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Vleskó G, Meznerics FA, Hegyi P, Teutsch B, Unicsovics M, Sipos Z, Fehérvári P, Ács N, Várbíró S, Keszthelyi M. Comparison of Combined Parenteral and Oral Hormonal Contraceptives: A Systematic Review and Meta-Analysis of Randomized Trials. J Clin Med 2024; 13:575. [PMID: 38276081 PMCID: PMC10816843 DOI: 10.3390/jcm13020575] [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: 11/30/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Delivering contraceptive hormones through a transdermal patch or a vaginal ring might have advantages over the traditional oral route. OBJECTIVES To compare the effectiveness, compliance, and side effect profile of oral and parenteral drug administration methods. METHODS We performed a systematic literature search in four medical databases-MEDLINE (via PubMed), Cochrane Library (CENTRAL), Embase, and Scopus-from inception to 20 November 2022. Randomized controlled trials assessing the efficacy, compliance, and adverse event profile of combined parenteral and oral hormonal contraceptives were included. RESULTS Our systematic search provided 3952 records; after duplicate removal, we screened 2707 duplicate-free records. A total of 13 eligible studies were identified after title, abstract, and full-text selection. We observed no significant difference in contraceptive efficacy (Pearl Index) between oral and parenteral drug administration (MD = -0.06, CI: -0.66-0.53; I2 = 0%). We found significant subgroup differences between parenteral methods in terms of compliance (χ2 = 4.32, p =0.038, I2 = 80%) and certain adverse events: breast discomfort (χ2 = 19.04, p =0.001, I2 = 80%), nausea (χ2 = 8.04, p =0.005, I2 = 75%), and vomiting (χ2 = 9.30, p =0.002; I2 = 72%). CONCLUSION Both parenteral and oral contraceptives can be used as an effective contraceptive method, and the route of administration should be tailored to patient needs and adverse event occurrence.
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Affiliation(s)
- Gábor Vleskó
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary; (G.V.); (M.U.); (N.Á.); (M.K.)
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (F.A.M.); (P.H.); (B.T.); (P.F.)
| | - Fanni Adél Meznerics
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (F.A.M.); (P.H.); (B.T.); (P.F.)
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, 1082 Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (F.A.M.); (P.H.); (B.T.); (P.F.)
- Institute for Translational Medicine, Medical School, University of Pécs, 7621 Pécs, Hungary;
- Institute of Pancreatic Diseases, Semmelweis University, 1085 Budapest, Hungary
| | - Brigitta Teutsch
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (F.A.M.); (P.H.); (B.T.); (P.F.)
- Institute for Translational Medicine, Medical School, University of Pécs, 7621 Pécs, Hungary;
| | - Márkó Unicsovics
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary; (G.V.); (M.U.); (N.Á.); (M.K.)
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (F.A.M.); (P.H.); (B.T.); (P.F.)
| | - Zoltán Sipos
- Institute for Translational Medicine, Medical School, University of Pécs, 7621 Pécs, Hungary;
- Institute of Bioanalysis, Medical School, University of Pécs, 7621 Pécs, Hungary
| | - Péter Fehérvári
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (F.A.M.); (P.H.); (B.T.); (P.F.)
- Department of Biostatistics, University of Veterinary Medicine, 1078 Budapest, Hungary
| | - Nándor Ács
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary; (G.V.); (M.U.); (N.Á.); (M.K.)
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (F.A.M.); (P.H.); (B.T.); (P.F.)
| | - Szabolcs Várbíró
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary; (G.V.); (M.U.); (N.Á.); (M.K.)
- Workgroup of Research Management, Doctoral School, Semmelweis University, 1085 Budapest, Hungary
| | - Márton Keszthelyi
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary; (G.V.); (M.U.); (N.Á.); (M.K.)
- Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (F.A.M.); (P.H.); (B.T.); (P.F.)
