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Vegunta S, Houston LE, Nicholson NA, David PS. Counseling Women About Sexual Health Effects of Contraceptives. J Womens Health (Larchmt) 2024. [PMID: 38848279 DOI: 10.1089/jwh.2023.0625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
Background: Choosing a contraceptive method is a pivotal decision for patients, whereas health care professionals (HCPs) face challenges in providing suitable recommendations. Adverse sexual effects often lead to dissatisfaction and discontinuation of contraceptives, underscoring the importance of thorough counseling and shared decision making between HCPs and patients. Objective: This article aims to investigate the relationship between contraceptive methods and female sexual function through a comprehensive review of available literature, emphasizing the importance of considering sexual health in contraceptive prescription and management. Methods: A systematic analysis of existing literature, incorporating studies utilizing validated sexual health questionnaires, was conducted to elucidate the intricate interplay between contraceptives and female sexual function. Results: The review encompasses various contraceptive methods, including combined hormonal contraceptives, progestin-only pills, depot medroxyprogesterone acetate, subdermal contraceptive implants, hormonal intrauterine devices, permanent sterilization, and barrier methods. Insights gleaned from the analysis shed light on the impact of these methods on female sexual health. Conclusion: Comprehensive understanding of the effects of contraceptives on female sexual function is crucial for both HCPs and patients. By integrating sexual health considerations into contraceptive surveillance, compliance can be improved, contraceptive efficacy optimized, and the risk of unwanted pregnancies minimized. This review underscores the significance of tailored counseling and shared decision making in contraceptive management, particularly for cisgender women.
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Affiliation(s)
- Suneela Vegunta
- Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, Arizona, USA
| | - Lisa E Houston
- Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, Arizona, USA
| | - Nicola A Nicholson
- Department of Medical and Surgical Gynecology, Mayo Clinic Hospital, Phoenix, Arizona, USA
| | - Paru S David
- Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, Arizona, USA
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Coelingh Bennink HJT, Schultz IJ, Schmidt M, Jordan VC, Briggs P, Egberts JFM, Gemzell-Danielsson K, Kiesel L, Kluivers K, Krijgh J, Simoncini T, Stanczyk FZ, Langer RD. Progesterone from ovulatory menstrual cycles is an important cause of breast cancer. Breast Cancer Res 2023; 25:60. [PMID: 37254150 DOI: 10.1186/s13058-023-01661-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/22/2023] [Indexed: 06/01/2023] Open
Abstract
Many factors, including reproductive hormones, have been linked to a woman's risk of developing breast cancer (BC). We reviewed the literature regarding the relationship between ovulatory menstrual cycles (MCs) and BC risk. Physiological variations in the frequency of MCs and interference with MCs through genetic variations, pathological conditions and or pharmaceutical interventions revealed a strong link between BC risk and the lifetime number of MCs. A substantial reduction in BC risk is observed in situations without MCs. In genetic or transgender situations with normal female breasts and estrogens, but no progesterone (P4), the incidence of BC is very low, suggesting an essential role of P4. During the MC, P4 has a strong proliferative effect on normal breast epithelium, whereas estradiol (E2) has only a minimal effect. The origin of BC has been strongly linked to proliferation associated DNA replication errors, and the repeated stimulation of the breast epithelium by P4 with each MC is likely to impact the epithelial mutational burden. Long-lived cells, such as stem cells, present in the breast epithelium, can carry mutations forward for an extended period of time, and studies show that breast tumors tend to take decades to develop before detection. We therefore postulate that P4 is an important factor in a woman's lifetime risk of developing BC, and that breast tumors arising during hormonal contraception or after menopause, with or without menopausal hormone therapy, are the consequence of the outgrowth of pre-existing neoplastic lesions, eventually stimulated by estrogens and some progestins.
