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Thurley J, Buades-Rotger M, Serfling G, Howaldt T, Reisch N, Krämer UM. Reduced threat avoidance but increased stress induced approach bias in women taking oral contraceptives. Psychoneuroendocrinology 2024; 167:107111. [PMID: 38943719 DOI: 10.1016/j.psyneuen.2024.107111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 05/15/2024] [Accepted: 06/21/2024] [Indexed: 07/01/2024]
Abstract
Recent research has increasingly acknowledged the impact of oral contraceptives on affective behavior and stress responses; however, the underlying mechanisms are still not well understood. Studies have previously shown that steroid hormones modulate automatic approach and avoidance behavior. Here, we thus investigated the effects of oral contraceptives on approach and avoidance behavior and whether these effects are modulated by stress. The study comprised 130 female participants, half of whom were using oral contraceptives, while the other half were not using any hormonal contraception (NC). The participants completed the Approach Avoidance Task (AAT), which measures automatic approach and avoidance behavior to socio-affective signals. The AAT was run once before and once after a stress manipulation using the Socially Evaluated Cold Pressor Test. OC users showed absent avoidance behavior to social threat signals and a stress-induced increase in approach behavior to positive social signals. The latter was found in particular in women taking androgenic acting OC, demonstrating that different OC preparations need to be taken into account in research on OC effects. However, OC and NC group did not differ in their cortisol stress response. Overall, the results suggest that OC usage impacts on approach and avoidance behavior to social signals, which might also contribute to the development of affective side effects.
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Affiliation(s)
| | - Macià Buades-Rotger
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Georg Serfling
- Medizinische Klinik I und Institut für Endokrinologie und Diabetes, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Universität zu Lübeck, Lübeck, Germany
| | | | - Nicole Reisch
- Medizinische Klinik und Poliklinik IV, LMU Klinikum München, Munich, Germany
| | - Ulrike M Krämer
- Institute of Medical Psychology, Center of Brain, Behavior and Metabolism (CBBM), University of Lübeck, Lübeck, Germany.
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He TY, Zhou HY, Zhu MH, Zhang JL. COVID-19 acts like a stress test, uncovering the vulnerable part of the human body: a retrospective study of 1640 cases in China. Eur J Public Health 2024; 34:760-765. [PMID: 38607985 PMCID: PMC11293811 DOI: 10.1093/eurpub/ckae056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Since the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection exhibits multi-organ damage with diverse complications, the correlation between age, gender, medical history and clinical manifestations of novel coronavirus disease 2019 (COVID-19) patients was investigated. METHODS 1640 patients who were infected with SARS-CoV-2 and hospitalized at the First Affiliated Hospital of Ningbo University from 22 December 2022 to 1 March 2023 were categorized and analysed. Normal distribution test and variance homogeneity test were performed. Based on the test results, one-way analysis of variance, Pearson's chi-squared test and logistic regression analysis were conducted in the study. RESULTS According to the ANOVA, there was a significant difference in the age distribution (P = .001) between different clinical presentations, while gender did not (P = .06). And regression analysis showed that age, hypertension, atherosclerosis and cancer were significant hazard factors for the development of predominant clinical manifestations in patients hospitalized with novel COVID-19. Additionally, infection with SARS-CoV-2 has the potential to exacerbate the burden on specific diseased or related organs. CONCLUSION The elderly who are infected with SARS-CoV-2 ought to be treated with emphasis not only on antiviral therapy but also on individualized treatment that takes their medical history and comorbidities into account.
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Affiliation(s)
- Tian-Yi He
- Health Science Center, Ningbo University, Ningbo, China
| | - Hong-Yu Zhou
- The First Affiliated Hospital of Ningbo University, Ningbo, China
| | - Ming-Hui Zhu
- The First Affiliated Hospital of Ningbo University, Ningbo, China
| | - Ji-Li Zhang
- Health Science Center, Ningbo University, Ningbo, China
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3
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Rayinda T, McSweeney SM, Christou E, Ung CY, Fenton DA, McGrath JA, Dand N, Simpson MA, Tziotzios C. Gene-Environment Interaction Between CYP1B1 and Oral Contraception on Frontal Fibrosing Alopecia. JAMA Dermatol 2024; 160:732-735. [PMID: 38809548 PMCID: PMC11137654 DOI: 10.1001/jamadermatol.2024.1315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/29/2024] [Indexed: 05/30/2024]
Abstract
Importance Frontal fibrosing alopecia (FFA) is an increasingly prevalent form of follicular lichen planus, causing irreversible hair loss predominantly in postmenopausal individuals. An earlier genome-wide meta-analysis of female FFA identified risk loci in genes implicated in self-antigen presentation and T-cell homeostasis, including HLA-B*07:02, ST3GAL1, and SEMA4B. However, CYP1B1, which is important for hormone metabolism, was also implicated with the substitution of serine for asparagine at position 453 (c.1358A>G, p.Asn453Ser) exhibiting a protective effect against FFA. Increasing understanding of genetic and environmental variables and their interactions will improve understanding of disease pathogenesis and has the potential to inform risk mitigation strategies. Objective To investigate whether oral contraceptive pill (OCP) use modulates the protective effect of the common missense variant in CYP1B1 (c.1358A>G, p.Asn453Ser) on FFA risk. Design, Setting, and Participants This gene-environment interaction study using a case-control design enrolled female patients with FFA from UK-based dermatology clinics. The patients were matched with unrelated age- and ancestry-matched female control individuals derived from UK Biobank in a 1:66 ratio, determined by the first 4 principal components from genome-wide genotypes. Data were collected from July 2015 to September 2017, and analyzed from October 2022 to December 2023. Main Outcome and Measure The main outcomes were the modulatory effect of OCP use on the contribution of the CYP1B1 missense variant to female FFA risk and a formal gene-environment interaction test evaluated by a logistic regression model with a multiplicative interaction term, under the assumptions of an additive genetic model interaction term, under the assumptions of an additive genetic model. Results Of the 489 female patients with FFA, the mean (SD) age was 65.8 (9.7) years, and 370 (75.7%) had a history of OCP use. Of the 34 254 age- and ancestry-matched control individuals, the mean (SD) age was 65.0 (8.4) years, and previous OCP use was reported in 31 177 (91.0%). An association between female FFA and the CYP1B1 risk allele was observed in individuals who reported OCP use (odds ratio, 1.90 [95% CI, 1.50-2.40]; P = 8.41 × 10-8) but not in those with no documented exposure to OCPs (odds ratio, 1.16 [95% CI, 0.82-1.64]; P = .39). A full gene-environment interaction model demonstrated a significant additive statistical interaction between c.1358A, p.453Asn, and history of OCP use on FFA risk (OR for interaction, 1.63 [95% CI, 1.07-2.46]; P = .02). Conclusions and Relevance This gene-environment interaction analysis suggests that the protective effect of the CYP1B1 missense variant on FFA risk might be mediated by exposure to OCPs. The allele that encodes an asparagine at position 453 of CYP1B1 was associated with increased odds of FFA only in participants with OCP history.
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Affiliation(s)
- Tuntas Rayinda
- St John’s Institute of Dermatology, King’s College London, London, United Kingdom
- Department of Dermatology and Venereology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Sleman, Special Region of Yogyakarta, Indonesia
| | - Sheila M. McSweeney
- St John’s Institute of Dermatology, King’s College London, London, United Kingdom
| | - Evangelos Christou
- St John’s Institute of Dermatology, King’s College London, London, United Kingdom
| | - Chuin Ying Ung
- St John’s Institute of Dermatology, King’s College London, London, United Kingdom
| | - David A. Fenton
- St John’s Institute of Dermatology, King’s College London, London, United Kingdom
| | - John A. McGrath
- St John’s Institute of Dermatology, King’s College London, London, United Kingdom
| | - Nick Dand
- Department of Medical and Molecular Genetics, King’s College London, London, United Kingdom
| | - Michael A. Simpson
- Department of Medical and Molecular Genetics, King’s College London, London, United Kingdom
| | - Christos Tziotzios
- St John’s Institute of Dermatology, King’s College London, London, United Kingdom
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4
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McCarthy SF, Townsend LK, McKie GL, Bornath DPD, Islam H, Gurd BJ, Medeiros PJ, Hazell TJ. Differential changes in appetite hormones post-prandially based on menstrual cycle phase and oral contraceptive use: A preliminary study. Appetite 2024; 198:107362. [PMID: 38636667 DOI: 10.1016/j.appet.2024.107362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 04/01/2024] [Accepted: 04/14/2024] [Indexed: 04/20/2024]
Abstract
This was a preliminary study that examined whether appetite regulation is altered during the menstrual cycle or with oral contraceptives. Ten naturally cycling females (NON-USERS) and nine tri-phasic oral contraceptive using females (USERS) completed experimental sessions during each menstrual phase (follicular phase: FP; ovulatory phase: OP; luteal phase: LP). Appetite perceptions and blood samples were obtained fasted, 30, 60, and 90 min post-prandial to measure acylated ghrelin, active glucagon-like peptide-1 (GLP-1), and total peptide tyrosine tyrosine (PYY). Changes were considered important if p < 0.100 and the effect size was ≥medium. There appeared to be a three-way (group x phase x time) interaction for acylated ghrelin where concentrations appeared to be greater in USERS versus NON-USERS during the OP 90-min post-prandial and during the LP fasted, and 90-min post-prandial. In USERS, ghrelin appeared to be greater 90-min post-prandial in the OP versus the FP with no other apparent differences between phases. There were no apparent differences between phases in NON-USERS. There appeared to be a three-way interaction for PYY where concentrations appeared to be greater in USERS during the FP 60-min post-prandial and during the OP 30-min post-prandial. In USERS PYY appeared to be greater 60-min post-prandial during the OP versus the LP with no other apparent differences. There were no apparent differences between phases in NON-USERS. There appeared to be no effect of group or phase on GLP-1, or appetite perceptions. These data demonstrate small effects of menstrual cycle phase and oral contraceptive use on the acylated ghrelin and total PYY response to a standardized meal, with no effects on active GLP-1 or perceived appetite, though more work with a large sample size is necessary.
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Affiliation(s)
- Seth F McCarthy
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Logan K Townsend
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada; Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
| | - Greg L McKie
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Derek P D Bornath
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Hashim Islam
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada; School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Brendon J Gurd
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Philip J Medeiros
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Tom J Hazell
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada.
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Fruzzetti F, Fidecicchi T, Gambacciani M. Oestrogens in oral contraception: considerations for tailoring prescription to women's needs. EUR J CONTRACEP REPR 2024; 29:93-102. [PMID: 38683756 DOI: 10.1080/13625187.2024.2334350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/19/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND The oestrogenic component of combined oral contraceptives (COCs) has changed over years with the aim of reducing oestrogen-related side effects and risks, whilst maintaining oestrogen beneficial effects, particularly on cycle control. PURPOSE To describe the pharmacological profiles of different oestrogens commonly used in COCs to provide insights on contraceptive prescription tailored to women's needs. RESULTS All COCs ensure a high contraceptive efficacy. COCs containing the natural oestrogens oestradiol (E2), oestradiol valerate (E2V) and estetrol (E4) have limited impact on liver metabolism, lipid and carbohydrate metabolism, haemostasis and sex hormone binding globulin levels, compared with ethinylestradiol (EE). COCs with E2 and E2V appear also to entail a lower elevation of the risk of venous thromboembolism vs. EE-containing pills. No epidemiological data are available for E4-COC. E2- and E2V-containing COCs seem to exert a less stabilising oestrogenic effect on the endometrium compared with EE-COCs. The E4-COC results in a predictable bleeding pattern with a high rate of scheduled bleeding and minimal unscheduled bleeding per cycle. Based on in vitro and in vivo animal data, E4 seems to be associated with a lower effect on cell breast proliferation. CONCLUSION Today various COCs contain different oestrogens. Prescribers must be familiar with the different properties of each oestrogen for a tailored contraceptive recommendation, considering their safety and contraceptive efficacy, as well as women's needs and preferences.
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Affiliation(s)
- Franca Fruzzetti
- Gynecological Endocrinology Unit, San Rossore Clinical Center, Pisa, Italy
| | - Tiziana Fidecicchi
- Department of Obstetrics and Gynecology, Ospedale Santa Chiara, University of Pisa, Pisa, Italy
| | - Marco Gambacciani
- Gynecological Endocrinology Unit, San Rossore Clinical Center, Pisa, Italy
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Baekelandt S, Bouchat A, Leroux N, Robert JB, Burattin L, Cishibanji E, Lambert J, Gérard C, Delierneux C, Kestemont P. Estetrol/drospirenone versus 17α-ethinylestradiol/drospirenone: An extended one generation test to evaluate the endocrine disruption potential on zebrafish (Danio rerio). ENVIRONMENT INTERNATIONAL 2024; 187:108702. [PMID: 38678935 DOI: 10.1016/j.envint.2024.108702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/24/2024] [Accepted: 04/24/2024] [Indexed: 05/01/2024]
Abstract
Combined oral contraceptives, comprising of both an oestrogen and a progestin component, are released in aquatic environments and potentially pose a risk to aquatic wildlife by their capacity to disrupt physiological mechanisms. In this study, the endocrine disruptive potential of two mixtures, 17α-ethinylestradiol (EE2), a synthetic oestrogen, or estetrol (E4), a natural oestrogen, with the progestin drospirenone (DRSP) have been characterised in three generations of zebrafish, according to an adapted Medaka Extended One Generation Reproduction Test. Zebrafish (Danio rerio) were exposed to a range of concentrations of EE2/DRSP and E4/DRSP (∼1×, ∼3×, ∼10× and ∼30× predicted environmental concentration, PEC). Survival, growth, hatching success, fecundity, fertilisation success, vitellogenin (VTG), gonad histopathology, sex differentiation, and transcriptional analysis of genes related to gonadal sex steroid hormones synthesis were assessed. In the F0 generation, exposure to EE2/DRSP at ∼10 and ∼30× PEC decreased fecundity and increased male VTG concentrations. The highest concentration of EE2/DRSP also affected VTG concentrations in female zebrafish and the expression of genes implicated in steroid hormones synthesis. In the F1 generation, sex determination was impaired in fish exposed to EE2/DRSP at concentrations as low as ∼3× PEC. Decreased fecundity and fertility, and abnormal gonadal histopathology were also observed. No effects were observed in the F2 generation. In contrast, E4/DRSP induced only minor histopathological changes and an increase in the proportion of males, at the highest concentration tested (∼30× PEC) in the F1 generation and had no effect on hatching success of F2 generation. Overall, this study suggests that the combination E4/DRSP has a more favourable environmental profile than EE2/DRSP.
