es una complicación infrecuente, que suele encontrarse solo en un 3% de los pacientes con osteonecrosis. Se ha relacionado con enfermedades sistémicas siendo los pacientes con LES, tratamiento prolongado con glucocorticoides a dosis altas, trasplantados o con alteraciones hematológicas los que presentan mayor riesgo de desarrollarla. La cabeza femoral es la zona que en más ocasiones se ve alterada. La patogenia no está bien establecida, aunque se conocen varios factores de riesgo. Presentamos el caso de una mujer joven, con antecedentes de tratamiento con glucocorticoides y anticonceptivos orales, y factores alterados de la hemostasia, que desarrolló una osteonecrosis bilateral de caderas y posteriormente de hombro. En el presente artículo se ha realizado una exhaustiva búsqueda bibliográfica sobre la etiología y tratamiento de la osteonecrosis avascular múltiple


Multifocal osteonecrosis is defined as the presence of osteonecrosis in three or more osseous sites. It is an infrequent entity representing less than 3% of cases among osteonecrosis patients. Multifocal osteonecrosis has been associated with systemic diseases, with patients at highest risk being those with lupus erythematosus, transplant recipients and those with haematological disorders or prolonged high-dose glucocorticoid treatment. The area most prone to disturbances is the femoral head. The pathogenesis of this particular disorder has not been fully defined, although several risk factors have been identified. We report the case of a young woman with abnormal hemostatic factors and a history of glucocorticoid and oral contraceptive therapy who developed bilateral hip osteonecrosis, followed by shoulder ON. The present article also provides an extensive literature review of the aetiology and treatment of multifocal ON


Assuntos
Humanos , Feminino , Adulto , Osteonecrose/terapia , Glucocorticoides/efeitos adversos , Anticoncepcionais Orais/efeitos adversos , Osteonecrose/etiologia , Fatores de Risco , Necrose da Cabeça do Fêmur/terapia
9.
J Pediatr Adolesc Gynecol ; 33(3): 249-254, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31972296

RESUMO

Peak bone mass acquisition during adolescence is an important determinant of adult bone health. Knowledge about the effects of different contraceptives on peak bone mass acquisition could influence choice of method recommended. This review summarizes normal bone acquisition during adolescence, discusses methods of assessing bone health in this age group, and reviews the effects of different contraceptive options on bone health, both in adults and in adolescents. Based on the evidence, long-acting reversible contraceptives do not appear to affect peak bone mass acquisition or future fracture risk and remain the first-line contraceptive choice for adolescents. Oral contraceptives with doses of ethinyl estradiol greater than 30 µg should be used in preference to lower-dose preparations, and the adverse effects of depo medroxyprogesterone acetate (DMPA) on bone health are reversible on discontinuation of the medication. Concerns about bone health should not prevent use of DMPA in an adolescent who prefers this method.


Assuntos
Densidade Óssea/efeitos dos fármacos , Anticoncepção/métodos , Adolescente , Densidade Óssea/fisiologia , Anticoncepção/efeitos adversos , Anticoncepcionais Femininos/administração & dosagem , Anticoncepcionais Orais/administração & dosagem , Anticoncepcionais Orais/efeitos adversos , Etinilestradiol/administração & dosagem , Etinilestradiol/efeitos adversos , Feminino , Humanos , Contracepção Reversível de Longo Prazo/métodos , Acetato de Medroxiprogesterona/administração & dosagem , Acetato de Medroxiprogesterona/efeitos adversos
10.
J Womens Health (Larchmt) ; 29(4): 570-576, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31436499

RESUMO

Background: Although oral contraceptives (OCs) have been widely used by women of childbearing age, their influence on pregnancy and birth outcomes, such as preterm birth (PB), low birth weight (LBW), and spontaneous abortion (SAB), is unclear. The aim of this systemic review was to assess these complications in women who had used OCs before pregnancy compared with those in a control group. Materials and Methods: The databases of PubMed, EMBASE, and Web of Science were searched up to December 2018. We included studies where the primary outcome was the risk of PB, LBW, and SAB in women with pregravid OCs use compared with the control group. Odds ratio (OR) value was calculated to assess the risk. Results: Eighteen studies were included in the systematic review, and a total of 148,406 subjects from 7 studies were pooled for the meta-analysis. Results showed that the risk of PB was slightly higher in the exposed group (OR = 1.17, 95% confidence interval [CI] = 1.07-1.27, p = 0.0005); however, there was a lower risk for SAB compared with the control group (OR = 0.63, 95% CI = 0.41-0.96, p = 0.03). No significant difference was found in the incidence of LBW (OR = 1.36, 95% CI = 0.92-2.02, p = 0.12). Conclusions: This systematic review and meta-analysis demonstrated a higher risk for PB and a lower risk for SAB in women with previous ORs use, whereas no association was found between ORs use and LBW risk.


