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Sütcüoğlu BM, Güler M. Social Media Videos on Contraceptive Implants: An Assessment of Video Quality and Reliability. J Pediatr Adolesc Gynecol 2024; 37:39-44. [PMID: 37634871 DOI: 10.1016/j.jpag.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 08/29/2023]
Abstract
STUDY OBJECTIVE There are many videos on contraception on YouTube and TikTok, and women around the world use video platforms extensively to seek health information from videos of uncertain reliability and quality. The main objective of this research was to evaluate the scientific reliability and quality of the most popular social media videos about contraceptive subdermal implants. METHODS TikTok and YouTube videos were assessed separately by two gynecologists. The video quality was evaluated according to the DISCERN score, modified DISCERN score, and Global Quality Scale (GQS) score. RESULTS The study included the 100 most popular videos, 44 of which were uploaded by health care professionals. The median DISCERN score for videos shared by health care professionals was 50 (range 15-75), whereas it was 22 (range 15-56) for videos shared by independent users (P < .001). The median modified DISCERN score was 4 (min-max 0-5), and the median GQS score was 4 (min-max 1-5) for the videos uploaded by health care professionals. The modified DISCERN and GQS scores of TikTok videos were lower than those of YouTube videos (both P < .001). CONCLUSION Social media videos about contraceptive subdermal implants are popular and have been viewed tens of thousands of times, but the overall medical validity, which we evaluated according to the scoring systems, was poor. Despite the large number of videos, the content's quality and reliability are quite limited. There is a need to prioritize the education provided to patients by gynecologists, as well as to create high-quality content for YouTube and other similar platforms.
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Affiliation(s)
| | - Melike Güler
- Lokman Hekim University, Department of Obstetrics and Gynaecology, Ankara, Turkey
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2
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Szabo GK, Mogus JP, Vandenberg LN. Effects of perinatal exposures to a TAML catalyst on the mammary gland and hormone-sensitive outcomes in male mice. Reprod Toxicol 2024; 123:108517. [PMID: 38040386 DOI: 10.1016/j.reprotox.2023.108517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/24/2023] [Accepted: 11/27/2023] [Indexed: 12/03/2023]
Abstract
Estrogenic chemicals are common pollutants in wastewater and current effluent treatment processes are not typically effective in removing these compounds. Tetra-amido macrocyclic ligands (TAMLs) are catalysts that mimic endogenous peroxidases that may provide a solution to remove environmental pollutants including low concentrations of estrogenic compounds. Yet relatively little is known about the toxicity of TAMLs, and few studies have evaluated whether they may have endocrine disrupting properties. We administered one of three doses of a TAML, NT7, to mice via drinking water throughout pregnancy and lactation. Two pharmacologically active compounds, ethinyl estradiol (EE2) and flutamide were also included to give comparator data for estrogen receptor agonist and androgen receptor antagonist activities. Male pups were evaluated for several outcomes at weaning, puberty, and early adulthood. We found that EE2 exposures during gestation and the perinatal period induced numerous effects that were observed across the three ages including changes to spleen and testis weight and drastic effects on the morphology of the mammary gland. Flutamide had fewer effects but altered anogenital distance at weaning as well as spleen, liver, and kidney weight. In contrast, relatively few effects of NT7 were observed, but included alterations to spleen weight and modest changes to adult testis weight and morphology of the mammary gland at weaning. Collectively, these results provide some of the first evidence suggesting that NT7 may alter some hormone-sensitive outcomes, but that the effects were distinct from either EE2 or flutamide. Additional studies are needed to characterize the biological activity of this and other TAML catalysts.
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Affiliation(s)
- Gillian K Szabo
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts, Amherst, USA
| | - Joshua P Mogus
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts, Amherst, USA
| | - Laura N Vandenberg
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts, Amherst, USA.
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3
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Stoddard RE, Pelletier A, Sundquist EN, Haas-Kogan ME, Kassamali B, Huang M, Johnson NR, Bartz D. Popular contraception videos on TikTok: An assessment of content topics. Contraception 2024; 129:110300. [PMID: 37802460 DOI: 10.1016/j.contraception.2023.110300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 09/14/2023] [Accepted: 10/02/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVES This study aimed to explore the contraception content topics on the highly popular social media platform TikTok to understand this influential information source patients may bring into birth control counseling visits. STUDY DESIGN Utilizing a snapshot method, we collected the 100 most popular TikTok English-language videos for each of the eight contraception-specific search terms. We abstracted video content topics addressed and creator attributes. Two independent abstractors coded each video with high agreement, with a third coder adjudicating discrepancies. RESULTS The final data set included 700 unique videos, with a total of 1.18 billion views, 131 million likes, 1.5 million comments, and 4.1 million shares. In these videos, the most common topics addressed were patient experience (n = 365, 52.1%) and logistics of use (n = 351, 50.1%). Health care professionals created only 19.3% of videos (n = 135), but these videos accounted for a larger portion of the total video views (41.3%). Health care professionals largely made educational videos (92.6%) compared to 22.5% of videos coded as educational videos when made by perceived non-health care professionals. A small number of prolific video creators developed the majority of videos made by health care professionals, with 91 (67.4%) made by six TikTok creators. CONCLUSIONS TikTok contains highly accessible contraception content, which garners high viewership, especially when created by health care providers. Clinicians should be aware of TikTok's potential to influence patients prior to contraceptive counseling visits and recognize this platform as a public health instrument to disseminate contraceptive information to a key demographic. IMPLICATIONS Few previous studies have examined the presence and popularity of contraception content topics on TikTok; little is known about the health content on this highly popular platform. Providers should be aware of the contraceptive topics on TikTok for understanding both patient perceptions and the potential for health education through this media.
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Affiliation(s)
| | - Andrea Pelletier
- Harvard Medical School, Boston, MA, United States; Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, United States
| | | | | | - Bina Kassamali
- Harvard Medical School, Boston, MA, United States; Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Melody Huang
- Harvard Medical School, Boston, MA, United States; Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Natasha R Johnson
- Harvard Medical School, Boston, MA, United States; Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, United States
| | - Deborah Bartz
- Harvard Medical School, Boston, MA, United States; Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, United States.
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4
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Derrigo K, LaFata EM. Examining the proportions of food addiction among women with and without polycystic ovarian syndrome who do and do not take hormonal birth control. Eat Behav 2023; 51:101824. [PMID: 37950975 DOI: 10.1016/j.eatbeh.2023.101824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 11/13/2023]
Abstract
Polycystic ovarian syndrome (PCOS) is a reproductive disorder driven by insulin resistance. Insulin resistance may increase weight gain and increase the rewarding intake of ultra-processed foods (UPFs). Individuals with PCOS may be more susceptible to the reinforcing properties of UPFs, increasing the risk to consume UPFs in addictive-like ways, operationalized by food addiction (FA). Additionally, hormonal birth control, commonly prescribed to women with PCOS, are found to increase food cravings and overeating. This study examined the relationships between PCOS status, FA, and hormonal birth control use. The study sample (N = 365, assigned female at birth) was drawn from Amazon Mechanical Turk, with half of the sample (n = 181) reporting having PCOS and the other half not (n = 184). Participants answered questions about women's reproductive health (i.e., PCOS, hormonal birth control use) and completed the modified Yale Food Addiction Scale 2.0 (mYFAS 2.0). A chi-square test found that 51.9 % of participants with PCOS (M = 6.23, SD = 3.82) met diagnostic criteria for FA (assessed by the mYFAS 2.0) compared to 16.8 % of participants without PCOS (M = 2.47, SD = 3.39). A hierarchical linear regression found independent main effects of PCOS status (β = 0.40, t(352) = 8.61, p < .001) and hormonal birth control use (β = 0.16, t(351) = 3.59, p < .001), to be associated with higher mYFAS symptom count scores. No differences were found between the types of hormonal birth control participants reported taking. The finding suggests that FA is an overlooked, understudied psychological condition impacting these individuals in weight loss treatments. Future studies are needed to understand the relationship between FA and PCOS in clinical samples.
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Affiliation(s)
- Karly Derrigo
- Department of Psychology, Drexel University, Philadelphia, PA, United States.
| | - Erica M LaFata
- Department of Psychology, Drexel University, Philadelphia, PA, United States.
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5
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Andringa KR, Schott RM, Ellerson RM, Carroll S, Jones HE. Sex and Female Empowerment (SAFE): Learning from health care providers, men and women to design a sexual health intervention for women with substance use disorders. Drug Alcohol Depend 2023; 253:111010. [PMID: 37931327 PMCID: PMC10842687 DOI: 10.1016/j.drugalcdep.2023.111010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/17/2023] [Accepted: 10/25/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Substance Use Disorder (SUD) treatment is a promising setting to provide sexual health education to women. This study examined barriers and possible solutions to effectively providing sexual health education and services during SUD treatment. METHODS To obtain a full picture of the barriers and solutions, 29 cisgender women and 17 cisgender men in treatment for a SUD and four health care providers in North Carolina were interviewed regarding the domains of pregnancy-planning, barriers to reproductive health services and contraception, selecting a method of contraception and desired aspects and elements of a sexual health intervention. RESULTS Eight themes and 12 sub-themes emerged that included how addiction impacts pregnancy planning and pregnancy motivations, the stigma and fear regarding accessing health services, the lack of accurate knowledge of the human reproductive cycle and contraceptive methods and worries about contraception side-effects. Recommendations for interventions to reduce unintended pregnancy in this treatment population included the need for simple and focused information given by trusted communicators in a short time frame in accessible locations, and offering incentives for participation such as food and transportation. CONCLUSION As SUD treatment providers and programs look to improve access to sexual health and contraceptive options for women with SUD, these eight themes provide helpful guidance in crafting future interventions.
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Affiliation(s)
- Kimberly R Andringa
- UNC Horizons and Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510, USA
| | - Rachel M Schott
- UNC Horizons and Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510, USA
| | - Rachel Middlesteadt Ellerson
- UNC Horizons and Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510, USA
| | - Senga Carroll
- UNC Horizons and Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510, USA
| | - Hendrée E Jones
- UNC Horizons and Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510, USA; Departments of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, School of Medicine, Johns Hopkins University, Baltimore, MD 21224, USA.
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6
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Strzelecki AM, Gipson CD, Childs E, Weafer J. Preliminary evidence of increased alcohol use associated with ethinyl estradiol levels in women using oral contraceptives. Drug Alcohol Depend Rep 2023; 9:100194. [PMID: 37954868 PMCID: PMC10632661 DOI: 10.1016/j.dadr.2023.100194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 11/14/2023]
Abstract
Alcohol use is highly prevalent in young adult women and rates of alcohol use disorder are rising rapidly in this population. Further, emerging evidence suggests that circulating levels of ovarian hormones influence alcohol consumption, with increased consumption associated with higher estradiol and lower progesterone levels. However, less is known about the influence of synthetic hormones (contained in oral contraceptive (OC) pills) on alcohol use. The current study examined the influence of OC pill phase, ethinyl estradiol (EE) levels, and progestin levels on self-reported alcohol consumption in healthy female drinkers. Young adult female drinkers using OCs (N = 21) reported alcohol use across one OC pill pack using the Timeline Followback and provided blood samples during both pill phases to measure synthetic hormone levels. We compared alcohol use between OC pill phases (active vs. inactive) using linear mixed effects models for repeated measures and examined correlations between alcohol use and EE and progestin levels. Results showed that women with higher EE levels reported increased alcohol consumption (r = 0.56, p = 0.01) and binge drinking (r = 0.45, p = 0.04) in the active pill phase. Progestin levels and pill phase were not significantly associated with alcohol consumption. These findings provide preliminary data suggesting increased levels of EE from OC pills are associated with excessive alcohol consumption in women. Further research is needed to determine if EE plays a causal role in increased alcohol consumption. This line of research could inform female-specific AUD prevention and treatment strategies among the large subpopulation of women using hormonal contraceptives.
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Affiliation(s)
| | - Cassandra D. Gipson
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, United States
| | - Emma Childs
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Jessica Weafer
- Department of Psychology, University of Kentucky, Lexington, KY, United States
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, United States
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7
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Moran RN, Guin JR, Gardner J, Simer J. Baseline Computerized Neurocognitive Testing and Oculomotor Measures are not Altered by Hormonal Contraceptive Use. Arch Clin Neuropsychol 2023; 38:922-928. [PMID: 36759181 DOI: 10.1093/arclin/acad015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/09/2023] [Accepted: 01/13/2023] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVE Neurocognitive testing and oculomotor assessment have been an integral component to provide objective measures for sport-related concussion (SRC) detection and management. Hormonal contraceptive (HC) use is common among collegiate female athletes and may modify baseline SRC performance. The purpose was to examine the effects of HC use on baseline computerized neurocognitive testing (CNT) and oculomotor testing in college-aged individuals. METHOD A total of 63 participants (22 HC using females, 22 non-HC using females, 19 males) completed a baseline SRC battery consisting of CNT, near point of convergence (NPC), and the King-Devick (KD) test. CNT measures were composite scores of verbal and visual memory, visual motor processing speed and reaction time, impulse control, and cognitive efficiency index (CEI). NPC was measured as the average convergence distance across three trials. KD time was recorded as total time for each of the two trials and best trial marked as baseline. RESULTS There were no group differences between HC, non-HC, and male control groups on all baseline CNT composite scores (p = .13-.98), impulse control (p = .47), and CEI (p = .49). NPC distance was similar between groups (p = .41), as well as KD time by trial (Trial 1 p = .65; 2 p = .48) and best time (p = .49). CONCLUSIONS HC use does not appear to influence baseline SRC measures of neurocognition and oculomotor assessment. Clinicians should continue to consider the effects of modifying factors at baseline and post-concussion. Additional research is needed to better understand sex hormone levels and SRC performance measures.
