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Gupta S, Harding K. Contraception and cardiovascular disorders. Br J Fam Plann 1999; 25:13-7. [PMID: 10228244] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Affiliation(s)
- S Gupta
- University of Manchester 63-65 Palatine Centre, Withington, Manchester M20 3LJ, UK
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2
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Testa G, Vegetti W, Motta T, Alagna F, Bianchedi D, Carlucci C, Bianchi M, Parazzini F, Crosignani PG. Two-year treatment with oral contraceptives in hyperprolactinemic patients. Contraception 1998; 58:69-73. [PMID: 9773260 DOI: 10.1016/s0010-7824(98)00069-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.9] [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] [Indexed: 02/09/2023]
Abstract
The aim of this prospective study was the follow-up for 2 years in symptoms, serum prolactin (PRL) levels, and radiological aspects of a group of young patients using oral contraceptives (OC) with hyperprolactinemia. A total of 16 hyperprolactinemic women (eight with idiopathic hyperprolactinemia and eight with pituitary microadenoma) who started OC use were admitted in the study. After 2 years of OC use, the assessable patients showed a nonsignificant decrease in plasma PRL level (26.8 +/- 29.4 micrograms/mL, range 4.2-97.1 micrograms/mL vs 56.3 +/- 31.5 micrograms/mL, range 23.5-144 micrograms/mL). No patient experienced any radiological changes during OC treatment. In conclusion, although the number of observations is limited, the data suggest that after 2 years of follow-up, no harmful effect of OC use was observed in these patients.
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Affiliation(s)
- G Testa
- Clinica Ostetrica Ginecologica, Università di Pavia, Italy
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Abstract
Several recent case control studies have shown an excess rate of venous thromboembolism in women using third generation progestogen-containing combined contraceptive pills compared to second generation combined contraceptive pills. This excess is about 1 in 10,000 women per year of use. It is likely that second and third generation pills have been preferentially prescribed to users who have varying susceptibility to venous thromboembolism and that this may account for at least part of the observed differences. In practice, it is essential that all women using combined oral contraceptive pills have a thorough history taken to exclude any contraindications or risk factors. Each client should be counselled about the risks and benefits of oral contraception. In New Zealand, the Ministry of Health has recommended that prescribers for women starting a contraceptive pill for the first time should consider a pill that does not contain a third generation progestogen. Women already receiving a third generation pill may elect to continue that pill after the differential rates of venous thromboembolism have been discussed.
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Affiliation(s)
- C Roke
- Family Planning Association, Northern Region, Auckland, New Zealand
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4
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Piegsa K, Guillebaud J. Oral contraceptives and the risk of DVT. Practitioner 1996; 240:544-51. [PMID: 8984464] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- K Piegsa
- Family Planning and Community Gynaecology, Margaret Pyke Centre, London
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Rutgeerts L, Ghillebert G, Drognee W, Tanghe W, Vuylsteke P, Decoster M. Ischemic colitis in a patient with Crohn's disease taking an oral contraceptive and an ergotamine alkaloid. Acta Clin Belg 1993; 48:48-51. [PMID: 8388603 DOI: 10.1080/17843286.1993.11718284] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [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] [Indexed: 01/30/2023]
Abstract
A 22-year-old woman developed transient left-sided ischemic colitis with submucosal oedema and bleeding, six weeks after an uneventful right hemicolectomy for Crohn's disease. The thrombogenic properties of the contraceptive pill and the concomitant use of an ergotamine alkaloid were thought to be the cause of this complication in a patient at risk. An increase of procoagulant activity and underlying vascular injury has been described in Crohn's disease.
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Affiliation(s)
- L Rutgeerts
- Department of Gastroenterology, Heilig Hart Kliniek, Belgium
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Abstract
With over 60 million users of 'the pill' worldwide, safety and efficacy remain the two most relevant issues to both the consumer and the research scientist. Safety of combined oral contraception (COC) has advanced appreciably. Lessons learned from cohort and case-control studies have been applied to the practical management of oral contraception use, based on screening, selection and regular monitoring of users. Most health risks of COCs appear to be dependent on the dose and potency (or biological impact) of the constituent steroids. While many of the non-contraceptive benefits of COCs are maintained when modern low dose preparations are used, most, if not all, of the adverse effects have been reduced progressively. Moreover the range of modern hormonal contraceptives has widened with the introduction of a new generation of 'selective' progestogens (Desogestrel, Norgestimate and Gestodene), which have minimal androgenicity. User failure of COCs is still high in many countries. The cause is a combination of poor compliance and anxiety about perceived adverse effects. Compliance can be enhanced by improving the quality of instruction in pill use. Fears of adverse effects of COCs may be allayed through education of users and providers, and sympathetic management of side effects.