Assuntos
Aborto Espontâneo/epidemiologia , Anticoncepcionais Orais/efeitos adversos , Recém-Nascido de Baixo Peso , Nascimento Prematuro/epidemiologia , Feminino , Humanos , Incidência , Recém-Nascido , Razão de Chances , Gravidez , Fatores de Risco
11.
Arch Iran Med ; 22(7): 355-360, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31679377

RESUMO

BACKGROUND: The incidence and survival of breast cancer (BC) vary across countries. This study aimed to determine risk factors for BC and estimate the overall survival rate in BC patients of the Golestan Cohort Study (GCS). METHODS: This case-control study was performed among participants of the GCS. Cases (N = 99) consisted of women who were diagnosed with BC and controls (n = 400) were selected out of women participating in the same cohort and had not developed any cancer during the follow-up period. Controls were frequency matched to case on both place of residency and 5-year categories of age. RESULTS: Considering confounding variables, logistic regression analysis manifested a reverse association between parity and BC (OR [odds ratio] = 0.87, 95% CI: 0.80-0.95, P = 0.001). In addition, we found women who had family history of any cancer (OR = 1.63, 95% CI: 1.02-2.60, P = 0.04) and long term oral contraceptive (OCP) use (≥10 years) (OR = 3.17, 95% CI: 1.27-7.95, P = 0.01) were at higher risk of BC. Of the total patients, 23 (23.2%) were died due to BC after a mean follow-up of 102.4 ± 5.31 months. Using the Kaplan-Meier analysis, the 5-year survival in these patients was 74%. CONCLUSION: In the Golestan Cohort population, long term OCP use and family history of cancer were risk factors for BC, while parity was a protective factor. The 5-year survival of BC patients in the GCS is still lower relative to Europe and the United States.


Assuntos
Neoplasias da Mama/mortalidade , Adulto , Idoso , Estudos de Casos e Controles , Estudos de Coortes , Anticoncepcionais Orais/efeitos adversos , Feminino , Humanos , Incidência , Irã (Geográfico)/epidemiologia , Anamnese , Pessoa de Meia-Idade , Análise Multivariada , Paridade , Fatores de Risco , Análise de Sobrevida , Fatores de Tempo
12.
Int J Colorectal Dis ; 34(12): 2023-2034, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31732875

RESUMO

PURPOSE: To review role of environmental factors in the pathogenesis of Crohn's disease. METHODS: We systematically reviewed trials and systematic reviews using PubMed and Web of science databases. Here, we review the current information on the causative factors and mechanisms of CD, including smoking, exercise, diet, animal protein, breastfeeding, history of childhood infection and vaccination, oral contraceptives, and antibiotics of CD. We also highlight important knowledge gaps that need to be filled in order to advance the field of CD research. RESULTS: Epidemiological studies have indicated the significance of environmental factors in the disease behavior and outcome of Crohn's disease (CD). There are a few recognized environmental factors, such as cigarette smoking, exercise, dietary habits, and breastfeeding, which are associated with the pathogenesis of CD. These factors are hypothesized to change the epithelial barrier function, which disturbs both the innate and adaptive immune systems and the intestinal flora. However, the effect of several risk factors, such as appendectomy and pharmaceutical use, differs across several studies, indicating the need for more rigorous research. Furthermore, few studies have examined effective interventions based on environmental factors that can improve disease outcomes. Recent studies have indicated that the pathogenesis of CD is related to environmental and genetic factors. CONCLUSION: We review the current information on the causative factors and mechanisms of CD, including smoking, exercise, diet, animal protein, breastfeeding, history of childhood infection and vaccination, oral contraceptives, and antibiotics of CD. However, further studies are needed to understand knowledge gaps in the field of CD.