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Affiliation(s)
- Ryan N Moran
- Department of Health Science, Athletic Training Research Laboratory, The University of Alabama, Tuscaloosa, AL, USA
| | - J Russell Guin
- Department of Health Science, Athletic Training Research Laboratory, The University of Alabama, Tuscaloosa, AL, USA
| | - James Gardner
- Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Josh Simer
- Department of Health Science, Athletic Training Research Laboratory, The University of Alabama, Tuscaloosa, AL, USA
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8
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Sims CA, Bermas BL, Clowse MEB. Vasculitis and Pregnancy: Disease State and Management. Rheum Dis Clin North Am 2023; 49:679-694. [PMID: 37331740 DOI: 10.1016/j.rdc.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Family planning in women with vasculitis requires an interdisciplinary approach. This article summarizes recommendations and guidance for each phase of family planning in persons with vasculitis including preconception counseling, birth control, pregnancy, and breastfeeding. Pregnancy complications are presented by category of vasculitis with accompanying diagnostic and therapeutic recommendations. Birth control and assisted reproductive technology options are reviewed with special considerations for women who are high risk or have a history of blood clots. This article can be used as a clinical reference for reproductive discussions in all patients with vasculitis.
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Affiliation(s)
- Catherine A Sims
- Division of Rheumatology, Duke University, 1021 Red Hat Lane, Durham, NC 27713, USA.
| | - Bonnie L Bermas
- University of Texas Southwestern, 2001 Inwood Road, Dallas, TX 75235, USA
| | - Megan E B Clowse
- Division of Rheumatology & Immunology, Duke University, 40 Duke Medicine Circle Clinic 1J, Durham, NC 27713, USA
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9
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Johnson EK. Telemedicine and direct to consumer advertising attitudes and the future of telehealth: Women report telemedicine as a comfortable option for accessing birth control. Health Mark Q 2023; 40:309-325. [PMID: 35762706 DOI: 10.1080/07359683.2022.2092377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE This paper addresses what variables predict and mediate relationships involving accessing telemedicine in the form of online birth control websites that are often advertised online on social media. BASIC PROCEDURES This is a survey study of N = 252 under 60 women (Mage = 24.71); multiple linear regression and mediation analyses were done to examine the influence of IBM variables on behavioral intentions. MAIN FINDINGS Women who currently use contraceptives report comfort and likelihood to use telemedicine services if they have positive attitudes about telemedicine and DTC advertising. Comfort with using an online contraceptive prescription service mediated the relationship between contraceptive use and likelihood to use telemedical services and between positive telemedicine attitudes and likelihood. PRINCIPAL CONCLUSIONS Women who are positive about telemedicine and DTC ads are comfortable using these resources, and comfort is a salient mediator. Comfort and its antecedents are important predictors and facilitators of telemedicine intentions and behaviors. Using telemedicine can improve the patient experience by offering alternatives to face-to-face visits (i.e., removing barriers to provider-to-patient communication).
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Affiliation(s)
- Erika Katherine Johnson
- School of Communication, Brody School of Medicine, East Carolina University, Greenville, NC, USA
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10
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Johansson L, Vesström J, Alehagen S, Kilander H. Women's experiences of dealing with fertility and side effects in contraceptive decision making: a qualitative study based on women's blog posts. Reprod Health 2023; 20:98. [PMID: 37381022 DOI: 10.1186/s12978-023-01642-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/20/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Worldwide, there is limited knowledge regarding women's views of future fertility in relation to contraceptive use. Few studies include material where women share their experiences at peer-written public domain websites, in spite of a larger portion of women discontinuing use of contraceptives. The objective of this study was to explore women's experiences of contraceptive methods based on data gathered from individual blog posts. METHODS Explorative qualitative study including 123 individual blog posts as the data source analysed with inductive thematic analysis. RESULTS Two themes were identified. Theme 1, 'Seeking control over reproduction and optimise fertility' including the sub-themes; Having the possibility to decide if, and when, to become pregnant, The value of effective contraceptive methods and the impact of women's sexuality, A wish to understand the body's normal fertility function and Limited knowledge-sharing information about the menstrual cycle during counselling and Theme 2, 'Making the complex decision on their own' including the sub- themes; Limited or subpar guidance in counselling and need for information from social media, Relational and environmental factors influencing contraceptive decision making and Considering beneficial effects and fears of adverse health effects when using hormonal contraceptive methods. CONCLUSIONS During counselling, women desired an extended dialogue regarding effectiveness, health effects of different methods and an increased understanding of their menstrual cycle. Insufficient understanding of contraceptive methods can lead to use of methods not providing the expected level of protection. Hormonal contraceptives, especially Long-acting reversible contraception (LARC) were believed to inhibit fertility long after ending treatment.
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Affiliation(s)
- Lydia Johansson
- Division of Nursing Sciences and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Julia Vesström
- Division of Nursing Sciences and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Siw Alehagen
- Division of Nursing Sciences and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Helena Kilander
- Division of Nursing Sciences and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, P.O. Box 1026, 551 11, Jönköping, Sweden.
- Department of Women's and Children's Health, Karolinska Institutet, and the WHO Collaborating Centre, Karolinska University Hospital, Stockholm, Sweden.
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11
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Gillen MM, Rosenbaum DL, Winter VR, Bloomer SA. Hormonal contraceptive use and women's well-being: links with body image, eating behavior, and sleep. PSYCHOL HEALTH MED 2023:1-12. [PMID: 37220269 DOI: 10.1080/13548506.2023.2216468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 05/16/2023] [Indexed: 05/25/2023]
Abstract
The goal of the current study was to examine associations between hormonal contraceptive use and indicators of well-being including body image, eating behavior, sleep and energy level. Drawing on a health protection framework, we expected that individuals who use hormonal contraceptives would be more attuned to health and report more positive health attitudes and behaviors on these dimensions. Undergraduate college women (N = 270; M = 19.39 years, SD = 2.43, range 18-39 years) from diverse racial/ethnic and sexual orientation groups completed a survey online. Measures included hormonal contraception use, body image, weight control behavior, breakfast consumption, sleep behavior, and daytime energy level. Nearly 1/3 (30.9%) of the sample reported current hormonal contraceptive use, with most users reporting use of birth control pills (74.7%). Women who used hormonal contraceptives reported significantly higher appearance orientation and body surveillance, lower average energy, more frequent night awakenings, and more naps. Longer duration of hormonal contraceptive use was significantly related to higher body surveillance, and engaging in more unhealthy weight control behavior. Hormonal contraceptive use is not related to indicators of greater well-being. Rather, hormonal contraceptive use is related to greater attention to appearance, lower daytime energy, and some indicators of poorer sleep quality. Clinicians who prescribe hormonal contraceptives should attend to body image, sleep and energy concerns among users.
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Affiliation(s)
- Meghan M Gillen
- Division of Social Sciences, The Pennsylvania State University, Abington, PA, USA
| | - Diane L Rosenbaum
- Division of Social Sciences, The Pennsylvania State University, Abington, PA, USA
| | | | - Steven A Bloomer
- Division of Science and Engineering, The Pennsylvania State University, Abington, PA, USA
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12
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Hunt JT, Kamat R, Yao M, Sharma N, Batur P. Effect of contraceptive hormonal therapy on mammographic breast density: A longitudinal cohort study. Clin Imaging 2023; 97:62-67. [PMID: 36893493 DOI: 10.1016/j.clinimag.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 02/25/2023] [Accepted: 03/01/2023] [Indexed: 03/08/2023]
Abstract
PURPOSE Evaluate the longitudinal relationship between mammographic density and hormonal contraceptive use in late reproductive-aged women. METHODS Patients aged 35-50 years old who underwent 5 or more screening mammograms within a 7.5-year period between 2004 and 2019 in a single urban tertiary care center were randomly selected. Patients were categorized into four cohorts based on hormonal contraceptive exposure during a 2-year lead-in period and a 7.5-year study period: 1) never exposed, 2) always exposed, 3) interval hormonal contraceptive start, and 4) interval hormonal contraceptive stop. The primary outcome was difference in BI-RADS breast density category between initial and final mammograms. RESULTS Of the 708 patients included, long-term use of combined oral contraceptives or a levonorgestrel intrauterine device were not associated with an increase in breast density category over the 7.5-year study period, compared to those with no hormonal contraceptive exposure. Initiation of combined oral contraceptives was associated with an increase in breast density category (β = 0.31, P = 0.045); however, no difference in initial density category was noted between those exposed and those never exposed to combined oral contraceptives during the 2-year lead-in period, and discontinuation was not associated with a decrease in breast density category when compared to those with continuous exposure. CONCLUSION(S) Long-term use of combined oral contraceptives or a levonorgestrel intrauterine device was not associated with an increase in BI-RADS breast density category. Initiation of a combined oral contraceptive was associated with an increase in breast density category, although this may be a transient effect.
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Affiliation(s)
- Jonathan T Hunt
- Department of Obstetrics & Gynecology, Women's Health Institute, Cleveland Clinic, Desk A81, 9500 Euclid Avenue, Cleveland, OH 44195, United States.
| | - Rachel Kamat
- Department of Obstetrics & Gynecology, Women's Health Institute, Cleveland Clinic, Desk A81, 9500 Euclid Avenue, Cleveland, OH 44195, United States
| | - Meng Yao
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH 44195, United States
| | - Nidhi Sharma
- Austin Radiological Association Women's Imaging Center, Suite 100, 1600 West 38(th) Street, Austin, TX 78731, United States
| | - Pelin Batur
- Department of Obstetrics & Gynecology, Women's Health Institute, Cleveland Clinic, Desk A81, 9500 Euclid Avenue, Cleveland, OH 44195, United States
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13
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Abstract
This article outlines the basics of all contraceptive options available in the United States, providing providers necessary information to best provide equitable contraceptive care for women. Long-acting reversible contraception should be considered in all women as there are few contraindications to use. Levonorgestrel intrauterine devices have been found to be safe for use for longer periods of time, in some cases up to eight years. Combination hormone contraceptives remain popular and offer benefits beyond contraception; importantly newer formulations exist providing patients with more contraceptive options. Education regarding emergency contraception should be provided to all patients.
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Affiliation(s)
- Rachel A Bonnema
- Internal Medicine, University of Texas Southwestern, 5323 Harry Hines Boulevard, Dallas, TX 75390-9126, USA.
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Frini O, Muller C. Revisiting fertility regulation and family ties in Tunisia. BMC Pregnancy Childbirth 2023; 23:88. [PMID: 36726068 PMCID: PMC9890736 DOI: 10.1186/s12884-023-05408-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 01/25/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND We revisit fertility regulation in Tunisia by examining the role of the extended family. As marriage is the exclusive acknowledged childbearing context, we examine fertility analysis in Tunisia through the sequence: woman's marriage age, post-marriage delay in the first use of contraception, and past and current contraceptive use. We trace the family socio-economic influences that operate through these decisions. METHODS Using data from the 2001 PAP-FAM Tunisian survey, we estimate the duration and probability models of these birth control decisions. RESULTS In Tunisia, family ties and socio-cultural environment appear to hamper fertility regulation that operates through the above decisions. This is notably the case for couples whose marriages are arranged by the extended family or who benefit from financial support from both parental families. CONCLUSION This calls for family planning policies that address more the extended families.
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Affiliation(s)
- Olfa Frini
- grid.424444.60000 0001 1103 8547Institut Supérieur de Comptabilité & d’Administration Des Entreprises, Manouba University, Tunis, Tunisia
| | - Christophe Muller
- grid.5399.60000 0001 2176 4817Aix-Marseille Univ, CNRS, AMSE, Marseille, France
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15
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Martell S, Marini C, Kondas CA, Deutch AB. Psychological side effects of hormonal contraception: a disconnect between patients and providers. Contracept Reprod Med 2023; 8:9. [PMID: 36647102 DOI: 10.1186/s40834-022-00204-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/29/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Existing literature about the psychological side effects of hormonal contraception (HC) is limited. The goal of this study is to better characterize patients' subjective experiences with HC, its side effects, and contraception counseling. METHODS This is a cross-sectional, survey-based study using a convenience sample of patients who had used HC at some point in their lives. Recruitment occurred from June 2021-February 2022. RESULTS Of the 188 responses included in the analysis, 43.6% reported experiencing mood changes as a side effect of HC at some point in their lives. The most common reason participants cited for discontinuing or switching contraception methods was side effects (48.3%). Participants with a history of psychiatric illness were significantly more likely to report mood changes as a side effect of their HC (61.2%) compared to participants with no history of psychiatric illness (29.5%). Among patients with a history of psychiatric illness, 38.8% responded that their psychiatric symptoms worsened with HC while only 11.2% responded that their symptoms improved with HC. The majority (83%) of participants responded that their provider never mentioned the possibility of psychological side effects during contraception counseling. If/when they experienced side effects associated with their HC, 22.7% of participants disagreed that their provider adequately addressed their concerns. CONCLUSION These findings suggest that mood changes may be among the most common perceived side effects of HC and speak to a disconnect between patients and providers when it comes to discussing the possibility of psychological side effects with HC.