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Affiliation(s)
- Sébastien Baekelandt
- Research Unit in Environmental and Evolutionary Biology (URBE), Institute of Life, Earth & Environment, University of Namur, Rue de Bruxelles 61, B-5000, Belgium.
| | - Antoine Bouchat
- Research Unit in Environmental and Evolutionary Biology (URBE), Institute of Life, Earth & Environment, University of Namur, Rue de Bruxelles 61, B-5000, Belgium
| | - Nathalie Leroux
- Research Unit in Environmental and Evolutionary Biology (URBE), Institute of Life, Earth & Environment, University of Namur, Rue de Bruxelles 61, B-5000, Belgium
| | - Jean-Baptiste Robert
- Research Unit in Environmental and Evolutionary Biology (URBE), Institute of Life, Earth & Environment, University of Namur, Rue de Bruxelles 61, B-5000, Belgium
| | - Laura Burattin
- Research Unit in Environmental and Evolutionary Biology (URBE), Institute of Life, Earth & Environment, University of Namur, Rue de Bruxelles 61, B-5000, Belgium
| | - Emmanuel Cishibanji
- Research Unit in Environmental and Evolutionary Biology (URBE), Institute of Life, Earth & Environment, University of Namur, Rue de Bruxelles 61, B-5000, Belgium
| | - Jérôme Lambert
- Research Unit in Environmental and Evolutionary Biology (URBE), Institute of Life, Earth & Environment, University of Namur, Rue de Bruxelles 61, B-5000, Belgium
| | - Céline Gérard
- Estetra SRL, An Affiliated Company of Mithra Pharmaceuticals, Rue Saint-Georges 5, 4000 Liège, Belgium
| | - Céline Delierneux
- Estetra SRL, An Affiliated Company of Mithra Pharmaceuticals, Rue Saint-Georges 5, 4000 Liège, Belgium
| | - Patrick Kestemont
- Research Unit in Environmental and Evolutionary Biology (URBE), Institute of Life, Earth & Environment, University of Namur, Rue de Bruxelles 61, B-5000, Belgium
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Wang M, Bi Y, Jin Y, Zheng ZJ. Global Incidence of Ovarian Cancer According to Histologic Subtype: A Population-Based Cancer Registry Study. JCO Glob Oncol 2024; 10:e2300393. [PMID: 38754054 DOI: 10.1200/go.23.00393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/02/2024] [Accepted: 02/20/2024] [Indexed: 05/18/2024] Open
Abstract
PURPOSE Ovarian cancer can be categorized into distinct histologic subtypes with varying identifiable risk factors, molecular composition, clinical features, and treatment. The global incidence of ovarian cancer subtypes remains limited, especially in low- and middle-income countries (LMICs) without high-quality cancer registry systems. MATERIALS AND METHODS We used data from population-based cancer registries of the Cancer Incidence in Five Continents project to calculate the proportions of serous, mucinous, endometrioid, clear cell, and other histologic subtypes of ovarian cancer. Proportions were applied to the estimated numbers of patients with ovarian cancer from Global Cancer Observatory 2020. Age-standardized incidence rates were calculated. RESULTS Globally, an estimated 133,818 new patients of serous cancer, 35,712 new patients of mucinous cancer, 29,319 new patients of endometrioid cancer, and 17,894 new patients of clear cell cancer were identified in 2020. The distribution of ovarian cancer histologic subtypes exhibited regional variation. Eastern Europe had the highest rate of serous and mucinous carcinomas, whereas Northern Africa and Eastern Asia had the highest burden of endometrioid and clear cell carcinomas, respectively. CONCLUSION This study provides a global incidence landscape of histologic subtypes of ovarian cancer, particularly in LMICs lacking comprehensive registry systems. Our analysis offers valuable insights into disease burden and guidance for tailored strategies for prevention of ovarian cancer.
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Affiliation(s)
- Minmin Wang
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Yanxin Bi
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Yinzi Jin
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
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Moussaoui D, Grover SR. Progestins as a Contributing Factor to Hepatocellular Adenoma: A Case Series and Literature Review. J Pediatr Adolesc Gynecol 2024; 37:184-191. [PMID: 37977437 DOI: 10.1016/j.jpag.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 11/02/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
STUDY OBJECTIVE To explore the role of progestins as potential contributing factors for the development of hepatocellular adenoma (HA) METHODS: We describe 3 cases of adolescents and young adults who developed HA while on norethindrone (NET), as well as their management. In addition, we provide a comprehensive literature review on the association between progestins and HA. RESULTS Since 1983, 16 cases of HA in patients on progestins have been reported. Ten patients were on NET and 5 on a prodrug of NET (4 on norethindrone acetate [NETA] and 1 on lynestrenol). One individual had a norgestrel implant. Eight subsequently ceased all hormones: 4 experienced a size reduction, and 3 had complete resolution of their HA. Among our patients, 1 ceased NET and instead had a levonorgestrel intrauterine device inserted, and another swapped from NET to oral medroxyprogesterone acetate. Both experienced complete resolution of their HA. The third ceased NET and underwent a hysterectomy, with size reduction of her HA. CONCLUSION These cases and the literature review suggest an association between progestin exposure, in particular NET and its prodrugs, and the development of HA. The pathophysiology is unknown but may include peripheral conversion of NET and NETA to ethinyl estradiol or a specific action of 19-nortestosterone derivatives on hepatocytes, especially those with higher systemic doses compared with the levonorgestrel intrauterine device. There are no case reports relating to other forms of progestins, such as 17-hydroxyprogesterone, which may be important when considering alternative therapeutic options in females requiring effective menstrual management who have comorbidities.
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Affiliation(s)
- Dehlia Moussaoui
- Department of Paediatric and Adolescent Gynaecology, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.
| | - Sonia R Grover
- Department of Paediatric and Adolescent Gynaecology, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
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9
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Gandhi AB, Supe PA. Evolution of Oral Contraceptive Pills. J Obstet Gynaecol India 2024; 74:109-112. [PMID: 38707879 PMCID: PMC11065849 DOI: 10.1007/s13224-024-01988-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 03/28/2024] [Indexed: 05/07/2024] Open
Affiliation(s)
- Ashwini Bhalerao Gandhi
- P.D. Hinduja National Hospital and Medical Research Centre, Mumbai, India
- Dept of OBGY, TNMC & BYL Nair Hospital, Mumbai, India
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10
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Stalas J, Morris R, Bu K, von Bargen K, Largmann R, Sanford K, Vandeventer J, Han W, Cheng F. Comparing the risk of deep vein thrombosis of two combined oral contraceptives: Norethindrone/ethinyl estradiol and drospirenone/ethinyl estradiol. Heliyon 2024; 10:e26462. [PMID: 38434341 PMCID: PMC10906292 DOI: 10.1016/j.heliyon.2024.e26462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/11/2024] [Accepted: 02/13/2024] [Indexed: 03/05/2024] Open
Abstract
Background Deep vein thrombosis (DVT) has been reported as an adverse event for patients receiving combined oral contraceptives. Norethindrone/ethinyl estradiol (NET/EE) and drospirenone/ethinyl estradiol (DRSP/EE) are two commonly prescribed combined hormonal oral contraceptive agents used in the United States, differing in their progestin component. Objective The purpose of this study was to determine the association between the progestin component of a combined oral contraceptive and the risk of DVT in patients taking oral contraceptives for birth control using data derived from the FDA Adverse Event Reporting System (FAERS). Methods The risk of DVT was compared between patients that had taken NET/EE with those that had taken the DRSP/EE COC formulation for birth control. In addition, age was assessed as a possible confounder and the outcome severity for those diagnosed with DVT were compared between the two groups. Finally, association rule mining was utilized to identify possible drug-drug interactions that result in elevated DVT risk. Results DVT was the fourth most commonly adverse event reported for patients taking DRSP/EE accounting for 8558 cases and the seventeenth most commonly reported adverse event for NET/EE accounting for 298 cases. Age was found to be a significant confounder for users of DRSP/EE with regards to DVT risk across all age groups assessed: 20 40 (ROR = 3.69, 95% CI 3.37-4.04) However, there was only a statistically significant elevated risk in patients over 40 years of age taking NET/EE (ROR = 1.98, 95% CI 1.36-2.88). Patients that had taken DRSP/EE and the corticosteroid prednisone simultaneously had an approximately 3-fold increase in DVT risk (ROR = 2.77, 95% CI 2.43-3.15) relative to individuals that had only taken DRSP/EE. Conclusion Based on this analysis, there is a higher risk of developing DVT when taking DRSP/EE than when taking NET/EE as hormonal contraception. In addition, a possibly significant drug-drug interaction between different COC formulations and prednisone were identified. This interaction may result in elevated DVT risk due to a synergistic impairment of fibrinolysis and a decrease in plasmin production.
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Affiliation(s)
- Jennifer Stalas
- Taneja College of Pharmacy, University of South Florida, 12901 Bruce B Downs Blvd Tampa, FL, 33612, USA
| | - Robert Morris
- Taneja College of Pharmacy, University of South Florida, 12901 Bruce B Downs Blvd Tampa, FL, 33612, USA
- Department of Biostatistics and Epidemiology, College of Public Health, University of South Florida, Tampa, FL, 33612, USA
| | - Kun Bu
- Department of Mathematics & Statistics, College of Art and Science, University of South Florida, Tampa, FL, 33620, USA
| | - Kevin von Bargen
- Taneja College of Pharmacy, University of South Florida, 12901 Bruce B Downs Blvd Tampa, FL, 33612, USA
| | - Rebekah Largmann
- Taneja College of Pharmacy, University of South Florida, 12901 Bruce B Downs Blvd Tampa, FL, 33612, USA
| | - Kathryn Sanford
- Taneja College of Pharmacy, University of South Florida, 12901 Bruce B Downs Blvd Tampa, FL, 33612, USA
| | - Jacob Vandeventer
- Taneja College of Pharmacy, University of South Florida, 12901 Bruce B Downs Blvd Tampa, FL, 33612, USA
| | - Weiru Han
- Department of Mathematics & Statistics, College of Art and Science, University of South Florida, Tampa, FL, 33620, USA
| | - Feng Cheng
- Taneja College of Pharmacy, University of South Florida, 12901 Bruce B Downs Blvd Tampa, FL, 33612, USA
- Department of Biostatistics and Epidemiology, College of Public Health, University of South Florida, Tampa, FL, 33612, USA
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11
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Pradhyumnan H, Perez GG, Patel SH, Blaya MO, Bramlett HM, Raval AP. A Perspective on Hormonal Contraception Usage in Central Nervous System Injury. J Neurotrauma 2024; 41:541-551. [PMID: 37975282 DOI: 10.1089/neu.2023.0219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Naturally occurring life stages in women are associated with changes in the milieu of endogenous ovarian hormones. Women of childbearing age may be exposed to exogenous ovarian hormone(s) because of their use of varying combinations of estrogen and progesterone hormones-containing oral contraceptives (OC; also known as "the pill"). If women have central nervous system (CNS) injury such as spinal cord injury (SCI) and traumatic brain injury (TBI) during their childbearing age, they are likely to retain their reproductive capabilities and may use OC. Many deleterious side effects of long-term OC use have been reported, such as aberrant blood clotting and endothelial dysfunction that consequently increase the risk of myocardial infarction, venous thromboembolism, and ischemic brain injury. Although controversial, studies have suggested that OC use is associated with neuropsychiatric ramifications, including uncontrollable mood swings and poorer cognitive performance. Our understanding about how the combination of endogenous hormones and OC-conferred exogenous hormones affect outcomes after CNS injuries remains limited. Therefore, understanding the impact of OC use on CNS injury outcomes needs further investigation to reveal underlying mechanisms, promote reporting in clinical or epidemiological studies, and raise awareness of possible compounded consequences. The goal of the current review is to discuss the impacts of CNS injury on endogenous ovarian hormones and vice-versa, as well as the putative consequences of exogenous ovarian hormones (OC) on the CNS to identify potential gaps in our knowledge to consider for future laboratory, epidemiological, and clinical studies.
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Affiliation(s)
- Hari Pradhyumnan
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratory (CVDRL), Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Gina G Perez
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratory (CVDRL), Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Shahil H Patel
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratory (CVDRL), Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Meghan O Blaya
- Department of Neurological Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
- The Miami Project to Cure Paralysis, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Helen M Bramlett
- Department of Neurological Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
- The Miami Project to Cure Paralysis, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
- Bruce W. Carter Department of Veterans Affairs Medical Center, Miami, Florida, USA
| | - Ami P Raval
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratory (CVDRL), Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
- Bruce W. Carter Department of Veterans Affairs Medical Center, Miami, Florida, USA
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12
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Hargreave M, Jezek AH, Hemmingsen CH, Andersen EA, Pagsberg AK, Holmberg T, Mørch LS, Kjaer SK. Maternal use of hormonal contraception and risk of childhood autism spectrum disorders: A Parental Exposures and Child Health (PECH) cohort study. Psychiatry Res 2024; 332:115695. [PMID: 38157710 DOI: 10.1016/j.psychres.2023.115695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/12/2023] [Accepted: 12/18/2023] [Indexed: 01/03/2024]
Abstract
A recent hypothesis suggests that maternal hormonal contraception use has contributed to the increasing incidence of autism spectrum disorders (ASD). We used a nationwide population-based cohort (the PECH cohort) including 1,056,149 Danish children born in the period January 1, 1998, to December 31, 2014, to assess associations between maternal hormonal contraception use and childhood ASD (end of follow-up: December 31, 2017). Maternal hormonal contraception use was grouped as "recent use" (≤ 3 months before pregnancy start or during pregnancy), "previous use" (>3 months before pregnancy start) and "never use", except for few products. Incidence rate ratios (IRRs) were estimated using Poisson regression. During follow-up of nearly 12 million person-years, 19,996 children were diagnosed with ASD. A slightly higher IRR was observed for maternal recent use of any hormonal contraception, compared to previous use. This association was largely driven by the non-oral progestin-only products, and associations were especially seen for infantile autism and other/unspecified ASD. An increased IRR of infantile autism was also observed for recent use of the oral progestin-only products, compared to previous use. Our results suggest that maternal use of hormonal contraception may be associated with ASD risk in children, especially for the progestin-only products.
