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Association of venous thromboembolism with hormonal contraception and thrombophilic genotypes.

https://arctichealth.org/en/permalink/ahliterature260784
Source
Obstet Gynecol. 2014 Sep;124(3):600-9
Publication Type
Article
Date
Sep-2014
Author
Annica Bergendal
Ingemar Persson
Jacob Odeberg
Anders Sundström
Margareta Holmström
Sam Schulman
Ola Björgell
Helle Kieler
Source
Obstet Gynecol. 2014 Sep;124(3):600-9
Date
Sep-2014
Language
English
Publication Type
Article
Keywords
Adult
Body mass index
Contraception - methods
Contraceptives, Oral, Combined - adverse effects - therapeutic use
Contraceptives, Oral, Hormonal - adverse effects - therapeutic use
Desogestrel - adverse effects - therapeutic use
Factor V - genetics
Female
Humans
Middle Aged
Point Mutation
Progestins - adverse effects - therapeutic use
Risk assessment
Risk factors
Smoking - epidemiology
Sweden - epidemiology
Thrombophilia - complications - epidemiology - genetics
Venous Thromboembolism - epidemiology - etiology - prevention & control
Abstract
To investigate associations between combined hormonal contraception and progestogen-only contraception and risks of venous thromboembolism by progestogen and carriership of genetic hemostatic variations.
This was a case-control study in Sweden carried out between 2003 and 2009, which included 948 patients with venous thromboembolism and 902 individuals in a control group, all aged 18-54 years. Information was obtained by telephone interviews and DNA analyses of blood samples. Radiologic referrals were used for case ascertainment. For comparisons, odds ratios were estimated by unconditional logistic regression analysis adjusting for smoking, body mass index (BMI), and immobilization.
The odds ratio (OR) for current use of combined hormonal contraception was 5.3 (95% confidence interval [CI] 4.0-7.0). Desogestrel combinations had the highest OR (11.4, 95% CI 6.0-22.0). The OR for injection of medroxyprogesterone acetate was 2.2 (95% CI 1.3-4.0). In users of combined hormonal contraception with the factor V Leiden mutation, the OR was 20.6 (95% CI 8.9-58). In women who used progestogen-only contraception and carried the factor V Leiden mutation, the OR was 5.4 (95% CI 2.5-13).
Risks of venous thromboembolism in association with combined hormonal contraception vary by type of progestogen and independently of BMI and smoking. Thrombophilic genotypes such as factor V Leiden increase risks of venous thromboembolism in users of combined hormonal contraception. Except for injection of medroxyprogesterone acetate, progestin-only contraception seems to be the least thrombogenic hormonal contraception for women carrying genetic hemostatic variations.
II.
PubMed ID
25162263 View in PubMed
Less detail

Combined oral contraception and obesity are strong predictors of low-grade inflammation in healthy individuals: results from the Danish Blood Donor Study (DBDS).

https://arctichealth.org/en/permalink/ahliterature259714
Source
PLoS One. 2014;9(2):e88196
Publication Type
Article
Date
2014
Author
Cecilie J Sørensen
Ole B Pedersen
Mikkel S Petersen
Erik Sørensen
Sebastian Kotzé
Lise W Thørner
Henrik Hjalgrim
Andreas S Rigas
Bjarne Møller
Klaus Rostgaard
Mads Riiskjær
Henrik Ullum
Christian Erikstrup
Source
PLoS One. 2014;9(2):e88196
Date
2014
Language
English
Publication Type
Article
Keywords
Adult
Blood Donors
C-Reactive Protein - metabolism
Cohort Studies
Contraceptives, Oral, Combined - adverse effects
Denmark
Female
Health
Humans
Inflammation - chemically induced - complications
Logistic Models
Male
Menopause
Multivariate Analysis
Obesity - complications
Smoking
Abstract
C-reactive protein (CRP) is a well-established marker of inflammation. The level of CRP is affected by several lifestyle factors. A slightly increased CRP level, also known as low-grade inflammation (LGI), is associated with increased risk of several diseases, especially cardiovascular disease. The aim of this study was to identify predictors of increased CRP levels in healthy individuals. We therefore assessed CRP in a large cohort of blood donors.
We measured plasma CRP levels in 15,684 participants from the Danish Blood Donor Study. CRP was measured by a commercial assay. Furthermore, all participants completed a standard questionnaire on smoking status, alcohol consumption, physical activity, diet, and various body measurements. Female participants also reported the use of contraception, childbirth, and menopausal status. The relationship between LGI (defined here as a plasma CRP level between 3 mg/L and 10 mg/L) and predictors was explored by multivariable logistic regression analysis. Results were presented as odds ratios (OR) with 95% confidence intervals (CI).
We found LGI in a total of 1,561 (10.0%) participants. LGI was more frequent in women using combined oral contraception (OC) (29.9%) than in men (6.1%) and women not using OC (7.9%). Among premenopausal women, OC was the strongest predictor of LGI (odds ratio?=?8.98, p
Notes
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PubMed ID
24516611 View in PubMed
Less detail