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16
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Song JY, Patton CD, Friedman R, Mahajan LS, Nordlicht R, Sayed R, Lipton ML. Hormonal contraceptives and the brain: A systematic review on 60 years of neuroimaging, EEG, and biochemical studies in humans and animals. Front Neuroendocrinol 2023; 68:101051. [PMID: 36577486 PMCID: PMC9898167 DOI: 10.1016/j.yfrne.2022.101051] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/26/2022]
Abstract
Hormonal contraception has been widely prescribed for decades. Although safety and efficacy are well-established, much uncertainty remains regarding brain effects of hormonal contraception. We systematically review human and animal studies on the brain effects of hormonal contraception which employed neuroimaging techniques such as MRI, PET and EEG, as well as animal studies which reported on neurotransmitter and other brain biochemical effects. We screened 1001 articles and ultimately extracted data from 70, comprising 51 human and 19 animal studies. Of note, there were no animal studies which employed structural or functional MRI, MRS or PET. In summary, our review shows hormonal contraceptive associations with changes in the brain have been documented. Many questions remain and more studies are needed to describe the effects of hormonal contraception on the brain.
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Affiliation(s)
- Joan Y Song
- The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA; Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA; The Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | | | - Renee Friedman
- The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Lakshmi S Mahajan
- The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Rachel Nordlicht
- The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Rahman Sayed
- The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Michael L Lipton
- The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA; Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA; Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA; The Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
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17
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Goyal S, Monsour M, Ko JY, Curtis KM, Whiteman MK, Coy KC, Cox S, Romero L. Contraception claims by medication for opioid use disorder prescription status among insured women with opioid use disorder, United States, 2018. Contraception 2023; 117:67-72. [PMID: 36243128 PMCID: PMC9722562 DOI: 10.1016/j.contraception.2022.09.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/14/2022] [Accepted: 09/23/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVE(S) To understand how contraception method use differed between women prescribed and not prescribed medications for opioid use disorder (MOUD) among commercially-insured and Medicaid-insured women. STUDY DESIGN IBM Watson Health MarketScan Commercial Claims and Encounters database and the Multi-State Medicaid database were used to calculate the (1) crude prevalence, and (2) adjusted odds ratios (adjusted for demographic characteristics) of using long-acting reversible or short-acting hormonal contraception methods or female sterilization compared with none of these methods (no method) in 2018 by MOUD status among women with OUD, aged 20 to 49 years, with continuous health insurance coverage through commercial insurance or Medicaid for ≥6 years. Claims data was used to define contraception use. Fisher exact test or χ2 test with a P-value ≤ 0.0001, based on the Holm-Bonferroni method, and 95% confidence intervals were used to determine statistically significant differences for prevalence estimates and adjusted odds ratios, respectively. RESULTS Only 41% of commercially-insured and Medicaid-insured women with OUD were prescribed MOUD. Medicaid-insured women with OUD prescribed MOUD had a significantly lower crude prevalence of using no method (71.1% vs 79.0%) and higher odds of using female sterilization (aOR, 1.33; 95% CI: 1.06-1.67 vs no method) than those not prescribed MOUD. Among commercially-insured women there were no differences in contraceptive use by MOUD status and 66% used no method. CONCLUSIONS Among women with ≥ 6 years of continuous insurance coverage, contraceptive use differed by MOUD status and insurance. Prescribing MOUD for women with OUD can be improved to ensure quality care. IMPLICATIONS Only two in five women with OUD had evidence of being prescribed MOUD, and majority did not use prescription contraception or female sterilization. Our findings support opportunities to improve prescribing for MOUD and integrate contraception and MOUD services to improve clinical care among women with OUD.
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Affiliation(s)
- Sonal Goyal
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Michael Monsour
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jean Y. Ko
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Kathryn M. Curtis
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Maura K. Whiteman
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Kelsey C. Coy
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States,Oak Ridge Institute for Science and Education, Oak Ridge, TN, United States
| | - Shanna Cox
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Lisa Romero
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States.
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18
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Rink E, Anastario M, Reimer GA, Peterson M. An ecological approach to understanding Women's reproductive health and pregnancy decision making in Greenland. Health Place 2022; 77:102868. [PMID: 35932597 DOI: 10.1016/j.healthplace.2022.102868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 12/27/2022]
Abstract
Using a community based participatory research framework and ecological systems theory we explored the experiences of reproductive health among Inuit women living in a remote Northwestern settlement in Greenland to understand the multiple diverse factors that influence their pregnancy outcomes. We conducted 15 in depth interviews with Inuit women between the ages of 19 and 45. Key factors influencing women's pregnancy decision making were: 1) precursors to pregnancy; 2) birth control use; 3) adoption and abortion; and 4) access to reproductive health care. Our results highlight the need to identify pathways through research, policy, health promotion, and health care practice that can support Inuit women in Greenland to be reproductively healthy and make informed decisions about pregnancy that resonate with their cultural beliefs as well as the realities of their everyday lives. We recommend the integration of cultural messaging into interdisciplinary approaches for preventive reproductive health care with women living in remote Arctic communities.
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Affiliation(s)
- Elizabeth Rink
- Montana State University, Department of Health and Human Development, 312 Herrick Hall, Bozeman, MT, 59719, USA.
| | - Mike Anastario
- Florida International University, Robert Stempel College of Public Health and Social Work, 11200 S.W. 8th Street, Miami, FL, 33199, USA.
| | - Gitte Adler Reimer
- Ilisimatusarfik, University of Greenland, Postboks 1061, Nuuk, 3900, Greenland.
| | - Malory Peterson
- Montana State University, Department of Health and Human Development, 312 Herrick Hall, Bozeman, MT, 59719, USA.
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19
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Suzuki N, Takai Y, Yonemura M, Negoro H, Motonaga S, Fujishiro N, Nakamura E, Takae S, Yoshida S, Uesugi K, Ohira T, Katsura A, Fujiwara M, Horiguchi I, Kosaki K, Onodera H, Nishiyama H. Guidance on the need for contraception related to use of pharmaceuticals: the Japan Agency for Medical Research and Development Study Group for providing information on the proper use of pharmaceuticals in patients with reproductive potential. Int J Clin Oncol 2022; 27:829-839. [PMID: 35347493 PMCID: PMC9023394 DOI: 10.1007/s10147-022-02149-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/28/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND The U.S. Food and Drug Administration (FDA) and European Medicines Agency (EMA) have published guidelines on the use of cancer treatments in young people of reproductive potential. However, no such guideline is available in Japan. Therefore, this project aimed to gather relevant data and draft a respective guidance paper. METHODS From April 2019 to March 2021, the Study Group for Providing Information on the Proper Use of Pharmaceuticals in Patients with Reproductive Potential at the Japan Agency for Medical Research and Development gathered opinions from experts in reproductive medicine, toxicology, and drug safety measures. The group considered these opinions, the FDA and EMA guidelines, and relevant Japanese guidelines and prepared a guidance paper, which they sent to 19 related organizations for comment. RESULTS By November 2020, the draft guidance paper was completed and sent to the related organizations, 17 of which provided a total of 156 comments. The study group finalized the guidance paper in March 2021. CONCLUSIONS The "Guidance on the Need for Contraception Related to Use of Pharmaceuticals" (The report of the Study Group for Providing Information on the Proper Use of Pharmaceuticals in Patients with Reproductive Potential, Research on Regulatory Science of Pharmaceuticals and Medical Devices, Japan Agency for Medical Research and Development: JP20mk0101139) is expected to help Japanese healthcare professionals provide fertility-related care and advice to adolescents, and young adults with cancer and their families.
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Affiliation(s)
- Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki-shi, Kanagawa, 216-8511, Japan.
| | - Yasushi Takai
- Department of Obstetrics and Gynecology, Saitama Medical Center, 1981 Kamoda, Kawagoe-shi, Saitama, Japan
| | - Masahito Yonemura
- Department of Pharmacy, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba, Japan
| | - Hiromitsu Negoro
- Department of Urology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, Japan
| | - Shinya Motonaga
- Pharmacovigilance Section, Office of Clinical Research Support, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba, Japan
| | - Noriko Fujishiro
- Pharmacovigilance Section, Office of Clinical Research Support, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba, Japan
| | - Eishin Nakamura
- Department of Obstetrics and Gynecology, Saitama Medical Center, 1981 Kamoda, Kawagoe-shi, Saitama, Japan
| | - Seido Takae
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki-shi, Kanagawa, 216-8511, Japan
| | - Saori Yoshida
- Qol Co., Ltd, 4-3-1 Toranomon, Minato-ku, Tokyo, Japan
| | - Koji Uesugi
- Pfizer R&D Japan G.K, 3-22-7 Yoyogi, Shibuya-ku, Tokyo, Japan
- Pharmaceutical Research and Manufacturers of America, 3-7-8 Toranomon, Minato-ku, Tokyo, Japan
| | - Takashi Ohira
- Takeda Pharmaceutical Company Limited, 2-1-1 Nihonbashi-Honcho, Chuo-ku, Tokyo, Japan
- Japan Pharmaceutical Manufacturers Association, 2-3-11 Nihonbashi-Honcho, Chuo-ku, Tokyo, Japan
| | - Aiko Katsura
- Novartis Pharma K.K, 1-23-1 Toranomon, Minato-ku, Tokyo, Japan
- European Federation of Pharmaceutical Industries and Associations, Japan, 2-1-1 Osaki, Shinagawa-ku, Tokyo, Japan
| | - Michio Fujiwara
- Japan Pharmaceutical Manufacturers Association, 2-3-11 Nihonbashi-Honcho, Chuo-ku, Tokyo, Japan
| | - Itsuko Horiguchi
- The Support Center for Clinical Pharmacy Education and Research, Tokyo University of Science, 1-3 Kagurazaka, Shinjuku-ku, Tokyo, Japan
| | - Kenjiro Kosaki
- Center for Medical Genetics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Hiroshi Onodera
- Division of Pathology, Center for Biological Safety Research, National Institute of Health Sciences, 3-25-26 Tonomachi, Kawasaki-ku, Kawasaki-shi, Kanagawa, 210-9501, Japan
| | - Hiroyuki Nishiyama
- Department of Urology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, Japan
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20
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Murphy EC, Danvers A, Zamudio AR, Avila K, Proehl M, Gonzalez-Argoti T, Mantell JE, Bauman LJ, Dolan SM. "Being able to do whatever you wanna do as a woman is important:" a qualitative exploration of contraception as a frame of reference for HIV prevention with PrEP. Reprod Health 2022; 19:92. [PMID: 35392943 PMCID: PMC8991476 DOI: 10.1186/s12978-022-01393-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background Use of HIV PrEP (pre-exposure prophylaxis) is a strategic tool in the effort to end the HIV epidemic. 20% of new HIV infections in the US are among cis-gender women, yet they comprise only 5% of all PrEP users. Black women disproportionately bear the burden of new HIV acquisition and accounted for almost 60% of new HIV diagnoses among women in 2018. Increasing understanding and uptake of PrEP among women at risk of HIV acquisition in alignment with their reproductive values and preferences is key to increasing PrEP uptake and decreasing HIV burden in this population. Objective This study examines how experiences with contraception among women of color shape their perceptions and preferences regarding HIV PrEP to inform counseling that aligns with their reproductive values. Methods Women aged 18–45 who self-identified as Black or Latina were recruited at an academic medical center in the Bronx from June 2018 to July 2019. We enrolled 30 participants seeking family planning care (10), prenatal care (10), or care for sexually transmitted infections (10). Participants completed a brief written survey assessing their risk of HIV acquisition. Semi-structured, face-to-face interviews were then audio-recorded, transcribed, and entered into Dedoose. Grounded theory and constant comparison approaches were used to analyze the data. Results Twenty-one participants (70%) screened positive for HIV acquisition risk. Four had received information on PrEP from a medical provider prior to the interview. Three themes emerged from the qualitative analysis: (1) Similar to oral contraception, women conceptualized PrEP as a “daily pill” to support their reproductive health; (2) Women perceived PrEP as a tool to support autonomy and pleasure in their sexual health; (3) Like birth control, women desired multiple delivery options for HIV prophylaxis. Conclusions Contraception may serve as a frame of reference when counseling about PrEP among cis-women at risk of acquiring HIV. Our study suggests that this approach re-contextualizes counseling on PrEP within a sex-positive framework that prioritizes pleasure, safety, and autonomy as integral to sexual and reproductive wellness. Consideration of historically marginalized women’s experiences with contraception and reproductive values may facilitate their use of PrEP. PrEP (pre-exposure prophylaxis) is a medicine taken daily by people at risk of getting HIV from sex or injection drug use. Although PrEP is a safe and effective medication for women, the use of PrEP remains exceedingly low among cis-gender women at risk of HIV in the US. This study examines how experiences with contraception among women of color, who disproportionately bear the burden of HIV acquisition, shape their perceptions and preferences regarding PrEP. We interviewed 30 women who self-identified as Black or Latina at an academic medical center in the Bronx. Similar to oral contraception, women in this study conceptualized PrEP as a “daily pill” to support their reproductive health. This report details how women’s experiences with contraception may serve as the foundation to re-contextualize conversations on PrEP within a sex-positive framework that prioritizes pleasure, safety, and autonomy as integral to sexual and reproductive wellness.
