RESUMEN
The consumption of progestins has increased considerably in recent decades, as has their disposal into the environment. These substances can negatively affect the reproduction, physiology, and behavior of non-target organisms, such as fish. We aimed to evaluate the effects of exposure to environmentally relevant concentrations of levonorgestrel-control birth based (1.3, 13.3, 133, and 1330 ng/L) on the development and behavior of zebrafish (Danio rerio) in terms of mortality, hatching, spontaneous movement, and larval and adult behavioral tests. Exposure caused anxiogenic-like behavior in larvae, which persisted in adults, as demonstrated by the light-dark test. In contrast, it caused anxiolytic-like behavior in the novel tank test. There was a high mortality rate at all tested concentrations and increases in the hormone cortisol at 13.3 ng/L that affected the sex ratio. These changes may lead to an ecological imbalance, emphasizing the risk of early exposure to progestins in the environment.
Asunto(s)
Contaminantes Químicos del Agua , Pez Cebra , Humanos , Animales , Femenino , Pez Cebra/fisiología , Levonorgestrel/toxicidad , Progestinas/toxicidad , Larva , Anticonceptivos Orales Combinados/farmacología , Anticoncepción , Contaminantes Químicos del Agua/toxicidad , Embrión no MamíferoRESUMEN
OBJECTIVE: The aim of the study was to evaluate whether combined oral contraceptives (COCs) can be used as hormone therapy (HT) to preserve bone mineral density (BMD) in women with premature ovarian insufficiency (POI). METHODS: An observational study of women with POI comparing the use of COC (ethinylestradiol 30 µg + levonorgestrel, continuously) with: low-dose HT (continuous conjugated estrogen 0.625âmg plus medroxyprogesterone or continuous estradiol [E2] 1âmgâ+ânorethisterone), high-dose HT (continuous conjugated estrogen 1.25âmgâ+âmedroxyprogesterone or continuous E2 2âmgâ+ânorethisterone), tibolone 2.5âmg, or no treatment. Bone density scans were performed every 2â±â1 years. The difference between final and initial (delta) BMD values was calculated for the lumbar spine, total femur, and femoral neck. Generalized estimating equations were used to analyze the effect of treatment over time. Variables without normal distribution were transformed into ranks. RESULTS: Overall, 420 scans (210 deltas) of 119 women were analyzed. The women were 30.3â±â9.2 years old (meanâ±âSD). BMD deltas at the lumbar spine and total femur were grater in the COC and high-dose HT groups. At the lumbar spine, the differences between two scans were greater in the COC group when compared to low-dose HT group: -0.043 (95% CI -0.062 to -0.024), untreated: -0.056 (-0.080 to -0.032), and tibolone: -0.050 (-0.094 to -0.006) groups. Total femur BMD decreases and the delta were lower in the low-dose HT group -0.038 (-0.052 to -0.024) when compared to COC. CONCLUSION: Continuous COC was associated with increased BMD in women with POI compared to low-dose HT, with similar improvement in the COC and high-dose HT groups. : Video Summary:http://links.lww.com/MENO/A620.
Video Summary:http://links.lww.com/MENO/A620.
Asunto(s)
Anticonceptivos Orales Combinados , Insuficiencia Ovárica Primaria , Adulto , Densidad Ósea , Anticonceptivos Orales Combinados/farmacología , Estrógenos/farmacología , Femenino , Cuello Femoral/diagnóstico por imagen , Humanos , Insuficiencia Ovárica Primaria/tratamiento farmacológico , Adulto JovenRESUMEN
Abstract Backgroud: Recent studies show that women on combined oral contraceptives (COC) present abnormal fasting lipid profile, increased postprandial lipemia, plasma C-reactive protein (CRP) and blood pressure (BP) compared to women not on combined oral contraceptives. Plasma renin is one of the factors responsible for abnormal BP. Objectives: To assess plasma renin levels in women using or not using COC, the correlation between renin and CRP, as well as divergences in lipid profile. Methods: A cross-sectional study with apparently healthy women aged 20 to 30, eutrophic, irregularly active, and with fasting triglycerides < 150 mg/dL. The sample was stratified into two groups: the No Combined Oral Contraceptive Group (NCOCG), comprised of women who did not use any type of hormone contraceptive, and the Combined Oral Contraceptive Group (COCG) comprised of women on low-dose COC for at least one year. After a 12-hour fast, 5 ml of blood was collected for renin dosing and PCR. Data were analyzed by the t-Test and bidirectional Mann-Whitney Test, both with significance < 0.05. Results: We evaluated 44 women equally distributed between the groups, age 23 ± 1.2 years, BMI 21.0 ± 3.2 kg/m2. Median and interquartile deviation of renin in the NCOCG and the COCG were, respectively, 0.5 (0.1-1.0) and 3.0 (2-6) (p < 0.01). A positive correlation between PCR and renin (p < 0.01 and r = 0.68) was found. Conclusion: The plasma renin levels of women using COC were higher, with a strong correlation with CRP.