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Affiliation(s)
- A Kubba
- Department of Obstetrics and Gynaecology, United Medical and Dental Schools, St Thomas' Hospital, London, UK
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Affiliation(s)
- G V Upton
- Wyeth-Ayerst Research, CR&D, Philadelphia, PA 19101
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9
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Miller C, Murtagh J. Combined oral contraception. Aust Fam Physician 1992; 21:1787-8. [PMID: 1476509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Abstract
As a general rule, the lowest-dose oral contraceptive should be prescribed that minimizes side effects while maintaining contraceptive protection. A woman who experiences mild side effects should be encouraged to tolerate symptoms for three menstrual cycles before a decision is made to change the prescription. Compliance may also be improved by informing women of the noncontraceptive health benefits of oral contraceptives: less menstrual blood loss and a lower incidence of menorrhagia, irregular bleeding, benign breast disease, endometrial cancer, dysmenorrhea, ovarian cysts or tumors, and salpingitis. Adequate patient education and supportive counseling are key factors in patient satisfaction and hence compliance.
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Affiliation(s)
- R S Williams
- University of Florida College of Medicine, Gainesville 32610
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Abstract
Hereditary angioedema is a rare disorder which is associated with an inherited deficiency of the inhibitor of the activated first component of complement. Genetic transmission occurs in an autosomal dominant manner. Affected patients are heterozygotes, and their deficiency is incomplete, many of them having up to 20% of the normal amount of the inhibitor. We describe two cases of C1 esterase inhibitor deficiency occurring in a mother and daughter in whom the symptoms appeared to be related to the menstrual cycle or the taking of the oral contraceptive pill. Although both features have been mentioned in the literature, to the best of our knowledge premenstrual exacerbations have not been documented previously. We examined the likely basis of hormonally exacerbated hereditary angioedema.
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Affiliation(s)
- J Yip
- Department of Dermatology, General Infirmary, Leeds, England
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12
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Abstract
Oral contraceptive (OC) use is a risk for thrombogenic events. This paper reviews effects of OC on oxidative status, coagulation, and platelet activity. Complicating effects of cardiovascular risk factors such as smoking, diabetes, hyperpidemia, and hypertension, are discussed. From these data we conclude that: 1. OC use modifies slightly but significantly the oxidative status in women and in animals by decreasing in plasma and blood cells the antioxidant defenses (vitamins and enzymes). 2. The changes in the oxidative status are related to an increase in plasma lipid peroxides apparently responsible for the hyperaggregability and possibly the imbalance in clotting factors associated with the OC-induced prethrombotic state. 3. These effects of OC appear to be increased by a high intake of polyunsaturated fat and counteracted by supplements of vitamin E. 4. The risk factors acting synergistically with OC, have all been shown to increase platelet reactivity. In addition, smoking, diabetes, and, to some extent, dyslipidemia are associated with an increased level of lipid peroxides and concomitant changes in the antioxidant defenses that can be additive to those induced by OC. Thus, free radicals and lipid peroxidation could be the underlying mechanism in the predisposition to thrombosis induced by most risk factors in OC users. 5. Results of epidemiologic and experimental studies in this field will be concordant only when diet and natural antioxidants will be systematically taken into consideration.
