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Niering M, Wolf-Belala N, Seifert J, Tovar O, Coldewey J, Kuranda J, Muehlbauer T. The Influence of Menstrual Cycle Phases on Maximal Strength Performance in Healthy Female Adults: A Systematic Review with Meta-Analysis. Sports (Basel) 2024; 12:31. [PMID: 38251305 PMCID: PMC10818650 DOI: 10.3390/sports12010031] [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: 11/02/2023] [Revised: 12/29/2023] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
Maximal strength is a significant factor in achieving peak performance and injury prevention in athletes. In individualization strategies for the efficient development of athletes, it is necessary to consider the respective components separately. The purpose of this study was to systematically examine the effects of the different cycle phases on isometric, isokinetic, and dynamic maximum strength. A systematic literature review was conducted; databases were searched from January 1960 to September 2023. The included studies focused on the expression of maximal strength in the earlier follicular phase as well as at least one comparative phase. Of the initial 707 articles identified, 22 met the selection criteria and were included. The studies considered a total of 433 subjects. Our results revealed medium effects (weighted mean standardized mean difference (SMD) = 0.60; seven studies) for isometric maximal strength in favor of the late follicular phase, small effects (weighted mean SMD = 0.39; five studies) for isokinetic maximal strength in favor of the ovulation phase, and small effects (weighted mean SMD = 0.14; three studies) for dynamic maximal strength in favor of the late follicular phase. The results indicate that the early follicular phase is unfavorable for all strength classes. Peak performance in isometric strength is seen in the late follicular phase, whereas isokinetic strength peaks during ovulation. Dynamic strength is optimal in the late follicular phase.
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Affiliation(s)
- Marc Niering
- Institute of Biomechanics and Neurosciences, Nordic Science, 30173 Hannover, Germany; (M.N.); (N.W.-B.); (J.S.)
| | - Nacera Wolf-Belala
- Institute of Biomechanics and Neurosciences, Nordic Science, 30173 Hannover, Germany; (M.N.); (N.W.-B.); (J.S.)
| | - Johanna Seifert
- Institute of Biomechanics and Neurosciences, Nordic Science, 30173 Hannover, Germany; (M.N.); (N.W.-B.); (J.S.)
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, 30625 Hannover, Germany
| | - Ole Tovar
- Department of Sports Science, Bielefeld University, 33615 Bielefeld, Germany;
| | - Jacqueline Coldewey
- Institute of Sport Sciences, Biosciences of Sports, University of Hildesheim, 31141 Hildesheim, Germany;
| | - Jennifer Kuranda
- Triagon Academy Munich, School of Sports, Psychology and Education, 85737 Ismaning, Germany;
| | - Thomas Muehlbauer
- Division of Movement and Training Sciences/Biomechanics of Sport, University of Duisburg-Essen, 45141 Essen, Germany
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Niggli A, Rothenbühler M, Sachs M, Leeners B. Can Wrist-Worn Medical Devices Correctly Identify Ovulation? SENSORS (BASEL, SWITZERLAND) 2023; 23:9730. [PMID: 38139575 PMCID: PMC10747116 DOI: 10.3390/s23249730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/03/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023]
Abstract
(1) Background: Hormonal fluctuations across the menstrual cycle lead to multiple changes in physiological parameters such as body temperature, cardiovascular function, respiratory rate and perfusion. Electronic wearables analyzing those parameters might present a convenient alternative to urinary ovulation tests for predicting the fertile window. (2) Methods: We conducted a prospective observational study including women aged 18-45 years without current hormonal therapy who used a wrist-worn medical device and urinary ovulation tests for a minimum of three cycles. We analyzed the accuracy of both the retrospective and prospective algorithms using a generalized linear mixed-effects model. The findings were compared to real-world data from bracelet users who also reported urinary ovulation tests. (3) Results: A total of 61 study participants contributing 205 cycles and 6081 real-life cycles from 3268 bracelet users were included in the analysis. The mean error in identifying ovulation with the wrist-worn medical device retrospective algorithm in the clinical study was 0.31 days (95% CI -0.13 to 0.75). The retrospective algorithm identified 75.4% of fertile days, and the prospective algorithm identified 73.8% of fertile days correctly within the pre-specified equivalence limits (±2 days). The quality of the retrospective algorithm in the clinical study could be confirmed by real-world data. (4) Conclusion: Our data indicate that wearable sensors may be used to accurately detect the periovulatory period.
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Affiliation(s)
- Angela Niggli
- Department of Reproductive Endocrinology, University Hospital of Zürich, Frauenklinikstrasse 10, 8091 Zürich, Switzerland; (M.S.); (B.L.)
- Faculty of Medicine, University of Zurich, 8032 Zurich, Switzerland
| | | | - Maike Sachs
- Department of Reproductive Endocrinology, University Hospital of Zürich, Frauenklinikstrasse 10, 8091 Zürich, Switzerland; (M.S.); (B.L.)
- Faculty of Medicine, University of Zurich, 8032 Zurich, Switzerland
| | - Brigitte Leeners
- Department of Reproductive Endocrinology, University Hospital of Zürich, Frauenklinikstrasse 10, 8091 Zürich, Switzerland; (M.S.); (B.L.)