Asunto(s)
Humanos , Femenino , Adulto , Adulto Joven , Renina/efectos de los fármacos , Renina/sangre , Anticonceptivos Orales Combinados/efectos adversos , Presión Arterial/efectos de los fármacos , Sistema Renina-Angiotensina/efectos de los fármacos , Estudios Transversales , Anticonceptivos Orales Combinados/farmacología , Factores de Riesgo de Enfermedad Cardiaca , Hipertensión/etiologíaRESUMEN
Abstract Background: The use of combined oral contraceptive (COC) has been related to changes in glycemic, lipid metabolism, increased oxidative stress, and systemic blood pressure, which could suggest a higher oxidation of low-density lipoprotein cholesterol (LDL-cholesterol) in women on use of COC. Objective: To test the hypothesis that there is a difference in the plasma values of oxidized LDL among women who use and do not use COC, as well as to evaluate the correlation between it and the lipid profile and high-sensitivity C-reactive protein (hs-CRP). Methods: Forty-two women with ages between 18 and 35 years old, who were eutrophic, irregularly active, with triglycerides < 150 mg/dL, blood glucose < 100 mg/dL, and who used or did not use COC were selected. These women were allocated in the COC group, formed by 21 women on COC use for at least 1 year; and a control group (CG), consisting of 21 women who had not used any type of hormonal contraceptive for at least 1 year. A significance level of 5% was adopted for statistical analyses. Results: It was observed that GCOC showed higher values of oxidized LDL than the CG, respectively 384 mU/mL versus 283 mU/mL (p < 0.01). A positive correlation between oxidized LDL and LDL-cholesterol (r = 0.3, p < 0.05), with total cholesterol (r = 0.47, p < 0.01) and with triglycerides (r = 0.32, p < 0.03) was observed, and there was no correlation with the hs-CRP. In the categorized analysis of oxidized LDL, 71.4% of GCOC women, and 28.6% of the CG remained above the established cutoff point. Conclusion: Women who use COC have higher plasma levels of oxidized LDL, and there is a positive correlation between oxidized LDL and other lipid variables.
Resumo Fundamento: O uso de contraceptivo oral combinado (COC) tem sido relacionado com alterações no metabolismo glicêmico, lipídico, maior estresse oxidativo e pressão arterial sistêmica, o que poderia sugerir maior oxidação da lipoproteína de baixa densidade colesterol (LDL-colesterol) em mulheres que utilizam COC. Objetivo: Testar a hipótese de que existe diferença nos valores plasmáticos da LDL-oxidada entre mulheres que utilizam e não utilizam COC, bem como avaliar a correlação entre ela e o perfil lipídico e proteína C reativa de alta sensibilidade (PCR-as). Métodos: Foram selecionadas 42 mulheres com idade entre 18 e 35 anos, eutróficas, irregularmente ativas, com triglicerídeos < 150 mg/dL, glicemia < 100 mg/dL e que utilizavam ou não COC. Essas foram alocadas no grupo COC, formado por 21 mulheres em uso COC há pelo menos 1 ano; e grupo controle (GC), composto por 21 mulheres que não utilizavam nenhum tipo de contraceptivo hormonal há pelo menos 1 ano. Adotado um nível de significância de 5% para as análises estatísticas. Resultados: Foi observado que o GCOC apresenta valores mais elevados da LDL-oxidada que o GC, respectivamente 384 mU/mL versus 283 mU/mL (p < 0,01). Também foi observado correlação positiva entre a LDL-oxidada e a LDL-colesterol (r = 0,3, p < 0,05), com o colesterol total (r = 0,47, p < 0,01) e com os triglicerídeos (r = 0,32, p < 0,03), não havendo correlação com a PCR-as. Na análise categorizada da LDL-oxidada, 71,4% das mulheres do GCOC e 28,6% do GC mantiveram-se acima do ponto de corte estabelecido. Conclusão: Mulheres que utilizam COC apresentam valores plasmáticos mais elevados da LDL-oxidada, existindo, correlação positiva entre a LDL-oxidada e outras variáveis lipídicas.