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Affiliation(s)
- Emma Chew Murphy
- Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Antoinette Danvers
- Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Andrés Ramírez Zamudio
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai and Mount Sinai Health System, New York, NY, USA
| | - Karina Avila
- Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Meghan Proehl
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai and Mount Sinai Health System, New York, NY, USA
| | - Tatiana Gonzalez-Argoti
- Departments of Pediatrics and Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Joanne E Mantell
- HIV Center for Clinical and Behavioral Studies, Gender, Sexuality and Health Area, Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Laurie J Bauman
- Departments of Pediatrics and Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Siobhan M Dolan
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai and Mount Sinai Health System, New York, NY, USA. .,Icahn School of Medicine at Mount Sinai and Mount Sinai Health System, 1176 Fifth Avenue, 9th Floor, Box 1170, New York, NY, 10029, USA.
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21
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Zareian B, Anderl C, LeMoult J, Galea LAM, Prior JC, Rights JD, Ross CJ, Ge S, Hayward AC, Chen FS. Assessing the role of adolescent hormonal contraceptive use on risk for depression: a 3-year longitudinal study protocol. BMC Womens Health 2022; 22:48. [PMID: 35197045 PMCID: PMC8864455 DOI: 10.1186/s12905-022-01623-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 02/09/2022] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND The incidence of depression in human females rises steadily throughout adolescence, a critical period of pubertal maturation marked by increasing levels of gonadal hormones including estrogens and progesterone. These gonadal hormones play a central role in social and emotional development and may also contribute to the increased occurrence of depression in females that begins in early adolescence. In this study, we examine whether and how introducing synthetic estrogen and progestin derivatives through the use of combined hormonal contraceptives (CHC), affects adolescent females' risk for developing depression. We further assess potential links between CHC use and alterations in stress responses and social-emotional functioning. METHODS Using a longitudinal cohort design, we will follow a sample of adolescent females over the span of three years. Participants will be assessed at three time points: once when they are between 13 and 15 years of age, and at approximately 18 and 36 months after their initial assessment. Each time point will consist of two online sessions during which participants will complete a clinical interview that screens for key symptoms of mental health disorders, along with a series of questionnaires assessing their level of depressive symptoms and history of contraceptive use. They will also complete a standardized social-evaluative stress test and an emotion recognition task, as well as provide saliva samples to allow for assessment of their circulating free cortisol levels. DISCUSSION In this study we will assess the effect of CHC use during adolescence on development of Major Depressive Disorder (MDD). We will control for variables previously found to or proposed to partially account for the observed relationship between CHC use and MDD, including socioeconomic status, age of sexual debut, and CHC-related variables including age of first use, reasons for use, and its duration. In particular, we will discover whether CHC use increases depressive symptoms and/or MDD, whether elevated depressive symptoms and/or MDD predict a higher likelihood of starting CHC, or both. Furthermore, this study will allow us to clarify whether alterations in stress reactivity and social-emotional functioning serve as pathways through which CHC use may result in increased risk of depressive symptoms and/or MDD.
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Affiliation(s)
- Bita Zareian
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Christine Anderl
- Department of Psychology, University of British Columbia, Vancouver, Canada.,Leibniz-Institut für Wissensmedien, Tübingen, Germany
| | - Joelle LeMoult
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Liisa A M Galea
- Department of Psychology, University of British Columbia, Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Jerilynn C Prior
- Centre for Menstrual Cycle and Ovulation Research, Endocrinology and Metabolism, University of British Columbia, Vancouver, Canada.,BC Women's Health Research Institute, Vancouver, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, Canada.,Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Jason D Rights
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Colin J Ross
- BC Children's Hospital Research Institute, Vancouver, Canada.,Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
| | - Sabrina Ge
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Annie C Hayward
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Frances S Chen
- Department of Psychology, University of British Columbia, Vancouver, Canada.
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22
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Gold JI, Gold NB, DeLeon DD, Ganetzky R. Contraceptive use in women with inherited metabolic disorders: a retrospective study and literature review. Orphanet J Rare Dis 2022; 17:41. [PMID: 35135572 PMCID: PMC8822780 DOI: 10.1186/s13023-022-02188-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Reproductive planning is an emerging concern for women with inherited metabolic disease (IMD). Anticipatory guidance on contraception is necessary to prevent unintended pregnancies in this population. Few resources exist to aid informed decision-making on contraceptive choice. A retrospective case-control study was performed to examine trends in reproductive planning for adolescent and adult women seen at the Children's Hospital of Philadelphia (CHOP). Literature review on contraception and IMD was performed to assess global use. RESULTS In a cohort of 221 reproductive-aged female IMD patients, 29.4% reported routine contraceptive use. Anticipatory guidance on contraception was provided by metabolic physicians to 36.8% of patients during the study period. Contraception discussion was more likely to occur in women older than 21 years, who lived independently and were followed by gynecology. Women who received contraception counseling from their metabolic physician were 40-fold more likely to use regular contraception. Use of combined hormonal contraceptives was most commonly reported, but contraception choice varied by age and IMD. CONCLUSION Metabolic physicians are ideally suited to provide guidance on contraception to women with IMD. Reproductive planning should be addressed routinely using shared decision-making. Contraceptives should be selected for their efficacy, effects on metabolism, and likelihood of patient adherence.
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Affiliation(s)
- Jessica I Gold
- Division of Human Genetics, Section of Biochemical Genetics, The Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA.
| | - Nina B Gold
- Division of Medical Genetics and Metabolism, Massachusetts General Hospital for Children, Boston, MA, USA
| | - Diva D DeLeon
- Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca Ganetzky
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,Division of Human Genetics, Section of Biochemical Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
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23
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Fikslin RA, Goldberg AJ, Gesselman AN, Reinka MA, Pervez O, Franklin ET, Ahn O, Price DM. Changes in Utilization of Birth Control and PrEP During COVID-19 in the USA: A Mixed-Method Analysis. Arch Sex Behav 2022; 51:365-381. [PMID: 34750774 PMCID: PMC8574936 DOI: 10.1007/s10508-021-02086-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 06/02/2023]
Abstract
In the USA, the COVID-19 pandemic has created challenges beyond the direct consequences of the infection. Because of shifting resources in response to need, many domains within the healthcare sector unrelated to COVID-19 have had interrupted abilities to provide care. In the current study, we focus on preventative sexual health care during the pandemic. In a sample of 511 (mean age = 27.7) people, we examined quantitative data regarding continuation and discontinuation of birth control and PrEP during the pandemic, along with qualitative data illustrating the underlying reasons for participants' (dis)continuation. Results showed that most (92.5%) of birth control users reported continuation of their birth control, with the predominant reasons reported being use for health reasons, long-acting reversible contraceptive use, access to remote healthcare services, and increased vigilance over pregnancy prevention. Conversely, around half (52.6%) of PrEP-using participants reported already discontinuing or planning to discontinue their PrEP regimen. Temporary abstinence and concerns about accessing in-person health care were the predominant reasons for PrEP discontinuation. These results have implications for both researchers and sexual healthcare providers. Disruptions to preventative sexual health care should be considered in ongoing research about patient needs, and healthcare providers may wish to consider particular challenges faced by PrEP users concerning re-start and continuation.
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Affiliation(s)
- Rachel A Fikslin
- Department of Psychology, Hunter College of the City University of New York, 695 Park Ave, New York, NY, 10065, USA
- Basic and Applied Social Psychology (BASP) PhD Program, Department of Psychology, Graduate Center of the City University of New York, New York, NY, USA
- Hunter Alliance for Research and Translation (HART), Hunter College of the City University of New York, New York, NY, USA
| | - Alison J Goldberg
- Department of Psychology, Hunter College of the City University of New York, 695 Park Ave, New York, NY, 10065, USA
- Basic and Applied Social Psychology (BASP) PhD Program, Department of Psychology, Graduate Center of the City University of New York, New York, NY, USA
- Hunter Alliance for Research and Translation (HART), Hunter College of the City University of New York, New York, NY, USA
| | | | - Mora A Reinka
- Department of Psychology, Ursinus College, Collegeville, PA, USA
| | - Omaima Pervez
- Department of Psychology, Hunter College of the City University of New York, 695 Park Ave, New York, NY, 10065, USA
| | - Elissia T Franklin
- Research Her, LLC, South Holland, IL, USA
- Silent Spring Institute, Newton, MA, USA
| | - Olivia Ahn
- Hunter Alliance for Research and Translation (HART), Hunter College of the City University of New York, New York, NY, USA
| | - Devon M Price
- Department of Psychology, Hunter College of the City University of New York, 695 Park Ave, New York, NY, 10065, USA.
- Hunter Alliance for Research and Translation (HART), Hunter College of the City University of New York, New York, NY, USA.
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Richard C, Pourchasse M, Freton L, Esvan M, Ravel C, Peyronnet B, Mathieu R, Chhor S. Male contraception: What do women think? Prog Urol 2021; 32:276-283. [PMID: 34924309 DOI: 10.1016/j.purol.2021.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 10/29/2021] [Accepted: 11/21/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Women currently bear the most responsibility in contraception, with a wide choice of methods, while only a few existing male contraceptives are available. However, it has been shown that men are willing to get involved in birth control and to control their own fertility. Our research was focused on female population and a survey was carried out to explore women's perceptions of male contraception. METHODS An observational quantitative cross-sectional study using a self-administered-questionnaire was carried out between November 2019 and February 2020. All women aged from 16-years-old to menopause completing the questionnaire were included. Descriptive statistical analyses were conducted, qualitative variables were expressed as counts and frequency. RESULTS In total, 379 interpretable completed questionnaires were included. Among the women, 69.7% were in favour of letting men deal with contraception, without referring to a specific method. After having been made aware of the medical information concerning existing male contraceptives and those in development, the proportion of women in favour dropped to 46.7%. The most acceptable method for a majority of women was the male pill, which is still being developed. The majority (78.4%) of the women in our survey felt insufficiently informed about male contraception. DISCUSSION In our study, women seemed to want to share contraceptive responsibility with men, but the lack of information and of acceptable contraception methods available remained an obstacle. Although larger-scale studies are needed to confirm these results, the development of a wider range of male contraception methods seems to be what both men and women have long been expecting.
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Affiliation(s)
- C Richard
- Department of Urology, University of Rennes, Rennes, France.
| | - M Pourchasse
- Department of General Medicine, University of Rennes, Rennes, France
| | - L Freton
- Department of Urology, University of Rennes, Rennes, France
| | - M Esvan
- Clinical Investigation Department, University of Rennes, Rennes, France
| | - C Ravel
- CECOS, University of Rennes, Rennes, France
| | - B Peyronnet
- Department of Urology, University of Rennes, Rennes, France
| | - R Mathieu
- Department of Urology, University of Rennes, Rennes, France
| | - S Chhor
- Department of General Medicine, University of Rennes, Rennes, France; Clinical Investigation Department, University of Rennes, Rennes, France
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Rosenthal MA, McQuillan SK. What do I need to know about the etonogestrel-relesasing contraceptive implant (Nexplanon)? Paediatr Child Health 2021; 26:394-395. [PMID: 34777656 DOI: 10.1093/pch/pxab014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/03/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- Margot A Rosenthal
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sarah K McQuillan
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, Alberta, Canada
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Rodriguez MI, Kaufman M, Manibusan B, Anderson L, McConnell KJ. Medical contraindications to combined hormonal contraceptive use among women using methods prescribed by a pharmacist. Contraception 2021; 104:547-552. [PMID: 34116068 DOI: 10.1016/j.contraception.2021.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/03/2021] [Accepted: 06/05/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine whether pharmacist prescription of combined hormonal contraception is associated with inappropriate prescription to women with medical contraindications. STUDY DESIGN We conducted a retrosopective cohort study of all short-acting, hormonal contraceptive users (pill, patch, ring, injectable) in Oregon's All Payer All Claims database from January 1, 2016 to December 31, 2018. Our primary outcome was the proportion of women receiving a combined hormonal method who had a Medical Eligibility Category (MEC) 3 or 4 condition. We identified potential contraindications using International Classification of Disease codes. We conducted descriptive analyses of contraindication prevalence and prescription error rate by prescriber type. We used a multivariable logistic regression model to test the association between pharmacist prescriber and population characteristics. RESULTS Our study sample consisted of 439,240 contraceptive users, of which 3782 (0.86%) received their prescriptions from a pharmacist. Women aged 25 to 29 were more likely than women over age 35 to receive contraception from a pharmacist (adjusted odds ratio (aOR) 2.74, 95% confidence interval [CI] 2.44-3.08). Pharmacist prescriptions were slightly less likely in rural areas (aOR 0.78, 95% CI 0.69-0.89) and among women on Medicaid, relative to those with commercial insurance (aOR 0.21, 95% CI 0.19-0.24). Among women given contraception in a clinical setting, 4.25% had evidence of an MEC 3 or 4 contraindication, compared to 0.9% for women seen by a pharmacist. Rates of prescribing a combined method to women with a potential contraindication were not meaningfully different by prescriber type (2.16% for clinicians vs 0.74% for pharmacists). CONCLUSION Rates of contraceptive prescribing with a contraindication were relatively low and did not differ between clinicians and pharmacists. IMPLICATIONS Pharmacists can safely screen for medical contraindications to combined hormonal contraception.