Combined Oral Contraceptives and Sexual Function in Women-a Double-Blind, Randomized, Placebo-Controlled Trial.

https://arctichealth.org/en/permalink/ahliterature283210
Source
J Clin Endocrinol Metab. 2016 Nov;101(11):4046-4053
Publication Type
Article
Date
Nov-2016
Author
Niklas Zethraeus
Anna Dreber
Eva Ranehill
Liselott Blomberg
Fernand Labrie
Bo von Schoultz
Magnus Johannesson
Angelica Lindén Hirschberg
Source
J Clin Endocrinol Metab. 2016 Nov;101(11):4046-4053
Date
Nov-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Arousal - drug effects
Contraceptives, Oral, Combined - adverse effects
Double-Blind Method
Ethinyl Estradiol - adverse effects
Female
Follow-Up Studies
Humans
Levonorgestrel - adverse effects
Lost to Follow-Up
Patient Dropouts
Patient satisfaction
Pleasure - drug effects
Psychiatric Status Rating Scales
Severity of Illness Index
Sexual Dysfunction, Physiological - chemically induced - physiopathology
Sexual Dysfunctions, Psychological - chemically induced - psychology
Stress, Psychological - chemically induced - psychology
Sweden
Young Adult
Abstract
There is a lack of knowledge about how oral contraceptives may affect sexual function.
To determine whether there is a causal effect of oral contraceptives on sexuality. We hypothesized that a widely used pill impairs sexuality.
A double-blind, randomized, placebo-controlled trial. Enrollment began in February 2012 and was completed in August 2015.
Karolinska University Hospital, Stockholm, Sweden.
A total of 340 healthy women, aged 18-35 years, were randomized to treatment, and 332 completed the study.
A combined oral contraceptive (150 µg levonorgestrel and 30 µg ethinylestradiol) or placebo for 3 months of treatment.
The primary outcome was the aggregate score on the Profile of Female Sexual Function (PFSF). Secondary outcomes were the seven domains of the PFSF, the Sexual Activity Log, and the Personal Distress Scale.
Overall sexual function was similar in women in the oral contraceptive and placebo groups. The PFSF domains desire (-4.4; 95% confidence interval [CI], -8.49 to -0.38; P = .032), arousal (-5.1; 95% CI, -9.63 to -0.48; P = .030), and pleasure (-5.1; 95% CI, -9.97 to -0.32; P = .036) were significantly reduced in comparison to placebo, whereas orgasm, concern, responsiveness, and self-image were similar between groups. The mean frequency of satisfying sexual episodes and personal distress were also similar between groups.
This study shows no negative impact of a levonorgestrel-containing oral contraceptive on overall sexual function, although three of seven sexual function domains were adversely affected.
PubMed ID
27525531 View in PubMed
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[Effect of combined hormonal oral contraception on the somatic and psychic status of women of reproductive age].

https://arctichealth.org/en/permalink/ahliterature120485
Source
Klin Med (Mosk). 2012;90(6):55-60
Publication Type
Article
Date
2012
Author
A L Vertkin
A V Nosova
Source
Klin Med (Mosk). 2012;90(6):55-60
Date
2012
Language
Russian
Publication Type
Article
Keywords
Adult
Contraception - adverse effects - classification - psychology
Contraceptives, Oral, Combined - adverse effects - pharmacology
Female
Health status
Humans
Middle Aged
Moscow - epidemiology
Questionnaires
Retrospective Studies
Young Adult
Abstract
The paper is devoted to the topical problem of maintaining somatic and psychic health of the women of reproductive age by rational pregnancy planning and prevention of abortions by modern methods of contraception including combined oral hormonal contraception. Unfortunately, this approach is rarely employed in this country (5-6%). Results of retrospective analysis of medical documentation, clinical efficacy and safety of modern combined oral hormonal contraception are presented.
PubMed ID
22997723 View in PubMed
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Effect of CSM's warning about safety of third generation oral contraceptives. Abortions increased by nearly 8% in Norway.