Asunto(s)
Humanos , Femenino , Adulto , Adulto Joven , Anticonceptivos Orales Combinados/sangre , Lipoproteínas LDL/sangre , Triglicéridos/sangre , Proteína C-Reactiva/análisis , Estudios Transversales , Factores de Riesgo , Estrés Oxidativo , Anticonceptivos Orales Combinados/farmacología , Lipoproteínas LDL/efectos de los fármacos , LDL-Colesterol/sangreRESUMEN
BACKGROUND: The use of combined oral contraceptive (COC) has been related to changes in glycemic, lipid metabolism, increased oxidative stress, and systemic blood pressure, which could suggest a higher oxidation of low-density lipoprotein cholesterol (LDL-cholesterol) in women on use of COC. OBJECTIVE: To test the hypothesis that there is a difference in the plasma values of oxidized LDL among women who use and do not use COC, as well as to evaluate the correlation between it and the lipid profile and high-sensitivity C-reactive protein (hs-CRP). METHODS: Forty-two women with ages between 18 and 35 years old, who were eutrophic, irregularly active, with triglycerides < 150 mg/dL, blood glucose < 100 mg/dL, and who used or did not use COC were selected. These women were allocated in the COC group, formed by 21 women on COC use for at least 1 year; and a control group (CG), consisting of 21 women who had not used any type of hormonal contraceptive for at least 1 year. A significance level of 5% was adopted for statistical analyses. RESULTS: It was observed that GCOC showed higher values of oxidized LDL than the CG, respectively 384 mU/mL versus 283 mU/mL (p < 0.01). A positive correlation between oxidized LDL and LDL-cholesterol (r = 0.3, p < 0.05), with total cholesterol (r = 0.47, p < 0.01) and with triglycerides (r = 0.32, p < 0.03) was observed, and there was no correlation with the hs-CRP. In the categorized analysis of oxidized LDL, 71.4% of GCOC women, and 28.6% of the CG remained above the established cutoff point. CONCLUSION: Women who use COC have higher plasma levels of oxidized LDL, and there is a positive correlation between oxidized LDL and other lipid variables.
Asunto(s)
Anticonceptivos Orales Combinados/sangre , Lipoproteínas LDL/sangre , Adulto , Proteína C-Reactiva/análisis , LDL-Colesterol/sangre , Anticonceptivos Orales Combinados/farmacología , Estudios Transversales , Femenino , Humanos , Lipoproteínas LDL/efectos de los fármacos , Estrés Oxidativo , Factores de Riesgo , Triglicéridos/sangre , Adulto JovenRESUMEN
The aim of this study was to evaluate the effects of cyproterone acetate (CPA) and ethinyloestradiol (EE) alone or in combination on the female prostate of adult gerbils. Adult females were exposed for 21 days to daily oral doses of CPA (1mgkg-1), EE (10µgkg-1) or a combination of CPA and EE. Female prostatic complexes were removed, weighed and subjected to morphological, stereological, immunohistochemical and ultrastructural analyses. CPA treatment caused epithelial atrophy and decreased prostate secretory activity. The EE treatment group showed glandular hyperplasia, a high cell-proliferation index and an increase in androgen and oestrogen receptor α (AR and ERα) immunoreactivity. Combined treatment (CPA+EE) caused adverse effects, such as an increase in cell proliferation, higher AR and ERα immunoreactivity, prostatic intraepithelial neoplasia, cell degeneration and aging. In conclusion, the CPA-only treatment promoted antiandrogenic effects on the female gerbil prostate, whereas EE-only had a potent oestrogenic activity. However, when combined, EE overlapped the effects of CPA, changing the pattern of glandular hormonal regulation and stimulating the development of prostatic lesions in female gerbils.
Asunto(s)
Anticonceptivos Orales Combinados/farmacología , Receptor alfa de Estrógeno/metabolismo , Genitales Femeninos/efectos de los fármacos , Genitales Femeninos/metabolismo , Gerbillinae/anatomía & histología , Gerbillinae/metabolismo , Receptores Androgénicos/metabolismo , Estructuras Animales/anatomía & histología , Estructuras Animales/efectos de los fármacos , Estructuras Animales/metabolismo , Animales , Acetato de Ciproterona/farmacología , Metilasas de Modificación del ADN/metabolismo , Combinación de Medicamentos , Etinilestradiol/farmacología , Femenino , Genitales Femeninos/anatomía & histología , Inmunohistoquímica , Masculino , Microscopía Electrónica de Transmisión , Antígeno Nuclear de Célula en Proliferación/metabolismo , Próstata/anatomía & histología , Próstata/efectos de los fármacos , Próstata/metabolismo , Regulación hacia Arriba/efectos de los fármacos , Uretra/anatomía & histología , Uretra/efectos de los fármacos , Uretra/metabolismo , Vagina/anatomía & histología , Vagina/efectos de los fármacos , Vagina/metabolismoRESUMEN
Objetivo: Describir las características del patrón sangrado uterino de las adolescentes que usan el implante anticonceptivo sudérmico de etonogestrel (IASE) que concurren a un centro especializado en salud sexual y reproductiva de adolescentes en Santiago, Chile, y su asociación con variables biopsicosocial. Método: Estudio de cohorte retrospectiva de las usuarias de IASE. Los datos fueron analizados utilizando la ecuación de estimación generalizada, análisis de sobrevida de Kaplan Meier y test de log-rank. Resultados: La cohorte incluyó a 62 adolescentes. La media de edad fue de 16,2 años. Las participantes recibieron asesoramiento anticonceptivo antes de la inserción del IASE, y fueron seguidas durante tres años. Los patrones de sangrado más frecuentes durante el primer año fue el de amenorrea (40,5%) y el sangrado aceptable (27,1%), mientras que el menos frecuente fue prolongado y/o sangrado frecuente (15,8%). De acuerdo con el análisis de sobrevida, la única variable biopsicosocial asociado con patrón prolongado y/o sangrado frecuente fue condición médica previa. Cinco adolescentes (8%) se retiraron el IASE. Conclusiones: El IASE es una opción anticonceptiva segura y altamente eficaz para las adolescentes, independientemente de la paridad. La consejería es de gran importancia para fomentar la tolerancia y la adhesión al implante.
