O impacto do uso de métodos contraceptivos orais na função sexual de mulheres em idade reprodutiva / The impact of the use of oral contraceptive methods on the sexual function of women of reproductive age

Objetivo: Investigar o impacto dos contraceptivos orais hormonais na função sexual de mulheres. Métodos: Estudo transversal realizado por meio do questionário traduzido e validado "Índice da Função Sexual Feminina", capaz de estimar o risco de disfunção sexual feminina. Dados sociodemográficos, ginecológicos, medicamentosos e outros foram avaliados e correlacionados estatisticamente a esse escore, estimando possíveis causas da disfunção sexual, com destaque para o uso de anticoncepcional oral. O estudo foi baseado em uma amostragem por conveniência, incluindo mulheres > 18 anos em idade reprodutiva, de 04/01/2021 a 04/01/2022, obedecendo aos critérios de inclusão e exclusão. Resultados: Participaram deste estudo 105 mulheres com média e desvio-padrão de idade de 23,4 ± 3,8 anos, predominantemente heterossexuais (84,0%) e bissexuais (13,2%). A maioria delas (93,4%) utiliza métodos contraceptivos, sendo esses anticoncepcional oral (45,3%), DIU hormonal (19,8%) e camisinha (17,0%). A composição hormonal mais utilizada foi levonorgestrel (26,4%) e etinilestradiol (25,5%). Oitenta por cento das mulheres são sexualmente ativas, 69,3% delas têm parceria fixa, 42,5% tinham relações quase sempre e 33,0% referiam que as relações sexuais eram sempre satisfatórias. Houve boa adequação da amostra (0,865) e significância estatística (p < 0,0001). Utilizar ou não método contraceptivo apresentou diferença nos domínios desejo, satisfação e dor. Contudo, as questões do histórico sexual foram as que mais apresentaram relevância estatística em relação aos domínios. Conclusão: Apesar de outros estudos serem necessários para provar a hipótese de que os contraceptivos orais têm impacto negativo na função sexual feminina, é clara a importância de os profissionais de saúde já estarem cientes dessa possibilidade e saberem como abordá-la.

Objective: To investigate the impact of hormonal oral contraceptives on women's sexual function. Methods: Cross-sectional study carried out using the translated and validated questionnaire "Index of Female Sexual Function", capable of estimating the risk of female sexual dysfunction. Sociodemographic, gynecological, medication and other data were evaluated and statistically correlated to this score, estimating possible causes of sexual dysfunction, with emphasis on the use of oral contraceptives. The study was based on a convenience sample, including women > 18 years of reproductive age, from 01/04/2021 to 01/04/2022, following inclusion and exclusion criteria. Results: The study included 105 women with a mean and standard deviation of (23.4 ± 3.8) years old, predominantly heterosexual (84.0%) and bisexual (13.2%). Most of them (93.4%) use contraceptive methods, these being (45.3%) oral contraceptives, (19.8%) hormonal IUDs and (17.0%) condoms. The most used hormonal composition was levonorgestrel (26.4%) and ethinylestradiol (25.5%). Eighty percent of the women are sexually active, 69.3% of them have a steady partner, 42.5% almost always had sex and 33.0% said that sex was always satisfactory. There was good sample adequacy (0.865) and statistical significance (p < 0.0001). Using or not using a contraceptive method showed a difference in the desire, satisfaction and pain domains. However, sexual history questions were the ones that showed the most statistical relevance in relation to the domains. Conclusion: Although further studies are needed to prove the hypothesis that oral contraceptives have a negative impact on female sexual function, it is clear that health professionals are already aware of this possibility and know how to approach it.

Efeitos do exercício físico sobre o perfil lipídico e inflamatório de mulheres jovens em uso de contraceptivo oral combinado: protocolo de um estudo sequencial cruzado / Effects of physical exercise on the lipid and inflammatory profile of young women using combined oral contraceptives: protocol of a crosssectional study