- Faculty of Medicine, University of Zurich, 8032 Zurich, Switzerland
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Johnson KA, Petrie MA, Shields RK. Biomarkers for rapid H-reflex operant conditioning among females. J Neurophysiol 2023; 129:685-699. [PMID: 36791051 PMCID: PMC10010925 DOI: 10.1152/jn.00188.2022] [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: 05/02/2022] [Revised: 02/05/2023] [Accepted: 02/07/2023] [Indexed: 02/16/2023] Open
Abstract
Operant conditioning of a spinal monosynaptic pathway using the Hoffman reflex (H-reflex) is well established in animal and human studies. There is a subset within the human population (∼20% nonresponders) who are unable to up train this pathway suggesting some distinct or unique identifying characteristics. Importantly, females, who have a nine times higher rate of injury during human performance activities than men, have been understudied in areas of CNS neuroplasticity. Our long-term goal is to understand if innate ability to rapidly up train the H-reflex is predictive of future performance-based injury among females. In this study, we primarily determined whether healthy, young females could rapidly increase the H-reflex within a single session of operant conditioning and secondarily determined if electro-physiological, humoral, cognitive, anthropometric, or anxiety biomarkers distinguished the responders from nonresponders. Eighteen females (mean age: 24) participated in the study. Overall, females showed a group main effect for up training the H-reflex (P < 0.05). Of the cohort, 10 of 18 females met the criteria for up training the H-reflex (responders). The responders showed lower levels of estradiol (P < 0.05). A multivariate stepwise regression model supported that extracellular to intracellular water ratio (ECW/ICW) and H-max/M-max ratio explained 60% of the variation in up training among females. These findings support that females can acutely upregulate the H-reflex with training and that electro-physiological and hormonal factors may be associated with the up training.NEW & NOTEWORTHY Young females who acutely increase their H-reflexes with operant conditioning had lower levels of estradiol. However, the best predictors of those who could up-train the H-reflex were baseline H-reflex excitability (H-max/M-max) and extracellular to intracellular water ratio (ECW/ICW). Future studies are warranted to understand the complex relationship between operant conditioning, human performance, and injury among active young females.
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Affiliation(s)
- Kristin A Johnson
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, Iowa, United States
| | - Michael A Petrie
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, Iowa, United States
| | - Richard K Shields
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, Iowa, United States
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Venter G, van der Berg CL, van der Westhuizen FH, Erasmus E. Health Status Is Affected, and Phase I/II Biotransformation Activity Altered in Young Women Using Oral Contraceptives Containing Drospirenone/Ethinyl Estradiol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010607. [PMID: 34682353 PMCID: PMC8535641 DOI: 10.3390/ijerph182010607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/01/2021] [Accepted: 10/03/2021] [Indexed: 12/21/2022]
Abstract
Combined oral contraceptive (COC) use has been associated with various adverse effects. Formulations containing drospirenone (DRSP) and ethinyl estradiol (EE) are generally regarded as milder COCs. Whether long term use of these pills indeed has a low health risk remains questionable. COC use may affect the biotransformation balance by increasing the toxic load or by interfering with the pharmacokinetics of other drugs. This may negatively impact overall health via the production of toxic biotransformation metabolites and induction of oxidative stress. Although individual enzymes involved in biotransformation are known to be regulated by COCs, the effect of COC use on the overall liver biotransformation efficiency has not been reported. Here, we evaluated the general subjective health status and overall liver biotransformation efficiency of healthy young women who were either long term chronic users of COCs containing DRSP/EE, or who were not using any hormonal products. COC users suffered from moderate to severe fatigue and reported more health-related symptoms. Furthermore, phase I (CYP1A2) activity was reduced whereas phase II conjugation reactions (glucuronide conjugation and glycine conjugation) were increased in COC users. Finally, serum peroxide levels were markedly elevated and antioxidant capacity of plasma was reduced in COC users. COCs containing DRSP/EE may, therefore, adversely affect health status and disturb the balance between phase I and II biotransformation reactions. These effects may be mediated by oxidative stress.
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Affiliation(s)
- Gerda Venter
- Correspondence: (G.V.); (E.E.); Tel.: +27-18-299-1867 (G.V.); +27-18-299-2305 (E.E.)
| | | | | | - Elardus Erasmus
- Correspondence: (G.V.); (E.E.); Tel.: +27-18-299-1867 (G.V.); +27-18-299-2305 (E.E.)
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Capozzi A, Scambia G, Lello S. Clinical pharmacology of progestins. Minerva Obstet Gynecol 2021; 74:364-376. [PMID: 34180615 DOI: 10.23736/s2724-606x.21.04881-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION In this paper, we report general pharmacological profile and major biological activities of natural progesterone (P) and progestins. The aim of this article consists of synthesizing the principal aspects of pharmacology and metabolism of P and progestins related to the clinical consequences of their use. METHODS We review scientific literature on the topic "Progestins", evaluating the most relevant data from original articles, reviews and meta-analyses. EVIDENCE SYNTHESIS Progestins represent a specific class of synthetic analogues of P clinically employed (alone or associated with estrogens) to manage several gynaecological conditions, for instance multiple abortions, luteal phase defect, premenstrual syndrome, abnormal uterine bleeding, endometriosis and menopause (for hormone replacement therapy). Besides their use in the field of contraception, many non-contraceptive benefits of estroprogestins are mostly due to the activities of progestins. Pharmacological characteristics, dosage and individual metabolism could be listed among the principal aspects influencing their clinical effects. CONCLUSIONS The choice of each progestin according to its pharmacological profile is crucial for the appropriate management of any gynaecological condition. An aware knowledge of these compounds is fundamental to hone medical practice.
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Affiliation(s)
- Anna Capozzi
- Department of Women and Child Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy -
| | - Giovanni Scambia
- Department of Women and Child Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Stefano Lello
- Department of Women and Child Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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Carmichael MA, Thomson RL, Moran LJ, Wycherley TP. The Impact of Menstrual Cycle Phase on Athletes' Performance: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1667. [PMID: 33572406 PMCID: PMC7916245 DOI: 10.3390/ijerph18041667] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/05/2021] [Accepted: 02/05/2021] [Indexed: 12/13/2022]
Abstract
The effect of the menstrual cycle on physical performance is being increasingly recognised as a key consideration for women's sport and a critical field for further research. This narrative review explores the findings of studies investigating the effects of menstrual cycle phase on perceived and objectively measured performance in an athletic population. Studies examining perceived performance consistently report that female athletes identify their performance to be relatively worse during the early follicular and late luteal phases. Studies examining objective performance (using anaerobic, aerobic or strength-related tests) do not report clear, consistent effects of the impact of menstrual cycle phase on physical performance. Overall sport performance can be influenced by both perceived and physical factors. Hence, to optimise performance and management of eumenorrheic female athletes, there is a need for further research to quantify the impact of menstrual cycle phase on perceived and physical performance outcomes and to identify factors affecting variability in objective performance outcomes between studies.