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Gompel A, Blétry O. [Contraception and pregnancy in systemic lupus erythematosus]. Rev Prat 1990; 40:1946-51. [PMID: 2237188] [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] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In 1990 conflicting views are still being held concerning oral contraception and risks associated with pregnancy in women with systemic lupus erythematosus. As regards oral contraceptives, all authors agree that oestrogen-progestin combination pills are harmful, but the best alternative hormonal contraception remains to be determined. Protein-based "micropills" seem to be harmless; cyproterone acetate appears to be without side-effects, and its usefulness in preventing recurrences is being evaluated. As regards pregnancy, it would be wise not to contemplate having a child until 6 months have elapsed since the onset of remission. Blood pressure, platelet count and serum creatinine and uric acid levels must be closely monitored. Two types of antibodies may be present in the mother and are known to be responsible for foetal complications. These are antibodies to phospholipids (antiprothrombinase, anticardiolipin, antibodies responsible for dissociated treponema serology), which expose to spontaneous abortion or intrauterine death, and the antibody to SS-A (or anti-Ro), which exposes to foetal cardiomyopathy and congenital atrioventricular block.
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Affiliation(s)
- A Gompel
- Service d'endocrinologie, hôpital Necker, Paris
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Miller C. The combined oral contraceptive. A practical guide. Aust Fam Physician 1990; 19:897, 900, 903-6. [PMID: 2248582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Prescribing the combined oral contraceptive pill is a rewarding combination of hands-on clinical medicine, logical therapeutics, prevention, and patient education. Lowest dose with the least side-effects is the overriding principle of prescribing. It is important to spend time teaching patients and partners how to manage their pill-taking and to be responsible for their medication and prevention follow up.
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Garnier LF, Gruel Y. [Oral contraception and the vascular risk]. Servir 1989; 37:322-6. [PMID: 2517520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Price MM. Find alternatives for patients using 80 to 100 mcg estrogen OCs. Contracept Technol Update 1988; 9:86-7. [PMID: 12281578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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17
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Gaspard U. [Oral contraception, glucid metabolism and monitoring criteria]. Contracept Fertil Sex (Paris) 1988; 16:113-8. [PMID: 12342000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Affiliation(s)
- J Newton
- Birmingham Maternity Hospital, Queen Elisabeth Medical Centre, Dept. Obstetrics and Gynaecology, U.K
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Most clinicians feel DES exposure does not contraindicate OC use. Contracept Technol Update 1987; 8:127-9. [PMID: 12341549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Dubois C, Le Strat N. [Contraception at risk]. Rev Prat 1987; 37:2293-301. [PMID: 3659796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Abstract
The risks of oral contraceptives are very small, and they cluster in a subset of users, although warning signs of cardiovascular complications must be heeded. The best choice of an oral contraceptive is one with an estrogen content of 30 to 35 micrograms. A greater (50 micrograms) content may be necessary if breakthrough bleeding or amenorrhea persists beyond a few treatment cycles. The starting date for the pill can be up to the sixth day of the cycle. Noncontraceptive benefits of the pill may include a protective effect against endometrial and ovarian malignancy, benign breast disease, and infection of the upper genital tract. Both the contraceptive and noncontraceptive benefits of low-dose combination oral contraceptives are desirable. They far outweigh the risks in women who require a high-efficacy, reversible contraceptive and who have no significant contraindication to use of the pill.
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Presl J. [Triphasic combined oral steroidal contraceptives]. Cesk Gynekol 1987; 52:230-2. [PMID: 3594595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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23
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Cohen J. Clinical use of biphasic and triphasic pills. IPPF Med Bull 1985; 19:1-2. [PMID: 12280230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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Neinstein Ls Katz B. Patients with hematologic disorders need careful birth control counseling. Contracept Technol Update 1985; 6:43-6. [PMID: 12266720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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Wemeau-jacquemont C. [Choosing contraception for adolescents]. NPN Med 1985; 5:185-9. [PMID: 12280585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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26
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Manuilova IA, Dubnitskaia LV, Trutko NS. [Effect of hormonal contraceptives on cardiovascular function]. Akush Ginekol (Mosk) 1983:5-8. [PMID: 6364872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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An update on the pill. Initiatives Popul 1983; 7:2-15. [PMID: 12339841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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28
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Van Lierde M, Thomas K. [The contraindications of estroprogestagens]. Louv Med 1981; 100:609-19. [PMID: 12279152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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Mutti P, Cesarini R. [Principle complications and contraindications of the use of oral contraceptives]. Minerva Ginecol 1979; 31:363-75. [PMID: 156884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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30
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Spellacy WN. Family planning and the diabetic mother. Semin Perinatol 1978; 2:395-9. [PMID: 755299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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