1.  Peer Reviewed Title: Oral contraceptives for functional ovarian cysts. Source: Obstetrics and Gynecology. 2009 Sep;114(3):679-80. Abstract: BACKGROUND:: Functional ovarian cysts are a common gynecological problem among women of reproductive age worldwide. When large, persistent, or painful, these cysts may require operations, sometimes resulting in removal of the ovary. Since early oral contraceptives were associated with a reduced incidence of functional ovarian cysts, many clinicians inferred that birth control pills could be used to treat cysts as well. This became a common clinical practice in the early 1970s. OBJECTIVES:: This review examined all randomized controlled trials that studied oral contraceptives as therapy for functional ovarian cysts. SEARCH STRATEGY:: We searched the databases of CENTRAL, MEDLINE, POPLINE, and EMBASE, as well as clinical trials databases (ClinicalTrials.gov and ICTRP). We also examined the reference lists of articles and wrote to authors of identified trials to seek articles we had missed. SELECTION CRITERIA:: We included randomized controlled trials in any language that included oral contraceptives used for treatment and not prevention of functional ovarian cysts. Criteria for diagnosis of cysts were those used by authors of trials. DATA COLLECTION AND ANALYSIS:: Two authors independently abstracted data from the articles. One entered the data into RevMan and a second verified accuracy of data entry. For dichotomous outcomes, we used Peto odds ratios with 95% confidence intervals (CIs). For continuous outcomes, we calculated mean differences with 95% CI. MAIN RESULTS:: We identified seven randomized controlled trials from four countries; the studies included a total of 500 women. Treatment with combined oral contraceptives did not hasten resolution of functional ovarian cysts in any trial. This held true for cysts that occurred spontaneously as well as those that developed after ovulation induction. Most cysts resolved without treatment within a few cycles; persistent cysts tended to be pathological (e.g., endometrioma or para-ovarian cyst) and not physiological. AUTHORS' CONCLUSION:: Although widely used for treating functional ovarian cysts, combined oral contraceptives appear to be of no benefit. Watchful waiting for two or three cycles is appropriate. Should cysts persist, surgical management is often indicated.Grimes DA, Jones LB, Lopez LM, Schulz KF. Oral contraceptives for functional ovarian cysts. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD006134. DOI: 10.1002/14651858.CD006134.pub2. Copyright the Cochrane Collaboration, reproduced with permission. Language: English Keywords: GLOBAL | RESEARCH REPORT | LITERATURE REVIEW | INCIDENCE | OVARIAN CYSTS | ORAL CONTRACEPTIVES | TREATMENT | EXAMINATIONS AND DIAGNOSES | Measurement | Research Methodology | Diseases | Contraceptive Methods | Contraception | Family Planning | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342569 |
2.  Title: Community-based distribution of injectable contraceptives. Approaches that work. Author: Futures Group International. Health Policy Initiative Source: Washington, D.C., Futures Group International, Health Policy Initiative, 2009 Apr. [1] p. Abstract: Contraceptive prevalence rates in many sub-Saharan African countries surged in the mid-1990s. Much of this increase can be attributed to additional resources devoted to family planning (FP) programs and the uptake of specific methods, including injectable contraceptives. For example, use of injectables in Malawi grew from 2 percent in 1992 to 18 percent in 2004. Surveys in many African countries have found that women prefer injectable contraceptives; in some cases, preference for injectables is 2-1 over oral contraceptives and other methods. In recent years, however, these same countries have experienced a stagnation or decline in overall contraceptive prevalence. Particularly in rural areas, modern contraceptives are often scarce, and few trained professionals are available to provide FP services. One way to increase access to and use of family planning is to promote community-based distribution (CBD) of injectables. Countries struggling with stagnating contraceptive prevalence can begin to alterthis trend by training and empowering community-based workers to provide injectable contraceptives. Language: English Keywords: DEVELOPING COUNTRIES | SUMMARY REPORT | CONTRACEPTIVE PREVALENCE | INJECTABLES | ORAL CONTRACEPTIVES | COMMUNITY-BASED DISTRIBUTION | PRIVATE SECTOR | HEALTH SERVICES | Contraceptive Usage | Contraception | Family Planning | Contraceptive Methods | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Macroeconomic Factors | Economic Factors | Delivery of Health Care | Health Document Number: 331532 |
| 3. Peer Reviewed Title: Evaluation of mifepristone as a once a month contraceptive pill. Author: Agarwal M; Das V; Agarwal A; Pandey A; Srivastava D Source: American Journal of Obstetrics and Gynecology. 2009 May;200(5):e27-9. Abstract: OBJECTIVE: The purpose of this study was to assess the efficacy and safety of mifepristone as a contraceptive pill. STUDY DESIGN: A prospective case-control study was conducted in a tertiary care center of North India. The study group (n = 86) was given 200-mg mifepristone tablets on the 16th day of the menstrual cycle. The control group (n = 92) received combined oral contraceptive (COC) as per protocol. Subjects were followed for drug compliance, satisfaction, side effects, and failure. RESULTS: Acceptability of mifepristone was significantly higher in educated population (P < .001), with fewer side effects (P = .001), good satisfaction (P < .001), and higher compliance rate (P = .05). The oral contraceptive pill group had higher adverse biochemical parameters. CONCLUSION: Mifepristone can be used as a monthly contraceptive pill effectively. Language: English Keywords: INDIA | RESEARCH REPORT | ORAL CONTRACEPTIVES | RU-486 | TIME FACTORS | ADMINISTRATION AND DOSAGE | Asia, Southern | Asia | Developing Countries | Contraceptive Methods | Contraception | Family Planning | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Population Dynamics | Demographic Factors | Population | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341243 |
| 4. Title: Oral Contraceptives: A Risk Factor for Squamous Cell Carcinoma? Author: Applebaum KM; Nelson HH; Zens MS; Stukel TA; Spencer SK; Karagas MR Source: Journal of Investigative Dermatology. 2009 Jun 25; Abstract: Oral contraceptives (OCs) affect the risk of several cancers in women, but have been virtually unstudied for squamous cell carcinoma (SCC). We examined the hypothesis that OCs influence SCC risk in a case-control study among women and also examined whether polymorphisms in the DNA repair gene, Xeroderma pigmentosum group D (XPD), modified the risk. Incident cases of SCC were identified by a network of dermatologists and pathology laboratories. Population-based controls were frequency matched to cases by age and gender (n=261 SCC cases, 298 controls). Overall, OC use was associated with a 60% higher risk of SCC (odds ratio (OR), 1.6; 95% confidence interval (95% CI): 1.0-2.5). ORs for SCC were higher among those who last used OCs >/=25 years before diagnosis (OR: 2.1; 95% CI: 1.2-3.7), and among these women, SCC risk increased with duration of use (OR for /=7 years, 2.7; 95% CI: 0.9-8.5, P(trend)=0.01). Furthermore, the XPD Lys751Gln polymorphism was a significant modifier of the OC-SCC association (P(interaction)=0.03). These findings lead us to hypothesize a potential relationship between OCs and SCC risk, and that this could involve DNA repair pathways.Journal of Investigative Dermatology advance online publication, 25 June 2009; doi:10.1038/jid.2009.168. Language: English Keywords: UNITED STATES OF AMERICA | NEW HAMPSHIRE | RESEARCH REPORT | CONTROL GROUPS | WOMEN | ORAL CONTRACEPTIVES | CONTRACEPTIVE AGENTS, SIDE EFFECTS | RISK FACTORS | CANCER | DERMATOLOGICAL EFFECTS | ESTROGENS | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents | Health | Neoplasms | Diseases | Physiology | Biology | Hormones | Endocrine System Document Number: 341751 |