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Affiliation(s)
- Mikaeli Anne Carmichael
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, SA 5001, Australia; (R.L.T.); (T.P.W.)
| | - Rebecca Louise Thomson
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, SA 5001, Australia; (R.L.T.); (T.P.W.)
- Adelaide Medical School and Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia;
| | - Lisa Jane Moran
- Adelaide Medical School and Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia;
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, VIC 3168, Australia
| | - Thomas Philip Wycherley
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, SA 5001, Australia; (R.L.T.); (T.P.W.)
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Neri M, Piras B, Paoletti AM, Vallerino V, Corda V, Ronchetti C, Taccori V, Pilloni M, Zedda P, Capobianco G, Dessole S, Melis GB, Mais V. Long-acting reversible contraception (LARC) with the intrauterine system with levonorgestrel (6 mcg/d): observational study on the acceptability, quality of life, and sexuality in Italian women. Gynecol Endocrinol 2018; 34:532-535. [PMID: 29254390 DOI: 10.1080/09513590.2017.1416465] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
This observational study was conducted in healthy premenopausal women, who presented themselves for contraception with an intrauterine system (IUS) releasing LNG (6 mcg/d) (Jaydess®, Bayer, Germany) at the outpatient Family Planning Clinics of the Departments of Obstetrics and Gynaecology of the Universities of Cagliari and Sassari (CA/SS), University-Hospitals of CA/SS (Italy). After a screening visit, 31 women without contraindications to Jaydess® were included in the study. No difficulty in Jaydess® insertion (Ji) was found in 87% of subjects, with pelvic pain (PP) (visual analogic scale, VAS:5.33 ± 2.54) reported by 27/31 subjects at the Ji. Pelvic pain was reported by 17/31 subjects on the first day (VAS: 3.07 ± 3.1), 16/31 subjects on the second day (VAS:2.37 ± 2.71), and 11/31 subjects on the third day (VAS:1.18 ± 2.02) from Ji, with a significant (p < .001) decrease in the intensity. The primary purposes of the study were to evaluate whether a 12-month-treatment (12-M-T) with Jaydess® interferes on either the quality of life (QoL) or sexuality. Jaydess® did not modify either QoL or sexuality in the 25 subjects who completed the 12-M-T. Throughout the 12-M-T, PP, or pregnancies were not found; the menstrual blood loss was significantly (p < .0001) reduced, and the intensity VAS of dysmenorrhea (#14 subjects) significantly (p < .001) improved.
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Affiliation(s)
- Manuela Neri
- a Department of Surgical Sciences , University of Cagliari , Cagliari , Italy
- b Department of Obstetrics and Gynecology , University Hospital of Cagliari (AOUCA) , Cagliari , Italy
| | - Bruno Piras
- a Department of Surgical Sciences , University of Cagliari , Cagliari , Italy
- b Department of Obstetrics and Gynecology , University Hospital of Cagliari (AOUCA) , Cagliari , Italy
| | - Anna Maria Paoletti
- a Department of Surgical Sciences , University of Cagliari , Cagliari , Italy
- b Department of Obstetrics and Gynecology , University Hospital of Cagliari (AOUCA) , Cagliari , Italy
| | - Valerio Vallerino
- a Department of Surgical Sciences , University of Cagliari , Cagliari , Italy
- b Department of Obstetrics and Gynecology , University Hospital of Cagliari (AOUCA) , Cagliari , Italy
| | - Valentina Corda
- a Department of Surgical Sciences , University of Cagliari , Cagliari , Italy
- b Department of Obstetrics and Gynecology , University Hospital of Cagliari (AOUCA) , Cagliari , Italy
| | - Camilla Ronchetti
- a Department of Surgical Sciences , University of Cagliari , Cagliari , Italy
- b Department of Obstetrics and Gynecology , University Hospital of Cagliari (AOUCA) , Cagliari , Italy
| | - Valeria Taccori
- a Department of Surgical Sciences , University of Cagliari , Cagliari , Italy
- b Department of Obstetrics and Gynecology , University Hospital of Cagliari (AOUCA) , Cagliari , Italy
| | - Monica Pilloni
- a Department of Surgical Sciences , University of Cagliari , Cagliari , Italy
- b Department of Obstetrics and Gynecology , University Hospital of Cagliari (AOUCA) , Cagliari , Italy
| | - Pierina Zedda
- a Department of Surgical Sciences , University of Cagliari , Cagliari , Italy
- b Department of Obstetrics and Gynecology , University Hospital of Cagliari (AOUCA) , Cagliari , Italy
| | - Giampiero Capobianco
- c Department of Surgical, Microsurgical and Medical Sciences , University of Sassari , Sassari , Italy
- d Department of Obstetrics and Gynecology , University Hospital of Sassari (AOUSS) , Sassari , Italy
| | - Salvatore Dessole
- c Department of Surgical, Microsurgical and Medical Sciences , University of Sassari , Sassari , Italy
- d Department of Obstetrics and Gynecology , University Hospital of Sassari (AOUSS) , Sassari , Italy
| | - Gian Benedetto Melis
- a Department of Surgical Sciences , University of Cagliari , Cagliari , Italy
- b Department of Obstetrics and Gynecology , University Hospital of Cagliari (AOUCA) , Cagliari , Italy
| | - Valerio Mais
- a Department of Surgical Sciences , University of Cagliari , Cagliari , Italy
- b Department of Obstetrics and Gynecology , University Hospital of Cagliari (AOUCA) , Cagliari , Italy
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Legerlotz K, Bey ME, Götz S, Böhlke N. Constant performance in balance and proprioception tests across the menstrual cycle - a pilot study in well trained female ice hockey players on hormonal contraception. Health Sci Rep 2018; 1:e18. [PMID: 30623036 PMCID: PMC6266417 DOI: 10.1002/hsr2.18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 10/04/2017] [Accepted: 10/16/2017] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION It has yet to be explained why female athletes appear to suffer more often from non-contact ligament injuries during the first half of the menstrual cycle. Fluctuations in balance, caused by impaired proprioception due to increased fluid retention, may be relevant factors contributing to this anomaly in distribution. The aim of this study was therefore to uncover relationships between dynamic stability, proprioception and fluid retention in association with the menstrual cycle as a possible explanation for the observed changes in injury rates. METHODS Nine healthy, female, well trained ice hockey players on hormonal contraception with regular cycles were tested at least twelve times during one menstrual cycle. Bioimpedance analysis was applied to investigate body composition and fluid distribution. A joint position sense test was performed to characterize changes in proprioception, while unexpected perturbations on a balance board were used to obtain measures for dynamic postural control. RESULTS No distinct changes in proprioception, dynamic stability and fluid retention were identified across the menstrual cycle in this population. Weak correlations were found between parameters for dynamic stability and proprioception. CONCLUSION Variations in proprioception, dynamic stability and fluid retention seem unlikely to be major contributors to injury risk peaks, at least in this population of healthy trained athletes using hormonal contraception.