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Affiliation(s)
- Maria I Rodriguez
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, United States; Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, OR, United States.
| | - Menolly Kaufman
- Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, OR, United States
| | - Brynna Manibusan
- Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, OR, United States
| | - Lorinda Anderson
- College of Pharmacy, Oregon State University, Corvallis, OR, United States
| | - K John McConnell
- Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, OR, United States
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Tyson N, Lopez M, Merchant M, Postlethwaite D. Subdermal Contraceptive Implant Insertion Trends and Retention in Adolescents. J Pediatr Adolesc Gynecol 2021; 34:348-354. [PMID: 33388444 DOI: 10.1016/j.jpag.2020.12.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/19/2020] [Accepted: 12/28/2020] [Indexed: 10/22/2022]
Abstract
STUDY OBJECTIVE There is growing advocacy for use of long-acting reversible contraception among sexually active adolescents. Our primary aims were to evaluate the etonogestrel subdermal contraceptive implant (SCI) insertion trends among adolescents, as well as SCI retention at 1, 2, and 3 years, indications for removal, and to identify pregnancies that occurred during SCI use. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: A retrospective cohort study was conducted of adolescents aged 13-19 years with SCI insertions in 2008-2014 within a large integrated health care system. Demographic and clinical characteristics included age, race/ethnicity, body mass index, gravidity, parity, insertions, reinsertions, indications for removal, and pregnancy. Electronic medical record review was conducted on a randomized sample of 540 adolescents with insertions during 2008-2011 for the retention objective to validate electronically extracted variables. Analyses included descriptive statistics, survival analysis with Kaplan-Meier estimates for implant retention and Cochran-Armitage trend test for insertions according to year during 2008-2014. RESULTS Most adolescent SCI users were non-Hispanic white (43%), or Hispanic (34.2%) and 16 years or older (84.2%) at the time of insertion. Overall, 1-, 2-, and 3-year retention rates were 78.6%, 59.4%, and 26.2%, respectively, with retention at 44.3% at 2 years 9 months (indicative of removal of method for near expiration of 3-year device). The insertion rate trend showed statistically significant increases annually, from 0.14% in 2008 to 0.91% in 2014; P < .0001. No pregnancies were documented during implant use. The most common indication for SCI removal was device expiration. CONCLUSION SCI insertions increased annually among adolescents, with more than a sixfold increase over the 6-year study period, and more than half of the SCIs were retained through 2 years of use. The most common indication of SCI removal was completion of Food and Drug Administration-approved duration.
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Affiliation(s)
- Nichole Tyson
- Department of Obstetrics and Gynecology, Kaiser Permanente, Roseville, California; Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California.
| | - MaryAlice Lopez
- Department of Obstetrics and Gynecology, Kaiser Permanente, Oakland, California; Women's Health Associates, Boise, Idaho
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Nguyen M, Chan EYL, Nguyen T, Markovic D, Sridhar A. Traditional or technological? A cross sectional survey of oral contraceptive reminders in young adults. Sex Reprod Healthc 2021; 29:100618. [PMID: 33857773 DOI: 10.1016/j.srhc.2021.100618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 03/06/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES For patients relying only on oral contraceptive pills (OCPs) for pregnancy prevention, timely and correct usage of OCPs is essential. This study describes the prevalence of reminder systems used among our patients, the patient population that uses those reminder systems, and whether the reminder system was effective for the user in terms of not missing pills per pack. METHODS We conducted a cross-sectional survey among 102 OCP users at 3 individual clinics in the UCLA Health System. To quantify OCP adherence, we used the unit pill pack to indicate one month's supply of OCPs. RESULTS Majority of patients were young educated individuals who used OCPs for 1 year or longer. 44% of participants used strictly technology-based reminders including alarms, phone applications, and text-based systems. 25% of participants used only traditional reminders, including co-administration with other medications, location placement, and as part of a morning/evening routine. 6% of participants used a combination of technology-based and traditional reminders. 21% of participants did not rely on any reminder system for OCP self-administration. 4% of participants used "Other or Unknown" reminder systems. The majority of participants missed less than 2 pills in their pill pack. Those who relied on technological reminders missed pills more frequently than those who depended on traditional reminders. CONCLUSION Our results indicate that despite growing prevalence of technology-based reminder systems, traditional reminders are as prevalent as the technology-based ones. There was no difference in the number of missed pills between the two groups. The study is limited by the use of convenience sampling. Our study sheds light on strategies that a majority young and educated patient population might use to increase OCP adherence.
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Affiliation(s)
| | | | - Tina Nguyen
- David Geffen School of Medicine at UCLA, United States
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Jones HE, Martin CE, Andringa KR, Ellerson RM, Johnson E, Hairston E, O’ Grady KE. Sex and female empowerment (SAFE): A randomized trial comparing sexual health interventions for women in treatment for opioid use disorder. Drug Alcohol Depend 2021; 221:108634. [PMID: 33676071 PMCID: PMC8048040 DOI: 10.1016/j.drugalcdep.2021.108634] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Unintended pregnancies are prevalent among women with opioid use disorder (OUD). The Sex and Female Empowerment (SAFE) project developed a social-cognitive, theory-driven intervention to increase acceptance of and adherence to contraceptive practices among women receiving medication for OUD (MOUD). This study evaluated the feasibility and acceptability of two SAFE interventions (Face-to-face and Computer-adapted) compared to usual care as well as their efficacy to improve contraception utilization. METHODS This pilot randomized trial enrolled 90 heterosexual, non-pregnant, reproductive-age women receiving MOUD. Participants were randomized into either a: SAFE Face-to-face intervention, SAFE Computer-adapted intervention, or usual care (UC) condition (n = 30 each) and followed for 6 months. Outcome measures included intervention completion, intervention satisfaction, attendance at a contraception consultation appointment, and long-acting reversible contraceptive (LARC) method receipt. A generalized linear model was used for inferential testing and to estimate least squares means (predicted probabilities for binary outcomes) and their standard errors. RESULTS Compared to the UC condition, both the SAFE Face-to-face and the SAFE Computer-adapted intervention had higher intervention completion [Means (Standard Errors) = 0.97 (.03) and 0.97 (.03), respectively, vs. 0.53 (.09); ps<.001], higher intervention satisfaction [Ms (SEs) = 3.7 (.11) and 3.8 (.11), respectively, vs. 3.1 (.11); ps<0.001), higher contraception consultation visit attendance [Ms(SEs) = 0.80 (.07) and 0.73 (.08) vs. 0.33 (.09); p < .001], and greater LARC receipt [Ms(SEs) = 0.77 (.08) and 0.73 (.08) vs. 0.23 (.08); p < .001). CONCLUSIONS SAFE appears feasible and efficacious for supporting women in contraception decision-making. Integrating SAFE into women's comprehensive OUD treatment services holds promise to increase contraceptive decision-making and initiation of a chosen method.
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Affiliation(s)
- Hendrée E. Jones
- UNC Horizons and Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510,Departments of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, School of Medicine, Johns Hopkins University, Baltimore, MD 21224 USA
| | - Caitlin E. Martin
- Department of Obstetrics and Gynecology & Institute of Drug and Alcohol Studies, Virginia Commonwealth University School of Medicine, Richmond, VA 23298
| | - Kimberly R. Andringa
- UNC Horizons and Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510
| | - Rachel Middlesteadt Ellerson
- UNC Horizons and Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510
| | - Elisabeth Johnson
- UNC Horizons and Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510
| | - Essence Hairston
- UNC Horizons and Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510
| | - Kevin E. O’ Grady
- Department of Psychology, University of Maryland, College Park, College Park, MD 20742
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Santoro JD, Hurtubise B, Rosario JD, Pagarkar D, Wiegand SE, Su E, Ahsan N. Underutilization of Contraception in Young Females with Demyelinating Disorders. Mult Scler Relat Disord 2021; 51:102881. [PMID: 33730609 DOI: 10.1016/j.msard.2021.102881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 02/02/2021] [Accepted: 03/04/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Demyelinating disorders in young females are frequently treated with immunomodulatory therapy which often have unknown risks to fetuses during pregnancy. In spite of this, there is no literature in this population about the use of contraception. Our objective was to determine the rate of use of contraception used in a real-world cohort of pediatric patients on immunotherapy for demyelinating diseases. METHODS A retrospective, multi-center, chart-based review was performed. Inclusion criteria was female gender, use of immunotherapy for a demyelinating disorder, and age >11 years. RESULTS Fifty-six female patients were identified with an average age of 15.4 years. The most common demyelinating disorders was multiple sclerosis (n = 33, 59%). The most common treatments were rituximab (n = 18, 32%), dimethyl fumarate (n = 13, 23%), IVIg (n = 11, 20%), and fingolimod (n = 11, 20%). Overall, only 16% (n = 9) of patients used contraception at any point during their immunotherapy regimen. Hispanic patients accounted for 41% of the cohort but were uniformly not on contraceptives (p = 0. 02). Contraceptive use did not impact ARR in any disease (p = 0.45). CONCLUSIONS Contraceptive use in young females with demyelinating disorders is less than 1/3rd of the general population with particular discrepancies in persons of Hispanic/Latino descent.
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Affiliation(s)
- Jonathan D Santoro
- Division of Neurology, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA; Department of Neurology, Keck School of Medicine at the University of Southern California, Los Angeles, CA 90027, USA.
| | - Brigitte Hurtubise
- Department of Neurology, Keck School of Medicine at the University of Southern California, Los Angeles, CA 90027, USA
| | - Justin Del Rosario
- Division of Neurology, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA
| | - Dania Pagarkar
- Keck School of Medicine at the University of Southern California, Los Angeles, CA 90027, USA
| | - Sarah E Wiegand
- Division of Neurology, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA
| | - Elaine Su
- Department of Neurology, Stanford University School of Medicine, Palo Alto, CA 94304, USA
| | - Nusrat Ahsan
- Division of Neurology, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA; Department of Neurology, Keck School of Medicine at the University of Southern California, Los Angeles, CA 90027, USA
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Taylor CM, Pritschet L, Jacobs EG. The scientific body of knowledge - Whose body does it serve? A spotlight on oral contraceptives and women's health factors in neuroimaging. Front Neuroendocrinol 2021; 60:100874. [PMID: 33002517 PMCID: PMC7882021 DOI: 10.1016/j.yfrne.2020.100874] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/13/2022]
Abstract
Women constitute half of the world's population, yet neuroscience research does not serve the sexes equally. Fifty years of preclinical animal evidence documents the tightly-coupled relationship between our endocrine and nervous systems, yet human neuroimaging studies rarely consider how endocrine factors shape the structural and functional architecture of the human brain. Here, we quantify several blind spots in neuroimaging research, which overlooks aspects of the human condition that impact women's health (e.g. the menstrual cycle, hormonal contraceptives, pregnancy, menopause). Next, we illuminate potential consequences of this oversight: today over 100 million women use oral hormonal contraceptives, yet relatively few investigations have systematically examined whether disrupting endogenous hormone production impacts the brain. We close by presenting a roadmap for progress, highlighting the University of California Women's Brain Initiative which is addressing unmet needs in women's health research.
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Affiliation(s)
- Caitlin M Taylor
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, United States.
| | - Laura Pritschet
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, United States
| | - Emily G Jacobs
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, United States; Neuroscience Research Institute, University of California, Santa Barbara, United States.