Objectives: To describe uterine bleeding patterns of adolescents using the long term etonogestrel contraceptive implant (ENG implant) attending a specialized adolescent sexual and reproductive health centre in Santiago, Chile, and test their association with bio-psychosocial variables. Methods: A retrospective cohort study of ENG implant users was conducted and data were analysed using the Generalized Estimating Equation, Kaplan Meier Survival Analysis and Log-Rank Test. Results: The cohort included 62 adolescents with and average age at inclusion of 16.2 years. Participants received contraceptive counselling prior to insertion of an ENG implant, and were followed up for three years. The most frequent bleeding patterns during the first year were amenorrhea (40.5%) and acceptable bleeding (27.1%), whilst the least frequent was prolonged and/or frequent bleeding (15.8%). According to the survival analysis, the only bio-psychosocial variable associated with prolonged and/or frequent bleeding was prior medical condition. Five adolescents (8%) withdrew from the treatment. Conclusions: The ENG implant is a safe and highly effective contraceptive option for adolescents, regardless of parity. Counselling is of great importance to foster tolerance and adherence to the ENG implant.
Asunto(s)
Humanos , Femenino , Adolescente , Adulto Joven , Anticonceptivos Orales Combinados/administración & dosificación , Desogestrel/administración & dosificación , Dispositivos Intrauterinos Medicados , Menstruación/efectos de los fármacos , Amenorrea , Anticonceptivos Orales Combinados/farmacología , Desogestrel/farmacología , Implantes de Medicamentos , Estudios de Seguimiento , Menstruación/psicología , Análisis de SupervivenciaRESUMEN
OBJECTIVE: Drospirenone (DRSP) is a progestogen derived from spironolactone with antimineralocorticoid action that seems to exert a favorable effect on blood pressure (BP); however, when associated with ethinylestradiol (EE), this effect does not seem to occur. This study aimed to assess possible differences in BP associated with the use of combined oral contraceptives containing DRSP with different doses of EE. MATERIALS AND METHODS: This open-label parallel-group randomized clinical trial involved women randomized to use either 30 mcg of EE+DRSP (n=22) or 20 mcg of EE+DRSP (n=22). Daytime, nighttime, and 24-h BP were evaluated by ambulatory blood pressure monitoring at the beginning of the trial and 6 months after drug therapy. RESULTS: The groups were similar in terms of demographic characteristics. The mean 24-h systolic blood pressure and diastolic blood pressure (DBP) were similar between the groups before and after treatment (P>0.05). With respect to day and nighttime systolic blood pressure and DBP, no statistically significant difference was observed in BP values between the two groups either before or after treatment, except for the daytime DBP in the 30EE+DRSP group. In this group, a decrease of 2 mmHg (3%) in daytime DBP was observed after 6 months of drug therapy (P=0.04). CONCLUSION: There was no difference in BP associated with the use of combined oral contraceptives containing DRSP irrespective of the EE dose used.