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Affiliation(s)
- Kirsten Legerlotz
- Department of Training and Movement SciencesHumboldt UniversityBerlinGermany
| | - Marie Elena Bey
- Department of Training and Movement SciencesHumboldt UniversityBerlinGermany
| | - Susann Götz
- Division of Training and Movement ScienceUniversity of PotsdamPotsdamGermany
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Neri M, Malune ME, Corda V, Piras B, Zedda P, Pilloni M, Orani MP, Vallerino V, Melis GB, Paoletti AM. Body composition and psychological improvement in healthy premenopausal women assuming the oral contraceptive containing micronized estradiol (E2) and nomegestrol acetate (NOMAC). Gynecol Endocrinol 2017; 33:958-962. [PMID: 28485628 DOI: 10.1080/09513590.2017.1322574] [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] [Indexed: 10/19/2022] Open
Abstract
This observational study was conducted in healthy premenopausal women, who presented themselves for contraceptive advice at the outpatient Family Planning Clinics of the Department of Obstetrics and Gynecology of the University of Cagliari, Hospital-University of Cagliari (Italy). After a screening period of three menstrual cycles, 48 women without contraindications to estroprogestin contraceptives (OCs) were included in the study. The primary purposes of the study were to evaluate whether a 12-month-treatment with the combined OC containing micronized estradiol (1.5 mg, E2) plus nomegestrol acetate (2.5 mg, NOMAC) (E2/NOMAC) interfere on anthropometric indices (AI), body composition (BC) and psychological status (PS). In subjects with dysmenorrhea (#36), its intensity was evaluated using the visuo analogic scale (VAS), both before and during the 12-month-treatment with E2/NOMAC. E2/NOMAC did not modify neither AI nor BC in the 40 subjects who concluded the study. The PS and the VAS of dysmenorrhea were significantly (p < 0.0001) improved from the first cycle of treatment and throughout the E2/NOMAC treatment in comparison with basal values. The study suggests that E2/NOMAC is devoid of negative effects on AI and BC, with additional benefits on PS and dysmenorrhea.
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Affiliation(s)
- Manuela Neri
- a Department of Surgical Sciences , University of Cagliari , Cagliari , Italy and
- b Department of Obstetrics and Gynecology at the University Hospital of Cagliari (AOUCA) , Cagliari , Italy
| | - Maria Elena Malune
- a Department of Surgical Sciences , University of Cagliari , Cagliari , Italy and
- b Department of Obstetrics and Gynecology at the University Hospital of Cagliari (AOUCA) , Cagliari , Italy
| | - Valentina Corda
- a Department of Surgical Sciences , University of Cagliari , Cagliari , Italy and
- b Department of Obstetrics and Gynecology at the University Hospital of Cagliari (AOUCA) , Cagliari , Italy
| | - Bruno Piras
- a Department of Surgical Sciences , University of Cagliari , Cagliari , Italy and
- b Department of Obstetrics and Gynecology at the University Hospital of Cagliari (AOUCA) , Cagliari , Italy
| | - Pierina Zedda
- a Department of Surgical Sciences , University of Cagliari , Cagliari , Italy and
- b Department of Obstetrics and Gynecology at the University Hospital of Cagliari (AOUCA) , Cagliari , Italy
| | - Monica Pilloni
- a Department of Surgical Sciences , University of Cagliari , Cagliari , Italy and
- b Department of Obstetrics and Gynecology at the University Hospital of Cagliari (AOUCA) , Cagliari , Italy
| | - Maria Paola Orani
- a Department of Surgical Sciences , University of Cagliari , Cagliari , Italy and
- b Department of Obstetrics and Gynecology at the University Hospital of Cagliari (AOUCA) , Cagliari , Italy
| | - Valerio Vallerino
- a Department of Surgical Sciences , University of Cagliari , Cagliari , Italy and
- b Department of Obstetrics and Gynecology at the University Hospital of Cagliari (AOUCA) , Cagliari , Italy
| | - Gian Benedetto Melis
- a Department of Surgical Sciences , University of Cagliari , Cagliari , Italy and
- b Department of Obstetrics and Gynecology at the University Hospital of Cagliari (AOUCA) , Cagliari , Italy
| | - Anna Maria Paoletti
- a Department of Surgical Sciences , University of Cagliari , Cagliari , Italy and
- b Department of Obstetrics and Gynecology at the University Hospital of Cagliari (AOUCA) , Cagliari , Italy
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Geronikolou SA, Bacopoulou F, Cokkinos D. Bioimpedance Measurements in Adolescents with Polycystic Ovary Syndrome: A Pilot Study. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 987:291-299. [PMID: 28971467 DOI: 10.1007/978-3-319-57379-3_26] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Limited data are available on the body composition of adolescent women with polycystic ovary syndrome (PCOS). The aim of this study was to examine differences in body composition indices of metabolism, homeostasis and inflammation, between Greek adolescent females suffering from PCOS and age- and body mass index (BMI)-matched non-PCOS controls. Thirteen PCOS patients and nine non-PCOS controls, aged 13-24 years participated in this cross-sectional study. Study participants underwent assessment by a novel dual frequency bioimpedance device (BIA-ACC). The following body composition indices were measured in each adolescent: extra cellular water (ECW) as inflammation marker, total body water (TBW) as homeostasis marker, extracellular mass to body cell mass ratio (ECM/BCM), fat mass (FM), fat-free mass (FFM) and intracellular water (ICW) as markers of body mass composition and metabolism. Non-linear analysis showed no statistically significant differences in the body composition characteristics between PCOS patients and controls. Further studies with larger sample sizes are needed to confirm whether adolescents with PCOS actually have similar body composition profile with their non-PCOS peers.