| 5. Title: Hormonal methods of contraception for youth. More effective strategies are needed to improve access and encourage consistent use. Author: Aradhya K; Lebetkin E Source: Research Triangle Park, North Carolina, Family Health International [FHI], Interagency Youth Working Group, 2009 May. [4] p. (YouthLens on Reproductive Health and HIV / AIDS No. 30) Abstract: Youth, defined here as people ages 10 to 24 years old, need better access to contraception. The decreasing age of menarche and increasing age of marriage have created an ever-widening window of time for premarital sexual intercourse and pregnancies. Hormonal methods of contraception -- including oral contraceptive pills, injectables, and implants -- are among the most effective methods of preventing unintended pregnancies. They are generally well known among youth and, as an alternative to condoms, allow a young woman to control her risk of pregnancy. (Excerpts) Language: English Keywords: DEVELOPING COUNTRIES | SUMMARY REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | YOUTH | ORAL CONTRACEPTIVES | INJECTABLES | CONTRACEPTIVE IMPLANTS | PREGNANCY, UNPLANNED | PREVENTION AND CONTROL | STIGMA | HEALTH FACILITIES | PROGRAM ACCESSIBILITY | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Age Factors | Population Characteristics | Contraceptive Methods | Contraception | Family Planning | Reproductive Behavior | Fertility | Diseases | Social Problems | Sociocultural Factors | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration Document Number: 331499 |
| 6. Peer Reviewed Title: Ovarian activity and safety of a novel levonorgestrel/ethinyl estradiol continuous oral contraceptive regimen. Author: Archer DF; Kovalevsky G; Ballagh SA; Grubb GS Source: Contraception. 2009 Sep;80(3):245-53. Abstract: BACKGROUND: A continuous regimen of oral levonorgestrel (LNG) 90 mcg/ethinyl estradiol (EE) 20 mcg was evaluated for inhibition of ovulation, time to return to ovulation after stopping treatment and safety. STUDY DESIGN: This open-label study was conducted in healthy women aged 18-35 years. Ovulation was documented before treatment, and then participants received oral tablets containing LNG 90 mcg/EE 20 mcg to be taken continuously for three 28-day intervals. Ovarian activity was assessed three times per week during the treatment period with transvaginal ultrasound scans and measurements of serum 17beta-estradiol, progesterone, follicle-stimulating hormone and luteinizing hormone concentrations. Safety assessments included physical examinations, laboratory evaluations and adverse event records. RESULTS: Thirty-seven of the 58 subjects who received treatment met predefined criteria for efficacy analysis. No on-treatment ovulations occurred in the efficacy or intent-to-treat population. There was evidence of ovulation within 37 days of stopping treatment for 46 (98%) of 47 subjects evaluated posttreatment. The final subject with a history of polycystic ovarian syndrome ovulated by Day 66. The safety profile observed during this 84-day continuous regimen was similar to that seen with other low-dose oral contraceptives administered in a cyclic regimen. CONCLUSIONS: The continuous LNG/EE regimen completely inhibited ovulation, with little evidence of follicular development and with rapid return of ovulatory capacity after stopping treatment. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | WOMEN | ORAL CONTRACEPTIVES | LEVONORGESTREL | ETHINYL ESTRADIOL | SAFETY | ULTRASONICS | OVARIAN EFFECTS | TREATMENT | Developed Countries | North America | Americas | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Estrogen | Public Health | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology Document Number: 342575 |
| 7. Peer Reviewed Title: Pill use in the month before conception linked to risk of low birth weight, preterm delivery Author: Ball H Source: Perspectives On Sexual and Reproductive Health. 2009 Jun;41(2):128. Abstract: Women who use oral contraceptives just prior to conception may be more likely than nonusers to experience adverse birth outcomes, according to a study of health records from the Canadian province of Saskatchewan.1 Those who used the pill within 30 days of their last menstrual period had elevated odds of preterm birth and low birth weight, conditions that are associated with infant morbidity and mortality. The researchers examined records from Saskatchewan Health Databases, which contain information on 99% of the province's residents. They obtained data on physician services, hospital stays and prescription drug use in the year prior to giving birth for a random sample of 50% of women who had a pregnancy between 1997 and 2000. these outcomes. In an analysis that adjusted for women's socioeconomic and chronic disease status, pill use within 30 days of the last menstrual period was positively associated with the occurrence of very low and low birth weight (odds ratios, 3.2 and 1.9, respectively) and preterm delivery (1.6). Use 2-3 months prior to the last menstrual period was not associated with adverse birth outcomes. (excerpt) Language: English Keywords: CANADA | SUMMARY REPORT | WOMEN | CONTRACEPTIVE USAGE | ORAL CONTRACEPTIVES | PREGNANCY | LOW BIRTH WEIGHT | RISK FACTORS | Developed Countries | North America, Northern | Americas | Demographic Factors | Population | Contraception | Family Planning | Contraceptive Methods | Reproduction | Birth Weight | Body Weight | Physiology | Biology | Health Document Number: 341884 |
| 8. Peer Reviewed Title: Return to fertility following discontinuation of oral contraceptives. Author: Barnhart KT; Schreiber CA Source: Fertility and Sterility. 2009 Mar;91(3):659-63. Abstract: OBJECTIVES: To provide an overview of the studies that have evaluated the return to fertility following cessation of oral contraceptives (OCs), including recent evidence in women discontinuing extended-cycle and continuous-use regimens. DESIGN: Comprehensive review. PATIENT(S): None. INTERVENTION(S): Relevant articles were identified through a PubMed literature search (1960-2007) and a cross-reference of published data. MAIN OUTCOME MEASURE(S): Time to fertility following contraceptive use. RESULT(S): Numerous studies have demonstrated some delay in the time to conception in previous users of OCs who discontinued use in order to conceive, but this impairment appears to be temporary and typically limited to the early months following cessation of OC use. Reported 12-month conception rates in former cyclic OC users range from 72%-94% and are similar to those observed in women discontinuing intrauterine devices (71%-92%), progestin-only contraceptives (70%-95%), condoms (91%), and natural family planning (92%). There is a limited amount of data on the time to conception in women stopping extended-cycle and continuous-use OCs, but the data suggest that subsequent return to fertility is generally comparable to that of cyclic OCs. CONCLUSION(S): A comprehensive survey of reported data indicates that the return of fertility in former OC users (both cyclic and extended/continuous regimens) in women who stop use in order to conceive is comparable to that observed with other contraceptive methods. Language: English Keywords: UNITED STATES OF AMERICA | PENNSYLVANIA | LITERATURE REVIEW | FERTILITY | ORAL CONTRACEPTIVES | CONTRACEPTIVE USAGE | REVERSIBILITY | Developed Countries | North America | Americas | Population Dynamics | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning Document Number: 330562 |