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Affiliation(s)
| | - Iman J Schultz
- Pantarhei Bioscience BV, P.O. Box 464, 3700 AL, Zeist, The Netherlands
| | - Marcus Schmidt
- Department of Obstetrics and Gynaecology, University Medical Center Mainz, Mainz, Germany
| | - V Craig Jordan
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Paula Briggs
- Sexual and Reproductive Health, Liverpool Women's NHS Foundation Trust, Liverpool, UK
| | | | | | - Ludwig Kiesel
- Department of Gynaecology and Obstetrics, University of Münster, Münster, Germany
| | - Kirsten Kluivers
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Jan Krijgh
- Pantarhei Bioscience BV, P.O. Box 464, 3700 AL, Zeist, The Netherlands
| | - Tommaso Simoncini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Frank Z Stanczyk
- Department of Obstetrics and Gynaecology, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Robert D Langer
- Department of Family Medicine and Public Health, University of California San Diego School of Medicine, San Diego, CA, USA
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Simon JA, Kingsberg SA, Portman D, Jordan R, Lucas J, Sadiq A, Krop J, Clayton AH. Prespecified and Integrated Subgroup Analyses from the RECONNECT Phase 3 Studies of Bremelanotide. J Womens Health (Larchmt) 2022; 31:391-400. [DOI: 10.1089/jwh.2021.0225] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- James A. Simon
- George Washington University and IntimMedicine® Specialists, Inc., Washington, District of Columbia, USA
| | - Sheryl A. Kingsberg
- Department of Reproductive Biology and Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | | | - Robert Jordan
- Palatin Technologies, Inc., Cranbury, New Jersey, USA
| | - Johna Lucas
- Palatin Technologies, Inc., Cranbury, New Jersey, USA
| | - Amama Sadiq
- AMAG Pharmaceuticals, Inc., Waltham, Massachusetts, USA
| | - Julie Krop
- AMAG Pharmaceuticals, Inc., Waltham, Massachusetts, USA
| | - Anita H. Clayton
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia, USA
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Greenfield AM, Charkoudian N, Alba BK. Influences of ovarian hormones on physiological responses to cold in women. Temperature (Austin) 2021; 9:23-45. [DOI: 10.1080/23328940.2021.1953688] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Andrew Martin Greenfield
- Thermal & Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
- Oak Ridge Institute of Science and Education, Belcamp, MD, USA
| | - Nisha Charkoudian
- Thermal & Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Billie Katherine Alba
- Thermal & Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
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Elevated plasma oxytocin levels and higher satisfaction with life in young oral contraceptive users. Sci Rep 2020; 10:8208. [PMID: 32427955 PMCID: PMC7237451 DOI: 10.1038/s41598-020-64528-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 04/14/2020] [Indexed: 01/07/2023] Open
Abstract
Oral contraception (OC) is used by approximately fifty-five million women in the USA alone and is listed as an essential medicine by the World Health Organisation. Altered mood is a common reason for OC cessation. Here we investigate the effects of OC on hormones that are linked to mood. We obtained blood samples from 185 young women (average age 21.2) in two cohorts and tested the effects of OC on plasma levels of oxytocin, adrenocorticotropic hormone (ACTH), estradiol, progesterone and testosterone. We related plasma hormone levels with self-reported measures of mood, well-being and depression. OC-users in both cohorts showed elevated basal oxytocin, lower ACTH, estradiol, progesterone and testosterone compared with non-OC users. Satisfaction With Life Score (SWLS) was higher in OC -users compared to non-OC users, with no differences in the Beck Depression Score (BDI) and Positive And Negative Affect Schedule (PANES). In conclusion, our data show alterations in hormone levels and SWLS in response to OC.
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Mackay K, González C, Zbinden-Foncea H, Peñailillo L. Effects of oral contraceptive use on female sexual salivary hormones and indirect markers of muscle damage following eccentric cycling in women. Eur J Appl Physiol 2019; 119:2733-2744. [PMID: 31686212 DOI: 10.1007/s00421-019-04254-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/31/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine the effects of oral contraceptive (OC) use on salivary concentrations of testosterone, estrogen, progesterone, and its effects on the changes in indirect markers of muscle damage following eccentric cycling in women. METHODS 10 oral contraceptive users at follicular phase (OC-FOL), 10 non-oral contraceptives users at follicular phase (NOC-FOL), and 10 non-oral contraceptives users at ovulation phase (NOC-OV) participated. Subjects performed 30 min of eccentric cycling at 90% of their maximal concentric power output (PO). Maximal voluntary isometric contraction (MVC), creatine kinase activity (CK), muscle soreness (SOR), and pain pressure threshold of vastus lateralis (PPT-VL) was assessed before, immediately after, and 24-96 h after cycling. Salivary estrogen, progesterone and testosterone concentrations were measured before, 72 and 96 h after exercise. RESULTS No difference in estrogen levels between users and non-users was observed. Testosterone was 45% lower in OC-FOL than NOC-FOL at 96 h post-exercise (P = 0.01). Progesterone was 30.8-fold higher in NOC-OV than OC-FOL and 9.7-fold higher than NOC-FOL at 96 h post-exercise. The NOC-FOL recovered all indirect markers of muscle damage by 72 h post-exercise (P > 0.05). NOC-OV recovered MVC strength and muscle soreness (SOR and PPT-VL) by 96 h post-exercise (P > 0.05). OC-FOL did not recover baseline values of MVC, SOR, CK, and PPT-VL by 96 h. CONCLUSION These results suggest that recovery after exercise-induced muscle damage took longer in OC-FOL, followed by NOC-OV and by NOC-FOL, respectively. Furthermore, testosterone and progesterone levels may affect recovery of indirect markers of muscle damage in women.