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Affiliation(s)
- Styliani A Geronikolou
- Clinical, Translational and Experimental Surgery Research Centre, Biomedical Research Foundation of Academy of Athens, 4 Soranou Ephessiou Street, 11527, Athens, Greece.
| | - Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, 3 Thivon Street, 11527, Athens, Greece
| | - Dennis Cokkinos
- Clinical, Translational and Experimental Surgery Research Centre, Biomedical Research Foundation of Academy of Athens, 4 Soranou Ephessiou Street, 11527, Athens, Greece
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De Leo V, Musacchio MC, Cappelli V, Piomboni P, Morgante G. Hormonal contraceptives: pharmacology tailored to women's health. Hum Reprod Update 2016; 22:634-46. [PMID: 27307386 DOI: 10.1093/humupd/dmw016] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 01/29/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND In recent years, several new oral contraceptives have become available. In some ways, they represent an evolution in terms of individualization and compliance on the part of women. The new formulations make it increasingly possible to prescribe a specific hormonal contraceptive on an individual basis. METHODS A systematic literature search of PubMed was performed using the following combination of terms: 'oral contraceptives', 'estroprogestins' and 'combined oral contraceptive'. Only English-language papers published between January 2000 and July 2014 were included in our analysis. The present review analyzes all aspects of the choice of oral contraceptives in the different phases of a woman's life in detail. RESULTS Regarding the estrogen component, lowering the dose of ethinylestradiol (EE) helped reduce associated side effects. Natural estradiol is now available and represents a valid alternative to EE. And regarding progestins, the dose has changed over time, as well as the endocrine and metabolic characteristics. These are the fruit of much research into improvement of old products (19-nor-progesterone-derived progestins) with androgenic effects and testing of new molecules with improved metabolic neutrality in terms of insulin sensitivity and lipid parameters. New progestins were a genuine turning point because they greatly reduced major side effects, such as water retention, and their anti-androgenic properties made them indicated for all forms of hyperandrogenism associated with acne and mild hirsutism. The associations of estradiol/dienogest and estradiol/nomegestrol acetate are the most suitable contraceptives for women with abundant menstrual bleeding and can increase the number of potential users of hormonal contraception. CONCLUSION Progress in the provision of new oral contraceptives has improved the risk/benefit ratio, by increasing benefits and reducing risks. The present challenge is to tailor contraceptives to individual needs in terms of efficacy and protection of reproductive health.
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Affiliation(s)
- Vincenzo De Leo
- Department of Molecular and Developmental Medicine, University of Siena, Policlinico Le Scotte, Viale Bracci 14, 53100 Siena, Italy
| | - Maria Concetta Musacchio
- Department of Molecular and Developmental Medicine, University of Siena, Policlinico Le Scotte, Viale Bracci 14, 53100 Siena, Italy
| | - Valentina Cappelli
- Department of Molecular and Developmental Medicine, University of Siena, Policlinico Le Scotte, Viale Bracci 14, 53100 Siena, Italy
| | - Paola Piomboni
- Department of Molecular and Developmental Medicine, University of Siena, Policlinico Le Scotte, Viale Bracci 14, 53100 Siena, Italy
| | - Giuseppe Morgante
- Department of Molecular and Developmental Medicine, University of Siena, Policlinico Le Scotte, Viale Bracci 14, 53100 Siena, Italy
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Sex differences in the pharmacokinetics of antidepressants: influence of female sex hormones and oral contraceptives. Clin Pharmacokinet 2015; 53:509-19. [PMID: 24859034 DOI: 10.1007/s40262-014-0145-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Women are twice as likely to develop depression as men. Moreover, the symptoms they experience also show sex differences: women tend to develop depression at an earlier age and show more severe symptoms than men. Likewise, the response to antidepressant pharmacotherapy appears to have sex differences. These differences can partially be explained by differences in pharmacokinetic properties (i.e., absorption, distribution, metabolism, and excretion) of drugs in males and females. More recent research has shown that sex hormones may influence all these previously named pharmacokinetic processes. As concentrations of sex hormones vary throughout the female lifespan, these hormonal variations can have effects on therapeutic responses to antidepressants as well as the occurrence of adverse events. The purpose of this paper is therefore to review the literature reporting on the effects of female sex hormones on the pharmacokinetics of antidepressants and to discuss and evaluate the implications of changes in levels of sex hormones throughout life for the treatment of depression.