Asunto(s)
Androstenos/farmacología , Presión Sanguínea/efectos de los fármacos , Anticonceptivos Orales Combinados/farmacología , Etinilestradiol/farmacología , Administración Oral , Adulto , Androstenos/administración & dosificación , Monitoreo Ambulatorio de la Presión Arterial , Anticonceptivos Orales Combinados/administración & dosificación , Etinilestradiol/administración & dosificación , Femenino , Humanos , Adulto JovenRESUMEN
UNLABELLED: The use of combined oral contraceptives is widespread among hypertensive women despite being associated with increased cardiovascular risk. Contraceptives containing drospirenone, which has antimineralocorticoid properties, may have a positive or neutral effect on neurohumoral activation and metabolic homeostasis of hypertensive women at reproductive age. OBJECTIVES: To evaluate the effect of combined oral contraceptive containing drospirenone+ethinylestradiol on the systemic blood pressure, metabolic variables and neurohumoral axis in hypertensive women in reproductive age. DESIGN: Prospective controlled trial with 56 hypertensive women allocated in two groups: 30 volunteers under oral combined contraceptive use and 26 volunteers using non-hormonal contraceptive methods. Subjects were tested before the introduction of the contraceptive method and 6 months after its use. For data acquisition, we used continuous non-invasive beat-to-beat blood pressure curve recordings and, for the biochemical and hormonal analyses two blood samples were obtained. Student's t test was used to determine differences between groups and moments and p<0.05 was considered statistically significant. RESULTS: Comparing antropometric and blood pressure measurements, cardiac sympatho-vagal modulation, baroreceptor sensitivity, metabolic and neurohumoral axis variables between baseline and after 6 months, no significant difference was detected in each group or between groups. Except serum triglyceride levels which increased in the group of women using EE+DRSP after 6 months of use. CONCLUSION: A contraceptive containing 20 mcg of ethinyl estradiol and 3 mg of drospirenone causes no significant changes in clinical and autonomic parameters, metabolic variables and neurohumoral axis of hypertensive women.
Asunto(s)
Androstenos/farmacología , Presión Sanguínea/efectos de los fármacos , Anticonceptivos Orales Combinados/farmacología , Etinilestradiol/farmacología , Adulto , Aldosterona/sangre , Antihipertensivos/uso terapéutico , Barorreflejo/efectos de los fármacos , Índice de Masa Corporal , Anticonceptivos Orales Combinados/química , Electrólitos/sangre , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Homeostasis/efectos de los fármacos , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/fisiopatología , Estudios Prospectivos , Triglicéridos/sangre , Adulto JovenRESUMEN
OBJECTIVE: To measure infants' breast milk intake and infant growth when their mothers initiated either combined oral contraceptive (COC), levonorgestrel-releasing intrauterine system, or etonogestrel-releasing implant, or copper intrauterine device (IUD) as a reference group. DESIGN: Prospective trial. SETTING: University-based hospital. PATIENT(S): On postpartum day 42, 40 women initiated a contraceptive method according to their choice. INTERVENTION(S): Deuterium (D2O; 0.5 g/kg mother's weight) was ingested by mothers on postpartum days 42, 52, and 63 as a marker of total body fluid. MAIN OUTCOME MEASURE(S): Infants' milk intake from 42 to 63 postpartum days was assessed by measurement of D2O levels in infants' saliva and infant growth by measuring their body weight, height, and tibia length. Women recorded all infant feed and changes of diapers wet with urine. Breastfeeding continuation was assessed at 6 months postpartum. RESULT(S): Infant mean milk intake, mean growth increase, mean number of breastfeeding episodes, daily wet diaper changes, and mean duration of exclusively breastfeeding (~5 months) were similar in the four groups. CONCLUSION(S): Use of a COC, the two progestin-only contraceptives, or copper IUD did not affect the amount of infant milk intake and growth up to 9 weeks of age. The incidence of full breastfeeding and breastfeeding continuation was similar with contraceptive hormonal use and no use. CLINICAL TRIALS REGISTRATION NUMBER: NCT01388582.
Asunto(s)
Lactancia Materna , Desarrollo Infantil/efectos de los fármacos , Anticonceptivos Orales Combinados/farmacología , Ingestión de Alimentos/efectos de los fármacos , Leche Humana , Adolescente , Adulto , Desogestrel/administración & dosificación , Desogestrel/farmacología , Femenino , Humanos , Lactante , Fenómenos Fisiológicos Nutricionales del Lactante/efectos de los fármacos , Dispositivos Intrauterinos de Cobre , Levonorgestrel/administración & dosificación , Levonorgestrel/farmacología , Masculino , Leche Humana/efectos de los fármacos , Progestinas/administración & dosificación , Progestinas/farmacología , Adulto JovenRESUMEN
PURPOSE: Because of the lack of data on hormone levels in the hormone-free interval of the contraceptive regimens with desogestrel and ethynil estradiol, the objective of this study was to compare hormonal levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, and inhibin B using two contraceptive regimens with those steroids. METHODS: Prospective and randomized study with 21 patients. Eleven patients received a 21/7 regimen (group 1) and ten patients received a 21/2 placebo/5 ethinyl estradiol 10 µg regimen (group 2). RESULTS: We found a significant increase in FSH and LH levels in both groups. There was a significant reduction of inhibin B in the 21/2/5 regimen. No difference in estradiol levels was found. CONCLUSIONS: Steroids withdrawal in the hormone-free interval causes reduced inhibition of the HPO axis. The significant decrease in inhibin B levels of group 2 suggests better suppression of the HPO axis in the 21/2/5 regimen.
