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Otte R, Thissen V, Mulder B. (Dis)continuation of the oral contraceptive pill: A focus group approach in the Netherlands. Heliyon 2023; 9:e19405. [PMID: 37810124 PMCID: PMC10558495 DOI: 10.1016/j.heliyon.2023.e19405] [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: 01/26/2022] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 10/10/2023] Open
Abstract
Objectives The oral contraceptive pill (OCP) is the most used contraceptive worldwide; nevertheless, discontinuation rates are relatively high. While advantages of the OCP, like pregnancy prevention and planned parenthood, result in autonomy and independence, side effects and other aspects play a role in the decision to (dis)continue usage. Informed and deliberate decision-making is of importance to prevent adverse effects in health and quality of life. Therefore, the present study aimed to explore how women in the Netherlands decide to (dis)continue the OCP. Study design This paper reports a qualitative study using four focus groups, conducted online or face-to-face, with 20 women of different educational background aged between 18 and 23. The topic guide was based on relevant theory and literature, and focused on personal beliefs, experiences and social interactions about the OCP. The study is reported according to SRQR guidelines. Results The main themes that were found the influence decision-making were effects, side effects, towards alternatives, interpersonal communication with peers, interpersonal communication with the general practitioner, and online information seeking. Feeling responsible emerged as a relevant additional theme, embedded in the decision-making process, and influencing other themes. Some educational differences emerged. Conclusions The decision to start the OCP is a highly normalized process in the Netherlands. However, women who feel a strong sense of responsibility for pregnancy prevention may be less open to considering alternative contraception methods. Results imply that women can be better supported in the decision-making process by providing balanced information on effects and side effects of a wide range of contraceptives, as well as restoring the balance in both sexual partner's responsibility for contraception. Implications for practice and suggestions for further research on the concept of responsibility, its influence, and underlying mechanisms are provided.
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Affiliation(s)
- R.S. Otte
- Strategic Communication Group, Wageningen University & Research, P.O. BOX 8130, 6700, EW Wageningen, the Netherlands
| | - V.T.M. Thissen
- Strategic Communication Group, Wageningen University & Research, P.O. BOX 8130, 6700, EW Wageningen, the Netherlands
| | - B.C. Mulder
- Strategic Communication Group, Wageningen University & Research, P.O. BOX 8130, 6700, EW Wageningen, the Netherlands
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Zhao Y, Versavel M, Tidemann-Miller B, Christmann R, Naik H. Evaluation of the Potential Pharmacokinetic Interactions Between Vixotrigine and an Oral Contraceptive. Clin Drug Investig 2020; 40:737-746. [PMID: 32564301 PMCID: PMC7359159 DOI: 10.1007/s40261-020-00931-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Vixotrigine is a voltage- and use-dependent sodium channel blocker in development for neuropathic pain management. This study evaluated the effect of coadministration of vixotrigine (metabolized primarily via uridine diphosphate-glucuronosyltransferases) and an oral contraceptive containing ethinyl estradiol (uridine diphosphate-glucuronosyltransferase inducer) and levonorgestrel on the pharmacokinetics and safety of all three compounds. METHODS In this phase I, open-label, fixed-sequence, multiple-dose study, 36 healthy women received oral vixotrigine 150 mg three times daily for 6 days and once on day 7. This was followed by a washout period, days 8-11. The oral contraceptive was administered alone on days 12-25 and with vixotrigine 150 mg three times daily on days 26-32. Serial blood samples were collected for pharmacokinetic analysis. Safety was assessed. RESULTS The geometric least-squares mean ratios (90% confidence intervals) for the area under the concentration-time curve over 8 h and maximum concentration of vixotrigine co-administered with an oral contraceptive vs vixotrigine alone were 0.85 (0.82-0.89) and 0.91 (0.87-0.96), respectively. The geometric least-squares mean ratios (90% confidence interval) for area under the concentration-time curve over 24 h and maximum concentration of ethinyl estradiol with vixotrigine vs ethinyl estradiol alone were 0.94 (0.91-0.97) and 0.89 (0.84-0.94), respectively; the ratios for levonorgestrel with vixotrigine vs levonorgestrel alone were 1.06 (0.98-1.16) and 1.05 (0.98-1.13), respectively. No adverse events occurring with vixotrigine alone were deemed related to the study drug by the investigators. CONCLUSIONS Coadministration of vixotrigine and an oral contraceptive containing ethinyl estradiol and levonorgestrel had no clinically relevant effect on exposure of all three compounds. TRIAL REGISTRATION ClinicalTrials.gov registration number: NCT03324685 (registered 25 October, 2017).