INTRODUÇÃO: O uso de contraceptivos orais combinados (COC) trata-se de um fator de risco para a doença aterosclerótica por comprometer o perfil lipídico e inflamatório, podendo o exercício físico minimizar essas condições. OBJETIVO: Testar a hipótese de que exercício físico pode modificar o perfil lipídico e inflamatório de mulheres em uso COC. MÉTODOS: Protocolo de um estudo sequencial cruzado com mulheres de 20 e 30 anos, irregularmente ativas, em uso de COC há pelo menos 6 meses. Realizouse uma avaliação físico-clínica (AFC) nas participantes com medidas antropométricas, VO2máx. indireto e análise do perfil lipídico e inflamatório. Na sequência separou-se as participantes em 2 grupos: O grupo intervenção inicial (GII) que iniciou praticando exercícios intervalados de alta intensidade por 2 meses, e o grupo intervenção posterior (GIP), que seguiu irregularmente ativo pelo mesmo período. Em seguida o GII e o GIP alternariam suas condições por mais 2 meses, totalizando 4 meses de acompanhamento e 3 AFC, realizadas no início, após 2 meses e ao final do estudo. As informações colhidas foram divididas em 3 momentos: Momento inicial (MI), momento pós exercício (MPE) e pós inatividade (MPI).

INTRODUCTION: The use of combined oral contraceptives (COC) is a risk factor for atherosclerotic disease because it compromises the lipid and inflammatory profile, and physical exercise can minimize these conditions. OBJECTIVE: To test the hypothesis that high intensity interval physical exercise promotes changes in the lipid and inflammatory profile of women who are irregularly active using COC. METHODS: Protocol of a crosssectional study with women of 20 and 30 years, irregularly active, using COC for at least 6 months. A physicalclinical assessment (AFC) was performed on the participants with anthropometric measurements, VO2max. analysis and analysis of the lipid and inflammatory profile. Afterwards, the participants were divided into 2 groups: the initial intervention group (GII) that started practicing high intensity interval exercises for 2 months, and the posterior intervention group (GIP), which remained irregularly active for the same period. Then the GII and GIP would alternate their conditions for another 2 months, totaling 4 months of follow-up and 3 AFC, performed at the beginning, after 2 months and at the end of the study. The information collected was divided into 3 moments: Initial moment (MI), post-exercise moment (MPE) and post-inactivity (MPI).

Manejo conservador de retención de productos de la concepción con anticonceptivos orales combinados / Conservative Management of Retained Products of Conception with Combined Oral Contraceptives. Case Report

Objetivo: presentar el caso de una paciente con retención de productos de la concepción (RPC) después de aborto médico, tratada con anticonceptivos orales combinados (ACOC), y efectuar revisión de la literatura. Caso Clínico: paciente de 37 años, con sangrado genital escaso y leve dolor pélvico, quien tuvo aborto provocado con misoprostol cuatro días antes, acude sin signos de infección, con endometrio mixto de 18,5 mm. Durante seis semanas de seguimiento persiste sangrado y endometrio mixto engrosado, con disminución lenta de la gonadotrofina corionica humana (GCH); se sospecha RPC, se suministra ciclo de ACOC y al terminarlos expulsa completamente el tejido retenido. Metodología: búsqueda bibliográfica en bases de datos Google Scholar, Science Direct, RIMA, PubMed. Revisión de literatura: la RPC se presenta después de parto o aborto (más frecuente). Criterios diagnósticos: sangrado persistente, hallazgos ecográficos y medición de GCH. Diagnóstico diferencial: enfermedad trofoblastica gestacional y malformaciones arteriovenosas uterinas. Es factible el manejo conservador, con bajas tasas de infección o procedimientos quirúrgicos. Ante la evolución prolongada, presencia de signos de infección o hemorragia importante, se impone la evacuación quirúrgica, tradicionalmente con dilatación y legrado, y más recientemente resección histeroscópica. La bibliografía reciente sugiere el uso de ACOC como manejo médico. En nuestro caso, la paciente tomó un ciclo de ACOC y al terminarlos presentó expulsión de los restos retenidos. Conclusiones: el manejo conservador de la RPC con ACOC surge como una opción en casos seleccionados; son necesarios estudios controlados para definir su utilidad..Au

Objective: to report the case of a patient with retained products of conception (RPC) after a medical abortion, successfully treated with combined oral contraceptives (COCs), and to review the literature. Clinical case: a 37-year-old patient, with little genital bleeding and slight pelvic pain, who had had a misoprostol-induced abortion four days before consulting, she attended without signs of infection, with a thikened 18.5 mm mixed endometrium. After six weeks follow-up genital bleeding and thickened mixed endometrium persist, with a slow decrease in human chorionic gonadotropin (HCG), RPC is suspected, and a COC cycle is administered, when finished, she completely expelled the retained tissue. Methodology: Google Scholar, Science Direct, RIMA and PubMed databases were searched. Literature review: RPC occurs after delivery or abortion (more frequent), diagnostic criteria: persistent bleeding, ultrasound findings and HCG measurement; the differential diagnosis includes gestational trophoblastic disease and uterine arteriovenous malformations. Conservative management is feasible, with low rates of infection or surgical procedures, however, in case of prolonged evolution, evident signs of infection or significant bleeding, surgical evacuation is required, traditionally with dilation and curettage, and more recently hysteroscopic resection. Novel bibliography suggests the use of ACOC as medical management. In our case, the patient took a cycle of COC and at the end she expelled the retained remains. Conclusions: conservative management of RPC with COC arises as an option in selected cases, controlled trails are needed to define its usefulness..Au