Asunto(s)
Anticonceptivos Orales Combinados/farmacología , Anticonceptivos Hormonales Orales/farmacología , Desogestrel/farmacología , Etinilestradiol/farmacología , Sistema Hipotálamo-Hipofisario/efectos de los fármacos , Ovario/efectos de los fármacos , Adolescente , Adulto , Biomarcadores/sangre , Anticonceptivos Orales Combinados/administración & dosificación , Anticonceptivos Hormonales Orales/administración & dosificación , Desogestrel/administración & dosificación , Esquema de Medicación , Estradiol/sangre , Etinilestradiol/administración & dosificación , Femenino , Hormona Folículo Estimulante/sangre , Humanos , Sistema Hipotálamo-Hipofisario/metabolismo , Inhibinas/sangre , Hormona Luteinizante/sangre , Ovario/metabolismo , Estudios Prospectivos , Adulto JovenRESUMEN
BACKGROUND: Although the use of combined oral contraceptives (COCs) is associated with an increased risk of arterial and venous thromboembolic events, less is known about the impact of COCs on endothelial function. The present study evaluated the effects on the endothelium of healthy women of combinations of 30 mcg ethinylestradiol (EE)/2 mg chlormadinone acetate (CMA) and 30 mcg EE/150 mcg levonorgestrel (LNG). STUDY DESIGN: Sixty-four healthy women were evaluated, 21 using a nonhormonal contraceptive method (control) and 43 using COCs, randomized to EE 30 mcg /CMA 2 mg or to EE 30 mcg/LNG 150 mcg. Anthropometric parameters, systolic arterial pressure (SAP), diastolic arterial pressure (DAP), ultrasound markers of endothelial function, flow-mediated dilation (FMD) of the brachial artery, intima-media thickness (IMT) and common carotid artery stiffness were measured at randomization and 6 months later. RESULTS: Relative to baseline, EE/CMA users showed a significant reduction in mean DAP at 6 months (p=.02), and EE/LNG users showed a significant increase in mean IMT (p=.02) and a significant reduction in mean FMD (p=.01) at 6 months. DAP at 6 months was significantly lower in COC users than in controls (p=.01). Intergroup evaluations showed that, at 6 months, mean SAP (p=.02) was significantly lower in EE/LNG users than in controls (p=.02) and that mean DAP was significantly lower in EE/CMA (p<.01) and EE/LNG (p=.01) users than in controls. EE/LNG users experienced a mean FMD reduction almost threefold greater than that of EE/CMA users. Compared to controls, EE/LNG users experienced a 7.5-fold greater reduction in mean FMD. CONCLUSIONS: COC containing LNG is associated with more pronounced changes in the FMD and IMT of healthy women than a COC containing CMA and nonhormonal contraception. Further studies are needed to determine whether these differences may lead to higher risk of arterial thromboembolic events.
Asunto(s)
Acetato de Clormadinona/efectos adversos , Anticonceptivos Orales Combinados/efectos adversos , Endotelio Vascular/efectos de los fármacos , Levonorgestrel/efectos adversos , Progestinas/efectos adversos , Vasoconstricción/efectos de los fármacos , Adolescente , Adulto , Presión Sanguínea/efectos de los fármacos , Arteria Braquial/diagnóstico por imagen , Arteria Braquial/efectos de los fármacos , Brasil/epidemiología , Arteria Carótida Común/diagnóstico por imagen , Arteria Carótida Común/efectos de los fármacos , Grosor Intima-Media Carotídeo , Anticonceptivos Orales Combinados/farmacología , Endotelio Vascular/diagnóstico por imagen , Etinilestradiol/efectos adversos , Femenino , Humanos , Estudios Longitudinales , Riesgo , Tromboembolia/inducido químicamente , Tromboembolia/epidemiología , Tromboembolia/prevención & control , Rigidez Vascular/efectos de los fármacos , Vasoconstrictores/efectos adversos , Adulto JovenAsunto(s)
Humanos , Femenino , Anticonceptivos Orales Combinados/farmacología , Suplementos Dietéticos , Ácido Fólico , Defectos del Tubo Neural/epidemiología , Anticonceptivos Orales Combinados/efectos adversos , Anticonceptivos Orales Combinados/farmacocinética , Defectos del Tubo Neural/prevención & controlRESUMEN
BACKGROUND: Cervical cancer has been extensively studied, as well as the various risk factors for that cancer. One such factor is the prolonged use of hormonal contraceptives. OBJECTIVE: To report the biological, immunological and epidemiological findings arising from the use of oral contraceptives and their relation to cervical cancer. MATERIAL AND METHODS: Retrospective study based on information published in national and international literature. CONCLUSIONS: Controversy persists between the epidemiological data and experimental biological association between hormonal contraceptives and cancer induced by HPV. It is important to consider the biological findings because in Mexico the use of hormonal contraceptives is very broad and the number of cases of cervical cancer and only extensive epidemiological studies will clarify this controversy.