| 9. Title: Quantitative analysis of DHEA and androsterone in female urine: investigating the effects of menstrual cycle, oral contraception and training on exercise-induced changes in young women. Author: Bayle ML; Enea C; Goetinck P; Lafay F; Boisseau N; Dugue B; Flament-Waton MM; Grenier-Loustalot MF Source: Analytical and Bioanalytical Chemistry. 2009 Feb;393(4):1315-25. Abstract: Dehydroepiandrosterone (DHEA) and its metabolite androsterone (A) are natural steroids secreted in high quantities in human body. To assess the influence of oral contraceptives, menstrual cycle phase, and also physical exercise (acute and chronic such as training) on these metabolites excretions, a collection of 28 female urine specimens was organized. A three-extraction-step method was developed, and the analyses were performed by gas chromatography-mass spectrometry using deuterated 19-noretiocholanolone as the internal standard. Sample hydration state was found to be of great importance for kinetic studies, as it directly influenced the concentrations. No influence of menstrual cycle and training was found for androsterone and DHEA. However, oral contraceptive intake lowered DHEA excretion in urine and A seems to be slightly affected by exercise. Language: English Keywords: FRANCE | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | ATHLETES | MENSTRUAL CYCLE | ORAL CONTRACEPTIVES | FITNESS | DEHYDROEPIANDROSTERONE | ANALYSIS | LABORATORY EXAMINATIONS AND DIAGNOSES | PHYSIOLOGY | Developed Countries | Europe, Western | Europe | Research Methodology | Demographic Factors | Population | Population Characteristics | Menstruation | Reproduction | Contraceptive Methods | Contraception | Family Planning | Health | Androgens | Hormones | Endocrine System | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 330963 |
| 10. Title: Genetic counseling for teratogenic risk due to exposure to medications: 89 pregnancies conceived during oral contraceptive use. Author: Belli S; Mazzola S; Luongo R; Barcella L; Alushi B Source: American Journal of Medical Genetics. Part A. 2009 Jun 5; Abstract: Congenital malformations are relatively frequent (2% of the general population) but only a small proportion of them can be ascribed to medication exposure during pregnancy. Nevertheless, for the purposes of accurate prenatal diagnosis, monitoring and research, is it important to offer teratology counseling to patients exposed to drugs. There are approximately 20 medications currently on the market that have been universally acknowledged as teratogenic. At the current state of the art, exposure of early embryos to oral contraceptives is not considered teratogenic. Oral contraceptive use may be continuous (estrogen and progesterone or progesterone alone) or emergency (levonorgestrel is the only drug authorized in Italy). Like all drugs, oral contraceptives have a therapeutic failure rate, which means that a number of women on oral contraceptives conceive each year and request genetic counseling about teratogenic effects. During the period 1998-2006 at our genetics clinic we received 89 requests for counseling regarding teratogenic risk due to oral contraceptives. Our study of these patients confirms an absence of teratogenic risk for pregnancies occurring during oral contraceptive use. Teratology counseling was useful to reassure the mothers about the low risk (in the case of oral contraceptive use alone), since only 12 women chose to terminate pregnancy. Language: English Keywords: ITALY | RESEARCH REPORT | GENETICS | COUNSELING | EXPOSURE | ORAL CONTRACEPTIVES | CONTRACEPTIVE AGENTS, ESTROGEN | PROGESTERONE | LEVONORGESTREL | CONGENITAL ABNORMALITIES | RISK FACTORS | PREGNANCY | Developed Countries | Europe, Southern | Europe | Biology | Clinic Activities | Program Activities | Programs | Organization and Administration | Health | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Female | Contraceptive Agents | Progestational Hormones | Hormones | Endocrine System | Physiology | Contraceptive Agents, Progestin | Neonatal Diseases and Abnormalities | Diseases | Reproduction Document Number: 341602 |
| 11. Peer Reviewed Title: Changes in weight, total fat, percent body fat, and central-to-peripheral fat ratio associated with injectable and oral contraceptive use. Author: Berenson AB; Rahman M Source: American Journal of Obstetrics and Gynecology. 2009 Mar;200(3):329.e1-8. Abstract: OBJECTIVE: The purpose of this study was to determine changes in bodyweight and composition that result from hormonal contraception. STUDY DESIGN: Dual-energy x-ray absorptiometry was performed at baseline and every 6 months for 3 years for 703 women (African American, 200; white, 247; Hispanic, 256) who were beginning the use of oral contraception (OC; n = 245), depot medroxyprogesterone acetate (DMPA; n = 240), or nonhormonal contraception (NH; n = 218). DMPA discontinuers were observed for up to 2 years to examine the reversibility of the observed changes. RESULTS: Over 36 months, DMPA users increased their weight (+5.1 kg), body fat (+4.1 kg), percent body fat (+3.4%), and central-to-peripheral fat ratio (+0.1) more than OC and NH users (P < .01). OC use did not cause weight gain. After DMPA discontinuation, NH users lost 0.42 kg in 6 months; OC users gained 0.43 kg in 6 months. CONCLUSION: Bodyweight and fat significantly increase with the use of DMPA. After discontinuation of DMPA, some decrease in bodyweight and fat occurs when NH is used. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | RETROSPECTIVE STUDIES | WOMEN | ORAL CONTRACEPTIVES | BODY WEIGHT | MEDROXYPROGESTERONE ACETATE | CONTRACEPTIVE USAGE | LIPIDS | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Physiology | Biology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents Document Number: 330467 |
| 12. Title: [Progestagen use in oral contraception - Basic knowledge] Grundlagen zur Gestagen-Komponente in der hormonalen Kontrazeption. Author: Birkhauser M Source: therapeutische Umschau. Revue therapeutique. 2009 Feb;66(2):71-87. Abstract: The effects of most prostagens used in hormone replacement therapy (HRT) and in hormonal contraception are not identical. They differ in their structure, the metabolisation, their bioavailability and their partial activities. Therefore, it does not make any sense to declare that the different progestagens with their different profiles belong to one class of substances, having all the same effect. In function of their partial activities, progestagens are used today specifically for HRT, for hormonal contraception or as an anti-androgen. Because of their metabolic profile, some newer progestagens can be considered to be specifically favourable, such as Norpregnanes, Dienogest and Drospirenone. This review summarizes the properties and partial activities of progestagens used today and analyzes its clinical consequences. Language: German Keywords: RESEARCH REPORT | ORAL CONTRACEPTIVES | HORMONE REPLACEMENT THERAPY | Contraceptive Methods | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 329575 |
