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The use of combined hormonal contraceptives amid the COVID-19 pandemic

Kow CS, Mustafa ZU, Hasan SS

Eur J Contracept Reprod Health Care, 2021 02;26(1):85-86.
PMID: 33245006 DOI: 10.1080/13625187.2020.1849618
Matched MeSH terms: Contraceptives, Oral, Hormonal
Fulltext Reproduction research and health: part III: fertility health

Sinnathuray TA

Med J Malaysia, 1980 Mar;34(3):307-13.
PMID: 7412671

The tremendous research advances in recent decades in the three widely used methods of fertility regulation (family planning), namely hormonal steroidal contraception, sterilisation and legal abortion, have been presented and discussed. The considerable health benefits accruing to the woman, in particular, and to the society, in general, from the practice of these fertility regulation methods. especially in the context of developing countries, have been reviewed. Recent research advances in the area of fertility augmentation (infertility management) have been presented and discussed. The manner in which some of the future trends in fertility regulation are likely to develop has been briefly stated.

Matched MeSH terms: Contraceptives, Oral, Hormonal
Fertility control and the risk of gynecological malignancies

Sivanesaratnam V

Obstet Gynecol Surv, 1991 Mar;46(3):131-7.
PMID: 1849623
Matched MeSH terms: Contraceptives, Oral, Hormonal/adverse effects*
Role of hormonal fluctuations in temporomandibular disorder pain: facts to ponder

Das S, Rajalingham S

Pain, 2012 Jan;153(1):250-251.
PMID: 22119339 DOI: 10.1016/j.pain.2011.10.039
Matched MeSH terms: Contraceptives, Oral, Hormonal/administration & dosage*
Fulltext Reproductive and hormone-related risk factors for epithelial ovarian cancer by histologic pathways, invasiveness and histologic subtypes: Results from the EPIC cohort

Fortner RT, Ose J, Merritt MA, Schock H, Tjønneland A, Hansen L, et al.

Int J Cancer, 2015 Sep 01;137(5):1196-208.
PMID: 25656413 DOI: 10.1002/ijc.29471

Whether risk factors for epithelial ovarian cancer (EOC) differ by subtype (i.e., dualistic pathway of carcinogenesis, histologic subtype) is not well understood; however, data to date suggest risk factor differences. We examined associations between reproductive and hormone-related risk factors for EOC by subtype in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Among 334,126 women with data on reproductive and hormone-related risk factors (follow-up: 1992-2010), 1,245 incident cases of EOC with known histology and invasiveness were identified. Data on tumor histology, grade, and invasiveness, were available from cancer registries and pathology record review. We observed significant heterogeneity by the dualistic model (i.e., type I [low grade serous or endometrioid, mucinous, clear cell, malignant Brenner] vs. type II [high grade serous or endometrioid]) for full-term pregnancy (phet = 0.02). Full-term pregnancy was more strongly inversely associated with type I than type II tumors (ever vs. never: type I: relative risk (RR) 0.47 [95% confidence interval (CI): 0.33-0.69]; type II, RR: 0.81 [0.61-1.06]). We observed no significant differences in risk in analyses by major histologic subtypes of invasive EOC (serous, mucinous, endometrioid, clear cell). None of the investigated factors were associated with borderline tumors. Established protective factors, including duration of oral contraceptive use and full term pregnancy, were consistently inversely associated with risk across histologic subtypes (e.g., ever full-term pregnancy: serous, RR: 0.73 [0.58-0.92]; mucinous, RR: 0.53 [0.30-0.95]; endometrioid, RR: 0.65 [0.40-1.06]; clear cell, RR: 0.34 [0.18-0.64]; phet = 0.16). These results suggest limited heterogeneity between reproductive and hormone-related risk factors and EOC subtypes.

Matched MeSH terms: Contraceptives, Oral, Hormonal/administration & dosage*
Fulltext Exogenous hormone use and cutaneous melanoma risk in women: The European Prospective Investigation into Cancer and Nutrition

Cervenka I, Al Rahmoun M, Mahamat-Saleh Y, Fournier A, Boutron-Ruault MC, Severi G, et al.