Asunto(s)
Alphapapillomavirus , Carcinoma de Células Escamosas/epidemiología , Anticonceptivos Orales Combinados/efectos adversos , Anticonceptivos Hormonales Orales/efectos adversos , Infecciones por Papillomavirus/epidemiología , Neoplasias del Cuello Uterino/epidemiología , Alphapapillomavirus/efectos de los fármacos , Animales , Carcinoma de Células Escamosas/inmunología , Carcinoma de Células Escamosas/virología , Anticonceptivos Orales Combinados/farmacología , Anticonceptivos Hormonales Orales/farmacología , Progresión de la Enfermedad , Femenino , Regulación Viral de la Expresión Génica/efectos de los fármacos , Humanos , Ratones , Estudios Retrospectivos , Factores de Riesgo , Neoplasias del Cuello Uterino/inmunología , Neoplasias del Cuello Uterino/virología , Cervicitis Uterina/epidemiología , Cervicitis Uterina/virología , Proteínas Virales/genética , Proteínas Virales/fisiologíaRESUMEN
Considerable advances have been made in the field of combined oral contraceptives since their introduction 50 years ago. This ongoing evolution has been focused on reducing the estrogen dose and synthesizing new progestogens. A recently launched combination of ethinylestradiol 20 µg and drospirenone 3 mg demonstrates the advantages of a lower estrogen dose with the antimineralocorticoid activity of drospirenone that is responsible for the drug's significant antiandrogenic and antimineralocorticoid effects, reflected clinically in lower rates of adverse events including less fluid retention. In addition to the drug's contraceptive efficacy, its effects on the skin and other classic noncontraceptive benefits, the ethinylestradiol 20 µg and drospirenone 3 mg combination has demonstrated highly satisfactory results in women with premenstrual dysphoric syndrome.
Asunto(s)
Acné Vulgar/tratamiento farmacológico , Androstenos/farmacología , Anticonceptivos Orales Combinados/farmacología , Dismenorrea/tratamiento farmacológico , Etinilestradiol/farmacología , Síndrome Premenstrual/prevención & control , Androstenos/farmacocinética , Anticonceptivos Orales Combinados/farmacocinética , Endometrio/efectos de los fármacos , Etinilestradiol/farmacocinética , Femenino , Humanos , Antagonistas de Receptores de Mineralocorticoides/farmacocinética , Antagonistas de Receptores de Mineralocorticoides/farmacología , Síndrome Premenstrual/tratamiento farmacológicoRESUMEN
OBJECTIVE: To compare the bleeding patterns, satisfaction and tolerability of 3 different contraceptive in an extended regimens in the service of Family Planning of the North Central Hospital of PEMEX. MATERIAL AND METHODS: Healthy, adult women with desire of contraception for one year (N 120) were randomly assigned to receive oral contraceptive drospirenone/ethinyl E2 (group1), the norelgestromin/ethinyl E2 transdermal patch (group 2) and vaginal ring etonogestrel/ ethinyl E2 (group 3) in an extended regimen (42 consecutive days, 1 hormone-free week). Study assessments were conducted at scheduled visits at the time of initial screening, at baseline after 1, 3, 6, and 12 months. Subjects recorded menstrual associated symptoms bleeding data and completed satisfaction questionnaires. Subjects and investigators provided overall assessments of the regimens. RESULTS: Extended use of 3 different contraceptive resulted in fewer bleeding days in every group (66.6%, 55% and 58.3% P 0.0024), and less mastalgia and menstrual pain. Subjects were highly satisfied with three regimens (93.3%, 96.6% and 91.6% P 0.00421). Although not mayor adverse events were reported with this regimen, there was an increase in spotting days; it decreased with each successive cycle of therapy. Efficacy and safety were similar to those reported for traditional cycle. CONCLUSION: Extended-contraceptive regimen delays menses and reduces bleeding, a profile that may be preferred by women who seek flexibility with their contraceptive method.