Assuntos
Doença de Crohn/epidemiologia , Meio Ambiente , Exposição Ambiental/efeitos adversos , Estilo de Vida , Proteínas Animais da Dieta/efeitos adversos , Antibacterianos/efeitos adversos , Aleitamento Materno , Anticoncepcionais Orais/efeitos adversos , Doença de Crohn/genética , Doença de Crohn/imunologia , Doença de Crohn/microbiologia , Comportamento Alimentar , Microbioma Gastrointestinal/efeitos dos fármacos , Interação Gene-Ambiente , Humanos , Prognóstico , Medição de Risco , Fatores de Risco , Comportamento Sedentário , Fumar/efeitos adversos , Fumar/epidemiologia , Vacinação
13.
BMJ Case Rep ; 12(11)2019 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-31748351

RESUMO

This is a case report of a 48-year-old woman who presented with heavy per vaginal bleeding to the emergency department after being commenced on direct oral anticoagulants (DOACs) for venous thromboembolism. She had significant bleeding which initially required resuscitation and stabilisation. Her symptoms were ultimately managed by changing her anticoagulation agent to therapeutic low molecular weight heparin with Clexane© the agent of choice. This case study highlights the complexity of managing these patients as well as highlighting the need for ongoing research into DOACs in this area.


Assuntos
Anticoagulantes/efeitos adversos , Hemorragia Uterina/induzido quimicamente , Tromboembolia Venosa/tratamento farmacológico , Administração Oral , Anticoncepcionais Orais/efeitos adversos , Diagnóstico Diferencial , Enoxaparina/uso terapêutico , Inibidores do Fator Xa/efeitos adversos , Inibidores do Fator Xa/uso terapêutico , Feminino , Fibrinolíticos/uso terapêutico , Heparina de Baixo Peso Molecular/uso terapêutico , Humanos , Pessoa de Meia-Idade , Rivaroxabana/efeitos adversos , Rivaroxabana/uso terapêutico , Resultado do Tratamento , Hemorragia Uterina/tratamento farmacológico , Tromboembolia Venosa/induzido quimicamente
14.
Head Neck ; 41(12): 4199-4208, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31595581

RESUMO

BACKGROUND: Assessed pooled risk on reproductive factors and oral contraceptives (OC) on thyroid cancer (TC) using published studies (1996-2017). METHODS: Summary odds ratio (OR) for case-control studies (n = 10) and risk ratio (RR) for cohort studies (n = 9) was done. RESULTS: OR was 1.43 (95% CI: 1.16-1.77) for age at menarche >14 years, 1.49 (95% CI: 1.19-1.86) for parity >2, 1.38 (95% CI: 1.18-1.61) for miscarriage/abortion, and 2.05 (95% CI: 1.39-3.01) for artificial menopause. A protective effect (ORs: 0.85; 95% CI: 0.72-0.99) on TC was observed for prolonged use of OCs. RR was 1.17 (95% CI: 0.90-1.57) for age at menarche >14 years, 1.10 (95% CI: 0.94-1.27) for parity >2, 1.20 (95% CI: 1.03-1.40) for miscarriage/abortion, and 2.16 (95% CI: 1.41-3.31) for artificial menopause and protective effect (RR: 0.78; 95% CI: 0.65-0.92) for prolonged use of OCs. CONCLUSIONS: This meta-analysis supports an association due to changes in female hormones during menstrual cycle and pregnancy with the risk of TC and explains female preponderance.


Assuntos
Anticoncepcionais Orais/uso terapêutico , Reprodução , Neoplasias da Glândula Tireoide/epidemiologia , Aborto Espontâneo/epidemiologia , Adolescente , Adulto , Fatores Etários , Estudos de Casos e Controles , Estudos de Coortes , Anticoncepcionais Orais/efeitos adversos , Feminino , Humanos , Menarca , Menopausa , Ciclo Menstrual , Pessoa de Meia-Idade , Razão de Chances , Paridade , Gravidez , Fatores de Risco , Neoplasias da Glândula Tireoide/etiologia , Adulto Jovem
16.
Biol Psychol ; 148: 107767, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31509765