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Grandi G, Piacenti I, Volpe A, Cagnacci A. Modification of body composition and metabolism during oral contraceptives containing non-androgenic progestins in association with estradiol or ethinyl estradiol. Gynecol Endocrinol 2014; 30:676-80. [PMID: 24918262 DOI: 10.3109/09513590.2014.922947] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
AIM To observe the influence on metabolism and body composition of two oral contraceptives containing non-androgenic progestins in association with estradiol or ethinyl estradiol (EE). STUDY DESIGN Women on hormonal contraception with estradiol valerate (E2V)/dienogest (DNG) in a quadriphasic regimen (n = 16) or 30 μg EE/2 mg chlormadinone acetate (CMA) (n = 16) in a monophasic regimen were evaluated at the third cycle for modifications in lipoproteins, apoproteins and homeostatic model assessment for insulin resistance (HOMA-IR), and at the sixth cycle for body composition and the markers of bone turnover osteocalcin and C-telopeptide X. RESULTS During E2V/DNG lipoprotein, apoproteins and HOMA-IR remained stable. During EE/CMA, total-cholesterol (p = 0.003), high-density lipoprotein (HDL)-cholesterol (p = 0.001), triglycerides (p = 0.003) Apoprotein-A1 (Apo-A1; p = 0.001) and Apo B (p = 0.04) increased, low-density lipoprotein/HDL (p = 0.039) decreased and total-cholesterol/HDL and Apoprotein-B/Apo-A1 ratio did not vary. HOMA-IR slightly increased from 1.33 ± 0.87 to 1.95 ± 0.88 (p = 0.005). There was a reduction of markers of bone metabolism in both groups with no modification of body composition. CONCLUSIONS Administration of E2V/DNG does not influence lipid and glucose metabolism, while mixed effect are exerted by EE/CMA. Both preparations reduce bone metabolism without influencing short-term effect on body composition.
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Affiliation(s)
- Giovanni Grandi
- Department of Obstetrics Gynecology and Pediatrics, Obstetrics and Gynecology Unit, Azienda Policlinico of Modena , Modena , Italy
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Finan R, Annab AW, Abdalla S, Bedran F, El-Zibdeh M, Shahen L, Gerlinger C, Solomayer E, Ertan K, Endrikat J. A drospirenone-containing oral contraceptive improved bleeding pattern and personal satisfaction in 914 women from Jordan, Lebanon and Syria. Health (London) 2013. [DOI: 10.4236/health.2013.57a4006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Anzai Y, Heger-Mahn D, Schellschmidt I, Marr J. Suppression of ovarian activity with a low-dose 21/7-day regimen oral contraceptive containing ethinylestradiol 20 mcg/drospirenone 3 mg in Japanese and Caucasian women. Contraception 2012; 86:28-34. [PMID: 22402257 DOI: 10.1016/j.contraception.2011.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Revised: 10/27/2011] [Accepted: 11/01/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND Two studies assessed the effect of a low-estrogen-dose 21/7-day oral contraceptive containing ethinylestradiol and drospirenone (EE 20 mcg/drsp 3 mg) on ovarian activity in Japanese and Caucasian women. STUDY DESIGN Study 1 was conducted in Japanese women (20-35 years), and Study 2 was conducted in Caucasian women (18-35 years). All women received EE 20 mcg/drsp 3 mg in a 21-day active pill regimen. The primary endpoint was the proportion of women with ovulation inhibition (Hoogland score <6; as assessed by transvaginal ultrasonography) during treatment cycle 2. RESULTS Japanese (n=23) and Caucasian (n=30) women received two cycles of study treatment. During treatment cycle 2, ovulation was inhibited in 100% and 92.9% of Japanese and Caucasian women, respectively. CONCLUSIONS EE 20 mcg/drsp 3 mg in a 21/7-day regimen provides comparable ovarian suppression in Japanese and Caucasian women, with normal ovarian function resuming shortly after treatment end in both populations.
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Affiliation(s)
- Yuzuru Anzai
- Department of Obstetrics and Gynecology, NYU-Langone Medical Center, New York 10017, USA.
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16
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Fruzzetti F. Beyaz®: An Oral Contraceptive Fortified with Folate. WOMENS HEALTH 2012; 8:13-9. [DOI: 10.2217/whe.11.68] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Beyaz® (Bayer Healthcare Pharmaceuticals, Berlin, Germany) consists of 28 film-coated tablets: 24 tablets each containing 3 mg drospirenone plus 20 µg ethinylestradiol (EE) and 451 µg levomefolate calcium followed by four tablets, each containing 451 µg levomefolate calcium. It has the same indications of the parent compound 20 µg EE/3 mg drospirenone in a 24/4-day regimen (i.e., contraception, moderate acne, premenstrual dysforic disorder). In addition, the 24-day regimen with 20 µg EE/3 mg drospirenone/levomefolate calcium assure significant increases in red blood cell and plasma folate levels reaching values indicated to be protective in reducing the risk of neural tube defects. A progressive decrease in folate levels has been observed in women taking a 30 µg EE pill fortified with the same dose of levomefolate calcium upon discontinuation. At 4 and 8 weeks following cessation of the oral contraceptive, red blood cell folate levels >906 nmol/l were measured in 85 and 60% of women respectively. Because of this, the folate-containing pill may aid in reducing the risk of neural tube defects in a pregnancy conceived during use or shortly after the discontinuation of the product.