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Affiliation(s)
- Yuan Zhao
- Clinical Pharmacology and Pharmacometrics, Biogen, 225 Binney Street, Cambridge, MA, 02142, USA
| | | | | | - Romy Christmann
- Global Safety Regulatory Sciences, Biogen, Cambridge, MA, USA
| | - Himanshu Naik
- Clinical Pharmacology and Pharmacometrics, Biogen, 225 Binney Street, Cambridge, MA, 02142, USA.
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Huang CC, Huang CC, Lin SY, Chang CYY, Lin WC, Chung CH, Lin FH, Tsao CH, Lo CM, Chien WC. Association between hypertensive pregnancy disorders and future risk of stroke in Taiwan: a Nationwide population-based retrospective case-control study. BMC Pregnancy Childbirth 2020; 20:217. [PMID: 32295527 PMCID: PMC7160910 DOI: 10.1186/s12884-020-02898-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 03/27/2020] [Indexed: 12/14/2022] Open
Abstract
Background The incidence of female stroke has increased gradually and has begun occurring at a younger age in recent years. Given that women live longer than men, stroke would cause more negative and longer-term impacts on the rest of the lives of women. There are few related studies on Asian women. We aimed to evaluate stroke risk in Asian women following hypertensive pregnancy disorders. Methods Using the Taiwan National Health Insurance database, we designed a retrospective study that included pregnant women between 2000 and 2013. We selected an age-matched control group of women without hypertensive pregnancy disorders at a 1:3 ratio. The endpoint was any episode of stroke; otherwise, the patients were tracked until December 31, 2013. After the index date until the end of 2013, Cox proportional hazards analysis was used to compare the risk of incident stroke. The risk factors for stroke were determined using Cox proportional regression to calculate the hazard ratio (HR) compared with the control group. Results During the follow-up period, the Kaplan-Meier analysis indicated that patients with hypertensive pregnancy disorders had a significantly higher risk of developing stroke than did patients without hypertensive pregnancy disorders (log-rank test P < 0.001). Multivariate Cox regression analysis demonstrated that the case group had a 2.134-fold increased risk of stroke (HR = 2.134; 95% CI = 1.817–2.505; P < 0.001). Conclusion Our study provided evidence of an increased risk of stroke in patients with hypertensive pregnancy disorders. Compared with those without such disorders, the patients who had experienced the disorders had a 2.134-fold (P < 0.001) higher risk of developing stroke in the future.
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Affiliation(s)
- Chun-Chung Huang
- Department of Biomedical Engineering, National Yang-Ming University, 2, Linong St., Beitou Dist, Taipei City, 112, Taiwan
| | - Chien-Chu Huang
- Graduate Institution of Biomedical Sciences, China Medical University, No. 2, Yuh-Der Road, Taichung, 404, Taiwan.,Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung, Taiwan
| | - Shao-Yi Lin
- Department of Mechanical and Computer-Aided Engineering, National Formosa University, No. 64, Wunhua Rd, Huwei Township, Yunlin County, 632, Taiwan
| | - Cherry Yin-Yi Chang
- Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung, Taiwan.,Department of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 404, Taiwan
| | - Wu-Chou Lin
- Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung, Taiwan.,Department of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 404, Taiwan
| | - Chi-Hsiang Chung
- School of Public Health, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association (TIPSPA), No. 325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan
| | - Fu-Huang Lin
- School of Public Health, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan
| | - Chang-Huei Tsao
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, No.325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan.,Department of Microbiology & Immunology, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan
| | - Chun-Min Lo
- Department of Biomedical Engineering, National Yang-Ming University, 2, Linong St., Beitou Dist, Taipei City, 112, Taiwan.
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, No.325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan. .,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei City, Taiwan. .,School of Public Health, National Defense Medical Center, Taipei City, Taiwan.