RESUMO

Indications exist that use of oral contraceptives affects women's socio-emotional behaviour, brain function and, cognitive abilities, but the information is still scarce and ambiguous. We aimed to examine affective processing of visual stimuli between oral contraceptive users (OC, n = 33) and naturally cycling women (NC, n = 37) using the event-related potential (ERP) method. The main findings are: (i) emotionally arousing stimuli elicited significantly enlarged late positive potential (LPP) amplitudes compared to neutral stimuli, (ii) anti-androgenic OC users demonstrated diminished brain reactivity to visual stimuli, and (iii) significantly blunted reaction to highly unpleasant images. In addition, a positive relationship between GFP evoked by the highly unpleasant and highly pleasant visual emotional stimuli and progesterone was observed in NC women, while OC users demonstrated a trend of negative relationship between GFP and progesterone level. These findings suggest possible modulations of affective processing of visual stimuli when hormonal contraceptives are used.


Assuntos
Anticoncepcionais Orais/efeitos adversos , Emoções/efeitos dos fármacos , Potenciais Evocados/efeitos dos fármacos , Adulto , Encéfalo/fisiologia , Eletroencefalografia/métodos , Feminino , Humanos , Estimulação Luminosa/métodos
17.
Medicine (Baltimore) ; 98(35): e16996, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31464951

RESUMO

RATIONALE: Hormone imbalance and menstrual irregularities are normal for postpill women. Pharmacopuncture and moxibustion can stimulate acupoints with herbal extract and heat, respectively, to regulate the function of qi and blood, expel pathogens, and support health. PATIENT CONCERNS: A 39-year-old female patient presented with amenorrhea, >6 months after she had stopped taking the oral contraceptive pill, which she had taken for more than 10 years, and possible associated infertility. Additionally, she reported sudden weight gain of approximately 12 kg in 1 year. DIAGNOSES: In this study, we examined the amenorrhea lasted more than 6 months for postpill patient. INTERVENTIONS: She refused a strong acupuncture stimulus; she underwent lower abdomen pharmacopuncture with wild ginseng complex (WGC) and moxibustion at CV4, 5 times during 1 month. As a secondary treatment, 1 g Geoseub-hwan pills were prescribed for overeating and during social events. After 5 weekly primary treatments, Geoseub-hwan was prescribed intermittently. OUTCOME: After 3 primary treatments, she began menstruation without menstrual cramps or discomfort. After 5 treatments, she exhibited improvement of body weight and body composition. At 1- and 3-month follow-up examinations, she confirmed regular menstruation without discomfort. LESSONS: Pharmacopuncture with WGC and moxibustion may be effective for the treatment of postpill amenorrhea with abdominal obesity and can be used for patients with fear of a strong acupuncture stimulus.


Assuntos
Terapia por Acupuntura/métodos , Amenorreia/terapia , Medicina Tradicional Coreana/métodos , Adulto , Amenorreia/etiologia , Terapia Combinada , Anticoncepcionais Orais/efeitos adversos , Feminino , Humanos , Moxibustão/métodos , Panax , República da Coreia , Ganho de Peso
18.
Artigo em Inglês | MEDLINE | ID: mdl-31469652

RESUMO

Background Combined oral contraceptive (COC) use has been associated with an increased risk of insulin resistance (IR) and other adverse cardiovascular events, despite efforts to reduce the dosage and/or progestin type. COC containing drospirenone (DRSP) is an analog of spironolactone, hence its antimineralocorticoid and antiandrogenic characteristics have been deemed beneficial, although the benefits and/or negative outcome of its usage have not been fully elucidated. We therefore hypothesized that COC with DRSP component will not affect glucose regulation and circulating corticosterone. Method Ten-week-old female Wistar rats were divided into three groups: control (CON), ethinylestradiol/drospirenone COC (EE/DRSP)-treated, and ethinylestradiol/levonorgestrel COC (EE/LN)-treated rats. The treatment lasted for 8 weeks. Results Results showed that with the exception of lipid profiles, EE/LN but not EE/DRSP COC treatment affected body weight, glucose tolerance, plasma insulin, corticosterone, (IR), and pancreatic ß-cell dysfunction. Conclusion Taken together, the findings showed that the beneficial effect of EE/DRSP could possibly be through the DRSP component. The result also implies that COCs containing DRSP may be a better and safer means of contraception than those with LN with less cardiovascular risks.