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Affiliation(s)
- Franca Fruzzetti
- Department of Obstetrics & Gynecology, Santa Chiara Hospital, via Roma 35, 56100 Pisa, Italy, Tel.: +39 328 783 5816,
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Tepper NK, Paulen ME, Marchbanks PA, Curtis KM. Safety of contraceptive use among women with peripartum cardiomyopathy: a systematic review. Contraception 2010; 82:95-101. [DOI: 10.1016/j.contraception.2010.02.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2010] [Accepted: 02/02/2010] [Indexed: 11/16/2022]
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Efficacy and safety of a low-dose combined oral contraceptive containing drospirenone 3 mg and ethinylestradiol 20 mcg in a 24/4-day regimen. Contraception 2009; 80:18-24. [PMID: 19501211 DOI: 10.1016/j.contraception.2009.01.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2008] [Revised: 01/23/2009] [Accepted: 01/28/2009] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The study was conducted to assess the efficacy of a low-dose combined oral contraceptive (COC) containing drospirenone (drsp) 3 mg/ethinylestradiol (EE) 20 mcg administered for 24 days of active treatment followed by a 4-day hormone-free interval (24/4 regimen). STUDY DESIGN In this open-label uncontrolled study conducted in 50 European centers, healthy females aged 18-35 years with a body mass index of less than 30 kg/m(2) received drsp 3 mg/EE 20 mcg 24/4 over 13 cycles. The primary efficacy variable was the number of unintended pregnancies. RESULTS Five pregnancies occurred among 1101 women over 13,248 treatment cycles, resulting in a Pearl Index (PI) of 0.49 with an upper two-sided 95% CI limit of 1.14. Of these pregnancies, three were attributed to noncompliance with tablet use resulting in an adjusted PI for 'perfect use' of 0.22 (upper limit of two-sided 95% CI: 0.80) based on 11,755 cycles. CONCLUSION Drospirenone 3 mg/EE 20 mcg 24/4 is a highly effective COC in nonobese women.
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Endrikat JS, Milchev NP, Kapamadzija A, Georgievska J, Gerlinger C, Schmidt W, Feroze S. Bleeding pattern, tolerance and patient satisfaction with a drospirenone-containing oral contraceptive evaluated in 3488 women in Europe, the Middle East and Canada. Contraception 2009; 79:428-32. [PMID: 19442777 DOI: 10.1016/j.contraception.2008.12.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2008] [Revised: 12/19/2008] [Accepted: 12/20/2008] [Indexed: 01/28/2023]
Abstract
BACKGROUND This study was conducted to assess the bleeding pattern, tolerance and patient satisfaction associated with an oral contraceptive (OC) containing 3 mg of drospirenone and 30 mcg of ethinyl estradiol under real-life conditions. STUDY DESIGN A multicenter, prospective and observational six-cycle study was conducted in 12 countries in Europe, the Middle East and Canada. The efficacy variables included an assessment of bleeding patterns, premenstrual symptoms of water retention and patient satisfaction as determined by a visual analog scale. RESULTS A total of 3488 women was enrolled in the study. The percentage of women with intermenstrual bleeding decreased from 27.9% at baseline to 5.4% at the end of Cycle 6, while dysmenorrhea decreased from 67% to 17.7%. Also, amenorrhea decreased from 21.3% to 7.5%. The decreases in all three parameters were statistically significant (p<.0001). Approximately 70% of the women reported abdominal bloating and/or breast tenderness at baseline and less than 38% did so at the end of Cycle 6 (p<.0001). Patient satisfaction increased for all investigated items. Upon completion of the study, 86.2% of the women answered "yes" to continuing treatment with this OC. CONCLUSION The OC containing 3 mg of drospirenone and 30 mcg of ethinyl estradiol has beneficial effects on bleeding pattern, symptoms of water retention and patient satisfaction.
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Evidence that in healthy young women, a six-cycle treatment with oral contraceptive containing 30 mcg of ethinylestradiol plus 2 mg of chlormadinone acetate reduces fat mass. Contraception 2009; 79:117-21. [DOI: 10.1016/j.contraception.2008.08.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2008] [Revised: 08/26/2008] [Accepted: 08/26/2008] [Indexed: 01/10/2023]
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Bitzer J, Paoletti AM. Added Benefits and User Satisfaction with a Low-Dose Oral Contraceptive Containing Drospirenone. Clin Drug Investig 2009; 29:73-8. [DOI: 10.2165/0044011-200929020-00001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Piccoli A, Crosignani P, Nappi C, Ronsini S, Bruni V, Marelli S. Effect of the ethinylestradiol/norelgestromin contraceptive patch on body composition. Results of bioelectrical impedance analysis in a population of Italian women. Nutr J 2008; 7:21. [PMID: 18727825 PMCID: PMC2557005 DOI: 10.1186/1475-2891-7-21] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2008] [Accepted: 08/26/2008] [Indexed: 02/02/2023] Open
Abstract
Background As weight gain is one of the most frequently cited reasons for not using and for discontinuing hormonal contraceptives, in an open-label, single-arm, multicentre clinical study we evaluated the effect of the ethinylestradiol/norelgestromin contraceptive patch (EVRA, Janssen-Cilag International, Belgium) on body composition using bioelectrical impedance analysis (BIA). Methods Body weight and impedance vector components (resistance (R) and reactance (Xc), at 50 kHz frequency, Akern-RJL Systems analyzer) were recorded before entry, after 1, 3 and 6 months in 182 Italian healthy women aged 29 yr (18 to 45), and with BMI 21.8 kg/m2 (16 to 31). Total body water (TBW) was estimated with a BIA regression equation. Vector BIA was performed with the RXc mean graph method and the Hotelling's T2 test for paired and unpaired data. Results After 6 months body weight increased by 0.64 kg (1.1%) and TBW increased by 0.51 L (1.7%). The pattern of impedance vector displacement indicated a small increase in soft tissue hydration (interstitial gel fluid). Body composition changes did not significantly differ among groups of previous contraceptive methods. Arterial blood pressure did not significantly change over time. Conclusion After 6 months of treatment with the ethinylestradiol/norelgestromin contraceptive patch we found a minimal, clinically not relevant, increase in body weight less than 1 kg that could be attributed to an adaptive interstitial gel hydration. This fluctuation is physiological as confirmed by the lack of any effect on blood pressure. This could be useful in increasing women's choice, acceptability and compliance of the ethinylestradiol/norelgestromin contraceptive patch.