Asunto(s)
Androstenos/farmacología , Anticonceptivos Orales Combinados/farmacología , Anticonceptivos Hormonales Orales/farmacología , Desogestrel/farmacología , Etinilestradiol/farmacología , Ciclo Menstrual/efectos de los fármacos , Norgestrel/análogos & derivados , Administración Cutánea , Adolescente , Adulto , Androstenos/administración & dosificación , Androstenos/efectos adversos , Enfermedades de la Mama/inducido químicamente , Dispositivos Anticonceptivos Femeninos , Anticonceptivos Orales Combinados/administración & dosificación , Anticonceptivos Orales Combinados/efectos adversos , Anticonceptivos Hormonales Orales/administración & dosificación , Anticonceptivos Hormonales Orales/efectos adversos , Desogestrel/administración & dosificación , Desogestrel/efectos adversos , Combinación de Medicamentos , Dismenorrea/prevención & control , Etinilestradiol/administración & dosificación , Etinilestradiol/efectos adversos , Femenino , Cefalea/inducido químicamente , Humanos , Norgestrel/administración & dosificación , Norgestrel/efectos adversos , Norgestrel/farmacología , Aceptación de la Atención de Salud , Estudios Prospectivos , Factores de Tiempo , Hemorragia Uterina/inducido químicamente , Adulto JovenRESUMEN
BACKGROUND: This study was conducted to compare the effects of two contraceptive pills with different doses of the same components, on plasma androgen levels and female sexual function among women without previous sexual dysfunction. STUDY DESIGN: The participants were randomized into two groups, to receive pills containing ethynylestradiol (EE) 30 mcg and levonorgestrel (LNG) 150 mcg or EE 20 mcg and LNG 100 mcg, for six cycles. Sexual function was assessed using a standardized questionnaire [Female Sexual Function Index (FSFI)]. Hormone assays were performed at baseline and after the sixth cycle. RESULTS: Forty-nine women were included in the EE30/LNG150 group and 48 in the EE20/LNG100 group. EE30/LNG150 group presented 54% and 67% decreases of total testosterone and free androgen index, respectively, with statistical significance. EE20/LNG100 presented reductions of 20% and 42%, respectively, but without statistical significance. Both groups showed improvements in the FSFI "desire" score, but with statistical significance only for EE20/LNG100 group. CONCLUSIONS: EE30/LNG150 decreased plasma androgen levels, but there was no impairment in sexual desire, on the other hand, sexual desire score increased with EE20/LNG100 formulation.
Asunto(s)
Anticonceptivos Orales Combinados/farmacología , Etinilestradiol/farmacología , Levonorgestrel/farmacología , Libido/fisiología , Administración Oral , Adolescente , Adulto , Anticonceptivos Orales Combinados/administración & dosificación , Etinilestradiol/administración & dosificación , Femenino , Humanos , Levonorgestrel/administración & dosificación , Libido/efectos de los fármacos , Estudios Prospectivos , Análisis de Regresión , Globulina de Unión a Hormona Sexual/análisis , Encuestas y Cuestionarios , Testosterona/sangre , Adulto JovenAsunto(s)
Anticoncepción/métodos , Lupus Eritematoso Sistémico , Adulto , Anticuerpos Monoclonales/uso terapéutico , Anticuerpos Monoclonales Humanizados , Síndrome Antifosfolípido/complicaciones , Anticoncepción de Barrera , Anticonceptivos Orales Combinados/efectos adversos , Anticonceptivos Orales Combinados/farmacología , Anticonceptivos Hormonales Orales/efectos adversos , Anticonceptivos Hormonales Orales/farmacología , Contraindicaciones , Femenino , Hormonas Esteroides Gonadales/efectos adversos , Hormonas Esteroides Gonadales/metabolismo , Humanos , Dispositivos Intrauterinos de Cobre , Dispositivos Intrauterinos Medicados/efectos adversos , Levonorgestrel/efectos adversos , Lupus Eritematoso Sistémico/complicaciones , Lupus Eritematoso Sistémico/tratamiento farmacológico , Lupus Eritematoso Sistémico/metabolismo , Guías de Práctica Clínica como Asunto , Embarazo , Embarazo de Alto Riesgo , Progestinas/administración & dosificación , Progestinas/efectos adversos , Progestinas/farmacología , Trombofilia/inducido químicamente , Trombofilia/etiologíaRESUMEN
INTRODUCTION AND HYPOTHESIS: Urinary glycosaminoglycans (uGAG) have protective effects against urinary tract disorders. Here we investigated whether oral hormonal contraceptives (OC) affect uGAG excretion. METHODS: Urine specimens were from young women regularly taking: ethinyl estradiol + drospirenone, n = 9; ethinyl estradiol + cyproterone acetate, n = 9; and ethinyl estradiol + gestodene, n = 7. Controls were from ten women not taking OC. Total uGAG was assayed as hexuronic acid/urinary creatinine. Sulfated uGAG species was determined by electrophoresis. RESULTS: Unlike controls, total uGAG in the two halves of the menstrual cycle was similar in the OC groups. Whole cycle uGAG was higher in the OC groups (p < 0.01), especially for ethinyl estradiol + cyproterone acetate (p < 0.005). The three OC produced decreases of approximately 50% in heparan sulfate (p < 0.02) and dermatan sulfate (p < 0.02), and a approximately 100% increase in chondroitin sulfate (p < 0.004). CONCLUSIONS: uGAG excretion is changed in women taking OC, and this might enhance the protective effects of these molecules against urinary tract disorders.