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Affiliation(s)
- Karen Mackay
- Exercise Science Laboratory, School of Kinesiology, Finis Terrae University, 1509 Pedro de Valdivia Av., Providencia, Santiago, Chile
| | - Cristopher González
- Exercise Science Laboratory, School of Kinesiology, Finis Terrae University, 1509 Pedro de Valdivia Av., Providencia, Santiago, Chile
| | - Hermann Zbinden-Foncea
- Exercise Science Laboratory, School of Kinesiology, Finis Terrae University, 1509 Pedro de Valdivia Av., Providencia, Santiago, Chile
| | - Luis Peñailillo
- Exercise Science Laboratory, School of Kinesiology, Finis Terrae University, 1509 Pedro de Valdivia Av., Providencia, Santiago, Chile.
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Laan ETM, Prins JM, van Lunsen RHW, Nieuwkerk PT, Nievaard-Boon MAF. Testosterone Insufficiency in Human Immunodeficiency Virus-Infected Women: A Cross-Sectional Study. Sex Med 2018; 7:72-79. [PMID: 30522976 PMCID: PMC6377426 DOI: 10.1016/j.esxm.2018.10.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 09/20/2018] [Accepted: 10/18/2018] [Indexed: 12/12/2022] Open
Abstract
Introduction Now that HIV infection has become a chronic disease, optimizing health status is an important goal of care for HIV-infected patients. Testosterone insufficiency (TI) can compromise health status, but little is known about the prevalence of TI and possible related factors in HIV-infected women. Aim To investigate the prevalence of TI among HIV-infected women attending our HIV outpatient clinic, and to study the relationship between TI and sexual function, fatigue, health status, and depression. Methods 56 HIV-infected women aged ≥18 years who attended the HIV outpatient clinic of the Amsterdam University Medical Center, The Netherlands, were included. Blood samples were taken for endocrinologic testing and patients filled out 6 validated questionnaires measuring sexual function, fatigue, health, and depression. Main Outcome Measure TI, the Female Sexual Function Index, the Female Sexual Distress Scale-Revised, the Multidimensional Fatigue Inventory, the Medical Outcomes Studies Short Form 36-item health survey, and the Beck Depression Inventory were assessed. Results A relatively high prevalence of TI, 37%, was found. Plasma viral load and CD4 cell count did not differ between women with or without TI. Clinical fatigue, physical fatigue, and impaired cognitive function were significantly more prevalent in women with TI. Women with TI also tended to report decreased sexual desire, reduced physical activity, increased mental fatigue, reduced physical function, increased health distress, and clinical depression. Conclusion We recommend that in all HIV-positive women with complaints typical for TI, testosterone is measured, and that in women with TI, testosterone replacement be considered as a treatment option. However, given that complaints are also prevalent in HIV-positive women without TI, the approach to women with these complaints should include sexual and psychological evaluation. Laan ETM, Prins JM, van Lunsen RHW, et al. Testosterone Insufficiency in Human Immunodeficiency Virus–Infected Women: A Cross-Sectional Study. Sex Med 2019;7:72–79.