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Affiliation(s)
- Marie Hargreave
- Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen DK-2100, Denmark.
| | - Andrea H Jezek
- Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen DK-2100, Denmark
| | | | | | - Anne K Pagsberg
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Lina S Mørch
- Cancer Surveillance and Pharmacoepidemiology, Danish Cancer Institute, Copenhagen, Denmark
| | - Susanne K Kjaer
- Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen DK-2100, Denmark; Department of Gynecology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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13
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Dunn SE, Perry WA, Klein SL. Mechanisms and consequences of sex differences in immune responses. Nat Rev Nephrol 2024; 20:37-55. [PMID: 37993681 DOI: 10.1038/s41581-023-00787-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2023] [Indexed: 11/24/2023]
Abstract
Biological sex differences refer to differences between males and females caused by the sex chromosome complement (that is, XY or XX), reproductive tissues (that is, the presence of testes or ovaries), and concentrations of sex steroids (that is, testosterone or oestrogens and progesterone). Although these sex differences are binary for most human individuals and mice, transgender individuals receiving hormone therapy, individuals with genetic syndromes (for example, Klinefelter and Turner syndromes) and people with disorders of sexual development reflect the diversity in sex-based biology. The broad distribution of sex steroid hormone receptors across diverse cell types and the differential expression of X-linked and autosomal genes means that sex is a biological variable that can affect the function of all physiological systems, including the immune system. Sex differences in immune cell function and immune responses to foreign and self antigens affect the development and outcome of diverse diseases and immune responses.
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Affiliation(s)
- Shannon E Dunn
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Whitney A Perry
- Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA, USA
| | - Sabra L Klein
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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14
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Diamond B, Sheeder J, Lazorwitz A. An exploratory study on the possible association of serum etonogestrel concentrations with mood concerns and symptoms among contraceptive implant users. Contraception 2024; 129:110298. [PMID: 37802462 PMCID: PMC10842501 DOI: 10.1016/j.contraception.2023.110298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 09/18/2023] [Accepted: 10/01/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE To evaluate if inter-individual variability in serum etonogestrel (ENG) concentrations accounts for variability in mood-related side effects among ENG implant users. STUDY DESIGN Participants underwent a single-time blood draw for measurement of serum ENG concentrations using a liquid-chromatography mass-spectrometry assay, and completed a questionnaire at enrollment that retrospectively assessed mood-related side effects during the period of implant use. For a subset of participants, Patient Health Questionnaire-9 (PHQ-9) scores, obtained for other clinical purposes, were also compared. We used independent medians tests and linear regression to evaluate associations between mood symptoms and serum ENG concentrations as our primary outcome. RESULTS Among 900 enrolled participants, 34% (306/900) reported mood changes on the baseline questionnaire. Of these, 31 (3.4%) participants also had documented PHQ-9 scores. Serum ENG concentrations (median 126.9 pg/mL [range 39.4-695.1]) were not associated with reported mood changes on the questionnaire (p = 0.19) or on the PHQ-9 (β = 0.00, 95% CI -0.03, 0.03). CONCLUSION Pharmacokinetic variability does not explain the inter-individual variability in mood-related side effects among ENG implant users. IMPLICATIONS Mood-related side effects and altered mental health metrics are commonly reported by etonogestrel contraceptive implant users but demonstrate wide inter-individual variability. Individual differences in serum drug levels do not appear to account for this variability in mood-related side effects, and so future research should focus on novel personal factors.
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Affiliation(s)
- Breea Diamond
- University of Colorado Anschutz Medical Campus, Department of Obstetrics and Gynecology, Division of Family Planning, Aurora, CO, USA
| | - Jeanelle Sheeder
- University of Colorado Anschutz Medical Campus, Department of Obstetrics and Gynecology, Division of Family Planning, Aurora, CO, USA
| | - Aaron Lazorwitz
- University of Colorado Anschutz Medical Campus, Department of Obstetrics and Gynecology, Division of Family Planning, Aurora, CO, USA.
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15
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Nickels L, Yan W. Nonhormonal Male Contraceptive Development-Strategies for Progress. Pharmacol Rev 2023; 76:37-48. [PMID: 38101934 PMCID: PMC10759220 DOI: 10.1124/pharmrev.122.000787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 12/17/2023] Open
Abstract
Despite the widely demonstrated public health benefits of contraception, limited contraceptive options are available for men, placing both the contraceptive burden and opportunity solely on women. This review outlines the need for an increased focus on male contraceptive development and highlights several related topics, including the perspectives of women and men on male contraceptives, historical challenges, and reasons behind the persistent delays in male contraceptive development. It also discusses the importance of serendipitous observations in drug discovery and the limitations of depleting sperm or spermatogenic cells as a contraceptive approach. It further provides an overview of ongoing research and development on novel methods, with a goal to offer insights into the multifaceted aspects of nonhormonal male contraceptive development, addressing its implications for the health of men and women. SIGNIFICANCE STATEMENT: Despite well over half a century of effort in developing male contraceptives, there are no approved male contraceptive drugs on the market. This review aims to present strategies for progress in nonhormonal male contraception based on lessons learned from history, with the hope of expediting development and bringing a male contraceptive drug closer to reality.
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Affiliation(s)
- Logan Nickels
- Male Contraceptive Initiative, Durham, North Carolina (L.N.); The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, California (W.Y.); and Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California (W.Y.)
| | - Wei Yan
- Male Contraceptive Initiative, Durham, North Carolina (L.N.); The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, California (W.Y.); and Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California (W.Y.)
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16
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Bezerra AG, Pires GN, Andersen ML, Tufik S, Hachul H. The Effects of Hormonal Contraceptives on the Sleep of Women of Reproductive Age. Sleep Med Clin 2023; 18:435-448. [PMID: 38501516 DOI: 10.1016/j.jsmc.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Research about the effects of hormonal contraceptives on sleep has been performed but is subjected to important levels of methodological heterogeneity. Hormonal contraceptives impact sleep, but the direction of this association is not clear. Most studies describe a negative sleep profile among contraceptive users, including increased sleepiness, insomnia symptoms, decreased sleep efficiency, and a reduced overall sleep quality. Hormonal intrauterine contraceptives are associated with less negative effects. More research on the field, especially randomized controlled trials, is needed to increase the level and certainty of evidence about the effects of hormonal contraceptives on sleep.
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Affiliation(s)
- Andréia Gomes Bezerra
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925 - CEP: 04024-002, São Paulo, Brazil
| | - Gabriel Natan Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925 - CEP: 04024-002, São Paulo, Brazil; Sleep Institute, Rua Marselhesa, 500 - CEP: 04020-060, São Paulo, Brazil
| | - Monica L Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925 - CEP: 04024-002, São Paulo, Brazil; Sleep Institute, Rua Marselhesa, 500 - CEP: 04020-060, São Paulo, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925 - CEP: 04024-002, São Paulo, Brazil; Sleep Institute, Rua Marselhesa, 500 - CEP: 04020-060, São Paulo, Brazil
| | - Helena Hachul
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925 - CEP: 04024-002, São Paulo, Brazil; Sleep Institute, Rua Marselhesa, 500 - CEP: 04020-060, São Paulo, Brazil.
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17
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Palacios S, Ayala G, González G, Badilla-Apuy CL, Marchena J, Martínez K, Mostajo D, Vernaza MS, Paradas A, Hernández L, Vásquez-Awad D, Celis-González C, de Melo NR. Combined oral contraceptives: update recommendations of the Latin American contraceptive association. Gynecol Endocrinol 2023; 39:2271072. [PMID: 37857350 DOI: 10.1080/09513590.2023.2271072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/10/2023] [Indexed: 10/21/2023] Open
Abstract
Background: In recent years, new combined oral contraceptives (COCs) have become available, representing an advance in terms of individualization and compliance by users.Objective: To provide recommendations regarding COCs: formulations, use, efficacy, benefits and safety.Method: For these recommendations, we have used the modified Delphi methodology and carried out a systematic review of studies found in the literature and reviews performed in humans, published in English and Spanish in Pubmed, Medline and advanced medicine and computer networks until the year 2021, using the combination of terms: 'oral contraceptives', 'estroprogestins' and 'combined oral contraceptives'.Results: Regarding the estrogen component, initially switching from mestranol (the pro-drug of ethinylestradiol) to ethinylestradiol (EE) and then reducing the EE dose helped reduce side effects and associated adverse events. Natural estradiol and estradiol valerate are already available and represent a valid alternative to EE. The use of more potent 19-nortestosterone-derived progestins, in order to lower the dose and then the appearance of non-androgenic progestins with different endocrine and metabolic characteristics, has made it possible to individualize the prescription of COC according to the profile of each woman.Conclusion: Advances in the provision of new COCs have improved the risk/benefit ratio by increasing benefits and reducing risks. Currently, the challenge is to tailor contraceptives to individual needs in terms of safety, efficacy, and protection of female reproductive health.
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Affiliation(s)
- Santiago Palacios
- Ginecologia y Obstetricia Department, Clínica Palacios de la Salud de la Mujer, Madrid, Spain
| | - Gabriela Ayala
- Ginecologia y Obstetricia Department, Hospital Metropolitano, Quito, Ecuador
| | - Gemarilis González
- Ginecología y Obstetricia Department, Consultorio América, Ciudad de Panamá, Panamá
| | - Can L Badilla-Apuy
- Ginecología y Obstetricia Department, Oncogine Servicios Médicos S.A., San José, Costa Rica
| | - Jeannette Marchena
- Ginecología y Obstetricia Department, Coordinadora de la Unidad de Medicina Reproductiva de las Clínicas AUNA y Clínica Delgado, Lima, Perú
| | - Katia Martínez
- Centro de Obstetricia y Ginecología, Health Service Medical Center, Santo Domingo, República Dominicana
| | - Desireé Mostajo
- Medical Director, Jefe Médico del Centro Médico PERINAT, Santa Cruz de la Sierra, Bolivia
| | - María S Vernaza
- Ginecología y Obstetricia Department, Laparoscopía Ginecológica, Clínica IMBANACO, Cali, Colombia
| | - Alejandro Paradas
- Obstetrics and Gynecology Department, Hospital Universitario, Maternidad La Altagracia, Santo Domingo, República Dominicana
| | - Luis Hernández
- Departamento de Ginecología y Obstetricia, Hospital Herrera Llerandi, Ciudad de Guatemala, Guatemala
| | - David Vásquez-Awad
- Ginecologia y Obstetricia Department, Academia Nacional de Medicina, Bogotá, Colombia
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Genazzani AR, Fidecicchi T, Arduini D, Giannini A, Simoncini T. Hormonal and natural contraceptives: a review on efficacy and risks of different methods for an informed choice. Gynecol Endocrinol 2023; 39:2247093. [PMID: 37599373 DOI: 10.1080/09513590.2023.2247093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/19/2023] [Accepted: 08/07/2023] [Indexed: 08/22/2023] Open
Abstract
The debate about contraception has become increasingly important as more and more people seek safe and effective contraception. More than 1 billion women of reproductive age worldwide need a method of family planning, and wellbeing, socio-economic status, culture, religion and more influence the reasons why a woman may ask for contraception. Different contraceptive methods exist, ranging from 'natural methods' (fertility awareness-based methods - FABMs) to barrier methods and hormonal contraceptives (HCs). Each method works on a different principle, with different effectiveness.FABMs and HCs are usually pitted against each other, although it's difficult to really compare them. FABMs are a valid alternative for women who cannot or do not want to use hormone therapy, although they may have a high failure rate if not used appropriately and require specific training. HCs are commonly used to address various clinical situations, although concerns about their possible side effects are still widespread. However, many data show that the appropriate use of HC has a low rate of adverse events, mainly related to personal predisposition.The aim of this review is to summarize the information on the efficacy and safety of FABMs and HCs to help clinicians and women choose the best contraceptive method for their needs.
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Affiliation(s)
- Andrea R Genazzani
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Tiziana Fidecicchi
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Domenico Arduini
- Department of Obstetrics and Gynecology, Tor Vergata University, Rome, Italy
| | - Andrea Giannini
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Tommaso Simoncini
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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19
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Stone JC, MacDonald MJ. The impacts of endogenous progesterone and exogenous progestin on vascular endothelial cell, and smooth muscle cell function: A narrative review. Vascul Pharmacol 2023; 152:107209. [PMID: 37591444 DOI: 10.1016/j.vph.2023.107209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/04/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023]
Abstract
Vascular endothelial and smooth muscle cell dysfunction proceed the development of numerous vascular diseases, such as atherosclerosis. Both estrogen and progesterone receptors are present on vascular endothelial and smooth muscle cells, and therefore it has been postulated that these compounds may affect vascular function. It has been well-established that estrogen is a vasoprotective compound, however, the effects of progesterone on vascular function are not well understood. This narrative review summarizes the current research investigating the impact of both endogenous progesterone, and exogenous synthetic progestin on vascular endothelial and smooth muscle cell function and identifies discrepancies on their effects in vitro and in vivo. We speculate that an inverted-U dose response curve may exist between nitric oxide bioavailability and progesterone concentration, and that the androgenic properties of a progestin may influence vascular function. Future research is needed to discern the effects of both endogenous progesterone and exogenous progestin on vascular endothelial and smooth muscle cell function with consideration for the impacts of progesterone/progestin dose, and progestin type.
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Affiliation(s)
- Jenna C Stone
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Maureen J MacDonald
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada.
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20
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Greenwell S, Faskowitz J, Pritschet L, Santander T, Jacobs EG, Betzel RF. High-amplitude network co-fluctuations linked to variation in hormone concentrations over the menstrual cycle. Netw Neurosci 2023; 7:1181-1205. [PMID: 37781152 PMCID: PMC10473261 DOI: 10.1162/netn_a_00307] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/20/2022] [Indexed: 10/03/2023] Open
Abstract
Many studies have shown that the human endocrine system modulates brain function, reporting associations between fluctuations in hormone concentrations and brain connectivity. However, how hormonal fluctuations impact fast changes in brain network organization over short timescales remains unknown. Here, we leverage a recently proposed framework for modeling co-fluctuations between the activity of pairs of brain regions at a framewise timescale. In previous studies we showed that time points corresponding to high-amplitude co-fluctuations disproportionately contributed to the time-averaged functional connectivity pattern and that these co-fluctuation patterns could be clustered into a low-dimensional set of recurring "states." Here, we assessed the relationship between these network states and quotidian variation in hormone concentrations. Specifically, we were interested in whether the frequency with which network states occurred was related to hormone concentration. We addressed this question using a dense-sampling dataset (N = 1 brain). In this dataset, a single individual was sampled over the course of two endocrine states: a natural menstrual cycle and while the subject underwent selective progesterone suppression via oral hormonal contraceptives. During each cycle, the subject underwent 30 daily resting-state fMRI scans and blood draws. Our analysis of the imaging data revealed two repeating network states. We found that the frequency with which state 1 occurred in scan sessions was significantly correlated with follicle-stimulating and luteinizing hormone concentrations. We also constructed representative networks for each scan session using only "event frames"-those time points when an event was determined to have occurred. We found that the weights of specific subsets of functional connections were robustly correlated with fluctuations in the concentration of not only luteinizing and follicle-stimulating hormones, but also progesterone and estradiol.