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Affiliation(s)
- Antonio Piccoli
- Department of Medical and Surgical Sciences, University of Padova, Italy.
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Sims ST, Rehrer NJ, Bell ML, Cotter JD. Endogenous and exogenous female sex hormones and renal electrolyte handling: effects of an acute sodium load on plasma volume at rest. J Appl Physiol (1985) 2008; 105:121-7. [PMID: 18436693 DOI: 10.1152/japplphysiol.01331.2007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study was conducted to investigate effects of an acute sodium load on resting plasma volume (PV) and renal mechanisms across the menstrual cycle of endurance-trained women with natural (NAT) or oral contraceptive pill (OCP) controlled cycles. Twelve women were assigned to one of two groups, according to their usage status: 1) OCP [ n = 6, 29 yr (SD 6), 59.4 kg (SD 3.2)], or 2) NAT [ n = 6, 24 yr (SD 5), 61.3 kg (SD 3.6)]. The sodium load was administered as a concentrated sodium chloride/citrate beverage (164 mmol Na+/l, 253 mosmol/kgH2O, 10 ml/kg body mass) during the last high-hormone week of the OCP cycle (OCPhigh) or late luteal phase of the NAT cycle (NAThigh) and during the low-hormone sugar pill week of OCP (OCPlow) or early follicular phase of the NAT cycle (NATlow). The beverage (∼628 ml) was ingested in seven portions across 60 min. Over the next 4 h, PV expanded more in the low-hormone phase for both groups (time-averaged change): OCPlow 6.1% (SD 1.1) and NATlow 5.4% (SD 1.2) vs. OCPhigh 3.9% (SD 0.9) and NAThigh 3.5% (SD 0.8) ( P = 0.02). The arginine vasopressin increased less in the low-hormone phase [1.63 (SD 0.2) and 1.30 pg/ml (SD 0.2) vs. 1.82 (SD 0.3) and 1.57 pg/ml (SD 0.5), P = 0.0001], as did plasma aldosterone concentration (∼64% lower, P = 0.0001). Thus PV increased more and renal hormone sensitivity was decreased in the low-hormone menstrual phase following sodium/fluid ingestion, irrespective of OCP usage.
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Pérez-López FR. Clinical experiences with drospirenone: From reproductive to postmenopausal years. Maturitas 2008; 60:78-91. [DOI: 10.1016/j.maturitas.2008.03.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Revised: 03/17/2008] [Accepted: 03/26/2008] [Indexed: 10/22/2022]
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Gregoriou O, Papadias K, Konidaris S, Bakalianou K, Salakos N, Vrachnis N, Creatsas G. Treatment of hirsutism with combined pill containing drospirenone. Gynecol Endocrinol 2008; 24:220-3. [PMID: 18382909 DOI: 10.1080/09513590801948309] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
The aim of the present study was to evaluate the biochemical and clinical effects of the combined pill consisting of ethinyl estradiol (EE) and drospirenone (DRSP) in hirsute patients. Fifty-two adolescents or young women from Greece were treated with 30 mug EE and 3 mg DRSP for 1 year. Hirsutism was evaluated by the Ferriman-Gallway (FG) score in the initial visit and at 3, 6 and 12 months. Follicle-stimulating hormone, luteinizing hormone, etradiol, free and total testosterone (T), sex hormone-binding globulin (SHBG), androstenedione and dehydroepiandrosterone sulfate were determined at the same intervals. Hirsutism improved and FG scores reduced to 77.4%, 67.2% and 51.8% at 3, 6 and 12 months, respectively. Plasma SHBG levels rose, while free and total T levels reduced from the third month onwards. In conclusion, the EE/DRSP pill improves hirsutism in women via antiandrogenic and antimineralocorticoid action. The biochemical manifestations of hyperandrogenism are also improved.
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Affiliation(s)
- Odisseas Gregoriou
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, University of Athens Medical School, Athens, Greece
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Fruzzetti F, Lazzarini V, Ricci C, Quirici B, Gambacciani M, Paoletti AM, Genazzani AR. Effect of an oral contraceptive containing 30 microg ethinylestradiol plus 3 mg drospirenone on body composition of young women affected by premenstrual syndrome with symptoms of water retention. Contraception 2007; 76:190-4. [PMID: 17707715 DOI: 10.1016/j.contraception.2007.05.080] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2007] [Revised: 04/17/2007] [Accepted: 05/01/2007] [Indexed: 01/10/2023]
Abstract
PURPOSE This study was conducted to evaluate body weight and composition during oral contraception with 30 microg ethinylestradiol plus 3 mg drospirenone (30EE+DRSP) in women affected by premenstrual syndrome (PMS) with somatic symptoms related to water retention. DESIGN This prospective study was performed using multifrequency bioelectrical impedance analysis in 18 normally cycling PMS patients (mean age, 28.8 years) evaluated at baseline, during the luteal phase of the menstrual cycle and after 3 and 6 cycles of 30EE+DRSP. Total body water (TBW), intracellular water (ICW), extracellular water (ECW), fat mass and fat-free mass were evaluated. Body weight, waist-to-hip ratio and blood pressure were also determined at each visit. Basal values were compared with those measured in 31 healthy females without PMS (controls). RESULTS PMS patients have higher levels of TBW and ICW than controls. After 6 months of 30EE+DRSP, TBW and ECW were significantly lower than before treatment. No significant variations in ICW or in the other parameters were observed. CONCLUSION In women with PMS, 30EE+DRSP reduces the concentrations in TBW and ECW. This effect is likely due to the antimineralocorticoid activity of DRSP. Whether these changes may account for the improvement of premenstrual fluid-related symptoms reported with this formulation is discussed.
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Affiliation(s)
- Franca Fruzzetti
- Department of Obstetrics and Gynecology, University of Pisa, Via Roma 67, 56100 Pisa, Italy.
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