| 13. Title: The association of serotonin transporter genotypes and selective serotonin reuptake inhibitor (SSRI)-associated sexual side effects: possible relationship to oral contraceptives. Author: Bishop JR; Ellingrod VL; Akroush M; Moline J Source: Human Psychopharmacology. 2009 Apr;24(3):207-15. Abstract: OBJECTIVE: To study the relationship between functional variants in the serotonin transporter gene (SLC6A4) and selective serotonin reuptake inhibitor (SSRI)-associated sexual dysfunction. METHODS: One hundred fifteen subjects aged 18-40 years and currently being treated with an SSRI for depression were assessed for clinical variables known to affect sexual well-being. SSRI-associated sexual difficulties were assessed with the Changes in Sexual Functioning Questionnaire (CSFQ). Subjects were subsequently genotyped for the SLC6A4 promoter region (5HTTLPR) insertion/deletion variant and a variable number of tandem repeats (VNTR) in the second intron. RESULTS: The 5HTTLPR insertion/deletion variant was associated with sexual dysfunction in this study sample [odds ratio (OR) = 2.7; 95% confidence interval (CI) 1.2, 6.4; p = 0.02]. The relationship between promoter genotypes and sexual well-being differed in males and females and was related to whether females were taking an oral contraceptive (OC) medication. Females with the ll genotype were nearly eight times more likely to be categorized as having sexual dysfunction if they were taking OCs, while no relationship was observed in those not taking OCs. CONCLUSIONS: These results suggest that a functional variant in the serotonin transporter gene is associated with sexual difficulties in persons taking an SSRI for depression. This relationship may differ by sex and be dependent on OC status in females. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | SAMPLING STUDIES | CLIENTS | DEPRESSION | DRUGS | ADMINISTRATION AND DOSAGE | SEROTONIN | SIDE EFFECTS | DECREASED LIBIDO | ORAL CONTRACEPTIVES | GENETICS | Developed Countries | North America | Americas | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Mental Disorders | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physiology | Biology | Sex Behavior | Behavior | Contraceptive Methods | Contraception | Family Planning Document Number: 341959 |
| 14. Title: Added benefits and user satisfaction with a low-dose oral contraceptive containing drospirenone : results of three multicentre trials. Author: Bitzer J; Paoletti AM Source: Clinical Drug Investigation. 2009;29(2):73-8. Abstract: The ethinylestradiol 20 mug/drospirenone 3 mg combined oral contraceptive (COC), administered in cycles of 21 days continuous use followed by a 7-day hormone-free interval (21/7) [Yasminelle((R))], has been proven to be an effective and well tolerated contraceptive with an acceptable bleeding pattern and good safety profile. In addition, the ethinylestradiol 20 mug/drospirenone 3 mg 21/7 COC prevents water-retention-related weight gain, and improves physical and emotional well-being, consistent with other drospirenone-containing COCs. In clinical studies, >85% of those who received the ethinylestradiol 20 mug/drospirenone 3 mg 21/7 COC were satisfied or very satisfied with this contraceptive. The positive attributes of the ethinylestradiol 20 mug/drospirenone 3 mg 21/7 COC beyond contraceptive protection may have important implications for improving treatment compliance and reducing treatment discontinuation. Physical well-being stayed the same or improved during use of this COC in 56% and 34% of women, respectively. Emotional well-being stayed the same or improved in 71% and 20% of women, respectively. Language: English Keywords: ITALY | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | ORAL CONTRACEPTIVES | ETHINYL ESTRADIOL | ORAL CONTRACEPTIVES, COMBINED | CONTRACEPTIVE EFFECTIVENESS | SATISFACTION | Developed Countries | Europe, Southern | Europe | Studies | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Psychological Factors | Behavior Document Number: 329809 |
| 15. Peer Reviewed Title: Twenty or thirty microgram ethinyloestradiol in an oral contraceptive: Does it make a difference in the mind and the daily practice of gynaecologists and general practitioners? Author: Bitzer J; Frey B; von Schonau M; Sabler N; Tschudin S Source: European Journal of Contraception and Reproductive Health Care. 2009 Jun 5;:1-10. Abstract: Objectives Currently, evidence-based guidelines concerning the use of oral contraceptives (OCs) containing either 20 or 30 mug ethinyloestradiol (EE) and the same progestogen, are lacking. We wanted to identify whether Swiss gynaecologists and general practitioners (GPs) have specific criteria on which they base their prescribing habit. Methods Two questionnaires were submitted to 158 physicians. The first one contained a list of possible criteria relevant for decision making and a description of specific clinical situations. The second one concerned actual patients who received either a 20 mug (Yasminelle(R)) or a 30 mug (Yasmin(R)) OC containing the same progestogen drospirenone. Results The most relevant criteria for decision making (in hierarchical order) were family history of venous thromboembolic disease (VTE), headache, smoking, age beyond 35, stability of the menstrual cycle, breast tenderness, body mass index, irregular bleeding and acne. The 20 mug dosage was preferred for women older than 35, those smoking more than 15 cigarettes per day, those with a family history of VTE, and those complaining of breast tenderness or headache. The 30 mug dosage was preferred for patients with a history of irregular bleeding, a family history of osteoporosis, expected poor compliance and acne. Conclusion Swiss gynaecologists and GPs do not preferentially prescribe the lowest possible dosage of EE. They use indirect markers they consider relevant for differential prescribing. For some markers, there is inconsistency, indicating that preferences for 20 mug and 30 mug preparations may be influenced by other factors. Language: English Keywords: SWITZERLAND | RESEARCH REPORT | PHYSICIANS | WOMEN | CLIENTS | DECISION MAKING | TOBACCO USE | HEADACHE | ORAL CONTRACEPTIVES | ETHINYL ESTRADIOL | CONTRACEPTIVE AGENTS, SIDE EFFECTS | THROMBOEMBOLISM | AGE FACTORS | ADMINISTRATION AND DOSAGE | Developed Countries | Europe, Central | Europe | Health Personnel | Delivery of Health Care | Health | Demographic Factors | Population | Program Activities | Programs | Organization and Administration | Behavior | Signs and Symptoms | Diseases | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Embolism | Vascular Diseases | Population Characteristics | Drugs | Treatment | Medical Procedures | Medicine | Health Services Document Number: 341601 |
| 16. Title: Contraceptive use among canadian women of reproductive age: results of a national survey. Author: Black A; Yang Q; Wu Wen S; Lalonde AB; Guilbert E; Fisher W Source: Journal of Obstetrics and Gynaecology Canada. 