https://arctichealth.org/en/permalink/ahliterature64447
Source
BMJ. 1996 Aug 10;313(7053):363-4
Publication Type
Article
Date
Aug-10-1996
Source
J Obstet Gynaecol Can. 2003 Aug;25(8):673-9, 680-7; quiz 688-90
Publication Type
Article
Date
Aug-2003
Author
Sheila Dunn
Edith Guilbert
Guylaine Lefebvre
Catherine Allaire
Jagmit Arneja
Colin Birch
Michel Fortier
John Jeffrey
George Vilos
Marie-Soleil Wagner
Lorna Grant
François Beaudoin
Donna Cherniak
Rosana Pellizzari
Leslie Sadownik
Rajni Saraf-Dhar
Valerie Turnbull
Author Affiliation
Clinical Practice Gyneacology and Social Sexual Issues Committees, Society of Obstetricians and Gyneacologists of Canada (SOGC), Canada.
Source
J Obstet Gynaecol Can. 2003 Aug;25(8):673-9, 680-7; quiz 688-90
Date
Aug-2003
Language
English
French
Publication Type
Article
Keywords
Canada
Contraceptives, Oral, Combined - adverse effects
Contraceptives, Postcoital - adverse effects
Estradiol - administration & dosage
Female
Humans
Intrauterine Devices, Copper - adverse effects
Levonorgestrel - administration & dosage
Pharmaceutical Services - standards
Pregnancy
Abstract
To review current knowledge about emergency contraception (EC), including available options, their modes of action, efficacy, safety, and the effective provision of EC within a practice setting.
The combined estradiol-levonorgestrel (Yuzpe regimen) and the levonorgestrel-only regimen, as well as post-coital copper intrauterine devices, are reviewed.
Efficacy in terms of reduction in risk of pregnancy, safety, and side effects of methods for EC and the effect of the means of access to EC on its appropriate use and the use of consistent contraception.
MEDLINE and the Cochrane Database were searched for English-language articles published from January 1998 through March 2003, to update the previous SOGC guidelines published in 2000. Clinical guidelines and position papers developed by health or family planning organizations were also reviewed. Key words used were: emergency contraception, post-coital contraception, emergency contraceptive pills, postcoital copper IUD.
The studies reviewed were classified according to criteria described by the Canadian Task Force on the Periodic Health Exam and the recommendations for practice were ranked based on this classification.
These guidelines are intended to help reduce unintended pregnancies by increasing awareness and appropriate use of EC.
1. Women who have had unprotected intercourse and wish to prevent pregnancy should be offered hormonal EC up to 5 days after intercourse. (II-2A) 2. A copper IUD can be used up to 7 days after intercourse in women who have no contraindications. (III-B) 3. Women should be advised that the levonorgestrel EC regimen is more effective and causes fewer side effects than the Yuzpe regimen. (I-A) 4. Either 1 double dose of the levonorgestrel EC regimen (1.5 mg) or the regular 2-dose levonorgestrel regimen (0.75 mg each dose) may be used, as they have similar efficacy with no difference in side effects. (I-A) 5. Hormonal EC should be started as soon as possible after unprotected sexual intercourse. (II-2B)6. Women of reproductive age should be provided with a prescription for hormonal EC in advance of need. (I-A) 7. The woman should be evaluated for pregnancy if menses have not begun within 21 days following EC treatment. (III-A) 8. A pelvic examination is not indicated for the provision of hormonal EC. (III-A) Validation: These guidelines have been reviewed by the Clinical Practice Gynaecology and Social and Sexual Issues Committees of the Society of Obstetricians and Gynaecologists of Canada.
The Society of Obstetricians and Gynaecologists of Canada.
PubMed ID
12908020 View in PubMed
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Fatal venous thromboembolism associated with different combined oral contraceptives: a study of incidences and potential biases in spontaneous reporting.