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Schickler R, Crabtree-Sokol D, Patel J, Bender N, Nelson AL, Nguyen BT. The potential for intramuscular depot medroxyprogesterone acetate as a self-bridging emergency contraceptive. Contracept X 2021; 3:100050. [PMID: 33367229 DOI: 10.1016/j.conx.2020.100050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 11/17/2020] [Accepted: 11/17/2020] [Indexed: 12/30/2022] Open
Abstract
Objective To examine the rate of ovulatory disruption when intramuscular depot medroxyprogesterone acetate (DMPA) is administered across graded stages of dominant follicle development. Study design We assigned enrolled participants to one of three preassigned dominant follicle size groups: 12-14 mm, 15–17 mm and ≥ 18 mm. We followed dominant follicles via serial transvaginal ultrasound (TVUS) until the follicles reached their assigned size, at which time we administered DMPA. For 5 consecutive days thereafter, we followed the follicles via TVUS to observe follicle rupture and obtained serum luteinizing hormone (LH), estradiol, and progesterone concentrations. In the following 2 weeks, we collected serum progesterone concentrations twice weekly to detect possible ovulatory delay or dysfunction. We also collected serum medroxyprogesterone acetate (MPA) concentrations at 1 and 24 h after DMPA administration to examine against ovulatory outcomes. Results Twenty-six of 29 enrolled women completed the study. DMPA suppressed ovulation in 17/26 (65%) and caused ovulatory dysfunction in 1/26 (4%) participants. Larger follicles were more likely to rupture despite DMPA (12–14 mm: 0/10 (0%); 15–17 mm: 3/10 (30%); ≥ 18 mm: 6/6 (100%); p < .01). Pre-DMPA LH concentrations ranged from 13.8 to 93.7 IU/L (mean 49.0 IU/L) in cases of follicle rupture. We observed no cases of follicle rupture when DMPA was administered through cycle day 12. All 24-h MPA concentrations exceeded those needed for ovulation suppression. Conclusion DMPA suppressed and additionally disrupted ovulation in 65% and 4% of observed cycles, respectively. DMPA may provide effective emergency contraception as well as ongoing contraception if administered prior to an expected ovulation and specifically before the LH surge. Implications DMPA may be an alternative form of emergency contraception that can also self-bridge to ongoing contraception. As ovulation was not observed among any follicles when DMPA was given through cycle day 12, women who initiate DMPA up through cycle day 12 may not require backup contraception.
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Leonard AN, Shill AL, Thackray AE, Stensel DJ, Bishop NC. Fasted plasma asprosin concentrations are associated with menstrual cycle phase, oral contraceptive use and training status in healthy women. Eur J Appl Physiol 2020; 121:793-801. [PMID: 33289860 PMCID: PMC7892699 DOI: 10.1007/s00421-020-04570-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 11/21/2020] [Indexed: 12/22/2022]
Abstract
Purpose Asprosin, an orexigenic hormone that stimulates hepatic glucose release, is elevated in insulin resistance and associated with obesity. Plasma asprosin concentrations may also be related to female sex hormone levels; higher levels are reported in women with polycystic ovary syndrome (PCOS) but this may be related to peripheral insulin resistance also associated with PCOS. Clarification of female-specific factors influence on the plasma asprosin response is crucial for studies investigating asprosin. Therefore, this study determined the association of menstrual phase, oral contraceptive (OC) use (as a pharmacological influence on sex hormone levels) and training status (as a physiological influence on sex hormone levels) on plasma asprosin levels in pre-menopausal women. Methods Fasting plasma asprosin, 17β-estradiol (E2) and progesterone, were assessed in 32 healthy untrained and trained women with regular menstrual cycles (non-OC; n = 8 untrained, n = 6 trained) or using OC (n = 10 untrained, n = 8 trained) during early follicular, late follicular and mid-luteal menstrual phases (or the time-period equivalent for OC users). Results Asprosin was lower in OC (0.75 ± 0.38 ng mL−1) than non-OC users (1.00 ± 0.37 ng mL−1; p = 0.022). Across a cycle, asprosin was highest in the early follicular equivalent time-point in OC users (0.87 ± 0.37 ng mL−1) but highest in the mid-luteal phase in non-OC users (1.09 ± 0.40 ng mL−1). Asprosin concentrations varied more across a cycle in untrained than trained women, with higher concentrations in the early follicular phase compared to the late follicular and mid-luteal (training status-by-menstrual phase interaction p = 0.028). Conclusion These findings highlight the importance of considering OC use, menstrual cycle phase and to a lesser extent training status when investigating circulating asprosin concentrations in females. Supplementary Information The online version contains supplementary material available at 10.1007/s00421-020-04570-8.
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Affiliation(s)
- A N Leonard
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - A L Shill
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
- English Institute of Sport, Loughborough, UK
| | - A E Thackray
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - D J Stensel
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Nicolette C Bishop
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK.
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Ramanadhan S, Jusko WJ, Edelman A. Pharmacokinetics of Hormonal Contraception in Individuals with Obesity: a Review. Curr Obstet Gynecol Rep 2020; 9:72-78. [PMID: 33117601 DOI: 10.1007/s13669-020-00284-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose of Review Obesity continues to affect many women globally. In the USA, almost 40% of all women are obese and many of these women use hormonal contraception for pregnancy prevention. How well hormonal contraceptive works for these individuals has been an area of ongoing research. Pharmacokinetics (PK), the study of drug passage through the body, can shed light on how differences in physiology between obese and non-obese populations can impact drug disposition and subsequent efficacy. This review aims to reflect on these types of studies and empower clinicians with information to help tackle the challenges of the obesity epidemic and help them provide the best contraceptive options to their patients. Here, we present the basics of the mechanisms of action of hormonal contraception, fundamental pharmacokinetic principles, and the latest research into pharmacokinetics, obesity, and hormonal contraception. Recent Findings New studies focused on the PK of hormonal contraception in women with obesity have shown that while there are distinct differences in how steroid hormones are processed in women with different body mass indices, contraceptive efficacy is likely the same. This is replicated in studies involving a variety of hormonal contraceptive methods. Summary PK studies allow for a detailed analysis of steroid hormone processing in individuals with obesity. Observing PK parameters at each stage of the passage of these hormones through the body, researchers have drilled down on physiologic differences that accompany obesity. In reviewing these PK parameter differences, however, it appears that while processes are different, the end result of pregnancy prevention is likely not compromised in the setting of obesity. Emergency contraception, which functions by a different mechanism from that of continuous hormonal contraception, is the one area in which obesity has been demonstrated to impact efficacy.
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Affiliation(s)
| | - William J Jusko
- WJJ Department of Pharmaceutical Sciences, University at Buffalo, Buffalo, NY 14214, USA
| | - Alison Edelman
- Oregon Health & Science University, Portland, OR 97239, USA
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Uhm S, Chen MJ, Cutler ED, Creinin MD. Twelve-month prescribing of contraceptive pill, patch, and ring before and after a standardized electronic medical record order change. Contraception 2020; 103:60-63. [PMID: 33098853 DOI: 10.1016/j.contraception.2020.10.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 10/01/2020] [Accepted: 10/12/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the proportion of 12-month contraceptive pill, patch, and ring prescriptions before and after an institution-wide change of default electronic medical record facility orders to dispensing 12-month supply. STUDY DESIGN This retrospective pre-post study compares outpatient contraception prescriptions from August 10, 2019 through April 9, 2020 obtained from our institutional electronic medical record prescription database. On December 10, 2019, we facilitated a change in the default orders for dispensing self-administered hormonal contraceptives from one-month to 12-months. We evaluated the primary outcome of 12-month supply prescriptions during the four months before and after the change. We also compared 12-month supply prescriptions for pills, patch, and ring by prescriber specialty and location. RESULTS The dataset included 4897 distinct evaluable prescriptions for the pill, patch, or ring, with an overall increase in 12-month prescriptions from 260/2437 (10.7%) to 669/2460 (27.2%) after the order change (p < 0.001). Twelve-month pill prescriptions increased from 238/2250 (10.6%) to 607/2250 (27.0%) (p < 0.001), patch prescriptions from 6/40 (15.0%) to 21/44 (47.7%) (p = 0.002), and ring prescriptions from 16/147 (10.9%) to 41/165 (24.8%) (p = 0.001). Twelve-month prescriptions increased after the order change among all provider types at the medical center campus (194/594 [32.7%] to 329/623 [52.8%], p < 0.001). At community clinics, non-obstetrics/gynecology providers increased 12-month prescriptions after the order change (58/1616 [3.6%] to 327/1612 [20.3%], p < 0.001), but obstetrics/gynecology providers did not (8/227 [3.5%] to 13/225 [5.8%], p = 0.27). CONCLUSION Providers more frequently prescribed a 12-month supply of contraceptive pills, patches, and rings after a change in the default dispensing quantity in electronic medical record orders. IMPLICATIONS Institution-wide changes to the electronic medical record default facility order settings can increase 12-month supply contraceptive prescriptions. As a 12-month prescription order represents only one step of many in obtaining a 12-month contraception supply, additional research is required to elucidate and remove other potential barriers.
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Affiliation(s)
- Suji Uhm
- Department of Obstetrics and Gynecology, University of California, Davis, Sacramento, CA, USA
| | - Melissa J Chen
- Department of Obstetrics and Gynecology, University of California, Davis, Sacramento, CA, USA
| | - Erika D Cutler
- Department of Pharmacy Services, University of California, Davis, Sacramento, CA, USA
| | - Mitchell D Creinin
- Department of Obstetrics and Gynecology, University of California, Davis, Sacramento, CA, USA.
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Getaneh T, Negesse A, Dessie G, Desta M, Moltot T. Predictors of unmet need for family planning in Ethiopia 2019: a systematic review and meta analysis. ACTA ACUST UNITED AC 2020; 78:102. [PMID: 33088503 PMCID: PMC7566059 DOI: 10.1186/s13690-020-00483-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 10/06/2020] [Indexed: 11/13/2022]
Abstract
Background unmet need for family planning is a common cause of uninteded pregnancy which mostly end up with abortion. Many studies were conducted on predictors of unmet need of family planning in Ethiopia. But, up until now, single evidence has not been synthesized and various point prevalence estimates of unmet need for family planning have been reported. Therefore, this sytematic review and meta analysis was established to identify the predictors of unmet need for family planning in Ethiopia. Methods search engines including PubMed, Embase, CINAHL, Google Scholar, HINARI portal, and Cochrane Library were used to retrieve included articles and reported using the preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA) checklist guidelines. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was applied for critical appraisal. All observational studies done on reproductive age women and reported on unmet need for family planning were included. Unmet need for family planning is the percentage of women of reproductive age, either married or in a union, who have an unmet need for family planning to stop or delay childbearing. Random effect model was done to estimate the pooled prevalence of unmet need for family planning. Odds ratio with 95% confidence interval was considered to determine the association of identified variables with unmet need of family planning. Cochran’s Q statistic, Egger’s and Begg’s test were carried out to assess heterogeneity and publication bias. Results Fifteen articles and 17, 585 reproductive aged women were included to estimate the pooled prevalence of unmet need for family planning and its predictors in Ethiopia. The prevalence of unmet need for family planning in Ethiopia ranges from 26.52 to 36.39%. Age at first marriage < 18 yrs. with OR = 2.3 (95% CI: 1.08, 4.87), women with no formal education with OR = 1.9 (95%CI: 1.19, 3.04), partner with no formal education with OR = 1.78 (95%CI: 1.18, 2.68) and absence of discussion with their partner about family planning with OR = 3.52 (95%CI, 2.56, 4.87) were predictors of unmet need of family planning in Ethiopia. Conclusion This meta analysis revealed that, the prevalence of unmet need for family planning in Ethiopia was high as compared with the United Nations sphere standard of unmet need for planning, considered to be high if it is greater than 25%. Early marriage, no formal eduaction and lack of discussion with partner on family planning were predictors of unmet need for family planning. Therefore, efforts are needed to empower women through eduaction, avoiding early marriage and facilitating dicussion of partners about family planning in order to improve family planning usage.
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Affiliation(s)
- Temesgen Getaneh
- Department of Midwifery, College of Health Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Ayenew Negesse
- Department of Human Nutrition and Food Sciences, College of Health Science, Debre Markos University, Debre Markos, Ethiopia.,Center of excellence in Human Nutrition, School of Human Nutrition, Food Science and Technology, Hawassa University, Hawassa, Ethiopia
| | - Getenet Dessie
- Department of Nursing, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Melaku Desta
- Department of Midwifery, College of Health Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Tebabere Moltot
- Department of Midwifery, College of Health Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
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Masho SW, Orekoya O, Lowery E, Wallenborn JT. Female genital mutilation and contraceptive use: findings from the 2014 Egypt demographic health survey. Int J Public Health 2020; 65:1151-1158. [PMID: 32770347 DOI: 10.1007/s00038-020-01452-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 07/13/2020] [Accepted: 07/24/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Female genital mutilation (FGM) includes procedures that remove partial or total external female genitalia, or causes other injury to female genital organs with no medical reason. Physical and psychological trauma associated with FGM may interfere with a woman's ability and intent to utilize contraception. Our study examines the association between FGM and utilization of contraception methods among sexually active reproductive-aged women in Egypt. METHODS Data from the 2014 Egypt Demographic and Health Survey were analyzed (n = 20,055). Multinomial logistic regression was used to obtain odds ratios (OR) and 95% confidence intervals. RESULTS Our study found that FGM was performed on over 90% of Egyptian women and almost half (45%) of women did not use contraception. Women with FGM had significantly lower odds (OR = 0.6) of using barrier/natural contraceptive methods (e.g., condoms) than intrauterine devices (IUDs). However, women with FGM were more likely to use hormonal methods (OR = 1.2) than IUDs compared to those who had not experienced FGM. CONCLUSIONS In order to promote women's health and support use of effective contraception methods, a large reduction in FGM practice is essential.