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Affiliation(s)
- Sarah Greenwell
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Joshua Faskowitz
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
- Program in Neurosciences, Indiana University, Bloomington, IN, USA
| | - Laura Pritschet
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Tyler Santander
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Emily G. Jacobs
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, USA
- Neuroscience Research Institute, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Richard F. Betzel
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
- Program in Neurosciences, Indiana University, Bloomington, IN, USA
- Cognitive Science Program, Indiana University, Bloomington, IN, USA
- Network Science Institute, Indiana University, Bloomington, IN, USA
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21
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Zhou Z, Wu H, Wu Z, Mo L, Li D, Zeng W, Luo H, Huang J. Identification of sex pheromone of red swamp crayfish Procambarus clarkii and exploration of the chemosensory mechanism of their antennae. PESTICIDE BIOCHEMISTRY AND PHYSIOLOGY 2023; 195:105580. [PMID: 37666605 DOI: 10.1016/j.pestbp.2023.105580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 09/06/2023]
Abstract
Red swamp crayfish, Procambarus clarkii, is a globally invasive species, which has caused great damage to biodiversity, agriculture, and fishing. Therefore, the development of effective management methods, such as pheromone control, is necessary for biological control and biodiversity protection. However, the components of P. clarkii sex pheromones have not yet been explored, and the chemosensory mechanism of the P. clarkii antennae after stimulation by sex pheromone also remains unknown. In this study, we isolated and identified the candidate bioactive component of the female P. clarkii sex pheromone using ultrafiltration centrifugation, semi-preparative liquid phase separation and omics technologies and conducted bioassays to determine its attraction ability. Meanwhile, RNA-Seq technology was used to analyze the potential chemosensory mechanism of antennae. Our results indicated that the male P. clarkii were uniaxially attracted to the female crude conditioned water (FCW), medium fraction (MF, isolated by ultrafiltration centrifugation), and preparative fragment 6 of females (PFF6, isolated by semi-preparative liquid phase separation). Metabolomic analysis revealed the presence of 18 differential metabolites between the PFF6 and PFM6 samples, among which 15 were significantly upregulated in the PFF6 sample. Bioassay test also showed that mestranol, especially at concentrations of 10-5-10-2 mol∙l-1, could significantly attract P. clarkii males; therefore, mestranol was identified as the candidate sex pheromone component of P. clarkii females. Furthermore, RNA-Seq results showed that most differentially expressed genes (DEGs) enriched in lipid metabolism and signal transduction pathways were up-regulated in P. clarkii males. In addition, high expressions of Ca2+-binding protein and ion transporting ATPases may enhance the sensitivity of the antennae of P. clarkii males towards sex pheromones. Our study provides data on P. clarkii sex pheromone composition and reveals the molecular mechanism of sex pheromone response in P. clarkii. Moreover, our study provides a referable method for the isolation of candidate bioactive molecules from the P. clarkii sex pheromone.
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Affiliation(s)
- Zihao Zhou
- Key Laboratory of Ecology of Rare and Endangered Species and Environmental Protection (Guangxi Normal University), Ministry of Education, Guilin, Guangxi 541006, China; Guangxi Key Laboratory of Rare and Endangered Animal Ecology, Guangxi Normal University, Guilin, Guangxi 541006, China; College of Life Sciences, Guangxi Normal University, Guilin, Guangxi 541006, China
| | - Hongying Wu
- College of Life Sciences, Guangxi Normal University, Guilin, Guangxi 541006, China
| | - Zhengjun Wu
- Key Laboratory of Ecology of Rare and Endangered Species and Environmental Protection (Guangxi Normal University), Ministry of Education, Guilin, Guangxi 541006, China; Guangxi Key Laboratory of Rare and Endangered Animal Ecology, Guangxi Normal University, Guilin, Guangxi 541006, China; College of Life Sciences, Guangxi Normal University, Guilin, Guangxi 541006, China
| | - Lili Mo
- Key Laboratory of Ecology of Rare and Endangered Species and Environmental Protection (Guangxi Normal University), Ministry of Education, Guilin, Guangxi 541006, China; Guangxi Key Laboratory of Rare and Endangered Animal Ecology, Guangxi Normal University, Guilin, Guangxi 541006, China; College of Life Sciences, Guangxi Normal University, Guilin, Guangxi 541006, China
| | - Dinghong Li
- College of Life Sciences, Guangxi Normal University, Guilin, Guangxi 541006, China
| | - Wenlong Zeng
- College of Life Sciences, Guangxi Normal University, Guilin, Guangxi 541006, China
| | - Haiyu Luo
- Key Laboratory of Ecology of Rare and Endangered Species and Environmental Protection (Guangxi Normal University), Ministry of Education, Guilin, Guangxi 541006, China; Guangxi Key Laboratory of Rare and Endangered Animal Ecology, Guangxi Normal University, Guilin, Guangxi 541006, China; College of Life Sciences, Guangxi Normal University, Guilin, Guangxi 541006, China
| | - Jinlong Huang
- Key Laboratory of Ecology of Rare and Endangered Species and Environmental Protection (Guangxi Normal University), Ministry of Education, Guilin, Guangxi 541006, China; Guangxi Key Laboratory of Rare and Endangered Animal Ecology, Guangxi Normal University, Guilin, Guangxi 541006, China; College of Life Sciences, Guangxi Normal University, Guilin, Guangxi 541006, China.
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22
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Kheloui S, Jacmin-Park S, Larocque O, Kerr P, Rossi M, Cartier L, Juster RP. Sex/gender differences in cognitive abilities. Neurosci Biobehav Rev 2023; 152:105333. [PMID: 37517542 DOI: 10.1016/j.neubiorev.2023.105333] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 07/09/2023] [Accepted: 07/27/2023] [Indexed: 08/01/2023]
Abstract
Sex/gender differences in cognitive sciences are riddled by conflicting perspectives. At the center of debates are clinical, social, and political perspectives. Front and center, evolutionary and biological perspectives have often focused on 'nature' arguments, while feminist and constructivist views have often focused on 'nurture arguments regarding cognitive sex differences. In the current narrative review, we provide a comprehensive overview regarding the origins and historical advancement of these debates while providing a summary of the results in the field of sexually polymorphic cognition. In so doing, we attempt to highlight the importance of using transdisciplinary perspectives which help bridge disciplines together to provide a refined understanding the specific factors that drive sex differences a gender diversity in cognitive abilities. To summarize, biological sex (e.g., birth-assigned sex, sex hormones), socio-cultural gender (gender identity, gender roles), and sexual orientation each uniquely shape the cognitive abilities reviewed. To date, however, few studies integrate these sex and gender factors together to better understand individual differences in cognitive functioning. This has potential benefits if a broader understanding of sex and gender factors are systematically measured when researching and treating numerous conditions where cognition is altered.
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Affiliation(s)
- Sarah Kheloui
- Department of Psychiatry and Addiction, University of Montreal, Montreal, Quebec, Canada; Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada; Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Canada; Center on Sex⁎Gender, Allostasis and Resilience, Canada
| | - Silke Jacmin-Park
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada; Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada; Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Canada; Center on Sex⁎Gender, Allostasis and Resilience, Canada
| | - Ophélie Larocque
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada; Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada; Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Canada; Center on Sex⁎Gender, Allostasis and Resilience, Canada
| | - Philippe Kerr
- Department of Psychiatry and Addiction, University of Montreal, Montreal, Quebec, Canada; Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada; Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Canada; Center on Sex⁎Gender, Allostasis and Resilience, Canada
| | - Mathias Rossi
- Department of Psychiatry and Addiction, University of Montreal, Montreal, Quebec, Canada; Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada; Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Canada; Center on Sex⁎Gender, Allostasis and Resilience, Canada
| | - Louis Cartier
- Department of Psychiatry and Addiction, University of Montreal, Montreal, Quebec, Canada; Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada; Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Canada; Center on Sex⁎Gender, Allostasis and Resilience, Canada
| | - Robert-Paul Juster
- Department of Psychiatry and Addiction, University of Montreal, Montreal, Quebec, Canada; Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada; Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Canada; Center on Sex⁎Gender, Allostasis and Resilience, Canada.
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23
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Armbruster D, Lesch KP, Strobel A. The long and the short of it: 5-HTTLPR and moral judgement. Behav Brain Res 2023; 452:114524. [PMID: 37269929 DOI: 10.1016/j.bbr.2023.114524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 04/28/2023] [Accepted: 05/31/2023] [Indexed: 06/05/2023]
Abstract
Differences in moral sentiments are widespread. Increasingly, their biological correlates are investigated to elucidate potential sources of divergent moral attitudes and choices. Serotonin is one such potential modulator. We investigated the effects of a functional serotonergic polymorphism, 5-HTTLPR, which was previously linked to moral choices albeit with inconsistent findings. N = 157 healthy young adults completed a set of congruent and incongruent moral dilemmas. In addition to the traditional moral response score, this set allows by using a process dissociation (PD) approach an estimation a deontological and a utilitarian parameter. While there was no main effect of 5-HTTLPR on any of the three moral judgement parameters, there was an interaction effect between 5-HTTLPR and endocrine status on PD parameters, which was mainly due to the deontological but not the utilitarian parameter. In men and free cycling women, LL homozygotes showed reduced deontological tendencies compared to S allele carriers. Contrariwise, in women using oral contraceptives, LL homozygotes had increased deontology parameter scores. Furthermore, LL genotypes in general reported less difficulty in making harmful choices, which were in addition associated with less negative emotions. The findings suggest that 5-HTTLPR might be involved in modulating cognitive and emotional processes contributing to moral decisions.
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Affiliation(s)
- Diana Armbruster
- Personality Psychology and Assessment, Institute of Psychology, Chemnitz University of Technology, Chemnitz, Germany.
| | - Klaus-Peter Lesch
- Division of Molecular Psychiatry, Center of Mental Health, University of Wuerzburg, Wuerzburg, Germany; Laboratory of Psychiatric Neurobiology, Institute of Molecular Medicine, Sechenov First Moscow State Medical University, Moscow, Russia; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands
| | - Alexander Strobel
- Personality and Individual Differences, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
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24
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de Santana DLP, Gonçalves MB, Zimpel VMH, Figueiredo EG. Does the use of oral contraceptives or hormone replacement therapy offer protection against the formation or rupture of intracranial aneurysms in women?: a systematic review and meta-analysis. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e2023S118. [PMID: 37556637 PMCID: PMC10411690 DOI: 10.1590/1806-9282.2023s118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/15/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVE The aim of this study was to carry out a systematic review of the literature with meta-analysis to evaluate the effect of using oral contraceptive and hormone replacement therapy as a protective factor in the formation of intracranial aneurysms and subarachnoid hemorrhage. METHODS This is a systematic review of the literature with meta-analysis, using PubMed and Embase as databases and the PRISMA method. Case-control and cohort studies published until December 2022 were included in this review. RESULTS Four studies were included in this review; three of which were eligible for meta-analysis. Regarding the use of oral contraceptive and the development of subarachnoid hemorrhage, there was a lower risk of aneurysm rupture with an odds ratio 0.65 (confidence interval 0.5-0.85). In the analysis of patients using hormone replacement therapy and developing subarachnoid hemorrhage, there was also a lower risk of aneurysm rupture with an OR 0.54 (CI 0.39-0.74). Only one article analyzed the formation of intracranial aneurysm and the use of hormone replacement therapy and oral contraceptive, and there was a protective effect with the use of these medications. oral contraceptive: OR 2.1 (CI 1.2-3.8) and hormone replacement therapy: OR 3.1 (CI 1.5-6.2). CONCLUSION The use of hormone replacement therapy and oral contraceptive has a protective effect in intracranial aneurysm rupture and formation.
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Affiliation(s)
| | - Mariangela Barbi Gonçalves
- Sociedade de Neurocirurgia do Rio de Janeiro – Rio de Janeiro (RJ), Brazil
- Instituto Estadual do Cérebro Paulo Niemeyer – Rio de Janeiro (RJ), Brazil
- Hospital Municipal Miguel Couto – Rio de Janeiro (RJ), Brazil
| | - Vanessa Milanese Holanda Zimpel
- A Beneficência Portuguesa de São Paulo – São Paulo (SP), Brazil
- Department of Neurosurgery, Mayo Clinic – Jacksonville (FL), United States
| | - Eberval Gadelha Figueiredo
- Universidade de São Paulo – São Paulo (SP), Brazil
- Harvard University Alumni, Harvard Medical School – Boston (MA), United States
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25
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Römer C, Zessin E, Czupajllo J, Fischer T, Wolfarth B, Lerchbaumer MH. Effect of Physical Parameters and Training Load on Patellar Tendon Stiffness in Professional Athletes. Diagnostics (Basel) 2023; 13:2541. [PMID: 37568903 PMCID: PMC10417388 DOI: 10.3390/diagnostics13152541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/17/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Injuries of the patellar tendon commonly occur as a result of mechanical loading of the tendon during physical activity. Shear wave elastography (SWE) is an established technique for assessing tendon stiffness, and has good interindividual reliability. The aim of this study was to investigate the impacts of physical parameters and different sports on patellar tendon stiffness in professional athletes using SWE. METHODS Standardized patellar tendon SWE was performed in a relaxed supine position with a small roll under the knee (20° flexion) in 60 healthy professional athletes (30 female, 30 male). Multiple linear regression was performed for patellar tendon stiffness including gender, age, body mass index (BMI), and type of sport. RESULTS Patellar tendon stiffness showed no significant difference between female (3.320 m/s) and male (3.416 m/s) professional athletes. Mean age (female: 20.53 years; male: 19.80 years) and BMI (female: 23.24 kg/m2; male: 23.52 kg/m2) were comparable. Female professional athletes with oral contraceptive (OC) intake showed higher patellar tendon stiffness than athletes without OC intake (3.723 versus 3.017; p = 0.053), but not significantly. CONCLUSION In professional athletes, there are no significant differences in patellar tendon stiffness according to gender, age, BMI and type of sport (handball, volleyball, soccer, sprint, hammer throw). Oral contraceptives may not have an impact on patellar tendon stiffness in female athletes. Further studies are necessary.