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de Laat W, Pagan L, Malcolm RK, Wiegerinck M, Nickolson V, Huisman B, Stuurman R, van Esdonk M, Klarenbeek N. First-in-human study to assess the pharmacokinetics, tolerability, and safety of single-dose oxybutynin hydrochloride administered via a microprocessor-controlled intravaginal ring. Drug Deliv 2023; 30:2180113. [PMID: 36815245 PMCID: PMC9970198 DOI: 10.1080/10717544.2023.2180113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/08/2023] [Indexed: 02/24/2023] Open
Abstract
Polymeric drug-releasing vaginal rings are useful for both local and systemic administration of drugs via the intravaginal route. Typically, they provide continuous sustained or controlled release of drug(s) over extended time periods, thereby avoiding overdose and improving adherence. This first-in-human study (EudraCT number: 2020-0050044-30) evaluated the pharmacokinetics, safety, and tolerability of a single dose of oxybutynin administered by a novel microprocessor-controlled vaginal ring (MedRing). Eight healthy female subjects received an electronically controlled single intravaginal dose of 3 mg oxybutynin hydrochloride (100 mg/mL) dissolved in 1:1 water/propylene glycol administered via MedRing. Following dosing, MedRing was kept in situ for up to 6 h. Blood samples were collected 1 h prior to oxybutynin dosing and subsequently at regular intervals post-dose for the assessment of plasma concentrations of oxybutynin and its active metabolite N-desethyloxybutynin. The results showed that MedRing efficiently administered oxybutynin via the intravaginal route, resulting in plasma oxybutynin levels comparable to orally administered oxybutynin. The mean ± standard deviation pharmacokinetic parameters for oxybutynin were Cmax 5.4 ± 2.7 ng/mL, AUCinf 34.9 ± 17.4 h ng/mL, t1/2 8.5 ± 3.5 h and for N-desethyloxybutynin were Cmax 3.9 ± 2.5 ng/mL, AUCinf 51.1 ± 43.1 h ng/mL, t1/2 7.7 ± 5.9 h. No serious adverse events were reported. The study demonstrates that intravaginal administration of oxybutynin hydrochloride using the MedRing device was well tolerated.
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Affiliation(s)
| | - Lisa Pagan
- Centre for Human Drug Research, Leiden, The Netherlands
- Department of Gynaecology and Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands
| | - R. Karl Malcolm
- School of Pharmacy, Queen’s University Belfast, United Kingdom
| | | | | | - Bertine Huisman
- Centre for Human Drug Research, Leiden, The Netherlands
- Department of Gynaecology and Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Rik Stuurman
- Centre for Human Drug Research, Leiden, The Netherlands
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Centre, Leiden, The Netherlands
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Alhetheli G, Alhazmi S, Almutairi S, Alharbi S, Alharbi N, Alsweed M, Al-Dhubaibi MS, Alsaud J, Asiri L. The Effects of Isotretinoin on The Menstrual Cycle: A Cross-Sectional Study. Clin Pract 2022; 12:908-917. [PMID: 36412674 PMCID: PMC9680279 DOI: 10.3390/clinpract12060095] [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: 10/17/2022] [Revised: 11/03/2022] [Accepted: 11/07/2022] [Indexed: 11/12/2022] Open
Abstract
Menstrual irregularities during isotretinoin therapy, including amenorrhea, can cause a great deal of health-status uncertainty such as the possibility of pregnancy. This study aimed to evaluate the effects of isotretinoin treatment on the menstrual cycle. This cross-sectional study was conducted among females aged between 15−45 years taking isotretinoin for acne. Descriptive statistics were used in the form of frequencies and percentages to represent categorical variables. Pearson’s chi-squared test was performed to assess the relationship between some of the variables with menstrual irregularities. A logistic regression model was performed to assess the risk factors for developing menstrual irregularities during isotretinoin therapy. Of participants with a known regular menstrual cycle, 10.4% were found to have irregularity in their cycle after starting the drug (p < 0.001). Amenorrhea was the most commonly reported menstrual irregularity in isotretinoin-treated females. Our results showed that single females, those who took isotretinoin for 10−12 months and who were concurrently taking hormonal contraceptives all have a statistically significant higher risk of developing menstrual irregularities than others. In conclusion, we found that a statistically significant number of participants with a regular menstrual cycle pre-isotretinoin intake developed irregularity in their cycle after starting the drug. The mechanism of how isotretinoin influences female hormonal imbalances, thereby affecting menstrual irregularities is still poorly understood and needs to be clarified in further clinical studies.