Assuntos
Androstenos/efeitos adversos , Corticosterona/sangue , Animais , Glicemia/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Anticoncepcionais Orais/efeitos adversos , Combinação de Medicamentos , Etinilestradiol/efeitos adversos , Feminino , Insulina/sangue , Células Secretoras de Insulina/efeitos dos fármacos , Levanogestrel/efeitos adversos , Ratos
19.
Medicine (Baltimore) ; 98(33): e16440, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415348

RESUMO

RATIONALE: Consumption of oral contraceptive pills (OCP) is a known risk factor for cerebral venous sinus thrombosis (CVST) among women. Development of dural arteriovenous fistula (dAVF) afterwards was very uncommon. We present a rare chronic complication of development of dAVF after CVST. PATIENT CONCERNS: A 22-year-old woman suffered headache for a week. She was then admitted into our hospital. DIAGNOSIS: Contrast enhanced magnetic resonance venography (MRV) demonstrated the thrombosis of the left transverse-sigmoid sinus the second day. INTERVENTIONS: The intravenous thrombolysis was carried out. As the symptoms improved, the patient was discharged, while the treatment with oral dabigatran continued. However, 3 months after the onset, magnetic resonance imaging (MRI) showed swelling brainstem, and digital subtraction angiography (DSA) confirmed a dAVF. Clipping of the fistula was conducted, and her clinical symptoms improved gradually. OUTCOMES: The patient was transferred to rehabilitation center later, and received follow-up care. LESSONS: When a patient taking OCP and suffering from a sudden headache, a clinical suspicion of possible CVST should always arise to avoid the onset of dAVF as soon as possible.


Assuntos
Malformações Vasculares do Sistema Nervoso Central/induzido quimicamente , Anticoncepcionais Orais/efeitos adversos , Trombose dos Seios Intracranianos/induzido quimicamente , Feminino , Cefaleia/induzido quimicamente , Humanos , Adulto Jovem
20.
Obstet Gynecol ; 134(3): 581-589, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31403601

RESUMO

OBJECTIVE: To assess fracture risk among women with depot medroxyprogesterone acetate (DMPA), oral contraceptive pill (OCP), and intrauterine device (IUD) use. METHODS: A retrospective cohort study of 308,876 women age 12-45 years who initiated DMPA, combined or progestin-only OCPs, and copper and levonorgestrel IUDs from 2005 to 2015. Cumulative DMPA, OCP, and IUD use was assessed. Time since last DMPA injection was quantified as recent (within 2 years) and past (more than 2 years ago). Crude fracture rate was estimated using a Poisson distribution. Unadjusted and adjusted hazard ratios (HRs) were estimated using cox proportional hazards models. RESULTS: Thirteen percent of women used DMPA, 78.6% combined OCPs, 17.4% progestin-only OCPs, and 26.2% IUDs; 29.5% used more than one method. There were 7,659 fractures in 1,391,251 person-years (5.5/1,000 person-years [95% CI 5.4-5.6]). The fracture rate for women with any DMPA use was 6.6 (95% CI 6.1-7.2) and 7.8 (95% CI 6.0-10.0) for women with recent use and more than 2 years of cumulative use. Women who had recent use with 2 years or less, or more than 2 years of cumulative use had higher fracture risk compared with women who had no DMPA use and used other methods (adjusted HR 1.15 [95% CI 1.01-1.31] and 1.42 [95% CI 1.10-1.83], respectively). Fracture risk was not increased in women with past DMPA use. Women who had more than 2 years cumulative use of combined OCPs and women with any progestin-only OCP use had lower fracture risk compared with women who did not use OCPs and used other methods (adjusted HR 0.85 [95% CI 0.76-0.96] and 0.88 [95% CI 0.80-0.97], respectively). CONCLUSION: Use of DMPA beyond 2 years should not be considered an absolute contraindication. Although DMPA use was associated with slightly increased fracture risk compared with other methods, the absolute risk of fracture was small and was not observed after discontinuation.


Assuntos
Anticoncepcionais Femininos/efeitos adversos , Anticoncepcionais Orais/efeitos adversos , Fraturas Ósseas/induzido quimicamente , Dispositivos Intrauterinos Medicados/efeitos adversos , Acetato de Medroxiprogesterona/efeitos adversos , Adolescente , Adulto , Criança , Feminino , Humanos , Levanogestrel/efeitos adversos , Pessoa de Meia-Idade , Progestinas/efeitos adversos , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
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