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Affiliation(s)
- Claudia Römer
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
| | - Enrico Zessin
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
| | - Julia Czupajllo
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
| | - Thomas Fischer
- Department of Radiology, Charité Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Bernd Wolfarth
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
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26
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Howard SA, Benhabbour SR. Non-Hormonal Contraception. J Clin Med 2023; 12:4791. [PMID: 37510905 PMCID: PMC10381146 DOI: 10.3390/jcm12144791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
While hormonal contraceptives are efficacious and available in several forms for women, perception of safety and concern over side effects are a deterrent for many. Existing non-hormonal contraceptives include permanent sterilization, copper intrauterine devices (IUDs), chemical/physical barriers such as spermicides and condoms, as well as traditional family planning methods including withdrawal and the rhythm method. Individuals who wish to retain their fertility in the future can achieve highest adherence and efficacy with long-acting, reversible contraceptives (LARCs), though there is only one, the copper IUD, that is non-hormonal. As rates of unintended pregnancies remain high with existing contraceptive options, it is becoming increasingly attractive to develop novel pregnancy prevention methods for both women and men. Non-hormonal contraceptives can target a variety of critical reproductive processes discussed here. This review focuses on identified non-hormonal contraceptive targets and subsequent drug candidates in development.
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Affiliation(s)
- Sarah Anne Howard
- Division of Pharmacoengineering and Molecular Pharmaceutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Soumya Rahima Benhabbour
- Division of Pharmacoengineering and Molecular Pharmaceutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Joint Department of Biomedical Engineering, North Carolina State University and The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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27
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Clasen JL, Mabunda R, Heath AK, Kaaks R, Katzke V, Schulze MB, Birukov A, Tagliabue G, Chiodini P, Tumino R, Milani L, Braaten T, Gram I, Lukic M, Luján‐Barroso L, Rodriguez‐Barranco M, Chirlaque M, Ardanaz E, Amiano P, Manjer J, Huss L, Ljungberg B, Travis R, Smith‐Byrne K, Gunter M, Johansson M, Rinaldi S, Weiderpass E, Riboli E, Cross AJ, Muller DC. Reproductive and hormonal factors and risk of renal cell carcinoma among women in the European Prospective Investigation into Cancer and Nutrition. Cancer Med 2023; 12:15588-15600. [PMID: 37269199 PMCID: PMC10417104 DOI: 10.1002/cam4.6207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/05/2023] [Accepted: 05/23/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Renal cell carcinoma (RCC) is twice as common among men compared with women, and hormonal factors have been suggested to partially explain this difference. There is currently little evidence on the roles of reproductive and hormonal risk factors in RCC aetiology. MATERIALS & METHODS We investigated associations of age at menarche and age at menopause, pregnancy-related factors, hysterectomy and ovariectomy and exogenous hormone use with RCC risk among 298,042 women in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. RESULTS During 15 years of follow-up, 438 RCC cases were identified. Parous women had higher rates of RCC compared with nulliparous women (HR = 1.71, 95% CI 1.18, 2.46), and women who were older at age of first pregnancy had lower rates of RCC (30 years + vs. <20 years HR = 0.53, 95% CI 0.34, 0.82). Additionally, we identified a positive association for hysterectomy (HR = 1.43 95% CI 1.09, 1.86) and bilateral ovariectomy (HR = 1.67, 95% CI 1.13, 2.47), but not unilateral ovariectomy (HR = 0.99, 95% CI 0.61, 1.62) with RCC risk. No clear associations were found for age at menarche, age at menopause or exogenous hormone use. CONCLUSION Our results suggest that parity and reproductive organ surgeries may play a role in RCC aetiology.
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Affiliation(s)
- Joanna L. Clasen
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Rita Mabunda
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Alicia K. Heath
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Rudolf Kaaks
- Division of Cancer EpidemiologyGerman Cancer research Center (DKFZ)HeidelbergGermany
| | - Verena Katzke
- Division of Cancer EpidemiologyGerman Cancer research Center (DKFZ)HeidelbergGermany
| | - Matthias B. Schulze
- German Institute of Human Nutrition Potsdam‐RehbrueckeNuthetalGermany
- Institute of Nutritional Science, University of PotsdamNuthetalGermany
| | - Anna Birukov
- German Institute of Human Nutrition Potsdam‐RehbrueckeNuthetalGermany
- German Center for Diabetes Research (DZD)Muenchen‐NeuherbergGermany
- Department of Nutrition, Harvard T.H. Chan School of Public HealthBostonMassachusettsUnited States
| | | | - Paolo Chiodini
- Medical Statistics UnitUniversity L. VanvitelliNaplesItaly
| | - Rosario Tumino
- Hyblean Association for Epidemiological Research (AIRE ‐ONLUS)RagusaItaly
| | - Lorenzo Milani
- Department of Clinical and Biological SciencesUniversity of TurinTurinItaly
| | - Tonje Braaten
- Department of Community MedicineUiT The Arctic University of Norway
| | - Inger Gram
- Faculty of Health Sciences, Department of Community MedicineUniversity of Tromsø, The Arctic University of NorwayTromsøNorway
| | - Marko Lukic
- Faculty of Health Sciences, Department of Community MedicineUniversity of Tromsø, The Arctic University of NorwayTromsøNorway
| | - Leila Luján‐Barroso
- Catalan Institute of Oncology (ICO‐IDIBELL), Cancer Epidemiology Research Program, Unit of Nutrition and CancerL'Hospitalet de LlobregatSpain
| | - Miguel Rodriguez‐Barranco
- Escuela Andaluza de Salud Pública (EASP)GranadaSpain
- Instituto de Investigación Biosanitaria ibs.GRANADAGranadaSpain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)MadridSpain
| | - María‐Dolores Chirlaque
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)MadridSpain
- Department of Epidemiology, Regional Health Council, IMIB‐ArrixacaMurcia UniversityMurciaSpain
| | - Eva Ardanaz
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)MadridSpain
- Navarra Public Health InstitutePamplonaSpain
- IdiSNA, Navarra Institute for Health ResearchPamplonaSpain
| | - Pilar Amiano
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)MadridSpain
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of GipuzkoaSan SebastianSpain
- Biodonostia Health Research InstituteEpidemiology of Chronic and Communicable Diseases GroupSan SebastiánSpain
| | - Jonas Manjer
- Department of Surgery, Skåne University Hospital MalmöLund UniversityMalmöSweden
| | - Linnea Huss
- Department of Clinical Sciences MalmöLund UniversityMalmöSweden
- Department of SurgeryHelsingborg HospitalHelsingborgSweden
| | - Börje Ljungberg
- Department of Surgical and perioperative sciences, Urology and AndrologyUmeå UniversitySweden
| | - Ruth Travis
- Cancer Epidemiology Unit, Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Karl Smith‐Byrne
- Cancer Epidemiology Unit, Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Marc Gunter
- International Agency for Research on CancerLyonFrance
| | | | | | | | - Elio Riboli
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Amanda J. Cross
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - David C. Muller
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
- Department of Epidemiology and Biostatistics, School of Public HealthMRC‐PHE Centre for Environment and Health, Imperial College LondonLondonUK
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28
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Chand RR, Nimick M, Cridge B, Rosengren RJ. Investigating the Contribution of Major Drug-Metabolising Enzymes to Possum-Specific Fertility Control. Int J Mol Sci 2023; 24:ijms24119424. [PMID: 37298375 DOI: 10.3390/ijms24119424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/15/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
The potential to improve the effectiveness and efficiency of potential oestrogen-based oral contraceptives (fertility control) for possums was investigated by comparing the inhibitory potential of hepatic CYP3A and UGT2B catalytic activity using a selected compound library (CYP450 inhibitor-based compounds) in possums to that of three other species (mouse, avian, and human). The results showed higher CYP3A protein levels in possum liver microsomes compared to other test species (up to a 4-fold difference). Moreover, possum liver microsomes had significantly higher basal p-nitrophenol glucuronidation activity than other test species (up to an 8-fold difference). However, no CYP450 inhibitor-based compounds significantly decreased the catalytic activity of possum CYP3A and UGT2B below the estimated IC50 and 2-fold IC50 values and were therefore not considered to be potent inhibitors of these enzymes. However, compounds such as isosilybin (65%), ketoconazole (72%), and fluconazole (74%) showed reduced UGT2B glucuronidation activity in possums, mainly at 2-fold IC50 values compared to the control (p < 0.05). Given the structural features of these compounds, these results could provide opportunities for future compound screening. More importantly, however, this study provided preliminary evidence that the basal activity and protein content of two major drug-metabolising enzymes differ in possums compared to other test species, suggesting that this could be further exploited to reach the ultimate goal: a potential target-specific fertility control for possums in New Zealand.
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Affiliation(s)
- Ravneel R Chand
- Department of Pharmacology and Toxicology, School of Biomedical Sciences, University of Otago, Dunedin 9016, New Zealand
| | - Mhairi Nimick
- Department of Pharmacology and Toxicology, School of Biomedical Sciences, University of Otago, Dunedin 9016, New Zealand
| | - Belinda Cridge
- Science for Communities, Christchurch Science Centre, Christchurch 8041, New Zealand
| | - Rhonda J Rosengren
- Department of Pharmacology and Toxicology, School of Biomedical Sciences, University of Otago, Dunedin 9016, New Zealand
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29
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Cameron NA, Blyler CA, Bello NA. Oral Contraceptive Pills and Hypertension: A Review of Current Evidence and Recommendations. Hypertension 2023; 80:924-935. [PMID: 37075131 PMCID: PMC10852998 DOI: 10.1161/hypertensionaha.122.20018] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Oral contraceptive pills (OCPs) have been used as effective and popular forms of contraception since the middle of the last century. By 2019, over 150 million reproductive-aged individuals were using OCPs to prevent unintended pregnancies worldwide. Safety concerns regarding the effects of OCPs on blood pressure were reported soon after these pills gained approval. Although OCP doses were subsequently reduced, epidemiologic evidence continued to support a smaller, but significant association between OCPs and hypertension. Given the rising prevalence of hypertension, as well as the adverse effects of cumulative exposure to blood pressure elevations on cardiovascular disease risk, understanding the nature of the association between OCPs and hypertension is important for clinicians and patients to assess the risks and benefits of use, and make individualized decisions regarding contraception. Therefore, this review summarizes the current and historical evidence describing the association between OCP use and blood pressure elevations. Specifically, it identifies the pathophysiologic mechanisms linking OCPs to hypertension risk, describes the magnitude of the association between OCPs and blood pressure elevations, and distinguishes the effects of various OCP types on blood pressure. Finally, it describes current recommendations regarding hypertension and OCP use, as well as identifies strategies, such as over-the-counter OCP prescribing, to safely and equitably improve access to oral contraception.
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Affiliation(s)
- Natalie A Cameron
- Northwestern University Feinberg School of Medicine, Department of Medicine, Division of General Internal Medicine, Chicago, Illinois
| | - Ciantel A. Blyler
- Department of Cardiology Smidt Heart Institute Cedars-Sinai Medical Center, Los Angeles, California
| | - Natalie A Bello
- Department of Cardiology Smidt Heart Institute Cedars-Sinai Medical Center, Los Angeles, California
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30
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Fabunmi OA, Dludla PV, Nkambule BB. Investigating cardiovascular risk in premenopausal women on oral contraceptives: Systematic review with meta-analysis. Front Cardiovasc Med 2023; 10:1127104. [PMID: 37180788 PMCID: PMC10167286 DOI: 10.3389/fcvm.2023.1127104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/09/2023] [Indexed: 05/16/2023] Open
Abstract
Background The use of oral contraceptives (OCs) is associated with an increased risk of cardiovascular events such as arterial and venous thrombosis (VTE). Cardiovascular diseases (CVDs) are the leading cause of death worldwide, with low- and middle-income nations accounting for over three-quarter of CVD deaths. The aim of this systematic review is to provide a comprehensive synthesis of the available evidence on the link between OC use and CVD risk in premenopausal women and to further assess the role of geographic disparities in the reported prevalence of CVD risk in women on OCs. Methods A comprehensive search of databases such as MEDLINE, Academic Search Complete, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Health Source: Nursing/Academic Edition was conducted, right from the inception to the present, by using the EBSCOhost search engine. The Cochrane Central Register of Clinical trials (CENTRAL) was also searched to augment relevant sources of information. OpenGrey, which is a repository of information providing open access to bibliographical references, was searched and the reference list of the selected studies was also scanned. The potential risk of bias of the included studies was assessed using the modified Downs and Black checklist. Data analysis was performed using the Review Manager (RevMan) version 5.3. Results We included 25 studies that comprised 3,245 participants, of which 1,605 (49.5%) are OC users, while 1,640 (50.5%) are non-OC users. A total of 15 studies were included for meta-analysis, and the overall pooled estimates suggested a significant increase in the traditional cardiovascular risk variables [standardized mean difference (SMD) = 0.73, (0.46, 0.99) (Z = 5.41, p < 0.001)] and little to no difference in endothelial activation among OC users when compared with non-OC users [SMD = -0.11, (-0.81, 0.60) (Z = 0.30, p = 0.76)]. Europe [SMD = 0.03, (-0.21, 0.27), (Z = 0.25 p = 0.88)] had the least effect size, while North America had the highest effect size [SMD = 1.86, (-0.31, 4.04), (Z = 1.68 p = 0.09)] for CVD risk in OC users when compared with non-OC users. Conclusion The use of OCs suggests a significant increase in the prevalence of traditional cardiovascular risk variables with little to no difference in the risk of endothelial dysfunction when compared with non-OC users, and the magnitude of CVD risks varies across different geographical regions. Registration and protocol This systematic review was registered in the international prospective register of systematic reviews (PROSPERO) under the registration number: CRD42020216169.