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Affiliation(s)
- Ghadah Alhetheli
- Division of Dermatology and Cutaneous Surgery, College of Medicine, Qassim University, Buraydah 52571, Saudi Arabia
- Correspondence:
| | - Sadin Alhazmi
- College of Medicine, Qassim University, Buraydah 52571, Saudi Arabia
| | - Shumukh Almutairi
- College of Medicine, Qassim University, Buraydah 52571, Saudi Arabia
| | - Samar Alharbi
- College of Medicine, Qassim University, Buraydah 52571, Saudi Arabia
| | - Norah Alharbi
- College of Medicine, Qassim University, Buraydah 52571, Saudi Arabia
| | - Maha Alsweed
- College of Medicine, Qassim University, Buraydah 52571, Saudi Arabia
| | | | - Jolan Alsaud
- College of Medicine, Qassim University, Buraydah 52571, Saudi Arabia
| | - Lina Asiri
- College of Medicine, Qassim University, Buraydah 52571, Saudi Arabia
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Verma N, Cwiak C, Kaunitz AM. Hormonal Contraception: Systemic Estrogen and Progestin Preparations. Clin Obstet Gynecol 2021; 64:721-738. [PMID: 34668886 DOI: 10.1097/grf.0000000000000634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Combined hormonal contraception (CHC) are short-acting, reversible methods containing both estrogen and progestin. Available CHC methods include combined oral contraceptives, transdermal patches, and vaginal rings. The combined oral contraceptive remains the most commonly used contraceptive method in the United States. The general principles of CHC will be reviewed, including mechanism of action and effectiveness. Unless otherwise stated, these principles apply to all CHCs. When discussing clinical studies and specific considerations related only to pills, patches, or rings, the method(s) will be specified. Words that specify sex are used when discussing studies in which sex was specified.
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Affiliation(s)
- Nisha Verma
- Department of GYN/OB, Emory University School of Medicine, Atlanta, Georgia
| | - Carrie Cwiak
- Department of GYN/OB, Emory University School of Medicine, Atlanta, Georgia
| | - Andrew M Kaunitz
- Department of Obstetrics & Gynecology, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida
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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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Hogden K, Mikelberg F, Sodhi M, Khosrow-Khavar F, Mansournia MA, Kezouh A, Etminan M. The association between hormonal contraceptive use and glaucoma in women of reproductive age. Br J Clin Pharmacol 2021; 87:4780-4785. [PMID: 34159623 DOI: 10.1111/bcp.14920] [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: 11/11/2020] [Revised: 03/29/2021] [Accepted: 05/04/2021] [Indexed: 11/30/2022] Open
Abstract
AIMS We aimed to investigate the association between hormonal contraceptive (HC) use and the incidence of glaucoma in females of reproductive age with a focus on duration and type of HCs used. METHODS A retrospective cohort study with a case-control analysis (nested case-control) was undertaken using data from IQVIA's electronic medical record (IQVIA, USA) from 2008 to 2018. Within a cohort of 4 871 504 women, cases of glaucoma or ocular hypertension were identified. Subjects were followed to the first diagnosis of glaucoma. Each glaucoma case was matched to four controls by age, body mass index and follow up time. The main outcome measure was the first diagnosis of glaucoma defined by the first ICD-9/10 code for glaucoma or ocular hypertension. RESULTS Among 4 871 504 women identified, there were 2366 cases of glaucoma and 9464 controls. Regular users of hormonal contraceptives had an elevated risk of glaucoma compared to non-users with an adjusted incident rate ratio (aIRR) of 1.57 (95% CI: 1.29-1.92). Current users were of greatest risk (aIRR of 2.38, 95% CI: 1.81-3.13), whereas the aIRR among past users was 1.08 (95% CI: 0.82-1.43). The aIRR for glaucoma increased from 0.82 (95% CI: 0.70-0.95) among those with one or two prescriptions in the 2 years prior to the first diagnosis of glaucoma to 1.54 (95% CI: 1.32-1.81) among those with greater than four prescriptions. CONCLUSIONS This nested case-control study demonstrated an elevated risk, albeit low, of glaucoma in females of reproductive age who use regular hormonal contraception. Future studies are needed to confirm these findings.