2009 Jul;31(7):627-40. Abstract: Objective: Past studies indicate that despite a wide range of contraceptive options, Canadian women tend to use a narrow selection of contraceptive methods. New contraceptive methods have recently been introduced in Canada. The objective of this research is to characterize Canadian women's current contraceptive choices and adherence to contraceptive regimens. Methods: A national cross-sectional survey was conducted in November 2006. A standardized, confidential, Internet questionnaire was administered to female members of a previously recruited national market research panel. Percentages of current contraceptive use and consistency of use were calculated by age group, marital status, and province and were weighted according to age and region. Chi-square test was used to detect within-group differences for consistency of contraceptive use, oral contraceptive (OC) use, and condom use. Multivariate logistic regression analyses predicting consistent contraception use, OC use, and condom use were performed. Results: Of 5597 survey respondents, 3253 were eligible for data analysis. Of these women, 2751 had had vaginal intercourse in the previous six months, were not trying to conceive, and reported whether they or their partner had used contraception. Of these 2751 women, 410 (14.9%) never used contraception. Among contraception users, the most frequently used methods of contraception were condoms (54.3%), OCs (43.7%), and withdrawal (11.6%). Newer contraceptive methods were used by less than 4%. Choice of contraceptive method varied by age. Only 65.2% of respondents who were sexually active and not trying to conceive "always used" contraception. Multivariate logistic regression analyses found significantly higher odds of no contraception use in women over 40 years of age, without higher education, living in PEI or Newfoundland, married or living common-law, or having annual household incomes under $100 000. Conclusion: Despite many contraceptive options, Canadian women continue to use a narrow range of contraceptive methods and to use contraception inconsistently. Consistent contraceptive use is influenced by a number of independent social variables. Future public health initiatives should focus on raising awareness of contraception options, increased access to a variety of contraceptive methods, and assisting with contraceptive adherence. Language: English Keywords: CANADA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | SURVEYS | WOMEN | CONTRACEPTIVE USAGE | REPRODUCTIVE AGE | CONDOM USE | USER COMPLIANCE | CONTRACEPTION | ORAL CONTRACEPTIVES | Developed Countries | North America, Northern | Americas | Research Methodology | Sampling Studies | Studies | Demographic Factors | Population | Family Planning | Reproduction | Risk Reduction Behavior | Behavior | Contraceptive Methods Document Number: 342765 |
| 17. Peer Reviewed Title: A longitudinal comparison of body composition changes in adolescent girls receiving hormonal contraception. Author: Bonny AE; Secic M; Cromer BA Source: Journal of Adolescent Health. 2009 Oct;45(4):423-5. Abstract: The objective of this study was to examine body composition changes in adolescent girls initiating depot medroxyprogesterone acetate (DMPA), oral contraceptives, or no hormonal contraceptive method. At 6 months, DMPA resulted in significant increases in adiposity with concomitant decreases in lean body mass. Supplemental estrogen may lessen these DMPA effects. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | COMPARATIVE STUDIES | LONGITUDINAL STUDIES | CONTROL GROUPS | ADOLESCENTS, FEMALE | DEPO-PROVERA | ORAL CONTRACEPTIVES | BODY WEIGHT | OBESITY | ESTROGENS | Developed Countries | North America | Americas | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Contraceptive Methods | Physiology | Biology | Hormones | Endocrine System Document Number: 342847 |
| 18. Title: Oral contraceptives and colorectal cancer risk: a systematic review and meta-analysis. Author: Bosetti C; Bravi F; Negri E; La Vecchia C Source: Human Reproduction Update. 2009 May 4;1(1):1-10. Abstract: BACKGROUND Various studies have reported an inverse relation between oral contraceptive (OC) use and the risk of colorectal cancer, but the issue is still open. METHODS In order to quantify the association between OC use and colorectal cancer risk, we performed a systematic review and meta-analysis of studies on this issue. We identified all relevant studies published, in English, as original articles up to December 2008 through a search of the literature using PubMed and EMBASE, and by reviewing the references from the retrieved articles. RESULTS The summary relative risk of colorectal cancer for ever versus never OC use was 0.82 (95% confidence interval, CI, 0.69-0.97) from 11 case-control studies, 0.81 (95% CI, 0.75-0.89) from seven cohort studies, and 0.81 (95% CI, 0.72-0.92) from all studies combined. The results were similar for colon and rectal cancer. No difference was evident according to duration of OC use both for colon and rectal cancer, although there is an indication that the protection is stronger for more recent use (OR = 0.70, 95% CI, 0.53-0.90, on the basis of four studies). CONCLUSION Epidemiological data consistently indicate that OC users have a reduced risk of colorectal cancer, and that the protection is greater for recent use in the absence, however, of a duration-risk relation. Language: English Keywords: ITALY | RESEARCH REPORT | EPIDEMIOLOGY | ORAL CONTRACEPTIVES | RISK FACTORS | CANCER | Developed Countries | Europe, Southern | Europe | Public Health | Health | Contraceptive Methods | Contraception | Family Planning | Neoplasms | Diseases Document Number: 341045 |
| 19. Title: Adolescents' cortisol responses to awakening and social stress; effects of gender, menstrual phase and oral contraceptives. The TRAILS study. Author: Bouma EM; Riese H; Ormel J; Verhulst FC; Oldehinkel AJ Source: Psychoneuroendocrinology. 2009 Jul;34(6):884-93. Abstract: Studies on the influence of sex hormones on cortisol responses to awakening and stress have mainly been conducted in adults, while reports on adolescents are scarce. We studied the effects of gender, menstrual cycle phase and oral contraceptive (OC) use on cortisol responses in a large sample of adolescents. Data come from TRAILS (TRacking Adolescents' Individual Lives Survey), a prospective population study of Dutch adolescents. This study uses data of 644 adolescents (age 15-17 years, 54.7% boys) who participated in a laboratory session including a performance-related social stress task (public speaking and mental arithmetic). Free cortisol levels were assessed by multiple saliva samples, both after awakening and during the laboratory session. No significant effects of gender and menstrual phase on cortisol responses to awakening were found, while girls using OC displayed a slightly blunted response (F(1, 244)=5.30, p=.02). Cortisol responses to social stress were different for boys and free-cycling girls (F(3, 494)=9.73, p<.001), and OC users and free-cycling girls (F(3, 279)=15.12, p<.001). Unexpectedly, OC users showed no response at all but displayed linearly decreasing levels F(1, 279)=19.03, p<.001) of cortisol during the social stress test. We found no effect of menstrual cycle phase on cortisol responses to social stress (F(3, 157)=0.58, p=.55). The absence of a gender difference in the adolescents' cortisol awakening response found in this study is consistent with previous reports. Our results further suggest that adolescent OC users display slightly blunted cortisol responses after awakening, and that gender differences in cortisol responses to social stress during adolescence are comparable to those described for adult populations, that is, stronger responses in men than in women. Whereas previous work in adults suggested blunted stress responses in OC users compared to men and free-cycling women, adolescent OC users showed no cortisol response. Effects of type of OC could not be studied because of low numbers of OC that were only progestin based. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | PROSPECTIVE STUDIES | ADOLESCENTS | GENDER ISSUES | MENSTRUATION | ORAL CONTRACEPTIVES | STRESS | HORMONES | TRANSCORTIN BOUND CORTISOL ALTERATIONS | Europe, Western | Europe | Developed Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Sociocultural Factors | Reproduction | Contraceptive Methods | Contraception | Family Planning | Psychological Factors | Behavior | Endocrine System | Physiology | Biology | Hematological Effects | Hemic System Document Number: 342582 |