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Affiliation(s)
- Saba W Masho
- School of Medicine, Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, 830 East Main Street, Suite 821, P.O. Box 980212, Richmond, VA, 23298-0212, USA
| | - Olubunmi Orekoya
- School of Medicine, Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, 830 East Main Street, Suite 821, P.O. Box 980212, Richmond, VA, 23298-0212, USA
| | - Elizabeth Lowery
- School of Medicine, Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, 830 East Main Street, Suite 821, P.O. Box 980212, Richmond, VA, 23298-0212, USA
| | - Jordyn T Wallenborn
- School of Medicine, Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, 830 East Main Street, Suite 821, P.O. Box 980212, Richmond, VA, 23298-0212, USA.
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OJO O, NDIKOM C, ALABI P. Predictors of the usage of contraceptive implants among women of reproductive age in Ondo State, Southwest Nigeria. J Prev Med Hyg 2020; 61:E39-E47. [PMID: 32490268 PMCID: PMC7225643 DOI: 10.15167/2421-4248/jpmh2020.61.1.1367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 02/18/2020] [Indexed: 11/16/2022]
Abstract
Background A major characteristic of all developing countries is rapid population growth which is due to high fertility, birth rates and poor utilization of contraceptive methods. This study therefore assessed the predictors of contraceptive implants utilization among women of reproductive age in Ondo State, Nigeria. Methods A descriptive cross-sectional study design was used and a total of 230 women were selected by multi-stage sampling technique. Questionnaire administration was interviewer-based majority of the women could not read. Data analysis was conducted using SPSS version 23. Research questions and hypotheses were answered and tested with descriptive statistics (frequency, percentages), chi-square test of significance and binary logistic regression. Levels of significance was set at p ≤ 0.05. Results The prevalence of contraceptive utilization (any method) and contraceptive implant utilization were 92.2% and 31.1% respectively. Variables such as education (χ2 = 6.91, p = 0.03) and lack of counseling from providers (χ2 = 5.05, p = 0.03) were significantly associated with the utilization of contraceptive implant. These two variables were also the predictors of contraceptive implant utilization. Women with secondary and tertiary education have higher odds of utilizing contraceptive implants (OR = 1.21, 95% CI = 1.01-7.82, p = 0.04) and (OR = 2.53, 95% CI = 1.49-11.47, p = 0.03) compared to women who had primary or no education while those who claimed to be adequately counseled by providers are about two times more likely to use contraceptive implants (OR = 2.33, 95% CI = 1.08-5.51) Conclusion This study showed the important role of education and health workers in providing information about contraceptive implants. Therefore, health workers’ knowledge of family planning counseling and services should be constantly upgraded so as to improve their roles in educating, mobilizing, counseling the women regarding contraceptive implant insertion.
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Affiliation(s)
- O.O. OJO
- Faculty of Nursing Science, University of Medical Sciences Akure Campus, Nigeria
- Department of Nursing, University of Ibadan, Nigeria
- Correspondence: Olufisayo Olusola Ojo, Department of Nursing, Faculty of Nursing Science, University of Medical Sciences Akure Campus, Nigeria - Tel. +2348034387290 - E-mail:
| | - C.M. NDIKOM
- Department of Nursing, University of Ibadan, Nigeria
| | - P.I. ALABI
- Medicins Sans Frontieres, Spain, Nigeria Mission, Damaturu Project
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Kelly L. The Contraceptive Pill in Ireland c.1964-79: Activism, Women and Patient-Doctor Relationships. Med Hist 2020; 64:195-218. [PMID: 32284634 PMCID: PMC7120263 DOI: 10.1017/mdh.2020.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The twentieth-century history of men and women's attempts to gain access to reproductive health services in the Republic of Ireland has been significantly shaped by Ireland's social and religious context. Although contraception was illegal in Ireland from 1935 to 1979, declining family sizes in this period suggest that many Irish men and women were practising fertility control measures. From the mid-1960s, the contraceptive pill was marketed in Ireland as a 'cycle regulator'. In order to obtain a prescription for the pill, Irish women would therefore complain to their doctors that they had heavy periods or irregular cycles. However, doing so could mean going against one's faith, and also depended on finding a sympathetic doctor. The contraceptive pill was heavily prescribed in Ireland during the 1960s and 1970s as it was the only contraceptive available legally, albeit prescribed through 'coded language'. The pill was critiqued by men and women on both sides of the debate over the legalisation of contraception. Anti-contraception activists argued that the contraceptive pill was an abortifacient, while both anti-contraception activists and feminist campaigners alike drew attention to its perceived health risks. As well as outlining these discussions, the paper also illustrates the importance of medical authority in the era prior to legalisation, and the significance of doctors' voices in relation to debates around the contraceptive pill. However, in spite of medical authority, it is clear that Irish women exercised significant agency in gaining access to the pill.
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Affiliation(s)
- Laura Kelly
- School of Humanities, University of Strathclyde, 141 St James Road, Glasgow G4 0LT, UK
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Attini R, Cabiddu G, Montersino B, Gammaro L, Gernone G, Moroni G, Santoro D, Spotti D, Masturzo B, Gazzani IB, Menato G, Donvito V, Paoletti AM, Piccoli GB. Contraception in chronic kidney disease: a best practice position statement by the Kidney and Pregnancy Group of the Italian Society of Nephrology. J Nephrol 2020; 33:1343-1359. [PMID: 32166655 PMCID: PMC7701165 DOI: 10.1007/s40620-020-00717-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 02/25/2020] [Indexed: 01/09/2023]
Abstract
Even though fertility is reduced, conception and delivery are possible in all stages of CKD. While successful planned pregnancies are increasing, an unwanted pregnancy may have long-lasting deleterious effects, hence the importance of birth control, an issue often disregarded in clinical practice. The evidence summarized in this position statement is mainly derived from the overall population, or other patient categories, in the lack of guidelines specifically addressed to CKD. Oestroprogestagents can be used in early, non-proteinuric CKD, excluding SLE and immunologic disorders, at high risk of thromboembolism and hypertension. Conversely, progestin only is generally safe and its main side effect is intramestrual spotting. Non-medicated intrauterine devices are a good alternative; their use needs to be carefully evaluated in patients at a high risk of pelvic infection, even though the degree of risk remains controversial. Barrier methods, relatively efficacious when correctly used, have few risks, and condoms are the only contraceptives that protect against sexually transmitted diseases. Surgical sterilization is rarely used also because of the risks surgery involves; it is not definitely contraindicated, and may be considered in selected cases. Emergency contraception with high-dose progestins or intrauterine devices is not contraindicated but should be avoided whenever possible, even if far preferable to abortion. Surgical abortion is invasive, but experience with medical abortion in CKD is still limited, especially in the late stages of the disease. In summary, personalized contraception is feasible, safe and should be offered to all CKD women of childbearing age who do not want to get pregnant.
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Affiliation(s)
- Rossella Attini
- Department of Obstetrics and Gynecology, Città della Salute e della Scienza, Ospedale Sant'Anna, Turin, Italy
| | | | - Benedetta Montersino
- Department of Obstetrics and Gynecology, Città della Salute e della Scienza, Ospedale Sant'Anna, Turin, Italy
| | - Linda Gammaro
- Nephrology Ospedale Fracastoro San Bonifacio, San Bonifacio, Italy
| | | | - Gabriella Moroni
- Nephrology, Fondazione Ca' Granda Ospedale Maggiore, Milan, Italy
| | - Domenico Santoro
- Nephrology and Dialysis, Azienda Ospedaliera Universitaria "G. Martino", Messina, Italy
| | - Donatella Spotti
- Nephrology and Dialysis, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Bianca Masturzo
- Department of Obstetrics and Gynecology, Città della Salute e della Scienza, Ospedale Sant'Anna, Turin, Italy
| | - Isabella Bianca Gazzani
- Department of Obstetrics and Gynecology, Città della Salute e della Scienza, Ospedale Sant'Anna, Turin, Italy
| | - Guido Menato
- Department of Obstetrics and Gynecology, Città della Salute e della Scienza, Ospedale Sant'Anna, Turin, Italy
| | - Valentina Donvito
- Department of Internal Medicine, Ospedale Sant'Anna, Città della Salute e della Scienza, Turin, Italy
| | - Anna Maria Paoletti
- Department of Surgical Sciences, Obstetrics and Gynecology, University Hospital of Cagliari, Cagliari, Italy
| | - Giorgina Barbara Piccoli
- Department of Clinical and Biological Sciences, Università di Torino, Turin, Italy. .,Nephrology and Dialysis, Centre Hospitalier Le Mans, Le Mans, France.
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Reyes-Lacalle A, Montero-Pons L, Manresa-Domínguez JM, Cabedo-Ferreiro R, Seguranyes G, Falguera-Puig G. Perinatal contraceptive counselling: Effectiveness of a reinforcement intervention on top of standard clinical practice. Midwifery 2020; 83:102631. [PMID: 32036192 DOI: 10.1016/j.midw.2020.102631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 11/05/2019] [Accepted: 01/14/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the effectiveness of supplemental perinatal contraceptive counselling in addition to standard Spanish postpartum contraceptive counselling with regard to contraceptive use and use of effective contraception up to 1 year postpartum. Women's satisfaction with counselling and the method chosen was also assessed. DESIGN Community-randomized trial. SETTING "Reproductive and Sexual Health Care" units of the National Health Care System at twenty public Primary Care facilities in Catalonia (Spain). PARTICIPANTS 1,004 consecutive pregnant women (~week 30) receiving prenatal care between 1st October 2015 and 31st March 2016. Women were considered eligible for analysis if appropriate information was available. INTERVENTIONS At half of the centres, midwives provided the standard Spanish postpartum contraceptive counselling (control group, CG). At the other half, supplemental perinatal contraceptive counselling was provided in addition to standard counselling (intervention group, IG) at different time points during pregnancy and postpartum. This consisted of a leaflet and a blog with practical information about all contraceptive options plus a short reminder message in the mobile phone during the third quarter of pregnancy and a face-to-face or a virtual meeting lasting 20 min in the first 15 days postpartum. Midwives used ad hoc questionnaires to collect information at week 30 of pregnancy (recruitment), and week 6, month 6 and month 12 postpartum. MEASUREMENTS AND FINDINGS 975 women were eligible for analysis (482 in the CG and 493 in the IG). ~33% women had resumed sexual intercourse by week 6, and nearly all by months 6 and 12. Use and effectiveness of contraceptives was similar in both groups at week 6 and month 6. At month 12, more women in the IG used more effective contraception and less women used contraceptives considered somewhat effective vs. those of the CG (P = 0.006). When considering the place of origin, this was only true for Spanish women. Women of other origins had a much higher use of very effective contraceptives at month 12 also in the CG, with contraceptive counselling having scarce effect. On multivariate analysis, conducted only in Spanish women, the additional counselling resulted in a higher use of highly effective methods while having a university degree increased 3.6 times the OR for this behaviour. A bias towards fostering use of very effective contraceptives among women with low education was seen in standard clinical practice. Satisfaction with counselling and the type of contraception chosen was higher in the IG. KEY CONCLUSIONS Our study has shown that the supplemental counselling tested has a moderate impact on contraceptive use and use of effective contraception in postpartum women. Results of this effort were seen after 6 months postpartum. A possible bias towards women who were more socially vulnerable was found in standard clinical practice, which reduced the effectiveness of the intervention in women who were otherwise the most needy. IMPLICATIONS FOR PRACTICE Despite the benefits provided by supplemental support in perinatal contraceptive counselling, the existence of a possible bias affecting the effectiveness of these interventions should be investigated and addressed.
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Affiliation(s)
- Azahara Reyes-Lacalle
- Grup Emergent Consolidat en Atenció a la Salut sexual i Reproductiva (GRASSIR), Institut Catala de la Salut (ICS), Sabadell, Barcelona, Spain.
| | - Laura Montero-Pons
- Grup Emergent Consolidat en Atenció a la Salut sexual i Reproductiva (GRASSIR), Institut Catala de la Salut (ICS), Santa Coloma de Gramanet, Barcelona, Spain
| | - Josep Maria Manresa-Domínguez
- Unitat de Suport a la Recerca Metropolitana Nord del IDIAP Jordi Gol, Cerdanyola del Valles, Barcelona, Spain; Departament d'Infermeria, Universitat Autonoma de Barcelona, Cerdanyola del Valles, Barcelona, Spain
| | - Rosa Cabedo-Ferreiro
- Grup Emergent Consolidat en Atenció a la Salut sexual i Reproductiva (GRASSIR), Institut Catala de la Salut (ICS), Granollers, Barcelona, Spain
| | - Glòria Seguranyes
- Nursing School, Universitat de Barcelona, Grup Emergent Consolidat en Atenció a la Salut sexual i Reproductiva (GRASSIR), Barcelona, Spain
| | - Gemma Falguera-Puig
- Coordinadora Grup Emergent Consolidat en Atenció a la Salut Sexual i Reproductiva (GRASSIR), Direccio d'Atenció Primaria Metropolitana Nord, Institut Catala de la Salut (ICS), Barcelona, Spain
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Sims J, Lutz E, Wallace K, Kassahun-Yimer W, Ngwudike C, Shwayder J. Depo-medroxyprogesterone acetate, weight gain and amenorrhea among obese adolescent and adult women. EUR J CONTRACEP REPR 2020; 25:54-59. [PMID: 31928370 DOI: 10.1080/13625187.2019.1709963] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objective: The aim of the study was to evaluate the correlation between obesity and the use of depot medroxyprogesterone (DMPA) with regard to weight gain and changes in bleeding pattern.Methods: A retrospective chart review was conducted of women receiving 150 mg DMPA via intramuscular injection at inpatient and outpatient clinics at the University of Mississippi Medical Centre between 1 June 2012 and 31 December 2016. Body mass indices (BMI) were assessed at baseline and at the time of final injection. Data on race, medical history, age at first DMPA injection, number and timing of injections, reported side effects, indication for DMPA use and reason for discontinuation, if applicable, were collected.Results: Of the 240 women included in the study, 3.3% were underweight, 30.8% were normal weight, 23.3% were overweight, 15% were class I obese, 9.6% were class II obese and 17.9% were class III obese; 87.9% of the population were African American. Women gained 2.40 kg (95% confidence interval 1.34-3.45) while they were on DMPA (p < .01), which after adjusting for confounding variables was inversely associated with age at initial injection (β coefficient -0.13; p = .02). Amenorrhoea was the most commonly reported change in bleeding pattern.Conclusion: Women who started DMPA at an earlier age gained the most weight over time, independently of initial BMI. Similar rates of amenorrhoea were found among all BMI categories.