Int J Cancer, 2020 Jun 15;146(12):3267-3280.
PMID: 31506954 DOI: 10.1002/ijc.32674

Evidence suggests an influence of sex hormones on cutaneous melanoma risk, but epidemiologic findings are conflicting. We examined the associations between use of oral contraceptives (OCs) and menopausal hormone therapy (MHT) and melanoma risk in women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC is a prospective cohort study initiated in 1992 in 10 European countries. Information on exogenous hormone use at baseline was derived from country-specific self-administered questionnaires. We used Cox proportional hazards regression models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Over 1992-2015, 1,696 melanoma cases were identified among 334,483 women, whereof 770 cases among 134,758 postmenopausal women. There was a positive, borderline-significant association between OC use and melanoma risk (HR = 1.12, 95% CI = 1.00-1.26), with no detected heterogeneity across countries (phomogeneity = 0.42). This risk increased linearly with duration of use (ptrend = 0.01). Among postmenopausal women, ever use of MHT was associated with a nonsignificant increase in melanoma risk overall (HR = 1.14, 95% CI = 0.97-1.43), which was heterogeneous across countries (phomogeneity = 0.05). Our findings do not support a strong and direct association between exogenous hormone use and melanoma risk. In order to better understand these relations, further research should be performed using prospectively collected data including detailed information on types of hormone, and on sun exposure, which may act as an important confounder or effect modifier on these relations.

Matched MeSH terms: Contraceptives, Oral, Hormonal/adverse effects*
Fulltext Coagulation profile in women on low-dose oral contraceptive pills

Roshidah I, Khalid H, Baharum Y

Malays J Reprod Health, 1990 Dec;8(2):97-100.
PMID: 12343152

A cross-sectional study looking at the coagulation system was carried out involving 175 women attending the National Population and Family Development Board's Clinic at the Maternity Clinic, General Hospital, Kuala Lumpur. Study subjects comprise of 50 combined low-dose estrogen/progestrogen oral contraceptive (DC) pill users and 75 non-DC users, acting as controls. The subjects were on the pill for a period of one year or more. There were significant shortening of the prothrombin time (PT) and partial thromboplastin time (PIT) in the DC group as compared to the control group. However, the activities of factors II, Vand VIII assayed were not significantly different between the two groups, suggesting that the changes in the PT and PIT were not significant clinically. The effect of long term usage of combined 10w..cJose DC pills does not seem to indicate changes in the coagulation profile of the women in our study.
PIP: The effect of low dose combined oral contraceptives containing 30 mcg ethinyl estradiol and either 150 mcg levonorgestrel or 150 mcg desogestrel on coagulation indices in Malaysian women was examined. 50 women who had been using the pills for 1 year or more, were compared to 75 non-users. All were attending the Maternity Clinic of the General Hospital, Kuala Lumpur. Pill users registered shorter prothrombin time, 11.5 vs. 11.1 seconds (p=0.016), and partial thromboplastin time, 40.1 vs 35.1 seconds (p=0.000). Since there were no significant differences in Factors II, V, VII, or VIII, the overall effects of low-dose pills on coagulation is probably not clinically significant.

Matched MeSH terms: Contraceptives, Oral, Hormonal
A prospective study of a monophasic oral contraceptive containing 30 mcg ethinyl oestradiol and 150 mcg desogestrel (Marvelon)