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Duhita MR, Schutz Y, Montani JP, Dulloo AG, Miles-Chan JL. Assessment of the Dose-Response Relationship between Meal Protein Content and Postprandial Thermogenesis: Effect of Sex and the Oral Contraceptive Pill. Nutrients 2019; 11:nu11071599. [PMID: 31311102 PMCID: PMC6682860 DOI: 10.3390/nu11071599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/06/2019] [Accepted: 07/11/2019] [Indexed: 11/16/2022] Open
Abstract
Implementation of efficacious dietary interventions to regulate energy balance requires understanding of the determinants of individual response. To date, information regarding individual variability in response to elevated meal protein content is lacking. This study investigates whether sex and/or oral contraceptive pill (OCP) use play a role in the response to elevated meal protein in 21 healthy young adults (seven men, seven women not taking OCP, and seven women who were OCP users). Participants consumed each of three standardized isocaloric (590 kcal) meals of differing protein content (11, 23, 31% kcal protein). Resting energy expenditure (EE), respiratory quotient (RQ), hunger and satiety were measured at baseline (fasting) and during 180 min postprandial. Whilst significant dose-response increases in EE were observed in men, meal protein-induced EE in women without OCP reached a maximum at <23% protein. Women taking OCP reported lower postprandial fullness than women without OCP, despite similar body size, but also, most notably, no significant difference in EE response between any of the meals. Whilst the mechanisms underpinning this thermogenic inflexibility in response across a wide-range (three-fold) of protein meal content require further investigation, this highlights the need for careful consideration of factors that may influence an individual's metabolic response to dietary interventions aimed at optimising postprandial thermogenesis for body weight regulation.
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Affiliation(s)
- Maharani R Duhita
- Department of Endocrinology, Metabolism and Cardiovascular System, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland
| | - Yves Schutz
- Department of Endocrinology, Metabolism and Cardiovascular System, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland
| | - Jean-Pierre Montani
- Department of Endocrinology, Metabolism and Cardiovascular System, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland
| | - Abdul G Dulloo
- Department of Endocrinology, Metabolism and Cardiovascular System, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland
| | - Jennifer L Miles-Chan
- Department of Endocrinology, Metabolism and Cardiovascular System, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland.
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, 1010 Auckland, New Zealand.
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Selke Krulichová I, Selke GW, Eichler U, Lappe V, Godman B, Schubert I. Impact of EU risk assessment process and administrative regulations for manufacturers of combined hormonal contraceptive prescribing. An analysis of developments in Germany and the implications. Curr Med Res Opin 2019; 35:697-704. [PMID: 30362365 DOI: 10.1080/03007995.2018.1541317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Combined hormonal contraceptives (CHC) exhibit differing risks for cardiovascular and thrombotic events (VTE). A European referral process confirmed higher VTE risks for 3rd generation gestagens and drospirenone. CHC are now grouped in risk classes (RC) I, II, and III, with RC III having a higher risk than RC I and X (risk not yet known). Marketing authorization holders were obliged to implement pharmacovigilance measures and risk minimization measures including changes of prescribing information. The study assessed whether these activities induced changes in prescription patterns. METHODS German prescription data for 1.1 million women below 20 years of age were used to analyze the effects of interventions and potential influence factors using logistic regression. Descriptive statistics were calculated for prescriptions for 3.3 million women from January 2011 to March 2016. RESULTS Shares of RC I and RC X recipients rose substantially over the observation period, while RC III recipient share showed a steady decrease. The referral induced a slightly faster decrease in RC III and increase in RC X. The implementation of pharmacovigilance measures manifested no additional effect. CONCLUSION The decrease in RC III share already observed before the referral process can be explained with pre-existing discussions around CHC. The effect attributable to the referral was statistically significant, although very small. While evidence for a connection between interventions and prescription change is only indirect, the study shows that routine data are suitable for impact analyses, and monitoring prescribing patterns can be recommended as feedback after regulatory or political interventions. This is being followed up.
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Affiliation(s)
- Iva Selke Krulichová
- a Department of Medical Biophysics, Faculty of Medicine in Hradec Králové , Charles University , Hradec Králové , Czech Republic
| | | | - Uwe Eichler
- b AOK Research Institute (WIdO) , Berlin , Germany
| | - Veronika Lappe
- c PMV research group, Clinic and Policlinic for Psychiatry, Psychosomatics and Psychotherapy of Children and Adolescents, Cologne University , Germany
| | - Brian Godman
- d Strathclyde Institute of Pharmacy and Biomedical Sciences , Strathclyde University , Glasgow , UK
- e Health Economics Centre , Liverpool University Management School , Liverpool , UK
- f Department of Laboratory Medicine, Division of Clinical Pharmacology , Karolinska Institute, Karolinska University Hospital Huddinge , Stockholm , Sweden
- g Department of Public Health Pharmacy and Management, School of Pharmacy , Sefako Makgatho Health Sciences University , Garankuwa, South Africa
| | - Ingrid Schubert
- c PMV research group, Clinic and Policlinic for Psychiatry, Psychosomatics and Psychotherapy of Children and Adolescents, Cologne University , Germany
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Kinoshita T, Tanaka S, Inagaki M, Takeuchi M, Kawakami K. Prescription pattern and trend of oral contraceptives in Japan: A descriptive study based on pharmacy claims data (2006 - 2014). SEXUAL & REPRODUCTIVE HEALTHCARE 2018; 17:50-55. [PMID: 30193720 DOI: 10.1016/j.srhc.2018.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 06/19/2018] [Accepted: 06/23/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The use of combined oral contraceptives (COC) as a contraceptive method is still limited in Japan, used only by 1.1% of women of reproductive age. The usage pattern of COC, such as continuation and preparation switch, between COC generations was investigated using large datasets. METHODS This descriptive study spanning from 2006 to 2014 used nationwide prescriptions based on administrative databases, including both reimbursed and non-reimbursed drugs. All the first-time COC users were included as a cohort. Usage patterns considering trends, continuation, and switch of COC generations were also investigated. RESULTS Of the 38,123 patients, the overall mean age at initial use of COC was 32.9 years. Of the first-time users, 51.2%, 23.7%, 5.6%, and 19.5% received first-, second-, third-, and fourth-generation COCs, respectively. The overall rate of continuation was 59.1%, and the rate of first-time use with switching to other generations within 180 days was 3.1%. CONCLUSION We revealed the actual usage of COC in Japan with frequent prescriptions of first- or fourth-generation COCs and relatively high age at initial use. Moreover, the COC continuation rate was low, and switch was limited. Further studies into its proper usage are recommended.