Descontinuidades contraceptivas no uso do contraceptivo hormonal oral, injetável e do preservativo masculino / Contraceptive discontinuities in the use of oral and injectable hormonal contraceptives, and male condoms / Discontinuidades contraceptivas en el uso del anticonceptivo hormonal oral o inyectable y del preservativo masculino

O objetivo foi estimar as taxas de descontinuidade total no uso do contraceptivo hormonal oral, injetável e do preservativo masculino, bem como verificar as taxas de interrupção por abandono e por troca para método mais eficaz e menos eficaz. Dados de 2.051 mulheres usuárias de unidades básicas de saúde de três capitais brasileiras foram coletados por meio do calendário contraceptivo. Os resultados mostraram que 24,5% das usuárias do contraceptivo hormonal oral, 33,5% das usuárias de contraceptivo hormonal injetável e 39% das usuárias do preservativo masculino haviam descontinuado o uso do método até 12 meses de uso, independentemente da razão. Houve pouca variação nas taxas entre capitais, mas não no método utilizado. A principal razão para descontinuar o uso do método contraceptivo foi por querer engravidar (20,8%). Um total de 20% das mulheres engravidou enquanto usava algum método, e essa proporção alcançou 25,7% entre usuárias do preservativo masculino. Ressalta-se que, após 12 meses de uso, a taxa de abandono por razões relacionadas ao método contraceptivo foi de 11,4% entre usuárias do injetável. A taxa de troca para método mais eficaz foi de 15,9% entre usuárias do preservativo masculino, e a taxa de troca para método menos eficaz foi de 16,3% entre usuárias do contraceptivo hormonal injetável. As taxas de descontinuidade contraceptiva foram altas e variaram conforme o tipo de método contraceptivo utilizado.

The study aimed to estimate the total contraceptive discontinuity rates in the use of oral and injectable hormonal contraceptives, and male condoms and dropout rates due to switches to more effective and less effective methods. Data on 2,051 women, users of primary healthcare services in three Brazilian state capitals, were collected using the contraceptive calendar. The results showed that 24.5% of users of oral hormonal contraceptives, 33.5% of users of injectables, and 39% of users of male condoms had discontinued the respective method after 12 months of use, independently of the reason, and that the rates varied little between the capitals but did depend on the method. The main reason for discontinuing use of the contraceptive method was the desire to become pregnant (20.8%). Conception while using the method was reported by 20% of the women, a proportion that reached 25.7% in users of male condoms. After 12 months with the method, the dropout rate for reasons related to the contraceptive method was 11.4% in users of injectables; 15.9% of users of male condoms switched to a more effective method; and 16.3% of users of injectables switched to a less effective method. Contraceptive discontinuity rates were high and varied according to the contraceptive method.

El objetivo fue estimar las tasas de discontinuidad contraceptiva totales en el uso del contraceptivo hormonal oral o inyectable y del preservativo masculino, así como por abandono, cambio por un método más eficaz o menos eficaz. Se recogieron datos de 2.051 mujeres usuarias de unidades básicas de salud de tres capitales brasileñas mediante el calendario contraceptivo. Los resultados expusieron que un 24,5% de las usuarias del contraceptivo hormonal oral, un 33,5% de las usuarias de inyectables y un 39% de las usuarias del preservativo masculino habían discontinuado el uso del método tras 12 meses de uso, independientemente de la razón, siendo que las tasas poco variaron entre las capitales, pero sí dependiendo del método utilizado. La principal razón para interrumpir el uso del método contraceptivo fue querer quedarse embarazada (20,8%). Quedarse embarazada mientras se usaba el método fue informado por un 20% de las mujeres, proporción que alcanza un 25,7% entre usuarias del preservativo masculino. Se resalta que, tras 12 meses de uso del método, la tasa de abandono por razones relacionadas con el método contraceptivo fue un 11,4% entre usuarias de los inyectables; la tasa de cambio hacia un método más eficaz fue 15,9% entre usuarias del preservativo masculino; y la tasa de cambio por un método menos eficaz fue 16,3% entre usuarias de los inyectables. Las tasas de discontinuidad contraceptiva fueron altas y variaron según el tipo de método contraceptivo utilizado.