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Affiliation(s)
- Oyesanmi A. Fabunmi
- School of Laboratory Medicine and Medical Sciences (SLMMS), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Department of Physiology, Ekiti State University, Ado-Ekiti, Nigeria
| | - Phiwayinkosi V. Dludla
- Biomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg, South Africa
| | - Bongani B. Nkambule
- School of Laboratory Medicine and Medical Sciences (SLMMS), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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31
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Anderson DJ, Johnston DS. A brief history and future prospects of contraception. Science 2023; 380:154-158. [PMID: 37053322 PMCID: PMC10615352 DOI: 10.1126/science.adf9341] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/01/2023] [Indexed: 04/15/2023]
Abstract
Modern contraception ushered in an era of improved family planning, but more than 60 years after approval of "the pill," product gaps and unmet needs still exist. Nearly 250 million women worldwide who want to delay or avoid pregnancy do so ineffectively or not at all, and the principal mechanism of male contraception, condoms, has not changed in 100 years. As a result, about half of the pregnancies that occur globally each year are unintended. Increasing contraceptive options and uptake will curtail abortions, empower women and men, promote healthy families, and moderate population growth that overtaxes the environment. This Review addresses the history of contraception, shortcomings in contraceptive methods, promising approaches for male and female contraception, and simultaneous protection against unintended pregnancy and sexually transmitted infections.
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Affiliation(s)
- Deborah J. Anderson
- Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA 02118, USA
| | - Daniel S. Johnston
- Contraception Research Branch, Eunice Kennedy Shriver National Institutes of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20817, USA
- Fertility and Infertility Branch, Eunice Kennedy Shriver National Institutes of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20817, USA
- Gynecologic Health and Disease Branch, Eunice Kennedy Shriver National Institutes of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20817, USA
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Moreillon B, Salamin O, Krumm B, Iannella L, Molaioni F, Kuuranne T, Nicoli R, Saugy JJ, Botrè F, Faiss R. Variability of the urinary and blood steroid profiles in healthy and physically active women with and without oral contraception. Drug Test Anal 2023; 15:324-333. [PMID: 36414566 DOI: 10.1002/dta.3412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 11/24/2022]
Abstract
The steroidal module of the athlete biological passport (ABP) targets the use of pseudo-endogenous androgenous anabolic steroids in elite sport by monitoring urinary steroid profiles. Urine and blood samples were collected weekly during two consecutive oral contraceptive pill (OCP) cycles in 15 physically active women to investigate the low urinary steroid concentrations and putative confounding effect of OCP. In urine, testosterone (T) and epitestosterone (E) were below the limit of quantification of 1 ng/ml in 62% of the samples. Biomarkers' variability ranged between 31% and 41%, with a significantly lesser variability for ratios (except for T/E [41%]): 20% for androsterone/etiocholanolone (p < 0.001) and 25% for 5α-androstane-3α,17β-diol/5ß-androstane-3α,17β-diol (p < 0.001). In serum, markers' variability (testosterone: 24%, androstenedione: 23%, dihydrotestosterone: 19%, and T/A4: 16%) was significantly lower than in urine (p < 0.001). Urinary A/Etio increased by >18% after the first 2 weeks (p < 0.05) following withdrawal blood loss. In contrast, serum T (0.98 nmol/l during the first week) and T/A4 (0.34 the first week) decreased significantly by more than 25% and 17% (p < 0.05), respectively, in the following weeks. Our results outline steroidal variations during the OCP cycle, highlighting exogenous hormonal preparations as confounder for steroid concentrations in blood. Low steroid levels in urine samples have a clear negative impact on the subsequent interpretation of steroid profile of the ABP. With a greater analytical sensitivity and lesser variability for steroids in healthy active women, serum represents a complementary matrix to urine in the ABP steroidal module.
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Affiliation(s)
- Basile Moreillon
- Research and Expertise in anti-Doping Sciences (REDs), Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Olivier Salamin
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne and Geneva, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Bastien Krumm
- Research and Expertise in anti-Doping Sciences (REDs), Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Loredana Iannella
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Francesco Molaioni
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Tiia Kuuranne
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne and Geneva, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Raul Nicoli
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne and Geneva, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jonas J Saugy
- Research and Expertise in anti-Doping Sciences (REDs), Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Francesco Botrè
- Research and Expertise in anti-Doping Sciences (REDs), Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.,Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Raphael Faiss
- Research and Expertise in anti-Doping Sciences (REDs), Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
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Whittaker J. Dietary trends and the decline in male reproductive health. Hormones (Athens) 2023; 22:165-197. [PMID: 36725796 DOI: 10.1007/s42000-023-00431-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/16/2023] [Indexed: 02/03/2023]
Abstract
Over the twentieth century, male reproductive health has suffered a substantial decline, as evidenced by decreases in sperm counts and testosterone levels and increases in reproductive pathologies. At the same time, the prevalence of chronic diseases such as obesity, diabetes, and metabolic syndrome has risen dramatically. Metabolic and reproductive health are highly interconnected, suggesting that their respective trends are intertwined and, given the timeframe of such trends, environmental and not genetic factors are most likely to be the primary causes. Industrialization, which began in Europe in the mid-eighteenth century, has resulted in profound changes to our diet, lifestyle, and environment, many of which are causal factors in the rise in chronic diseases. Industrialization results in a nutrition transition from an agricultural unprocessed to a modern processed diet, incorporating increases in sugar, vegetable oils, ultra-processed foods, linoleic acid, trans-fats, and total energy. This dietary shift has incurred numerous adverse effects on metabolic and reproductive health, characterized by chronic inflammation, oxidative stress, and insulin resistance. Moreover, these effects appear to multiply across subsequent generations via epigenetic inheritance. Men's fertility is markedly affected by obesity and diabetes, with an increase in total energy via processed food intake arguably being the key factor driving the diabesity pandemic. In contrast, wholefoods rich in micronutrients and phytonutrients support male fertility and a healthy body weight. Therefore, men wanting to maximize their fertility should consider making positive dietary changes, such as replacing processed foods with unprocessed foods that support metabolic and reproductive health.
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Affiliation(s)
- Joseph Whittaker
- The School of Allied Health and Community, University of Worcester, Henwick Grove, Worcester, WR2 6AJ, UK.
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Fabunmi OA, Dludla PV, Ngcobo SR, Nkambule BB. Investigating the risks of cardiovascular disease among premenopausal women using oral contraceptive: a protocol for a systematic review and meta-analysis. BMJ Open 2023; 13:e071118. [PMID: 36657759 PMCID: PMC9853212 DOI: 10.1136/bmjopen-2022-071118] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION The use of oral contraceptives (OCs) is linked to an increased risk of cardiovascular diseases (CVDs) in women of reproductive age. CVD remain one of the top causes of death worldwide, with at least three-quarters of deaths occurring in low-income and middle-income nations. The impact of various types of combined oral contraceptive (COC) on several modifiable risk factors associated with CVDs in premenopausal women is inconsistent regardless of genetic mutations. The aim of this systematic review will be to provide a comprehensive synthesis of the available evidence on the impact of COC usage on modifiable risk factors associated with CVDs and assess ethnic and geographic disparities in the reported prevalence of CVD. METHODS AND ANALYSIS This systematic review protocol was prepared in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses Protocols 2015 statement. An extensive search on the Embase, MEDLINE and Cochrane Library will be conducted from inception until. Two reviewers will independently screen for eligible studies using a predefined criterion. The risk of bias and quality of included studies will be assessed using the modified Downs and Black's checklist. Whereas the overall quality of included studies will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation assessment tool. ETHICS AND DISSEMINATION This is a review of existing studies and will not require ethical approval. The findings will be disseminated through peer-reviewed publication. The use of OC and the risk of CVDs including arterial and venous thrombosis remain a major concern among women of reproductive age. Thus, given the impact of COCs on the risk variables linked with CVDs, this review may provide an insight and assistance during COC use. PROSPERO REGISTRATION NUMBER CRD42020216169.
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Affiliation(s)
- Oyesanmi A Fabunmi
- Human Physiology, School of Laboratory Medicine and Medical Sciences (SLMMS), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Human Physiology, College of Medicine, Ekiti State University, Ado Ekiti, Nigeria
| | - Phiwayinkosi V Dludla
- Biomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg, South Africa
| | - Siphamandla R Ngcobo
- Human Physiology, School of Laboratory Medicine and Medical Sciences (SLMMS), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Bongani B Nkambule
- Human Physiology, School of Laboratory Medicine and Medical Sciences (SLMMS), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Liu R, Dong X, Ji X, Chen S, Yuan Q, Tao Y, Zhu Y, Wu S, Zhu J, Yang Y. Associations between sexual and reproductive health knowledge, attitude and practice of partners and the occurrence of unintended pregnancy. Front Public Health 2023; 10:1042879. [PMID: 36684880 PMCID: PMC9846217 DOI: 10.3389/fpubh.2022.1042879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/07/2022] [Indexed: 01/05/2023] Open
Abstract
Background Although global contraceptive coverage has increased significantly, high rates of unintended pregnancy remain the current global status quo. A comparative analysis of the differences and correlations of knowledge, attitude and practice (KAP) of sexual and reproductive health (SRH) of both partners will help guide public health work according to gender characteristics and needs, and reduce the occurrence of unintended pregnancy. Methods A questionnaire survey of people with unintended pregnancies including women and their male partners (n = 1,275 pairs) who sought help from the Shanghai General Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from October 2017 to October 2021. Data were collected on sexual and reproductive health knowledge, attitudes, and practices in both partners who had unintended pregnancies. Chi-square test and Logistic regression were used to analyze the relationship between the occurrence of unintended pregnancy and KAP and its influencing factors. Paired odds ratio and McNemar's test were used to estimate the difference and concordance of KAP between partners. Results This study included 1,275 partners with a mean age of 30.0 years. The partner's overall level of KAP is good. Compared with women, men had better knowledge (χ2 = 3.93, p = 0.047) and more active contraceptive practices (χ2 = 19.44, p < 0.001). In the analysis of partner concordance, male contraceptive intention was found to be better than female [matched pairs odds ratio (ORMP) = 2.56, p < 0.001], and the concordance of positive contraceptive practice between partners increased with male education [adjusted odds ratio (aOR) = 1.556, 95% confidence interval (CI) = 1.185-2.044, p = 0.001]. In partner-paired regression analysis, compared with good contraceptive knowledge in both men and women in the partner, the risk of negative contraceptive practice was 1.7 times (aOR = 1.721, 95% CI = 1.234-2.400, p = 0.001) higher with good contraceptive knowledge in women but negative in men, while women with poor contraceptive knowledge but men with good knowledge are 1.3 times (aOR = 1.349, 95% CI = 1.000-1.819, p = 0.05) more likely to have negative contraceptive practices. In addition, compared with partners with positive contraceptive attitudes, women with positive attitudes but negative men and women with negative attitudes but positive men had 1.7 and 1.4 times the risk of negative contraceptive practices, respectively. Conclusion The study found that unintended pregnancy occurs mainly in young people, and the younger age of first sexual intercourse, the low education background and the lack of discussion of contraception between partners are risk factors for not taking contraceptive measures. Men's better knowledge and contraceptive practices compared with female partners, and poor male contraceptive knowledge and attitudes may lead to a higher risk of negative contraceptive practices, the results suggest that male KAP plays an important role in promoting contraceptive use and reducing unintended pregnancy.
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Affiliation(s)
- Ruping Liu
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaotong Dong
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoning Ji
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shihan Chen
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qingqing Yuan
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Tao
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yaping Zhu
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sufang Wu
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingfen Zhu
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Yongbin Yang
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Roden RC. Reversible interventions for menstrual management in adolescents and young adults with gender incongruence. Ther Adv Reprod Health 2023; 17:26334941231158251. [PMID: 36938373 PMCID: PMC10017940 DOI: 10.1177/26334941231158251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 02/01/2023] [Indexed: 03/17/2023] Open
Abstract
The newly released World Professional Association for Transgender Health Standards of Care, 8th Edition specify that adolescents should be offered menstrual suppression as part of their treatment plans to suppress menses and alleviate dysphoria, provide contraception, or improve irregular bleeding on testosterone therapy. This is a review of current evidence-based options for reversible interventions for menstrual suppression in adolescents with gender dysphoria or incongruence. Shared decision-making should be used by the clinician at all times, and the clinician should be intentional in prioritizing the patient's stated needs and desires when offering interventions. No method should be withheld due to the experience of gender incongruence alone. Contraceptive options offering menstrual suppression include depot-medroxyprogesterone acetate, levonorgestrel intrauterine systems, progestin-only contraceptive pills, and combined hormonal contraceptives. Non-contraceptive options include norethindrone acetate, oral medroxyprogesterone acetate, gonadotropin-releasing hormone analogues/agonists, and danazol. Certain patients may also benefit from non-pharmacologic interventions, such as specialty menstrual underwear. Plain language summary Using medicine to stop Menstrual periods in teens with gender incongruence Summary: Newly released recommendations for the care of teens and young adults with gender dysphoria or incongruence specifically recommend using medications to get rid of menstrual periods if desired or medically necessary. Patients may ask for this to help improve dysphoria, as a feature they want in birth control, or simply because they do not want to have periods. Because temporarily getting rid of periods is something that doctors can do for any patient old enough to have periods, patients with gender dysphoria should also be able to have their periods temporarily stopped using medications if requested. Doctors should ensure that they always help the patient make a decision that is right for them instead of prescribing what they think is right without considering the patient's input. Options for temporarily getting rid of periods can include birth control, such as oral contraceptive pills, patches, or rings; intrauterine devices; or shots, and it can also be done with things that are not birth control, such a progesterone pills or puberty blockers. Finally, some patients may only need improved period hygiene with period underwear to feel better in their bodies.
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Kheloui S, Smith A, Ismail N. Combined oral contraceptives and mental health: Are adolescence and the gut-brain axis the missing links? Front Neuroendocrinol 2023; 68:101041. [PMID: 36244525 DOI: 10.1016/j.yfrne.2022.101041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/16/2022] [Accepted: 10/07/2022] [Indexed: 11/05/2022]
Abstract
Combined oral contraceptives (containing synthetic forms of estradiol and progestins) are one of the most commonly used drugs among females. However, their effects on the gut-brain axis have not been investigated to a great extent despite clear evidence that suggest bi-directional interactions between the gut microbiome and endogenous sex hormones. Moreover, oral contraceptives are prescribed during adolescence, a critical period of development during which several brain structures and systems, such as hypothalamic-pituitary-gonadal axis, undergo maturation. Considering that oral contraceptives could impact the developing adolescent brain and that these effects may be mediated by the gut-brain axis, further research investigating the effects of oral contraceptives on the gut-brain axis is imperative. This article briefly reviews evidence from animal and human studies on the effects of combined oral contraceptives on the brain and the gut microbiota particularly during adolescence.
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Affiliation(s)
- Sarah Kheloui
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Andra Smith
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada; uOttawa Brain and Mind Research Institute, Ottawa, ON, Canada
| | - Nafissa Ismail
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada; uOttawa Brain and Mind Research Institute, Ottawa, ON, Canada; LIFE Research Institute, Ottawa, ON, Canada.