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Affiliation(s)
- Jaleen Sims
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center School of Medicine, Jackson, MS, USA
| | - Elizabeth Lutz
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center School of Medicine, Jackson, MS, USA
| | - Kedra Wallace
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center School of Medicine, Jackson, MS, USA
| | | | | | - James Shwayder
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center School of Medicine, Jackson, MS, USA
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Abstract
The identification of parity effects on the hazard of a next birth in cross-family data requires accounting for heterogeneity in fecundity across couples. In a previously published article, Cinnirella et al. Demography, 54, 413-436 (2017), we stratified duration models at the maternal level for this purpose and found that the hazard of a next birth decreases with rising parity in historical England. Clark and Cummins Demography, 56 (2019) took issue with this finding, claiming that the result is a statistical artifact caused by stratification at the maternal level. This reply documents that our previous finding is robust to addressing Clark and Cummins' critique.
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Affiliation(s)
- Francesco Cinnirella
- Department of Business and Economics, University of Southern Denmark, Odense, Denmark. .,Danish Institute for Advanced Study (D-IAS), Odense, Denmark. .,CESifo, Munich, Germany. .,Centre for Economic Policy Research (CEPR), London, UK.
| | - Marc Klemp
- Centre for Economic Policy Research (CEPR), London, UK.,Department of Economics, University of Copenhagen, Copenhagen, Denmark.,Department of Economics, Brown University, Providence, RI, USA.,Population Studies and Training Center, Brown University, Providence, RI, USA
| | - Jacob Weisdorf
- Department of Business and Economics, University of Southern Denmark, Odense, Denmark.,Centre for Economic Policy Research (CEPR), London, UK.,Scuola Superiore Sant'Anna, Pisa, Italy
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Zuniga C, Wollum A, Katcher T, Grindlay K. Youth Perspectives on Pharmacists' Provision of Birth Control: Findings From a Focus Group Study. J Adolesc Health 2019; 65:514-519. [PMID: 31326247 DOI: 10.1016/j.jadohealth.2019.05.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 04/16/2019] [Accepted: 05/13/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Young women face numerous obstacles to accessing contraception, including lack of money, time, or transportation to visit a doctor. In addition, concerns about confidentiality deter many adolescents from seeking contraceptive care. Pharmacists in Washington, D.C. will soon be able to prescribe hormonal birth control, which can potentially increase contraceptive access for adolescents. This study explores the needs and concerns of teens and young women residing in Washington, D.C. to inform implementation of this service. METHODS In this community-based participatory research study, four focus group discussions were conducted in February 2017, two with teen females aged 14-17 years and two with young women aged 18-24 years. A youth advisory council, comprising 13 women aged 16-22 years living in Washington, D.C., helped develop the discussion guide and interpret findings. Data were analyzed thematically by age group using inductive and deductive codes. RESULTS Young people viewed pharmacies as convenient locations to access contraceptives but expressed concerns about privacy, affordability, and pharmacist approachability. Younger participants viewed these concerns as significant barriers for their peers. Participants suggested pharmacies protect privacy and confidentiality by offering private consultation spaces and clear information about what insurance plans can disclose to parents. Participants also recommended pharmacies create a youth-friendly, nonjudgmental environment and offer pharmacists training on contraceptive counseling for young women. CONCLUSIONS Addressing concerns about privacy, costs, and pharmacist approachability can help ensure that youth seeking contraceptives can easily access their preferred method. Pharmacies should continuously incorporate young people's feedback to ensure this service remains accessible and acceptable to adolescents.
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Thompson EL, Vamos CA, Jones J, Liggett LG, Griner SB, G Logan R, Daley EM. Perceptions of Zika Virus Prevention Among College Students in Florida. J Community Health 2019; 43:673-679. [PMID: 29380211 DOI: 10.1007/s10900-018-0468-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Zika virus in Florida prompted a strong public health response, due to its causal association with birth defects. While primarily spread by mosquitos, Zika can be transmitted sexually. The spread of Zika may influence reproductive behaviors among sexually active persons in Florida. This study examined factors associated with willingness to change birth control method use in response to Zika virus among college women and men in Florida. Women and men ages 18-44 at a Florida university (N = 328) were surveyed about Zika knowledge, beliefs about Zika, use of contraceptives and condoms, and socio-demographics between November 2016-April 2017. The outcome variable was willingness to change birth control method were Zika in their area. Logistic regression models in SAS 9.4 were used. Most participants were women (80%), and 47% were 20-22 years old. Only 27% of participants said they would change their birth control method if Zika were in their area. Participants who knew that Zika was sexually transmitted were more likely to be willing to change their birth control method (aOR = 1.71, 95%CI 1.01-2.91). Participants who agreed or strongly agreed that they were fearful of being infected with Zika virus were more likely to be willing to change their birth control methods (aOR = 1.98, 95%CI 1.07-3.67). This study found that, among Florida college students, Zika beliefs and knowledge were associated with a willingness to change birth control method in response to Zika. Understanding the factors that motivate individuals to change reproductive behaviors during an emerging health issue can help tailor preventative messages.
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Affiliation(s)
- Erika L Thompson
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL, 33612, USA. .,Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA.
| | - Cheryl A Vamos
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL, 33612, USA
| | - Julianna Jones
- Department of Global Health and Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL, 33612, USA
| | - Langdon G Liggett
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL, 33612, USA
| | - Stacey B Griner
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL, 33612, USA
| | - Rachel G Logan
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL, 33612, USA
| | - Ellen M Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL, 33612, USA
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Kusunoki Y, Barber JS. Intimate relationship dynamics and women's expected control over sex and contraception. Contraception 2019; 100:484-91. [PMID: 31484058 DOI: 10.1016/j.contraception.2019.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 08/06/2019] [Accepted: 08/26/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVE We examined whether women's experiences across and within their intimate relationships affect their expected level of control over sex and contraceptive use. STUDY DESIGN We used data from 648 women ages 18-20 in the Relationship Dynamics and Social Life (RDSL) study, which interviewed a random, population-based sample in a Michigan county. We used ordered logistic regression with fixed-effects to control for individual- and relationship-level characteristics. RESULTS We found a u-shaped relationship between intimacy/commitment and expected control, with the lowest expected control in the least intimate/committed and the most intimate/committed relationships, and the highest expected control in the intermediate relationships. Women expected more control in their long-term compared to short-term relationships, and expected control increases over time in a specific relationship. Women also expected less control in their conflictual and/or asymmetric relationships - those with older and/or violent partners, and expected control decreases after experiencing violence or a partner's non-monogamy. CONCLUSIONS Our results are consistent with cross-sectional research suggesting that women in violent relationships experience more reproductive coercion than women in non-violent relationships, but we also found that other aspects of intimate relationships are important determinants of expected control over sex and contraception. IMPLICATIONS Intervention strategies should consider a wider range of intimate relationship characteristics - beyond violence - to improve women's control of their reproductive behaviors.
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Abstract
Contraception is paramount to the overall health and longevity of women. Most women in the United States use birth control in their reproductive lifetimes. All options should be available and easily accessible to permit individualization and optimization of chosen methods. Current contraceptive methods available in the United States are reviewed. Emergency contraception, contraception in the postpartum period, and strategies to tailor methods to those affected by partner violence are also addressed. Tables and flow charts help providers and patients compare various contraceptive methods, optimize the start of a method, and identify resources for addressing safety in those with underlying medical conditions.
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Affiliation(s)
- Nichole A Tyson
- Department of Obstetrics and Gynecology, The Permanente Medical Group, 1600 Eureka Road, Medical Office Building C, 3rd Floor, Roseville, CA 95661, USA; UC Davis Medical Center, Sacramento, CA, USA.
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Vyver E, Hwang LY. A paediatric perspective on hormonal contraception and breast cancer risk: New literature about a recurring question. Paediatr Child Health 2019; 24:224-226. [PMID: 31239810 DOI: 10.1093/pch/pxy169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 09/27/2018] [Indexed: 11/14/2022] Open
Abstract
The New England Journal of Medicine recently featured an original research article, 'Contemporary Hormonal Contraception and the Risk of Breast Cancer'. (Source: Mørch LS, Skovlund CW, Hannaford PC, Iversen L, Fielding S, Lidegaard Ø. Contemporary hormonal contraception and the risk of breast cancer. N Engl J Med 2017;377(23):2228-39). This study of 1.8 million women ages 15 to 49 years in Denmark found that women who were currently or recently using any type of hormonal contraception had an increased risk of breast cancer and this risk increased with longer duration of use. To date, the implications of this study have focused on older female populations. In this commentary, the authors summarize the key findings of the study and discuss its unique implications for adolescents. The authors emphasize that health care providers need not change their practice as a result of this 'old but new again' controversy and should continue to support the prevention of unintended pregnancy by promoting access to ALL forms of contraception.
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Affiliation(s)
- Ellie Vyver
- Section of Adolescent Medicine, Department of Paediatrics, Alberta Children's Hospital, Cumming School of Medicine at the University of Calgary, Calgary, Alberta
| | - Loris Y Hwang
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UCLA Mattel Children's Hospital, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California, USA
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Stannov SU, Ries A, Bang UC. Hepatotoxicity induced by a second-generation combined oral contraceptive: case report and review of the literature. EUR J CONTRACEP REPR 2019; 24:322-324. [PMID: 30983430 DOI: 10.1080/13625187.2019.1602722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Case: Second-generation combined oral contraceptives (COCs) are widely used and are believed to be safe for birth control and in the treatment of gynaecological diseases. No randomised controlled study has shown elevations in alanine transaminase (ALT) levels in relation to the use of a second-generation COC. We report a case of drug-induced liver injury (DILI) in a young, moderately obese woman, due to the use of a second-generation COC containing 30 µg ethinylestradiol and 150 µg levonorgestrel. COC use had been initiated 2 years prior to admission to our department. The diagnosis was based on elevated levels of ALT during COC use and was confirmed by re-challenge and a liver biopsy showing signs of former tissue damage after a 3 week break of COC treatment. Conclusions: To our knowledge, this is the first case of biopsy-proven DILI due to COC use in which a re-challenge was performed.
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Affiliation(s)
- Søs U Stannov
- a The Gastro Unit, Medical Section , Hvidovre University Hospital , Hvidovre , Denmark
| | - Annedorte Ries
- b Department of Pathology , Hvidovre University Hospital , Hvidovre , Denmark
| | - Ulrich C Bang
- a The Gastro Unit, Medical Section , Hvidovre University Hospital , Hvidovre , Denmark
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Rusterholz C. English Women Doctors, Contraception and Family Planning in Transnational Perspective (1930s-70s). Med Hist 2019; 63:153-172. [PMID: 30912499 PMCID: PMC6434646 DOI: 10.1017/mdh.2019.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This paper explores the influence of English female doctors on the creation of the International Planned Parenthood Federation (IPPF) and the production and circulation of contraceptive knowledge in England and, to a lesser extent in France, between 1930 and 1970. By drawing on the writings of female doctors and proceedings of international conferences as well as the archives of the British Medical Women's Federation (MWF) and Family Planning Association (FPA), on the one hand, and Mouvement Français pour le Planning Familial (MFPF), on the other, this paper explores the agency of English female doctors at the national and transnational level. I recover their pioneering work and argue that they were pivotal in legitimising family planning within medical circles. I then turn to their influence on French doctors after World War II. Not only were English medical women active and experienced agents in the family planning movement in England; they also represented a conduit of information and training crucial for French doctors. Transfer of knowledge across the channel was thus a decisive tool for implementing family planning services in France.
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Affiliation(s)
- Caroline Rusterholz
- Wellcome Trust Research Fellow, Faculty of History, University of Cambridge, Alison Richard Building (level 3), 7 West Road, Cambridge CB3 9DT, UK
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