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Affiliation(s)
- Kate Hogden
- Department of Ophthalmology and Visual Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Frederick Mikelberg
- Department of Ophthalmology and Visual Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Mohit Sodhi
- Department of Ophthalmology and Visual Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Farzin Khosrow-Khavar
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | | | - Abbas Kezouh
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | - Mahyar Etminan
- Departments of Ophthalmology and Visual Sciences, Medicine and Pharmacology, University of British Columbia, Vancouver, Canada
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Lete I, Paz D. RETIRADO: Eficacia, seguridad y beneficios no anticonceptivos del uso extendido o continuo del anillo vaginal anticonceptivo. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2021. [DOI: 10.1016/j.gine.2021.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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das Neves J, Sverdlov Arzi R, Sosnik A. Molecular and cellular cues governing nanomaterial-mucosae interactions: from nanomedicine to nanotoxicology. Chem Soc Rev 2021; 49:5058-5100. [PMID: 32538405 DOI: 10.1039/c8cs00948a] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Mucosal tissues constitute the largest interface between the body and the surrounding environment and they regulate the access of molecules, supramolecular structures, particulate matter, and pathogens into it. All mucosae are characterized by an outer mucus layer that protects the underlying cells from physicochemical, biological and mechanical insults, a mono-layered or stratified epithelium that forms tight junctions and controls the selective transport of solutes across it and associated lymphoid tissues that play a sentinel role. Mucus is a gel-like material comprised mainly of the glycoprotein mucin and water and it displays both hydrophilic and hydrophobic domains, a net negative charge, and high porosity and pore interconnectivity, providing an efficient barrier for the absorption of therapeutic agents. To prolong the residence time, absorption and bioavailability of a broad spectrum of active compounds upon mucosal administration, mucus-penetrating and mucoadhesive particles have been designed by tuning the chemical composition, the size, the density, and the surface properties. The benefits of utilizing nanomaterials that interact intimately with mucosae by different mechanisms in the nanomedicine field have been extensively reported. To ensure the safety of these nanosystems, their compatibility is evaluated in vitro and in vivo in preclinical and clinical trials. Conversely, there is a growing concern about the toxicity of nanomaterials dispersed in air and water effluents that unintentionally come into contact with the airways and the gastrointestinal tract. Thus, deep understanding of the key nanomaterial properties that govern the interplay with mucus and tissues is crucial for the rational design of more efficient drug delivery nanosystems (nanomedicine) and to anticipate the fate and side-effects of nanoparticulate matter upon acute or chronic exposure (nanotoxicology). This review initially overviews the complex structural features of mucosal tissues, including the structure of mucus, the epithelial barrier, the mucosal-associated lymphatic tissues and microbiota. Then, the most relevant investigations attempting to identify and validate the key particle features that govern nanomaterial-mucosa interactions and that are relevant in both nanomedicine and nanotoxicology are discussed in a holistic manner. Finally, the most popular experimental techniques and the incipient use of mathematical and computational models to characterize these interactions are described.
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Affiliation(s)
- José das Neves
- i3S - Instituto de Investigação e Inovação em Saúde & INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal
| | - Roni Sverdlov Arzi
- Laboratory of Pharmaceutical Nanomaterials Science, Department of Materials Science and Engineering, Technion-Israel Institute of Technology, De-Jur Building, Office 607, Haifa, 3200003, Israel.
| | - Alejandro Sosnik
- Laboratory of Pharmaceutical Nanomaterials Science, Department of Materials Science and Engineering, Technion-Israel Institute of Technology, De-Jur Building, Office 607, Haifa, 3200003, Israel.
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Delaruelle Z, Ivanova TA, Khan S, Negro A, Ornello R, Raffaelli B, Terrin A, Mitsikostas DD, Reuter U. Male and female sex hormones in primary headaches. J Headache Pain 2018; 19:117. [PMID: 30497379 PMCID: PMC6755575 DOI: 10.1186/s10194-018-0922-7] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 09/20/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The three primary headaches, tension-type headache, migraine and cluster headache, occur in both genders, but all seem to have a sex-specific prevalence. These gender differences suggest that both male and female sex hormones could have an influence on the course of primary headaches. This review aims to summarise the most relevant and recent literature on this topic. METHODS Two independent reviewers searched PUBMED in a systematic manner. Search strings were composed using the terms LH, FSH, progesteron*, estrogen*, DHEA*, prolactin, testosterone, androgen*, headach*, migrain*, "tension type" or cluster. A timeframe was set limiting the search to articles published in the last 20 years, after January 1st 1997. RESULTS Migraine tends to follow a classic temporal pattern throughout a woman's life corresponding to the fluctuation of estrogen in the different reproductive stages. The estrogen withdrawal hypothesis forms the basis for most of the assumptions made on this behalf. The role of other hormones as well as the importance of sex hormones in other primary headaches is far less studied. CONCLUSION The available literature mainly covers the role of sex hormones in migraine in women. Detailed studies especially in the elderly of both sexes and in cluster headache and tension-type headache are warranted to fully elucidate the role of these hormones in all primary headaches.