https://arctichealth.org/en/permalink/ahliterature83242
Source
Drug Saf. 2005;28(10):907-16
Publication Type
Article
Date
2005
Author
Hedenmalm Karin
Samuelsson Eva
Author Affiliation
Pharmacovigilance Unit and Clinical Trial Unit, Medical Products Agency, Uppsala, Sweden. karin.hedenmalm@mpa.se
Source
Drug Saf. 2005;28(10):907-16
Date
2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Adverse Drug Reaction Reporting Systems
Bias (epidemiology)
Contraceptives, Oral, Combined - adverse effects
Female
Humans
Incidence
Retrospective Studies
Thromboembolism - chemically induced - mortality
Venous Thrombosis - chemically induced - mortality
Abstract
BACKGROUND: Fatal venous thromboembolism (VTE) is a rare complication of combined oral contraceptive (COC) treatment. This study aims to determine incidences of fatal VTE in relation to the type of COC and the percentage of cases reported to the Swedish Adverse Drug Reactions Advisory Committee (SADRAC). A further aim is to compare the characteristics of reported and not reported cases. METHODS: This retrospective study is a separate analysis using data from a larger study that included women aged 15-44 years between 1990 and 1999 with VTE coded as the underlying or contributory cause of death in the Swedish Cause of Death Register. COC use within 2 months of the date of symptom onset or death was identified in 28 cases. Sales data were obtained from the National Corporation of Swedish Pharmacies. Reported cases were identified in the SADRAC database. RESULTS: After excluding two cases where the type of COC was unknown, the crude incidences of fatal VTE were 5.1 (95% CI 2.3, 9.6), 8.6 (95% CI 4.3, 15.4) and 9.1 (95% CI 3.3, 19.8) cases per million women per year for levonorgestrel-, desogestrel- and norethisterone-containing COCs, respectively. Age-adjusted incidences were approximately twice as high for desogestrel- and norethisterone-containing COCs compared with levonorgestrel-containing COCs, although differences were not statistically significant. Thirty-six percent of cases were reported. Reporting was positively associated with information in medical records relevant to the VTE diagnosis that the patient was a COC user and was significantly higher in northern Sweden. CONCLUSION: Results from this study support a higher incidence of fatal VTE with desogestrel-containing COCs than with levonorgestrel-containing COCs.
PubMed ID
16180940 View in PubMed
Less detail

High-dose estrogen-progestagen oral contraceptives: a risk factor for aneurysmal subarachnoid hemorrhage?

https://arctichealth.org/en/permalink/ahliterature235005
Source
Acta Neurol Scand. 1987 Jul;76(1):37-45
Publication Type
Article
Date
Jul-1987
Author
B. Lindegård
M. Hillbom
S. Brody
Source
Acta Neurol Scand. 1987 Jul;76(1):37-45
Date
Jul-1987
Language
English
Publication Type
Article
Keywords
Adult
Aged
Contraceptives, Oral, Combined - adverse effects
Dose-Response Relationship, Drug
Estradiol Congeners - adverse effects
Female
Humans
Intracranial Aneurysm - chemically induced
Male
Middle Aged
Progesterone Congeners - adverse effects
Risk
Subarachnoid Hemorrhage - chemically induced
Sweden
Abstract
A 10-year follow-up (1970-79) of a defined general population (n = 159 200) of middle-aged (born in 1911-40), urban, native Swedes, revealed that the prevalence rate of subarachnoid hemorrhage was 2.8 times higher in females than in males. This was mainly due to an accumulation of non-hypertensive aneurysmal subarachnoid bleeds in women born in the period 1932-40. The cases were significantly (P less than 0.001) overrepresented among divorced women, with relative risks of 1.89, 0.98 and 0.63 for divorced women, married women and spinsters (never married), respectively. Since high-dose estrogen-progestagen oral contraceptives have largely been used by the younger members of this study cohort, it may be speculated whether the observed substantial excess prevalence rate of subarachnoid hemorrhage with saccular aneurysm, not reported previously, represents a cohort effect unexpected after the introduction of low-dose oral contraceptives.
PubMed ID
3630643 View in PubMed
Less detail

Hormonal contraception and risk of venous thromboembolism: national follow-up study.