| 20. Title: [Does hormonal contraception increase the risk for tumors?] Erhoht die hormonale Kontrazeption das Tumorrisiko? Author: Braendle W; Kuhl H; Mueck A; Birkhauser M; Thaler C Source: therapeutische Umschau. Revue therapeutique. 2009 Feb;66(2):129-35. Abstract: A non-contraceptive benefit of oral hormonal contraceptives (OC) is a dimished risk for certain benign as well as malignant tumours, such as benign breast tumours, uterine fibroids and ovarian cysts. Endometriosis itself is not positively influenced by OC, but dysmenorrhea is decreased. Modern low-dose OC do not increase the risk of liver cell adenomata or carcinomata. OC do not influence melanoma. Modern data do not suggest an increased risk for breast carcinoma in OC users. Long-term use of OC leads to a decreased risk of endometrial and colorectal carcinomata. Cervical carcinoma is not influenced directly by OC, but probably indirectly through a change in sexual behaviour. There is no increase of vulvar or vaginal carcinoma, even after long-term use of OC. Language: German Keywords: RESEARCH REPORT | RISK FACTORS | ORAL CONTRACEPTIVES | NEOPLASMS | ENDOMETRIOSIS | OVARIAN CYSTS | Biology | Contraceptive Methods | Contraception | Family Planning | Diseases Document Number: 329569 |
| 21. Title: Contraception for women with epilepsy. Author: Burakgazi E; Harden C; Kelly JJ Source: Reviews in Neurological Diseases. 2009 Spring;6(2):E62-7. Abstract: The choice of a contraceptive drug can be challenging for women with epilepsy due to possible interactions between antiepileptic drugs (AEDs) and hormonal contraception. Enzyme-inducing AEDs can cause hormonal contraception to fail and can increase the risk of teratogenicity. Higher doses of oral contraceptives can overcome pharmacologic failure but may create additional risks. The effects of reproductive hormones on individual AEDs have recently been clarified, providing helpful guidelines for physicians and patients. Studies show that lamotrigine has a significantly increased clearance (> 50%) when used with combined oral contraceptives, which results in an increased seizure frequency in most patients. Useful alternatives to oral contraceptives include depot injections and intrauterine devices. Subdermal implants may increase the risk of pregnancy in women with epilepsy on enzyme-inducing AEDs. Depot medroxyprogesterone acetate is effective but can increase side effects. Intrauterine devices arean alternative to pharmacologic approaches because they lack drug-drug interactions and side effects. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | WOMEN | ORAL CONTRACEPTIVES | IUD | INJECTABLES | NEUROLOGIC EFFECTS | DRUGS | DRUG INTERACTIONS | TREATMENT | SIDE EFFECTS | Developed Countries | North America | Americas | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341913 |
| 22. Peer Reviewed Title: Insulin sensitivity and lipid metabolism with oral contraceptives containing chlormadinone acetate or desogestrel: a randomized trial. Author: Cagnacci A; Ferrari S; Tirelli A; Zanin R; Volpe A Source: Contraception. 2009 Feb;79(2):111-6. Abstract: BACKGROUND: Second-generation and third-generation oral contraceptives containing 30 mcg or more of ethinylestradiol (EE) decrease insulin sensitivity (SI). In this study, we investigated whether SI is decreased by contraceptives containing lower doses EE or by progestins with antiandrogenic properties. STUDY DESIGN: Twenty-eight young healthy women were randomly allocated to receive 20 mcg of EE and 150 mcg of desogestrel (DSG) (n=14) or 30 mcg of EE and 2 mg of chlormadinone acetate (CMA) (n=14) for 6 months. SI and glucose utilization independent of insulin (Sg) were investigated by the minimal model method. Lipid modifications were also analyzed. RESULTS: SI decreased with EE/DSG (7.09+/-1.4 vs. 4.30+/-0.91; p=.04; n=12), but not with EE/CMA (5.79+/-0.93 vs. 6.79+/-1.1; p=.48; n=12). SI modifications observed in the two groups were significantly different (-2.79+/-1.15 vs. 1.0+/-1.38; p=.05). Sg did not vary with either treatment. The response of C-peptide to glucose increased, but significantly so only with EE/CMA (p=.01). The C-peptide/insulin response increased with both EE/DSG (p=.05) and EE/CMA (p=.04). High-density lipoprotein (HDL) cholesterol (p=.02) and triglycerides (p=.02 and p=.01) increased in both groups, but HDL/low-density lipoprotein cholesterol (p=.02), apoprotein A1 (Apo-A1) (p=.04) and Apo-A1/apoprotein B (p=.048) increased significantly only with EE/CMA. CONCLUSIONS: The present study confirms that DSG, even when associated with low EE dose, decreases SI. By contrast, EE/CMA does not deteriorate SI and induces a favorable lipid profile. Language: English Keywords: ITALY | RESEARCH REPORT | CLINICAL TRIALS | WOMEN | PROGESTERONE | DESOGESTREL | CONTRACEPTION | ORAL CONTRACEPTIVES | LIPIDS | METABOLIC EFFECTS | SIDE EFFECTS | Developed Countries | Europe, Southern | Europe | Clinical Research | Research Methodology | Demographic Factors | Population | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Family Planning | Contraceptive Methods | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 329611 |
| 23. Peer Reviewed Title: Contraception and gynaecological care. Author: Cameron S Source: Best Practice and Research. Clinical Obstetrics and Gynaecology. 2009 Apr;23(2):211-220. Abstract: Hormonal contraception, through suppression of ovarian activity or endometrial proliferation, can be used to treat and prevent a range of gynaecological disorders. There is evidence to support the effectiveness of the levonorgestrel intra-uterine system (LNG-IUS), combined oral contraceptive pill (COC) and progestogen-only injectable depot-medroxyprogesterone acetate for treating heavy menstrual bleeding and dysmenorrhoea. COCs are also an effective treatment for acne and hirsuitism, and may lessen the symptoms of premenstrual syndrome. There is good evidence that COCs can significantly reduce the risk of both ovarian and endometrial cancer. There is also some evidence that COCs may prevent ovarian cysts, endometrial hyperplasia and fibroids. The LNG-IUS may be used as endometrial protection in women using hormone replacement therapy or tamoxifen. This chapter will deal with the evidence for both treatment and prevention of a range of gynaecological disorders of different hormonal contraceptive methods. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | ORAL CONTRACEPTIVES | IUD | GYNECOLOGY | IUD, HORMONE RELEASING | Developed Countries | Europe, Western | Europe | Contraceptive Methods | Contraception | Family Planning | Medicine | Health Services | Delivery of Health Care | Health Document Number: 329666 |
| 24. Peer Reviewed Title: One versus multiple packs for women starting oral contraceptive pills: a comparison of two distribution regimens. Author: Chin-Quee D; Otterness C; Wedderburn M; McDonald O; Janowitz B Source: Contraception. 