Oral contraceptives and intrauterine devices as risk factors for breast and cervical cancers: a systematic review

Breast and cervical cancers have commandingly become major public health threats across the world. While studies have reported on the nexus between the use of oral contraceptives (OCs) and intrauterine devices (IUDs) as risk factors for breast and cervical cancers, there exists a paucity of explicit data on the nature of the association. Authors report the effect of oral contraceptives and the use of IUDs on the development of breast and cervical cancers. Several databases (Cochrane Library, Google Scholar and PubMed) were searched using well-specified criteria and a total of 15 papers selected. Meta-analyses, systematic reviews and studies that used cross-sectional designs were excluded from the review. Three and twelve cohort and case-control studies were reviewed respectively. Four of these studies reported an increased association between oral contraceptives and the risk of cervical cancer while nine showed positive correlation between oral contraceptives and risk of breast cancer. One study showed association between levonogestrel IUDs and risk of breast cancer while the other study did not show association between both levonogestrel and copper IUDs with risk of breast cancer. Use of copper IUDs was associated with diminishing risk of cervical cancer. Overall, use of oral contraceptives upsurges risk of breast and cervical cancers especially when used for longer periods of time. Further studies should therefore be done to understand the mechanisms of action of oral contraceptives and IUDs on the development of both cancers.

Influence of combined oral contraceptives on polycystic ovarian morphology-related parameters in Korean women with polycystic ovary syndrome

Tamoxifen for treatment of abnormal uterine bleeding in etonorgstrel implant users: a randomized clinical trial

Background: The current study aims to compare the use of tamoxifen and oral contraceptive pills in women using implanon and complain with irregular uterine bleeding.Methods: Women attended family planning clinic using implanon presented by bleeding were invited to participate in the study. They were randomized into two groups: Group A: 100 women received Tamoxifen 10 mg twice daily for 10 days taken at the onset of an episode of bleeding or spotting episode. Group B: 100 women received Combined oral contraceptive pills (microcept) once daily for 21 days take at the onset of an episode of bleeding or spotting episode.Results: No difference regarding the baseline criteria of both groups. No difference between both groups regarding the duration of irregular bleeding in the implanon users (p=0.090). Additionally, the number of bleeding days and spotting in the last month was similar in both groups (p=0.554). The percentage of women who stopped bleeding during the period of treatment is 84% in the tamoxifen group and 92% in the COCs group, but the COCs needs longer treatment time, where the mean of days required to stop bleeding is 5.03±1.8 days in the tamoxifen group and 6.5±2.5 in the COCs group. Headache and nausea were the most prominent adverse effects found in the COCs group (p=0.000).Conclusions: Oral administration of tamoxifen 10 mg twice daily for 10 days is effective on stopping bleeding attacks in implanon users.

An overview of Novel Drug Delivery Systems for Acne

Acne vulgaris is a type of chronic disease of the skin which is mainly caused by the blockage in the sebaceous gland or having any inflammation in those glands which is together is known as pilosebaceous units. It mainly affects the areas having the highest number of sebaceous follicles; those are the face, the back and upper region of the chest. It is a disease that mainly affects the adolescent age group but can be found in any age group. These are present as inflammatory pustules, papules, cysts and nodules, non-inflammatory closed comedones (whiteheads), ripen comedones (blackheads), or a mixture of lesions. Acne is most commonly seen in almost every human being at some point in their lives. There are 20-25 chances of progression of acne to the severe case which leads to permanent scarring. These complications lead to psychological problems like depression, social isolation, lowered self-esteem, and lowered self-confidence. The aim of treating acne is to prevent severe and long-term complications. The present review focuses on novel drug delivery systems for the treatment of acne. It also includes conventional treatments currently available in the market, its limitation and different strategies to overcome these

One-year adolescent bone mineral density and bone formation marker changes through the use or lack of use of combined hormonal contraceptives / Alterações na densidade mineral óssea e nos marcadores de formação óssea em adolescentes usuárias ou não de contraceptivos hormonais orais combinados por período de um ano