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Affiliation(s)
- Zoë Delaruelle
- Department of Neurology, University Hospital Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | | | - Sabrina Khan
- Danish Headache Center, Glostrup Hospital, Copenhagen, Denmark
| | - Andrea Negro
- Dipartimento di Medicina Clinica e Molecolare, Universita degli Studi di Roma La Sapienza, Rome, Italy
| | - Raffaele Ornello
- Department of Neurology, University of La’Aquila, L’Aquila, Italy
| | - Bianca Raffaelli
- Departmentt of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Alberto Terrin
- Department of Neurosciences, Headache Center, University of Padua, Padua, Italy
| | - Dimos D. Mitsikostas
- Neurology Department, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Uwe Reuter
- Charite Universitatsmedizin Berlin, Berlin, Germany
| | - on behalf of the European Headache Federation School of Advanced Studies (EHF-SAS)
- Department of Neurology, University Hospital Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium
- First Moscow State Medical University, Moscow, Russia
- Danish Headache Center, Glostrup Hospital, Copenhagen, Denmark
- Dipartimento di Medicina Clinica e Molecolare, Universita degli Studi di Roma La Sapienza, Rome, Italy
- Department of Neurology, University of La’Aquila, L’Aquila, Italy
- Departmentt of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Neurosciences, Headache Center, University of Padua, Padua, Italy
- Neurology Department, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Charite Universitatsmedizin Berlin, Berlin, Germany
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Robin G, Plouvier P, Delesalle AS, Rolland AL. [Effectiveness and use of hormonal contraceptives (except for intrauterine devices): CNGOF Contraception Guidelines]. ACTA ACUST UNITED AC 2018; 46:845-857. [PMID: 30413374 DOI: 10.1016/j.gofs.2018.10.003] [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: 10/04/2018] [Indexed: 11/20/2022]
Abstract
Hormonal contraceptives remain among the most popular methods used by women. The purpose of this work is to review the effectiveness and use of these different methods. In addition, some side-effects are feared and/or frequently reported by users of hormonal contraceptives: unscheduled bleeding, acne, catamenial migraines, weight gain, libido and/or mood disorders. In this review of the literature, the accountability of hormonal contraceptives for the occurrence of some of these side-effects was discussed and a management strategy was proposed.
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Affiliation(s)
- G Robin
- Service de gynécologie médicale, orthogénie et sexologie, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France; Service d'assistance médicale à la procréation et de préservation de la fertilité, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France.
| | - P Plouvier
- Service de gynécologie médicale, orthogénie et sexologie, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France; Service d'assistance médicale à la procréation et de préservation de la fertilité, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France
| | - A-S Delesalle
- Service de gynécologie médicale, orthogénie et sexologie, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France; Service de gynécologie-obstétrique, centre hospitalier régional de Saint-Omer, route de Blendecques, 62570 Helfaut, France
| | - A-L Rolland
- Service de gynécologie médicale, orthogénie et sexologie, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France; Service de gynécologie-obstétrique, maternité de Beaumont, 80, rue de Beaumont, 59100 Roubaix, France
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Monteiro I, Guazzelli CF, Bahamondes L. Advances in contraceptive vaginal rings: what does the future hold? Expert Opin Pharmacother 2018; 19:1685-1691. [PMID: 30286682 DOI: 10.1080/14656566.2018.1519549] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Contraceptive vaginal rings (CVRs) are good contraceptive options because they do not require skilled providers, are self-administered, and show a higher stability of drug diffusion. AREAS COVERED This article provides a review of the developments made with CVRs over the past number of years, while giving focus to the latest CVRs that have gone through clinical development. The author of the article also provides an expert perspective on the future of these useful therapeutic options. EXPERT OPINION Pharmacokinetic studies have shown that segesterone, an absorbable progestin that is used alone or in combination with ethinyl estradiol (EE) or E2, is the CVR of choice at this present time. Indeed, segesterone has demonstrated safety and efficacy as a CVR and is also an appropriate option for lactating women, as they are not absorbed orally. However, good cycle control is important for improved CVR adherence. CVRs that allow the combination of more than one drug may unravel another multi-purpose use when combined with microbicides and could provide combined protection to women who wish to protect themselves from pregnancy and sexually transmitted infection.