2009 May;79(5):369-74. Abstract: BACKGROUND: Despite World Health Organization and International Planned Parenthood Federation recommendations to provide multiple pill cycles to new users, many programs in developing countries still give only one pill cycle to new acceptors. STUDY DESIGN: To compare provision of a single versus multiple packs of pills, new pill users in 20 matched public sector clinics in Jamaica were assigned to one of two pill regimens in which they received either one (then subsequently three) or four pill cycles at method initiation. The primary outcome was the proportion of women who used pills beyond 4 months. RESULTS: Among 655 women, those receiving one cycle of pills at initiation, followed by counseling and a three-pack resupply, were no more likely to be using pills after 4 months than women who received four packs at initiation (odds ratio=1.33; 95% confidence interval=0.88-2.0). In both pill regimen groups, returning late to the clinic for resupply was a problem. However, more women in the 1+3-pack regimen group returned late to study clinics to obtain their fifth cycle of pills than their counterparts in the 4-pack regimen group (53% vs. 28%). CONCLUSION: Our findings support the recommendation that pill users should be given more than one cycle to start, because an extra visit for resupply contributes to clinic and provider costs. Moreover, providing more pill cycles at initiation would decrease the likelihood that women experience a gap in pill use between cycles. Language: English Keywords: JAMAICA | RESEARCH REPORT | CONTRACEPTIVE PREVALENCE SURVEYS | COMPARATIVE STUDIES | WOMEN IN DEVELOPMENT | CONTRACEPTIVE DISTRIBUTION | PACKAGING | ORAL CONTRACEPTIVES | TIME FACTORS | COUNSELING | USER COMPLIANCE | CONTRACEPTIVE PREVALENCE | CONTRACEPTION CONTINUATION | Caribbean | Americas | Developing Countries | Family Planning Surveys | Family Planning | Studies | Research Methodology | Economic Development | Economic Factors | Distributional Activities | Program Activities | Programs | Organization and Administration | Marketing | Contraceptive Methods | Contraception | Population Dynamics | Demographic Factors | Population | Clinic Activities | Behavior | Contraceptive Usage Document Number: 330940 |
| 25. Peer Reviewed Title: Rate of pregnancy after using drospirenone and other progestin-containing oral contraceptives. Author: Cronin M; Schellschmidt I; Dinger J Source: Obstetrics and Gynecology. 2009 Sep;114(3):616-22. Abstract: OBJECTIVES:: To determine whether prior oral-contraceptive use has a negative effect on the ability of women to conceive in both the short-term and long-term. METHODS:: The European Active Surveillance Study on Oral Contraceptives (EURAS-OC) was a controlled, prospective, noninterventional cohort study of 59,510 users of oral contraceptives containing drospirenone or other progestins in clinical practice in seven European countries. In a planned secondary analysis, pregnancy outcomes were investigated in 2,064 participants in EURAS-OC who stopped oral-contraceptive use after study entry because of planned pregnancy. The influence of age, parity, progestin type, ethinylestradiol dose, duration of oral-contraceptive use, and smoking status on the rate of pregnancy was assessed. RESULTS:: Overall, 21.1% (95% confidence interval [CI] 19.4-23.0%) of the past oral-contraceptive users were pregnant one cycle after oral-contraceptive cessation. This rate increased to 79.4% (95% CI 77.6-81.1%) at 1 year (13 cycles). Progestin type, ethinylestradiol dose, duration of oral-contraceptive use, and parity had no major influence on the rate of pregnancy after oral-contraceptive cessation. Up to age 35 years, age had only a minor influence on the rate of pregnancy. Rates of pregnancy were reduced in women older than 35 years and in current smokers. CONCLUSION:: Previous oral-contraceptive use does not negatively affect initial and 1-year rates of pregnancy after oral-contraceptive cessation. A comparison of these data with data external to this study indicates that the negative effect of aging on fecundity is not amplified by oral-contraceptive use. LEVEL OF EVIDENCE:: II. Language: English Keywords: EUROPE | RESEARCH REPORT | COMPARATIVE STUDIES | PREGNANCY | PREGNANCY OUTCOMES | ORAL CONTRACEPTIVES | LOW-DOSE PROGESTINS | CONTRACEPTION TERMINATION | PREGNANCY RATE | Developed Countries | Studies | Research Methodology | Reproduction | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population Document Number: 342570 |
| 26. Title: Reproductive and hormonal risk factors for postmenopausal luminal, HER-2-overexpressing, and triple-negative breast cancer [letter] Author: Dizdar O; Aksoy S; Altundag K Source: Cancer. 2009 Apr 15;115(8):1802; author reply 1802-3. Abstract: We read with great interest the article by Phipps et al, in which they examined the risk factors for different subtypes of postmenopausal breast cancer. They found that certain reproductive factors have a greater effect on the risk of certain molecular subtypes of disease compared with others. However, the authors did not analyze oral contraceptive use as a risk factor. Oral contraceptive use has been associated with an increased risk of breast cancer in young women. Narod et al demonstrated that among BRCA1 mutation carriers, women who first used oral contraceptives before 1975, who used them before age 30 years, or who used them for > or = 5 years may have an increased risk of developing breast cancer. Sporadic triple-negative breast cancers and tumors that are noted in carriers of the BRCA1 mutation share similar features, including estrogen receptor negativity, high nuclear grade, high Ki-67 staining, cytokeratin 5/6 expression, and epidermal growth factor receptor expression. Furthermore, BRCA1 is rarely mutated in sporadic breast cancers. However, the pathologic similarities suggest that BRCA1 or associated pathways can become inactivated in triple-negative tumors via other mechanisms, such as gene promoter methylation. We previously reported a positive association between oral contraceptive use and triple-negative breast cancer. Although we did not take into consideration the menopausal status of the patients, the frequency of oral contraceptive use in our small cohort was found to be higher in patients with the triple-negative subtype compared with patients with other subtypes of breast cancer (35.3% vs 12.2%; P=.02). Taken together, we propose that oral contraceptive use may be associated with an increased risk of developing triple-negative breast cancer. However, to identify the exact role of oral contraceptive use in the development of breast cancer, more preclinical and clinical studies are warranted. (full-text) Language: English Keywords: TURKEY | UNITED STATES OF AMERICA | CRITIQUE | BREAST CANCER | RISK FACTORS | GENETICS | ORAL CONTRACEPTIVES | MENOPAUSE | AGE FACTORS | Europe, Southeastern | Europe | Developing Countries | Developed Countries | North America | Americas | Cancer | Neoplasms | Diseases | Health | Biology | Contraceptive Methods | Contraception | Family Planning | Reproduction | Population Characteristics | Demographic Factors | Population Document Number: 341636 |
| 27. Title: Risk factors for triple-negative breast cancer in women under the age of 45 years. Author: Dolle JM; Daling JR; White E; Brinton LA; Doody DR; Porter PL; Malone KE Source: Cancer Epidemiology, Biomarkers and Prevention. 2009 Apr;18(4):1157-66. Abstract: Little is known about the etiologic profile of triple-negative breast cancer (negative for estrogen receptor/progesterone receptor/human epidermal growth factor), a breast cancer subtype associated with high mortality and inadequate therapeutic options. We undertook this study to assess the risk for triple-negative breast cancer among women 45 years of age and younger in relation to demographic/lifestyle factors, reproductive history, and oral contraceptive use. Study participants were ascertained in two previous population-based, case-control studies. Eligible cases included all primary invasive breast cancers among women ages 20 to 45 years in the Seattle-Puget Sound area, diagnosed between January 1983 and December 1992, for whom complete data was obtained for estrogen receptor, progesterone receptor, and human epidermal growth factor status (n = 897; including n = 187 triple-negative breast cancer cases). Controls were age matched and ascertained via random digit dialing. Oral contraceptive use > or =1 year was associated with a 2.5-fold increased risk for triple-negative breast cancer (95% confidence interval, 1.4-4.3) and no significantly increased risk for non-triple-negative