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Affiliation(s)
- Ellen T M Laan
- Department of Sexology & Psychosomatic Obstetrics/Gynecology, Amsterdam University Medical Center, The Netherlands.
| | - Jan M Prins
- Department of Internal Medicine, Tropical Medicine and AIDS, Amsterdam University Medical Center, The Netherlands
| | - Rik H W van Lunsen
- Department of Sexology & Psychosomatic Obstetrics/Gynecology, Amsterdam University Medical Center, The Netherlands
| | - Pythia T Nieuwkerk
- Department of Medical Psychology, Amsterdam University Medical Center, The Netherlands
| | - Marian A F Nievaard-Boon
- Department of Sexology & Psychosomatic Obstetrics/Gynecology, Amsterdam University Medical Center, The Netherlands
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8
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Neuroendocrine and inflammatory responses to DHEA administration in young healthy women. Pharmacol Biochem Behav 2018; 175:19-23. [DOI: 10.1016/j.pbb.2018.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/02/2018] [Accepted: 09/03/2018] [Indexed: 12/12/2022]
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9
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van Lunsen RH, Zimmerman Y, Coelingh Bennink HJ, Termeer HM, Appels N, Fauser BC, Laan E. Maintaining physiologic testosterone levels during combined oral contraceptives by adding dehydroepiandrosterone: II. Effects on sexual function. A phase II randomized, double-blind, placebo-controlled study. Contraception 2018; 98:56-62. [DOI: 10.1016/j.contraception.2018.02.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 02/12/2018] [Accepted: 02/21/2018] [Indexed: 10/17/2022]
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Collomp K, Buisson C, Gravisse N, Belgherbi S, Labsy Z, Do MC, Gagey O, Dufay S, Vibarel-Rebot N, Audran M. Effects of short-term DHEA intake on hormonal responses in young recreationally trained athletes: modulation by gender. Endocrine 2018; 59:538-546. [PMID: 29322301 DOI: 10.1007/s12020-017-1514-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 12/26/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Dehydroepiandrosterone (DHEA) figures on the World Anti-Doping Agency list of prohibited substances in sport because it is assumed that athletes expect a significant increase in testosterone through DHEA administration. The literature on the hormonal effects of DHEA intake nevertheless appears to be very scant in healthy young subjects, especially women. PURPOSE We examined the effects of DHEA on adrenal and gonadal hormones, IGF1 and free T3 in healthy young male and female recreationally trained volunteers. METHODS The study followed a double-blind, randomized-order crossover design. Lean healthy young men (n = 10) and women (n = 11), with all women using oral contraceptives, were treated daily with 100 mg of DHEA and placebo for 4 weeks. DHEA, DHEA-sulfate (DHEA-S), androstenedione, total testosterone (Tes), dihydrotestosterone (DHT), SHBG, estrone, cortisol, IGF1, and free T3 were measured before, in the middle and at the end of each treatment, as were blood glucose, liver transaminases and lipid status. RESULTS We observed a significant increase in DHEA, DHEA-S, androstenedione, Tes, DHT, and estrone in both men and women in the middle and at the end of DHEA treatment, but the increase in Tes was more marked in women (p < 0.001) than men (p < 0.05). No changes were found in the other parameters, irrespective of gender. CONCLUSION In young athletes, DHEA administration induces significant blood hormonal changes, some modulated by gender, which can be used as biomarkers of doping.
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Affiliation(s)
- Katia Collomp
- CIAMS, Univ. Paris-Sud, Université Paris-Saclay, Orsay, France.
- CIAMS, Université Orléans, Orléans, France.
- Département des Analyses, AFLD, Chatenay-Malabry, France.
| | | | - Nicolas Gravisse
- CIAMS, Univ. Paris-Sud, Université Paris-Saclay, Orsay, France
- CIAMS, Université Orléans, Orléans, France
| | - Soraya Belgherbi
- Service de Médecine Préventive, Univ. Paris-Sud, Université Paris-Saclay, Orsay, France
| | - Zakaria Labsy
- CIAMS, Univ. Paris-Sud, Université Paris-Saclay, Orsay, France
- CIAMS, Université Orléans, Orléans, France
| | - Manh-Cuong Do
- CIAMS, Univ. Paris-Sud, Université Paris-Saclay, Orsay, France
- CIAMS, Université Orléans, Orléans, France
| | - Olivier Gagey
- CIAMS, Univ. Paris-Sud, Université Paris-Saclay, Orsay, France
- CIAMS, Université Orléans, Orléans, France
| | - Sophie Dufay
- Laboratoire de Développement Analytique, AGEPS, Paris, France
| | - Nancy Vibarel-Rebot
- CIAMS, Univ. Paris-Sud, Université Paris-Saclay, Orsay, France
- CIAMS, Université Orléans, Orléans, France
| | - Michel Audran
- Département des Analyses, AFLD, Chatenay-Malabry, France
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