https://arctichealth.org/en/permalink/ahliterature94504
Source
BMJ. 2009;339:b2890
Publication Type
Article
Date
2009
Author
Lidegaard Øjvind
Løkkegaard Ellen
Svendsen Anne Louise
Agger Carsten
Author Affiliation
Gynaecological Clinic, Rigshospitalet, Copenhagen University, DK-2100 Copenhagen, Denmark. Lidegaard@rh.regionh.dk
Source
BMJ. 2009;339:b2890
Date
2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Contraceptives, Oral, Combined - adverse effects
Contraceptives, Oral, Hormonal - adverse effects
Denmark - epidemiology
Epidemiologic Methods
Female
Humans
Middle Aged
Venous Thromboembolism - chemically induced - epidemiology
Young Adult
Abstract
OBJECTIVE: To assess the risk of venous thrombosis in current users of different types of hormonal contraception, focusing on regimen, oestrogen dose, type of progestogen, and route of administration. DESIGN: National cohort study. SETTING: Denmark, 1995-2005. PARTICIPANTS: Danish women aged 15-49 with no history of cardiovascular or malignant disease. MAIN OUTCOME MEASURES: Adjusted rate ratios for all first time deep venous thrombosis, portal thrombosis, thrombosis of caval vein, thrombosis of renal vein, unspecified deep vein thrombosis, and pulmonary embolism during the study period. RESULTS: 10.4 million woman years were recorded, 3.3 million woman years in receipt of oral contraceptives. In total, 4213 venous thrombotic events were observed, 2045 in current users of oral contraceptives. The overall absolute risk of venous thrombosis per 10 000 woman years in non-users of oral contraceptives was 3.01 and in current users was 6.29. Compared with non-users of combined oral contraceptives the rate ratio of venous thrombembolism in current users decreased with duration of use (4 years 2.76, 2.53 to 3.02; P
Notes
Comment In: BMJ. 2009;339:b316419679617
PubMed ID
19679613 View in PubMed
Less detail

Maternal hormonal contraceptive use and offspring overweight or obesity.

https://arctichealth.org/en/permalink/ahliterature263595
Source
Int J Obes (Lond). 2014 Oct;38(10):1275-81
Publication Type
Article
Date
Oct-2014
Author
E T Jensen
J L Daniels
T. Stürmer
W R Robinson
C J Williams
D. Moster
P B Juliusson
K. Vejrup
P. Magnus
M P Longnecker
Source
Int J Obes (Lond). 2014 Oct;38(10):1275-81
Date
Oct-2014
Language
English
Publication Type
Article
Keywords
Adult
Cohort Studies
Contraceptive Agents, Female - adverse effects - pharmacology
Contraceptives, Oral, Combined - adverse effects
Contraceptives, Oral, Hormonal - adverse effects
Female
Humans
Infant, Newborn
Male
Norway - epidemiology
Odds Ratio
Pediatric Obesity - chemically induced - epidemiology
Pregnancy
Pregnancy, Unplanned
Prenatal Exposure Delayed Effects - chemically induced - epidemiology
Prospective Studies
Abstract
Experiments in animal models have shown a positive association between in utero exposure to pharmacologic sex hormones and offspring obesity. The developmental effects of such hormones on human obesity are unknown.
Using data from a large, prospective pregnancy cohort study (n=19?652), with linkage to a national prescription registry, we evaluated the association between use of hormonal contraceptives before and after conception (defined from dispensed prescription data and characterized by last date of use relative to conception, 12 to >4 months before (n=3392), 4 to >1 months before (n=2541), 1 to >0 months before (n=2997) and 0-12 weeks after (n=567)) in relation to offspring overweight or obesity at age 3 years.
We observed a weak, inverse association between early pregnancy use of a combination oral contraceptive and offspring overweight or obesity at age 3 (adjusted odds ratio (OR): 0.75, 95% confidence interval (CI): 0.53, 1.08) and a positive, but imprecise, association with use of a progestin-only oral contraceptive in early pregnancy (adjusted OR: 1.26, 95% CI: 0.79, 2.02). In general, no association was observed between the use of a hormonal contraceptive before conception and offspring overweight or obesity. A sensitivity analysis comparing combination oral contraceptive users in early pregnancy to other unplanned pregnancies without hormonal contraceptive use further strengthened the inverse association (adjusted OR: 0.70, 95% CI: 0.48, 1.02). Other sensitivity analyses were conducted to evaluate the robustness of the associations observed given varying assumptions.
Pharmacologic sex hormones in early pregnancy may be inversely or positively associated with offspring overweight or obesity at age 3, depending on the specific formulation used. The present study provides support for the potential for environmental sources of hormonally active agents to exert developmental effects.
Notes
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PubMed ID
24984751 View in PubMed
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32 records – page 1 of 4.