breast cancer (P(heterogeneity) = 0.008). Furthermore, the risk among oral contraceptive users conferred by longer oral contraceptive duration and by more recent use was significantly greater for triple-negative breast cancer than non-triple-negative breast cancer (P(heterogeneity) = 0.02 and 0.01, respectively). Among women < or =40 years, the relative risk for triple-negative breast cancer associated with oral contraceptive use > or =1 year was 4.2 (95% confidence interval, 1.9-9.3), whereas there was no significantly increased risk with oral contraceptive use for non-triple-negative breast cancer among women < or =40 years, nor for triple-negative breast cancer or non-triple-negative breast cancer among women 41 to 45 years of age. In conclusion, significant heterogeneity exists for the association of oral contraceptiveuse and breast cancer risk between triple-negative breast cancer and non-triple-negative breast cancer among young women, lending support to a distinct etiology. Language: English Keywords: UNITED STATES OF AMERICA | WASHINGTON | RESEARCH REPORT | CASE CONTROL STUDIES | BREAST CANCER | RISK FACTORS | ORAL CONTRACEPTIVES | TIME FACTORS | AGE FACTORS | Developed Countries | North America | Americas | Studies | Research Methodology | Cancer | Neoplasms | Diseases | Health | Contraceptive Methods | Contraception | Family Planning | Population Dynamics | Demographic Factors | Population | Population Characteristics Document Number: 341655 |
| 28. Title: Use of oral contraceptives, intrauterine devices and tubal sterilization and cancer risk in a large prospective study, from 1996 to 2006. Author: Dorjgochoo T; Shu XO; Li HL; Qian HZ; Yang G; Cai H; Gao YT; Zheng W Source: International Journal of Cancer. 2009;124(10):2442-2449. Abstract: The association of contraceptive methods, including oral contraceptives (OC), intrauterine devices (IUD) and tubal sterilization (TS), with overall and site-specific cancer were prospectively investigated in a cohort of 66,661 Chinese women in Shanghai, 76.7% of whom used contraception. During a median follow-up time of 7.5 years, 2,250 women were diagnosed with cancer. Ever-use of any contraceptive method was not associated with overall cancer risk [adjusted hazard ratio (HR(adj)) = 1.02, 95% CI, 0.92-1.12]. Use of any contraceptive method was associated with increased risk of rectal cancer (HR(adj) = 1.68, 95% CI, 1.08-2.62) and reduced risk of thyroid cancer (HR(adj) = 0.63, 95% CI, 0.38-1.04). Risk of gallbladder cancer increased with ever use of OC (HR(adj) = 2.38, 95% CI, 1.26-4.49). IUD use was associated with a possible reduced risk of thyroid cancer (HR(adj) = 0.64, 95% CI, 0.38-1.07). Longer duration of IUD use decreased risk for breast, thyroid and lung cancers. Ever having a TS was associated with increased uterine body cancer (HR(adj) = 2.50, 95% CI, 1.47-4.25) and decreased risk of stomach cancer (HR(adj) = 0.59, 95% CI, 0.39-0.91). We did not find any contraceptive method to be related to the risk of ovarian cancer but the analyses were based on few events. Although chance findings are a likely explanation for some of the associations found in our study, these findings suggest that various contraceptive methods or reproductive patterns may play a role in the etiology of cancer. (c) 2008 Wiley-Liss, Inc. Language: English Keywords: UNITED STATES OF AMERICA | CHINA | RESEARCH REPORT | WOMEN | ORAL CONTRACEPTIVES | IUD | NEOPLASMS | FEMALE STERILIZATION | TUBAL LIGATION | Developed Countries | North America | Americas | Asia, Eastern | Asia | Developing Countries | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Diseases | Sterilization, Sexual Document Number: 329657 |
| 29. Peer Reviewed Title: Profile of the progesterone derivative chlormadinone acetate - pharmocodynamic properties and therapeutic applications. Author: Druckmann R Source: Contraception. 2009 Apr;79(4):272-81. Abstract: Chlormadinone acetate (CMA) is a derivative of progesterone (17alpha-acetoxy-6-chloro-4,6-pregnadiene-3,20-dione), first synthesized in 1961 and is used as an orally effective progestogen in hormone replacement therapy (HRT), and in combination with ethinyl estradiol (EE) in contraception since 1999. Chlormadinone acetate has a strong progestogenic effect - about one-third higher than that of progesterone - and may vary depending on the previous effect of an estrogen, i.e., estrogens may promote the formation of progesterone receptors and proliferation of the endometrium. Like progesterone, it is anti-estrogenic and has no partial androgenic effect (at the doses used for contraception and HRT). In contrast to progesterone, it has a slight glucocorticoid effect, a pronounced anti-androgenic effect and no anti-mineralocorticoid effect. No pregnancy-maintaining effect of CMA has been demonstrated in humans. The anti-androgenic effect of CMA is presumed to be the result of both its binding to androgen receptors - competitively inhibiting the effect of endogenous testosterone and dihydrotestosterone - and the competitive inhibition of 5alpha-reductase. In this respect, dosing of CMA is crucial; agonistic effects are observed when doses are increased from those optimal for an antagonistic effect. Chlormadinone acetate has a strong anti-gonadotropic effect, through negative feedback on gonadotropin secretion, and has been used for more than 20 years alone for contraception in arterial risk patients. The clinical and metabolic tolerability of CMA has been demonstrated in numerous clinical studies with duration of treatment of up to 2.5 years. The more recent application of CMA as an oral contraceptive in combination with EE (Neo Eunomin, Belara) has proven highly successful, with studies reporting excellent contraceptive efficacy, high tolerability and adherence due to a good side effect profile and positive effects on preexisting dysmenorrhea, skin and hair conditions. Language: English Keywords: FRANCE | RESEARCH REPORT | ORAL CONTRACEPTIVES | CONTRACEPTIVE AGENTS, PROGESTIN | PROGESTERONE | CONTRACEPTIVE EFFECTIVENESS | Developed Countries | Europe, Western | Europe | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Female | Contraceptive Agents | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology Document Number: 341633 |
| 30. Title: Adolescent contraceptive care for the practicing pediatrician. Author: Duffy K; Wimberly Y; Brooks C Source: Adolescent Medicine. 2009 Apr;20(1):168-87, x. Abstract: Improved use of contraception has been intrinsic in the decline of teenaged pregnancies in the United States. Recent advances in contraception, including the development of new progestins and longer-acting reversible methods, have greatly increased the options available for adolescents. By frankly discussing adverse effects, offering clear explanations of noncontraceptive benefits, and developing strategies for improving compliance, providers can play a key role in facilitating successful contraceptive use in young patients. Language: English Keywords: GEORGIA | UNITED STATES OF AMERICA | RESEARCH REPORT | ADOLESCENTS | HEALTH PERSONNEL | ADOLESCENT HEALTH | HEALTH SERVICES | SEXUALLY TRANSMITTED DISEASE PREVENTION | CONTRACEPTION | CONFIDENTIAL INFORMATION | EMERGENCY CONTRACEPTION | ORAL CONTRACEPTIVES | PHYSICIAN-PATIENT RELATIONS | VAGINAL RING | INJECTABLES | IUD | COUNSELING | Developing Countries | Asia, Southwestern | Asia | Developed Countries | North America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Family Planning | Ethics | Sociocultural Factors | Contraceptive Methods | Interpersonal Relations | Behavior | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 341530 |
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