Abstract Objective: The objective of this study was to evaluate the effects of two low-dose combined oral contraceptives on bone metabolism in adolescents for one year. Methods: This was a quasi-experimental study. The adolescents were divided into three groups: oral contraceptives 1 (n = 42) (20 µg EE/150 µg desogestrel), oral contraceptives 2 (n = 66) (30 µg EE/3 mg drospirenone), and a control group (n = 70). Adolescents underwent anthropometric assessment and densitometry (dual-energy X-ray). Bone age and bone formation markers (osteocalcin and bone alkaline phosphatase) were evaluated. The oral contraceptives users were evaluated again after 12 months. Linear regression analysis was used to indirectly study the effect of each additional year of chronological age on anthropometric and densitometric variables as well as on bone markers in the control group. Results: At study entry, no significant differences were observed between the oral contraceptives 1, oral contraceptives 2, and controls in the analyzed variables. Linear regression analysis showed an increase in bone mineral density and bone mineral content for each additional year. There was a significant reduction in bone alkaline phosphatase levels; no significant difference was observed for osteocalcin in control individuals. Comparison of dual-energy X-ray variables at baseline and after one year showed no significant differences in the oral contraceptives 1 or oral contraceptives 2 groups. A significant reduction in bone alkaline phosphatase and osteocalcin levels was observed in both the oral contraceptives 1 and oral contraceptives 2 groups. Conclusion: Adolescent women gain peak bone mass during this phase of life. Two low-dose combined oral hormonal contraceptives were associated with lower bone gain and lower bone formation markers than in untreated controls.

Resumo: Objetivo: O objetivo deste estudo foi avaliar os efeitos de dois contraceptivos orais combinados de baixa dosagem por um ano sobre o metabolismo ósseo em adolescentes. Métodos: Este foi um estudo quase experimental. As adolescentes foram divididas em três grupos: contraceptivos orais 1 (n = 42) (20 µg de EE/150 µg de desogestrel), contraceptivos orais 2 (n = 66) (30 µg EE/3 mg de drospirenona) e grupo controle (n = 70). As adolescentes foram submetidas à avaliação antropométrica e densitometria (raio-X de dupla energia). Foram avaliados a idade óssea e os marcadores de formação óssea (osteocalcina e fosfatase alcalina óssea). As usuárias de contraceptivos orais foram novamente avaliadas após 12 meses. A análise de regressão linear foi utilizada para estudar, indiretamente, o efeito de cada ano adicional da idade cronológica sobre as variáveis antropométricas e densitométricas e sobre os marcadores ósseos no grupo de controle. Resultados: No início do estudo, não foram observadas diferenças significativas nas variáveis analisadas entre as usuárias de contraceptivos orais 1, contraceptivos orais 2 e o grupo controle. A análise de regressão linear mostrou um aumento na densidade mineral óssea e no conteúdo mineral ósseo para cada ano adicional. Houve uma redução significativa nos níveis de fosfatase alcalina óssea e não foi observada diferença significativa para osteocalcina nos indivíduos controles. A comparação das variáveis do raio-X de dupla energia no início e após um ano não mostrou diferença significativa no grupo de contraceptivos orais 1 ou contraceptivos orais 2. Foi observada uma redução significativa nos níveis de fosfatase alcalina óssea e osteocalcina nos dois grupos contraceptivos orais 1 e contraceptivos orais 2. Conclusão: As adolescentes atingiram o pico de massa óssea durante essa fase da vida. Duas formulações de contraceptivos hormonais orais de baixa dosagem, após um ano de uso, se associaram a menor incremento na densidade mineral óssea e menor concentração de marcadores de formação óssea quando confrontados com resultados de adolescentes não usuárias de contraceptivos.

Tecnologia educacional sobre contracepção oral: construção compartilhada com enfermeiros da assistência reprodutiva / Educational technology on oral contraception: construction shared with nurses reproductive assistance / La tecnología educativa en la anticoncepción oral: la construcción compartida con las enfermeras de asistencia reproductiva

Objetivo: Describir las prácticas de conocimiento y de enfermería en el contexto de la anticoncepción oral y construir de manera compartida, una tecnología educacional. Metodología: El estudio se realizó en 09 unidades de la Estrategia Salud de la Familia, que pertenece al municipio de Ananindeua, en la región metropolitana de Belém - Pará, con los participantes 21 enfermeras. La recolección de datos se llevó a cabo de agosto a noviembre 2015, a través de entrevistas individuales con semi-estructurada y análisis utilizó la técnica de análisis de contenido. Resultados: Se estableció contacto con las enfermeras que tienen un amplio conocimiento sobre la anticoncepción oral. Y sus prácticas, aunque relevante para lo que se recomienda para esta clientela, se ven obstaculizados por las condiciones de trabajo en sus unidades. Conclusión: Las enfermeras contribuyeron al contenido y la forma de la tecnología educativa, ya que consideraba pertinente para su uso como una herramienta importante para la educación sanitaria