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Fanse S, Bao Q, Burgess DJ. Long-acting intrauterine systems: Recent advances, current challenges, and future opportunities. Adv Drug Deliv Rev 2022; 191:114581. [PMID: 36270490 PMCID: PMC10302114 DOI: 10.1016/j.addr.2022.114581] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/13/2022] [Accepted: 09/27/2022] [Indexed: 01/24/2023]
Abstract
Levonorgestrel intrauterine systems (LNG-IUSs) are complex drug-device combination products designed to release a hormonal contraceptive drug for up to 7 years. These drug delivery systems offers a great promise as a modern method of long-acting reversible contraceptives (LARCs) to improve women's health. Unfortunately, there are some scientific challenges associated with the development of these products which are among the major reasons contributing to the availability of relatively few IUS products on the market. This review summarizes the formulation considerations (drug and excipient attributes), manufacturing methods, advances in characterization and in vitro drug release testing of IUSs, as well as factors influencing drug release from IUSs. A critical discussion on the major challenges to IUS product development is presented. Specifically, insights on bioequivalence evaluation, in vitro-in vivo correlation (IVIVC) establishment, and regulatory challenges are detailed. Lastly, methodological tools to overcome some of these hurdles to product development are proposed. The knowledge furnished through this review will be helpful towards obtaining better product understanding. Such understanding will facilitate the development of these complex drug products, as well as their regulatory approval process.
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Affiliation(s)
- Suraj Fanse
- University of Connecticut, School of Pharmacy, Storrs, CT 06269, USA
| | - Quanying Bao
- University of Connecticut, School of Pharmacy, Storrs, CT 06269, USA
| | - Diane J Burgess
- University of Connecticut, School of Pharmacy, Storrs, CT 06269, USA.
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Stan A, Ilut S, Dragos HM, Bota C, Hanghicel PN, Cristian A, Vlad I, Mocanu D, Strilciuc S, Panaitescu PS, Stan H, Muresanu DF. The Burden of Cerebral Venous Thrombosis in a Romanian Population across a 5-Year Period. Life (Basel) 2022; 12:life12111825. [PMID: 36362980 PMCID: PMC9693190 DOI: 10.3390/life12111825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/28/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022] Open
Abstract
Health policies in transitioning health systems are rarely informed by the social burden and the incidence shifts in disease epidemiology. Cerebral venous thrombosis (CVT) is a type of stroke more often affecting younger adults and women, with higher incidences being reported in recent studies. A retrospective, hospital-based population study was conducted at Cluj-Napoca Emergency County Hospital across a 5-year period between 2017 and 2021. The overall incidence and the rates in distinctive gender and age groups were assessed. Length of hospital stay (LHS), modified Rankin score (mRS) and mortality at discharge and at 3 months were calculated. Fifty-three patients were included. The median age was 45 years, and 64.2% were women. In our population of 3,043,998 person-years, 53 CVT cases resulted in an incidence of 1.74 per 100,000 (95% CI 1.30–2.27). CVT incidence was higher in women (2.13 per 100,000, 95% CI 1.47–2.07). There was a statistically significant difference in LHS between patients with different intracranial complications (Kruskal–Wallis, p = 0.008). The discharge mRS correlated with increasing age (rs = 0.334, p = 0.015), transient risk factors (Fisher’s exact test, p = 0.023) and intracranial complications (Fisher’s exact test, p = 0.022). In addition, the mRS at 3 months was statistically associated with increasing age (rs = 0.372, p = 0.006) and transient risk factors (Fisher’s exact test, p = 0.012). In-hospital mortality was 5.7%, and mortality at follow up was 7.5%, with higher rates in women (5.9% and 8.8%, respectively). Our findings may provide insight regarding the epidemiological features of certain patient groups more prone to developing CVT and its complications, informing local and central stakeholders’ efforts to improve standards of care.
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Affiliation(s)
- Adina Stan
- Department of Neurosciences, Iuliu Hatieganu University of Medicine and Pharmacy, No. 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, No. 37 Mircea Eliade Street, 400364 Cluj-Napoca, Romania
- Neurology Department, Emergency County Hospital Cluj-Napoca, 400347 Cluj-Napoca, Romania
| | - Silvina Ilut
- Department of Neurosciences, Iuliu Hatieganu University of Medicine and Pharmacy, No. 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, No. 37 Mircea Eliade Street, 400364 Cluj-Napoca, Romania
- Neurology Department, Emergency County Hospital Cluj-Napoca, 400347 Cluj-Napoca, Romania
| | - Hanna Maria Dragos
- Department of Neurosciences, Iuliu Hatieganu University of Medicine and Pharmacy, No. 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, No. 37 Mircea Eliade Street, 400364 Cluj-Napoca, Romania
- Neurology Department, Emergency County Hospital Cluj-Napoca, 400347 Cluj-Napoca, Romania
- Correspondence: ; Tel.: +40-773991273
| | - Claudia Bota
- RoNeuro Institute for Neurological Research and Diagnostic, No. 37 Mircea Eliade Street, 400364 Cluj-Napoca, Romania
- Neurology Department, Emergency County Hospital Cluj-Napoca, 400347 Cluj-Napoca, Romania
| | - Patricia Nicoleta Hanghicel
- RoNeuro Institute for Neurological Research and Diagnostic, No. 37 Mircea Eliade Street, 400364 Cluj-Napoca, Romania
- Neurology Department, Emergency County Hospital Cluj-Napoca, 400347 Cluj-Napoca, Romania
| | - Alexander Cristian
- RoNeuro Institute for Neurological Research and Diagnostic, No. 37 Mircea Eliade Street, 400364 Cluj-Napoca, Romania
- Neurology Department, Emergency County Hospital Cluj-Napoca, 400347 Cluj-Napoca, Romania
| | - Irina Vlad
- Department of Neurosciences, Iuliu Hatieganu University of Medicine and Pharmacy, No. 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, No. 37 Mircea Eliade Street, 400364 Cluj-Napoca, Romania
| | - Diana Mocanu
- Neurology Department, Emergency County Hospital Cluj-Napoca, 400347 Cluj-Napoca, Romania
| | - Stefan Strilciuc
- Department of Neurosciences, Iuliu Hatieganu University of Medicine and Pharmacy, No. 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, No. 37 Mircea Eliade Street, 400364 Cluj-Napoca, Romania
| | - Paul Stefan Panaitescu
- Department of Microbiology, Iuliu Hatieganu University of Medicine and Pharmacy, No. 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Horatiu Stan
- Department of Neurosciences, Iuliu Hatieganu University of Medicine and Pharmacy, No. 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Dafin F. Muresanu
- Department of Neurosciences, Iuliu Hatieganu University of Medicine and Pharmacy, No. 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, No. 37 Mircea Eliade Street, 400364 Cluj-Napoca, Romania
- Neurology Department, Emergency County Hospital Cluj-Napoca, 400347 Cluj-Napoca, Romania
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Introduction to the special issue on neurological disorders across the female life span. Neurobiol Dis 2022; 174:105886. [DOI: 10.1016/j.nbd.2022.105886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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DAM TINEVRIST, DALGAARD LINEBARNER, SEVDALIS VASSILIS, BIBBY BOMARTIN, JANSE DE JONGE XANNE, GRAVHOLT CLAUSH, HANSEN METTE. Muscle Performance during the Menstrual Cycle Correlates with Psychological Well-Being, but Not Fluctuations in Sex Hormones. Med Sci Sports Exerc 2022; 54:1678-1689. [PMID: 36106832 PMCID: PMC9473716 DOI: 10.1249/mss.0000000000002961] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE We aimed to study variations in strength and power performance during the menstrual cycle (MC) in eumenorrheic young women and during the pill cycle in oral contraceptives (OC) users. METHODS Forty healthy, normal-weight women between 18 and 35 yr (n = 30 eumenorrheic women; n = 10 OC users) completed this prospective cohort study. Seven to nine times during the MC/pill-cycle, the participants completed a physical performance test series, a questionnaire about psychological well-being, blood sampling, and determination of body mass. The physical tests included isometric handgrip strength, elbow flexor strength, countermovement jump (CMJ) height, and a 10-s Wingate bike test. RESULTS No direct correlation was observed between the variations in sex hormones and physical performance parameters. However, positive correlations were observed between physical performance outcomes and self-reported motivation, perception of own physical performance level, pleasure level, and arousal level. CMJ was 6% lower in the late luteal phase (LL) compared with the midluteal phase (ML) (P = 0.04). Wingate peak power was 3% lower in early follicular (EF) compared with the ML (P = 0.04). Furthermore, Wingate average power was 2%-5% lower in LL compared with all other MC phases. In line with these observations, physical pain was higher in EF and LL, and the pleasure level was lower in EF compared with the other MC phases. In OC users, we observed no variation in performance and self-reported parameters between the placebo-pill phase and the OC-pill phase. CONCLUSIONS Impairments in CMJ and Wingate performance were observed at the end and start of MC compared with other MC phases, which were associated with lower psychological well-being, but not the sex hormone fluctuations.
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Affiliation(s)
- TINE VRIST DAM
- Section of Sport Science, Department of Public Health, Aarhus University, Aarhus, DENMARK
| | - LINE BARNER DALGAARD
- Section of Sport Science, Department of Public Health, Aarhus University, Aarhus, DENMARK
| | - VASSILIS SEVDALIS
- Section of Sport Science, Department of Public Health, Aarhus University, Aarhus, DENMARK
| | - BO MARTIN BIBBY
- Section of Biostatistics, Department of Public Health, Aarhus University, Aarhus, DENMARK
| | | | - CLAUS H. GRAVHOLT
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, DENMARK
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, DENMARK
| | - METTE HANSEN
- Section of Sport Science, Department of Public Health, Aarhus University, Aarhus, DENMARK
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42
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Heller C, Kimmig ACS, Kubicki MR, Derntl B, Kikinis Z. Imaging the human brain on oral contraceptives: A review of structural imaging methods and implications for future research goals. Front Neuroendocrinol 2022; 67:101031. [PMID: 35998859 DOI: 10.1016/j.yfrne.2022.101031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/30/2022] [Accepted: 08/15/2022] [Indexed: 12/21/2022]
Abstract
Worldwide over 150 million women use oral contraceptives (OCs), which are the most prescribed form of contraception in both the United States and in European countries. Sex hormones, such as estradiol and progesterone, are important endogenous hormones known for shaping the brain across the life span. Synthetic hormones, which are present in OCs, interfere with the natural hormonal balance by reducing the endogenous hormone levels. Little is known how this affects the brain, especially during the most vulnerable times of brain maturation. Here, we review studies that investigate differences in brain gray and white matter in women using OCs in comparison to naturally cycling women. We focus on two neuroimaging methods used to quantify structural gray and white matter changes, namely structural MRI and diffusion MRI. Finally, we discuss the potential of these imaging techniques to advance knowledge about the effects of OCs on the brain and wellbeing in women.
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Affiliation(s)
- Carina Heller
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry and Psychotherapy, Jena University Hospital, Germany; Department of Clinical Psychology, Friedrich Schiller University Jena, Germany.
| | - Ann-Christin S Kimmig
- Department of Psychiatry and Psychotherapy, Innovative Neuroimaging, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany; Graduate Training Centre of Neuroscience, International Max Planck Research School, University of Tübingen, Tübingen, Germany
| | - Marek R Kubicki
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Innovative Neuroimaging, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany; Lead Graduate School, University of Tübingen, Tübingen, Germany
| | - Zora Kikinis
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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43
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Aziz JR, Oprea A, Bissonnette JN, Hull KM, Napier K, Schryver B, Myles EM, Newman RL, Perrot TS, Fisher DJ. Effect of caffeine on resting-state alpha activity across the human menstrual cycle. Psychopharmacology (Berl) 2022; 239:3161-3170. [PMID: 35904580 PMCID: PMC9335458 DOI: 10.1007/s00213-022-06197-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 07/20/2022] [Indexed: 11/30/2022]
Abstract
RATIONALE Caffeine is the most consumed stimulant worldwide, and there is great interest in understanding its neurophysiological effects. Resting-state electroencephalography (EEG) studies suggest that caffeine enhances arousal, which suppresses the spectral power of alpha frequencies associated with reduced alertness. However, it is unclear whether caffeine's neurophysiological effects vary across the human menstrual cycle. OBJECTIVE The objective of our study was to test whether caffeine's effect on EEG activity differs across the human menstrual cycle. METHODS Fifty-six female participants were randomly assigned to complete the experiment while in either their menstrual (n = 21), follicular (n = 19), or luteal (n = 16) phase. Each participant completed two study sessions in the same menstrual phase, approximately 1 month apart, during which they were administered either a caffeine pill (200 mg, oral) or a placebo pill in a counterbalanced order using a randomized double-blinded procedure. We measured their eyes-closed resting-state EEG approximately 30 min after pill administration and conducted a spectral power analysis at different frequency bands. RESULTS Caffeine reduced EEG power in the alpha1 frequency band (8-10 Hz), but only for participants who self-reported higher weekly caffeine consumption. Importantly, caffeine's effects did not differ by menstrual phase. CONCLUSIONS We conclude that when studying caffeine's effects on resting-state EEG, participants' baseline caffeine consumption is more influential than their menstrual cycle phase. This study has important implications for the inclusion of menstruating individuals in neurophysiological studies of caffeine.
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Affiliation(s)
- Jasmine R Aziz
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, NS, B3H 4J1, Canada
| | - Alexandra Oprea
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, NS, B3H 4J1, Canada
| | - Jenna N Bissonnette
- Department of Psychiatry, Dalhousie University, Halifax, NS, B3H 4J1, Canada.,Department of Psychology, Mount Saint Vincent University, Halifax, NS, B3M 2J6, Canada
| | - Krista M Hull
- Department of Psychology, Mount Saint Vincent University, Halifax, NS, B3M 2J6, Canada
| | - Kaitlyn Napier
- Department of Psychology, Mount Saint Vincent University, Halifax, NS, B3M 2J6, Canada
| | - Bronwen Schryver
- Department of Psychology, Mount Saint Vincent University, Halifax, NS, B3M 2J6, Canada
| | - Elizabeth M Myles
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, NS, B3H 4J1, Canada
| | - Randy L Newman
- Department of Psychology, Acadia University, Wolfville, NS, B4P 2R6, Canada
| | - Tara S Perrot
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, NS, B3H 4J1, Canada
| | - Derek J Fisher
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, NS, B3H 4J1, Canada. .,Department of Psychiatry, Dalhousie University, Halifax, NS, B3H 4J1, Canada. .,Department of Psychology, Mount Saint Vincent University, Halifax, NS, B3M 2J6, Canada. .,Department of Psychology, Acadia University, Wolfville, NS, B4P 2R6, Canada.