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Affiliation(s)
- Takuya Kinoshita
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto City, Kyoto 606-8501, Japan
| | - Shiro Tanaka
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto City, Kyoto 606-8501, Japan
| | - Mieko Inagaki
- Department of Obstetrics and Gynecology, Chibune General Hospital, 3-2-39 Fuku-machi, Nishi Yodogawa-ku, Osaka City, Osaka 555-0034, Japan
| | - Masato Takeuchi
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto City, Kyoto 606-8501, Japan
| | - Koji Kawakami
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto City, Kyoto 606-8501, Japan.
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Rooney JP, Visser AE, D'Ovidio F, Vermeulen R, Beghi E, Chio A, Veldink JH, Logroscino G, van den Berg LH, Hardiman O. A case-control study of hormonal exposures as etiologic factors for ALS in women. Neurology 2017; 89:1283-1290. [DOI: 10.1212/wnl.0000000000004390] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 07/03/2017] [Indexed: 11/15/2022] Open
Abstract
Objective:To investigate the role of hormonal risk factors for amyotrophic lateral sclerosis (ALS) among women from 3 European countries.Methods:ALS cases and matched controls were recruited over 4 years in Ireland, Italy, and the Netherlands. Hormonal exposures, including reproductive history, breastfeeding, contraceptive use, hormonal replacement therapy, and gynecologic surgical history, were recorded with a validated questionnaire. Logistic regression models adjusted for age, education, study site, smoking, alcohol, and physical activity were used to determine the association between female hormones and ALS risk.Results:We included 653 patients and 1,217 controls. Oral contraceptive use was higher among controls (odds ratio [OR] 0.65, 95% confidence interval [CI] 0.51–0.84), and a dose-response effect was apparent. Hormone replacement therapy (HRT) was associated with a reduced risk of ALS only in the Netherlands (OR = 0.57, 95% CI 0.37–0.85). These findings were robust to sensitivity analysis, but there was some heterogeneity across study sites.Conclusions:This large case-control study across 3 different countries has demonstrated an association between exogenous estrogens and progestogens and reduced odds of ALS in women. These results are at variance with previous findings, which may be partly explained by differential regulatory, social, and cultural attitudes toward pregnancy, birth control, and HRT across the countries included. Our results indicate that hormonal factors may be important etiologic factors in ALS; however, a full understanding requires further investigation.
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Lapi F, Simonetti M, Cricelli I, Cricelli C, Cassano N, Vena GA. Prescription Appropriateness of Cyproterone Acetate/Ethinylestradiol in Primary Care: A Population-Based Study in Italy. Clin Drug Investig 2017; 37:755-762. [DOI: 10.1007/s40261-017-0529-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Montoya ER, Bos PA. How Oral Contraceptives Impact Social-Emotional Behavior and Brain Function. Trends Cogn Sci 2017; 21:125-136. [DOI: 10.1016/j.tics.2016.11.005] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 11/16/2016] [Accepted: 11/21/2016] [Indexed: 01/14/2023]
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Vos MJ, Bisschop PH, Deckers MML, Endert E. The cortisol-CBG ratio affects cortisol immunoassay bias at elevated CBG concentrations. ACTA ACUST UNITED AC 2017; 55:e262-e264. [DOI: 10.1515/cclm-2017-0095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 03/13/2017] [Indexed: 11/15/2022]
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