Ismail MT

Malays J Reprod Health, 1994 Jun;12(1):43-8.
PMID: 12320338

PIP: Marvelon, a monophasic oral contraceptive (OC) containing 30 mcg of ethinyl estradiol and 150 mcg of desogestrel, has been available to Malaysian women through the national family planning program since 1982. To assess the safety, effectiveness, and side effects associated with this OC, 247 women who requested the pill were enrolled in a multicenter prospective study that included follow-up after the first, third, and sixth cycles of use. 81% of participants had never used any form of contraception before Marvelon. 194 women (79%) completed the 6-month study. There were no pregnancies recorded. Although women reported a slightly increased incidence of nausea, breast tenderness, and headache in the first treatment cycle, these side effects had abated by the end of the third cycle. After six cycles, mean body weight had decreased by an average of 0.4 kg. Both systolic and diastolic blood pressure were unaffected. An unexpected finding was a decrease in the severity of acne with continuous use of Marvelon. Although both spotting and breakthrough bleeding increased slightly in the first two cycles, irregular bleeding returned to pretreatment levels by the third cycle. The length of the withdrawal bleed in the pill-free week was reduced. The incidence of irregular bleeding and other side effects was substantially lower in this sample of Malaysian women than in Asian and Caucasian Marvelon users surveyed in other studies.

Matched MeSH terms: Contraceptives, Oral, Hormonal
Effect of the oral contraceptive pill on protein S and antithrombin-III levels in Malaysian women

Wong KK, Ng SC, Koong PL

Med Sci Res, 1992 Jun;20(12):439-40.
PMID: 12288974
Matched MeSH terms: Contraceptives, Oral, Hormonal
Study of rigevidon for oral contraception in a family planning clinic in Kota Bahru, Kelantan

Ang Eng Suan, Karim HA

Malays J Reprod Health, 1990 Jun;8(1):31-7.
PMID: 12316342
Matched MeSH terms: Contraceptives, Oral, Hormonal
Effect of combined low-dose oral contraceptives on blood viscosity and haematocrit

Ishak R, Loh Chooi Khim

Malays J Reprod Health, 1991 Jun;9(1):5-8.
PMID: 12317443
Matched MeSH terms: Contraceptives, Oral, Hormonal
Fulltext The Influence of Hormonal Factors on the Risk of Developing Cervical Cancer and Pre-Cancer: Results from the EPIC Cohort

Roura E, Travier N, Waterboer T, de Sanjosé S, Bosch FX, Pawlita M, et al.

PLoS One, 2016;11(1):e0147029.
PMID: 26808155 DOI: 10.1371/journal.pone.0147029

BACKGROUND: In addition to HPV, high parity and hormonal contraceptives have been associated with cervical cancer (CC). However, most of the evidence comes from retrospective case-control studies. The aim of this study is to prospectively evaluate associations between hormonal factors and risk of developing cervical intraepithelial neoplasia grade 3 (CIN3)/carcinoma in situ (CIS) and invasive cervical cancer (ICC).
METHODS AND FINDINGS: We followed a cohort of 308,036 women recruited in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study. At enrollment, participants completed a questionnaire and provided serum. After a 9-year median follow-up, 261 ICC and 804 CIN3/CIS cases were reported. In a nested case-control study, the sera from 609 cases and 1,218 matched controls were tested for L1 antibodies against HPV types 11,16,18,31,33,35,45,52,58, and antibodies against Chlamydia trachomatis and Human herpesvirus 2. Multivariate analyses were performed to estimate hazard ratios (HR), odds ratios (OR) and corresponding 95% confidence intervals (CI). The cohort analysis showed that number of full-term pregnancies was positively associated with CIN3/CIS risk (p-trend = 0.03). Duration of oral contraceptives use was associated with a significantly increased risk of both CIN3/CIS and ICC (HR = 1.6 and HR = 1.8 respectively for ≥ 15 years versus never use). Ever use of menopausal hormone therapy was associated with a reduced risk of ICC (HR = 0.5, 95%CI: 0.4-0.8). A non-significant reduced risk of ICC with ever use of intrauterine devices (IUD) was found in the nested case-control analysis (OR = 0.6). Analyses restricted to all cases and HPV seropositive controls yielded similar results, revealing a significant inverse association with IUD for combined CIN3/CIS and ICC (OR = 0.7).
CONCLUSIONS: Even though HPV is the necessary cause of CC, our results suggest that several hormonal factors are risk factors for cervical carcinogenesis. Adherence to current cervical cancer screening guidelines should minimize the increased risk of CC associated with these hormonal risk factors.

Matched MeSH terms: Contraceptives, Oral, Hormonal/adverse effects