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Otte R, Thissen V, Mulder B. (Dis)continuation of the oral contraceptive pill: A focus group approach in the Netherlands. Heliyon 2023; 9:e19405. [PMID: 37810124 PMCID: PMC10558495 DOI: 10.1016/j.heliyon.2023.e19405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 10/10/2023] Open
Abstract
Objectives The oral contraceptive pill (OCP) is the most used contraceptive worldwide; nevertheless, discontinuation rates are relatively high. While advantages of the OCP, like pregnancy prevention and planned parenthood, result in autonomy and independence, side effects and other aspects play a role in the decision to (dis)continue usage. Informed and deliberate decision-making is of importance to prevent adverse effects in health and quality of life. Therefore, the present study aimed to explore how women in the Netherlands decide to (dis)continue the OCP. Study design This paper reports a qualitative study using four focus groups, conducted online or face-to-face, with 20 women of different educational background aged between 18 and 23. The topic guide was based on relevant theory and literature, and focused on personal beliefs, experiences and social interactions about the OCP. The study is reported according to SRQR guidelines. Results The main themes that were found the influence decision-making were effects, side effects, towards alternatives, interpersonal communication with peers, interpersonal communication with the general practitioner, and online information seeking. Feeling responsible emerged as a relevant additional theme, embedded in the decision-making process, and influencing other themes. Some educational differences emerged. Conclusions The decision to start the OCP is a highly normalized process in the Netherlands. However, women who feel a strong sense of responsibility for pregnancy prevention may be less open to considering alternative contraception methods. Results imply that women can be better supported in the decision-making process by providing balanced information on effects and side effects of a wide range of contraceptives, as well as restoring the balance in both sexual partner's responsibility for contraception. Implications for practice and suggestions for further research on the concept of responsibility, its influence, and underlying mechanisms are provided.
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Affiliation(s)
- R.S. Otte
- Strategic Communication Group, Wageningen University & Research, P.O. BOX 8130, 6700, EW Wageningen, the Netherlands
| | - V.T.M. Thissen
- Strategic Communication Group, Wageningen University & Research, P.O. BOX 8130, 6700, EW Wageningen, the Netherlands
| | - B.C. Mulder
- Strategic Communication Group, Wageningen University & Research, P.O. BOX 8130, 6700, EW Wageningen, the Netherlands
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Lacasse JM, Ismail N, Tronson NC. Editorial overview: Hormonal contraceptives and the brain: A call for translational research. Front Neuroendocrinol 2023; 69:101063. [PMID: 36806552 DOI: 10.1016/j.yfrne.2023.101063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Affiliation(s)
- Jesse M Lacasse
- Department of Psychology, Brock University, St Catharines, ON, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Nafissa Ismail
- Department of Psychology, University of Ottawa, Ottawa, ON, Canada
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Patel SH, Timón-Gómez A, Pradhyumnan H, Mankaliye B, Dave KR, Perez-Pinzon MA, Raval AP. The Impact of Nicotine along with Oral Contraceptive Exposure on Brain Fatty Acid Metabolism in Female Rats. Int J Mol Sci 2022; 23:ijms232416075. [PMID: 36555717 PMCID: PMC9780830 DOI: 10.3390/ijms232416075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Smoking-derived nicotine (N) and oral contraceptive (OC) synergistically exacerbate ischemic brain damage in females, and the underlying mechanisms remain elusive. In a previous study, we showed that N + OC exposure altered brain glucose metabolism in females. Since lipid metabolism complements glycolysis, the current study aims to examine the metabolic fingerprint of fatty acids in the brain of female rats exposed to N+/-OC. Adolescent and adult Sprague-Dawley female rats were randomly (n = 8 per group) exposed to either saline or N (4.5 mg/kg) +/-OC (combined OC or placebo delivered via oral gavage) for 16-21 days. Following exposure, brain tissue was harvested for unbiased metabolomic analysis (performed by Metabolon Inc., Morrisville, NC, USA) and the metabolomic profile changes were complemented with Western blot analysis of key enzymes in the lipid pathway. Metabolomic data showed significant accumulation of fatty acids and phosphatidylcholine (PC) metabolites in the brain. Adolescent, more so than adult females, exposed to N + OC showed significant increases in carnitine-conjugated fatty acid metabolites compared to saline control animals. These changes in fatty acyl carnitines were accompanied by an increase in a subset of free fatty acids, suggesting elevated fatty acid β-oxidation in the mitochondria to meet energy demand. In support, β-hydroxybutyrate was significantly lower in N + OC exposure groups in adolescent animals, implying a complete shunting of acetyl CoA for energy production via the TCA cycle. The reported changes in fatty acids and PC metabolism due to N + OC could inhibit post-translational palmitoylation of membrane proteins and synaptic vesicle formation, respectively, thus exacerbating ischemic brain damage in female rats.
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Affiliation(s)
- Shahil H. Patel
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratories, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Alba Timón-Gómez
- Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Hari Pradhyumnan
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratories, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Berk Mankaliye
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratories, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Kunjan R. Dave
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratories, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Neuroscience Program, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Miguel A. Perez-Pinzon
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratories, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Neuroscience Program, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Ami P. Raval
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratories, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Neuroscience Program, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Bruce W. Carter Department of Veterans Affairs Medical Center, Miami, FL 33136, USA
- Correspondence: ; Tel.: +1-(305)-243-7491; Fax: +1-(305)-243-6955
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