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44
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Reddy V, Wurtz M, Patel SH, McCarthy M, Raval AP. Oral contraceptives and stroke: Foes or friends. Front Neuroendocrinol 2022; 67:101016. [PMID: 35870646 DOI: 10.1016/j.yfrne.2022.101016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/23/2022] [Accepted: 07/06/2022] [Indexed: 01/09/2023]
Abstract
Incidents of strokes are increased in young women relative to young men, suggesting that oral contraceptive (OC) use is one of the causes of stroke among young women. Long-term exposures to the varying combinations of estrogen and progestogen found in OCs affect blood clotting, lipid and lipoprotein metabolism, endothelial function, and de novo synthesis of neurosteroids, especially brain-derived 17β-estradiol. The latter is essential for neuroprotection, memory, sexual differentiation, synaptic transmission, and behavior. Deleterious effects of OCs may be exacerbated due to comorbidities like polycystic ovary syndrome, sickle cell anemia, COVID-19, exposures to endocrine disrupting chemicals, and conventional or electronic cigarette smoking. The goal of the current review is to revisit the available literature regarding the impact of OC use on stroke, to explain possible underlying mechanisms, and to identify gaps in our understanding to promote future research to reduce and cure stroke in OC users.
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Affiliation(s)
- Varun Reddy
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratory, Leonard M. Miller School of Medicine, University of Miami, Miami Florida 33136, USA; Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami Florida 33136, USA
| | - Megan Wurtz
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratory, Leonard M. Miller School of Medicine, University of Miami, Miami Florida 33136, USA; Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami Florida 33136, USA
| | - Shahil H Patel
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratory, Leonard M. Miller School of Medicine, University of Miami, Miami Florida 33136, USA; Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami Florida 33136, USA
| | - Micheline McCarthy
- Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami Florida 33136, USA
| | - Ami P Raval
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratory, Leonard M. Miller School of Medicine, University of Miami, Miami Florida 33136, USA; Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami Florida 33136, USA; Bruce W. Carter Department of Veterans Affairs Medical Center, Miami, FL, USA.
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45
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Kimmig ACS, Wildgruber D, Gärtner A, Drotleff B, Krylova M, Lämmerhofer M, Sundström-Poromaa I, Derntl B. Lower affective empathy in oral contraceptive users: a cross-sectional fMRI study. Cereb Cortex 2022; 33:4319-4333. [PMID: 36137568 DOI: 10.1093/cercor/bhac345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/03/2022] [Accepted: 08/03/2022] [Indexed: 01/10/2023] Open
Abstract
Evidence accumulates that oral contraceptive (OC) use modulates various socio-affective behaviors, including empathic abilities. Endogenous and synthetic sex hormones, such as estrogens and progestogens, bind to receptor sites in brain regions (i.e. frontal, limbic, and cerebellar) involved in socio-affective processing. Therefore, the aim of this study was to investigate the role of OC use in empathy. In a cross-sectional functional magnetic resonance imaging study, women in different hormonal states, including OC use (n = 46) or being naturally cycling in the early follicular (fNC: n = 37) or peri-ovulatory phase (oNC: n = 28), performed a visual, sentence-based empathy task. Behaviorally, OC users had lower empathy ratings than oNC women. Congruently, whole-brain analysis revealed significantly larger task-related activation of several brain regions, including the left dorsomedial prefrontal gyrus (dmPFG), left precentral gyrus, and left temporoparietal junction in oNC compared to OC women. In OC users, the activity of the left dmPFG and precentral gyrus was negatively associated with behavioral and self-reported affective empathy. Furthermore, empathy-related region-of-interest analysis indicated negative associations of brain activation with synthetic hormone levels in OC women. Overall, this multimodal, cross-sectional investigation of empathy suggests a role of OC intake in especially affective empathy and highlights the importance of including synthetic hormone levels in OC-related analyses.
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Affiliation(s)
- Ann-Christin Sophie Kimmig
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany.,Graduate Training Centre of Neuroscience, International Max Planck Research School, University of Tübingen, Ottfried-Müller-Str. 27, 72076 Tübingen, Germany
| | - Dirk Wildgruber
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
| | - Anna Gärtner
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
| | - Bernhard Drotleff
- Department of Pharmacy and Biochemistry, Institute of Pharmaceutical Sciences, Pharmaceutical (Bio-)Analysis, University of Tübingen, Auf der Morgenstelle 8, 72076 Tübingen, Germany
| | - Marina Krylova
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743 Jena, Germany.,Department of Radiology, Institute of Diagnostic and Interventional Radiology, Medical Physics Group, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
| | - Michael Lämmerhofer
- Department of Pharmacy and Biochemistry, Institute of Pharmaceutical Sciences, Pharmaceutical (Bio-)Analysis, University of Tübingen, Auf der Morgenstelle 8, 72076 Tübingen, Germany
| | - Inger Sundström-Poromaa
- Department of Women's and Children's Health, University of Uppsala, Akademiska sjukhuset, 751 85 Uppsala, Sweden
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany.,LEAD Graduate School & Research Network, University of Tübingen, Europastraße 6, 72072 Tübingen Germany
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46
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Franco A. Scaling up Contraception through Social and Behavior Change Intervention in Low and Middle-Income Countries. Stud Fam Plann 2022. [DOI: 10.5772/intechopen.104207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Despite its benefit and aged long practice, contraceptive use continues to be a problem in low and middle-income countries like Nigeria with one of the highest maternal and child mortality across the globe. This chapter aims to discuss social and behavior change interventions needed to scale up contraceptive use in low and middle-income countries. A review of literature in addition to field experiences in promoting contraceptives was made. Evidence reveals that a well plan and carefully implemented social and behavior change intervention based on formative research is key to improved contraceptive use needed for improved maternal and child health outcomes in low and middle-income countries. Contraception is the right of every woman and a recommended practice for the health and development of any nation.
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47
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Santos FR, Morais PCV, Nascimento RF, Cavalcante RM. Tracking the historical urban and rural sources of fecal pollution in a South American tropical semi-arid region using sterols and endocrine-disrupting chemicals. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 838:156497. [PMID: 35675885 DOI: 10.1016/j.scitotenv.2022.156497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 05/14/2022] [Accepted: 06/01/2022] [Indexed: 06/15/2023]
Abstract
Sterols and endocrine-disrupting chemicals were analyzed in two dated sediment cores collected in the Jaguaribe river to determine the recent decades' influence of urbanization and agropastoral activities on the inputs of fecal pollution in a semi-arid region of Brazil. Stigmasterol and sitosterol were the most abundant of the 6 sterols examined in both cores, indicating an important contribution of organic matter from mangrove forests to the study region. Coprostanol presented a continuous increase in concentrations from the 1930s to the 2000s in one core, however, showing higher concentrations (>100 ng g-1) in the upper layers of both cores. The sterols diagnostic ratios indicated fecal pollution through both cores, especially from the 1940s to 1970s. The coprostanol levels followed the variations in population growth in the state of Ceará. Estriol and estrone were the most abundant estrogenic hormones found in both cores. These compounds are probably related to the intense livestock activities in the Ceará state, especially after the 1970s. The baseline levels of fecal sterols and estrogen hormones found in this study possibly represent a previous unimpacted scenario and may be used for future evaluations of fecal pollution from urbanization and livestock activities.
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Affiliation(s)
- Felipe R Santos
- Instituto de Ciências do Mar, Universidade Federal do Ceará, Av. Abolição, 3207, 60165-081 Fortaleza, CE, Brazil; Instituto Oceanográfico, Universidade de São Paulo, Praça do Oceanográfico, 191, 05508-120 São Paulo, SP, Brazil.
| | - Pollyana C V Morais
- Instituto de Ciências do Mar, Universidade Federal do Ceará, Av. Abolição, 3207, 60165-081 Fortaleza, CE, Brazil
| | - Ronaldo F Nascimento
- Departamento de Química Analítica e Físico-Química, Universidade Federal do Ceará, 60455-760 Fortaleza, CE, Brazil
| | - Rivelino M Cavalcante
- Instituto de Ciências do Mar, Universidade Federal do Ceará, Av. Abolição, 3207, 60165-081 Fortaleza, CE, Brazil.
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48
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Kim JW, Kim HA, Suh CH, Jung JY. Sex hormones affect the pathogenesis and clinical characteristics of systemic lupus erythematosus. Front Med (Lausanne) 2022; 9:906475. [PMID: 36035435 PMCID: PMC9402996 DOI: 10.3389/fmed.2022.906475] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/26/2022] [Indexed: 11/13/2022] Open
Abstract
Systemic lupus erythematosus (SLE) affects women more frequently than men, similar to the female predilection for other autoimmune diseases. Moreover, male patients with SLE exhibit different clinical features than female patients. Sex-associated differences in SLE required special considerations for disease management such as during pregnancy or hormone replacement therapy (HRT). Sex hormones, namely, estrogen and testosterone, are known to affect immune responses and autoimmunity. While estrogen and progesterone promote type I immune response, and testosterone enhances T-helper 1 response. Sex hormones also influence Toll-like receptor pathways, and estrogen receptor signaling is involved in the activation and tolerance of immune cells. Further, the clinical features of SLE vary according to hormonal changes in female patients. Alterations in sex hormones during pregnancy can alter the disease activity of SLE, which is associated with pregnancy outcomes. Additionally, HRT may change SLE status. Sex hormones affect the pathogenesis, clinical features, and management of SLE; thus, understanding the occurrence and exacerbation of disease caused by sex hormones is necessary to improve its management.
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Affiliation(s)
- Ji-Won Kim
- Department of Rheumatology, Ajou University School of Medicine, Suwon, South Korea
| | - Hyoun-Ah Kim
- Department of Rheumatology, Ajou University School of Medicine, Suwon, South Korea
| | - Chang-Hee Suh
- Department of Rheumatology, Ajou University School of Medicine, Suwon, South Korea
- Department of Molecular Science and Technology, Ajou University, Suwon, South Korea
| | - Ju-Yang Jung
- Department of Rheumatology, Ajou University School of Medicine, Suwon, South Korea
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49
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Orsini CA, Truckenbrod LM, Wheeler AR. Regulation of sex differences in risk-based decision making by gonadal hormones: Insights from rodent models. Behav Processes 2022; 200:104663. [PMID: 35661794 PMCID: PMC9893517 DOI: 10.1016/j.beproc.2022.104663] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 04/22/2022] [Accepted: 05/24/2022] [Indexed: 02/04/2023]
Abstract
Men and women differ in their ability to evaluate options that vary in their rewards and the risks that are associated with these outcomes. Most studies have shown that women are more risk averse than men and that gonadal hormones significantly contribute to this sex difference. Gonadal hormones can influence risk-based decision making (i.e., risk taking) by modulating the neurobiological substrates underlying this cognitive process. Indeed, estradiol, progesterone and testosterone modulate activity in the prefrontal cortex, amygdala and nucleus accumbens associated with reward and risk-related information. The use of animal models of decision making has advanced our understanding of the intersection between the behavioral, neural and hormonal mechanisms underlying sex differences in risk taking. This review will outline the current state of this literature, identify the current gaps in knowledge and suggest the neurobiological mechanisms by which hormones regulate risky decision making. Collectively, this knowledge can be used to understand the potential consequences of significant hormonal changes, whether endogenously or exogenously induced, on risk-based decision making as well as the neuroendocrinological basis of neuropsychiatric diseases that are characterized by impaired risk taking, such as substance use disorder and schizophrenia.
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Affiliation(s)
- Caitlin A. Orsini
- Department of Psychology, University of Texas at Austin, Austin, TX, USA,Department of Neurology, University of Texas at Austin, Austin, TX, USA,Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, TX, USA,Institute for Neuroscience, University of Texas at Austin, Austin, TX, USA,Correspondence to: Department of Psychology & Neurology, Waggoner Center for Alcohol and Addiction Research, 108 E. Dean Keaton St., Stop A8000, Austin, TX 78712, USA. (C.A. Orsini)
| | - Leah M. Truckenbrod
- Department of Neurology, University of Texas at Austin, Austin, TX, USA,Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, TX, USA,Institute for Neuroscience, University of Texas at Austin, Austin, TX, USA
| | - Alexa-Rae Wheeler
- Department of Neurology, University of Texas at Austin, Austin, TX, USA,Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, TX, USA,Institute for Neuroscience, University of Texas at Austin, Austin, TX, USA
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50
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Lee JH, van der Linden C, Diaz FJ, Wong PK. A reconfigurable microfluidic building block platform for high-throughput nonhormonal contraceptive screening. LAB ON A CHIP 2022; 22:2531-2539. [PMID: 35678283 DOI: 10.1039/d2lc00424k] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Identifying nonhormonal contraceptives will have profound impacts on avoiding side effects of hormonal birth control methods, minimizing pregnancy complications and infant mortality rates, and promoting family planning. However, phenotypic screening of contraceptives is challenging due to the diverse procedures associated with oocyte culture, biochemical assays, and molecular imaging. This study reports a multifunctional microfluidic platform comprising reconfigurable building blocks and interfaces to implement various cell-based drug screening protocols. This versatile platform has three major layers. The top layer consists of interchangeable 3D microfluidic building blocks (e.g., branching microchannels, chemical gradient generators, pumpless flow controllers, and emulsion generators) or an open interface. The middle layer incorporates a multiwell array with embedded membrane filters for live cell culture, medium exchange, enzymatic cumulus cell removal, washing, and fluorescence staining. The bottom layer is also reconfigurable for waste collection, oocyte culture, plate reader measurement, and high-resolution microscopy. We demonstrate an 8 by 16 (128 wells) system for performing the cumulus-oocyte complex (COC) expansion and oocyte maturation assays for screening nonhormonal contraceptives. The microfluidic building block platform is scalable and can be reconfigured for a variety of drug screening applications in the future.
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Affiliation(s)
- Jyong-Huei Lee
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, PA, 16802, USA.
| | - Carl van der Linden
- Department of Animal Science, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Francisco J Diaz
- Department of Animal Science, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Pak Kin Wong
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, PA, 16802, USA.
- Department of Mechanical Engineering and Department of Surgery, The Pennsylvania State University, University Park, PA, 16802, USA
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