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Affiliation(s)
- Ilza Monteiro
- a Family Planning clinic, Department of Obstetrics and Gynecology , Federal University of Medical School , São Paulo, Campinas , Brazil
| | - Cristina Falbo Guazzelli
- b Family Planning clinic, Department of Obstetrics and Gynecology , University of Campinas Medical School , São Paulo , Brazil
| | - Luis Bahamondes
- a Family Planning clinic, Department of Obstetrics and Gynecology , Federal University of Medical School , São Paulo, Campinas , Brazil
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Polis CB, Hussain R, Berry A. There might be blood: a scoping review on women's responses to contraceptive-induced menstrual bleeding changes. Reprod Health 2018; 15:114. [PMID: 29940996 PMCID: PMC6020216 DOI: 10.1186/s12978-018-0561-0] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 06/15/2018] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Concern about side effects and health issues are common reasons for contraceptive non-use or discontinuation. Contraceptive-induced menstrual bleeding changes (CIMBCs) are linked to these concerns. Research on women's responses to CIMBCs has not been mapped or summarized in a systematic scoping review. METHODS We conducted a systematic scoping review of data on women's responses to CIMBCs in peer-reviewed, English-language publications in the last 15 years. Investigator dyads abstracted information from relevant studies on pre-specified and emergent themes using a standardized form. We held an expert consultation to obtain critical input. We provide recommendations for researchers, contraceptive counselors, and product developers. RESULTS We identified 100 relevant studies. All world regions were represented (except Antarctica), including Africa (11%), the Americas (32%), Asia (7%), Europe (20%), and Oceania (6%). We summarize findings pertinent to five thematic areas: women's responses to contraceptive-induced non-standard bleeding patterns; CIMBCs influence on non-use, dissatisfaction or discontinuation; conceptual linkages between CIMBCs and health; women's responses to menstrual suppression; and other emergent themes. Women's preferences for non-monthly bleeding patterns ranged widely, though amenorrhea appears most acceptable in the Americas and Europe. Multiple studies reported CIMBCs as top reasons for contraceptive dissatisfaction and discontinuation; others suggested disruption of regular bleeding patterns was associated with non-use. CIMBCs in some contexts were perceived as linked with a wide range of health concerns; e.g., some women perceived amenorrhea to cause a buildup of "dirty" or "blocked" blood, in turn perceived as causing blood clots, fibroids, emotional disturbances, weight gain, infertility, or death. Multiple studies addressed how CIMBCs (or menstruation) impacted daily activities, including participation in domestic, work, school, sports, or religious life; sexual or emotional relationships; and other domains. CONCLUSIONS Substantial variability exists around how women respond to CIMBCs; these responses are shaped by individual and social influences. Despite variation in responses across contexts and sub-populations, CIMBCs can impact multiple aspects of women's lives. Women's responses to CIMBCs should be recognized as a key issue in contraceptive research, counseling, and product development, but may be underappreciated, despite likely - and potentially substantial - impacts on contraceptive discontinuation and unmet need for modern contraception.
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Affiliation(s)
- Chelsea B. Polis
- Guttmacher Institute, 125 Maiden Lane, 7th Floor, New York, NY 10038 USA
| | - Rubina Hussain
- Guttmacher Institute, 125 Maiden Lane, 7th Floor, New York, NY 10038 USA
| | - Amanda Berry
- Guttmacher Institute, 125 Maiden Lane, 7th Floor, New York, NY 10038 USA
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3D printing of vaginal rings with personalized shapes for controlled release of progesterone. Int J Pharm 2018; 539:75-82. [DOI: 10.1016/j.ijpharm.2018.01.036] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 01/05/2018] [Accepted: 01/20/2018] [Indexed: 12/18/2022]
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