Objetivo: Descrever conhecimentos e práticas de enfermeiros no contexto da contracepção oral e construir, de forma compartilhada, uma tecnologia educacional. Método: A pesquisa foi desenvolvida em nove Unidades da Estratégia Saúde da Família, pertencentes ao município de Ananindeua, localizado na Região Metropolitana de Belém/Pará, tendo como participantes 21 enfermeiros. A coleta de dados ocorreu no período de agosto a novembro de 2015, por meio de entrevista individual com roteiro semiestruturado, e, para análise, utilizou-se a técnica de análise de conteúdo. Resultados: Contatou-se que os enfermeiros têm amplo conhecimento com relação à contracepção oral. E suas práticas, embora pertinentes ao que está preconizado para essa clientela, encontram-se dificultadas pelas condições de trabalho em suas Unidades. Conclusão: Os enfermeiros contribuíram no conteúdo e forma da tecnologia educacional, pois consideraram pertinente a sua utilização como importante ferramenta para a educação em saúde

Objective: To describe nurses' knowledge and practices in the context of oral contraception and to construct, in a collaborative way, an educational technology. Methodology: The research was developed in 09 Units of the Family Health Strategy, belonging to the municipality of Ananindeua, located in the Metropolitan Region of Belém - Pará, with 21 nurses as participants. The data collection took place from August to November 2015 through individual interview with a semi-structured script and for the analysis the content analysis technique was used. Results: It was found that nurses have extensive knowledge regarding oral contraception. And its practices, although pertinent to what is recommended for this clientele, are hampered by the working conditions in its Units. Conclusion: Nurses contributed to the content and form of the educational technology, considering their relevance as an important tool for health education

Métodos Contraceptivos e Prevalência de Mulheres Adultas e Jovens com risco de Trombose, no Campus Centro Universitário do Distrito Federal-UDF / Contraceptive Methods and Prevalence of Adult and Young Women at Risk of Thrombosis in the Campos Centro Universitário do Distrito Federal-UDF

A Pílula anticoncepcional é um método muito confiável. Além de impedir a gravidez, os anticoncepcionais vêm apresentando benefícios em outras situações, da dismenorreia (cólica menstrual), da menorragia (excesso de menstruação) e da tensão pré-menstrual. Ultimamente ele vem causando muitos desafios a serem enfrentados, muitos relatos de mulheres que concluíram que adquiriu trombose pelo uso do anticoncepcional. Com estudos de casos realizados em capitais Brasileiras, feito com mulheres de 15 a 39 anos, mostram o quanto os problemas relacionados à trombose profunda em seios venosos, doenças cardiovasculares e hipertensão esta crescendo não apenas com uso dos anticoncepcionais, mas a maneira que ele é tomado, as mulheres relataram que tomam para evitar gravidez, com isso leva ao aumento dos riscos que devido ao seu uso prologando, a influência dos fatores genéticos que estão influenciando drasticamente para o aumento de casos. Conhecimentos epidemiológicos indicam que o uso desses medicamentos preestabelece maior risco de desenvolvimento de (TVP) trombose venosa profunda. Determina-se que o uso de contraceptivos orais aumenta a perspectiva de ocorrer TVP, pois os hormônios composto nesses medicamentos atuam no sistema cardiovascular

The contraceptive pill is a very reliable method. In addition to preventing pregnancy, contraceptives have shown benefits in other situations, such as dysmenorrhea (menstrual cramps), menorrhagia (excessive menstruation), and premenstrual tension. Lately it has been causing many challenges to face, many reports from women who have concluded that they have acquired thrombosis through the use of contraception. With case studies conducted in Brazilian capitals, performed with women aged 15 to 39, show how problems related to deep thrombosis in venous sinuses, cardiovascular diseases and hypertension are growing not only with contraceptive use, but the way it is taken, women reported taking it to avoid pregnancy, with this leads to increased risks that due to their prolonged use, the influence of genetic factors that are drastically influencing the increase in cases. Epidemiological knowledge indicates that the use of these drugs pre-establishes a higher risk of developing deep venous thrombosis (DVT). It is determined that the use of oral contraceptives increases the prospect of DVT, since the hormones composed in these drugs act in the cardiovascular system.

The Awareness of Contraception and Experience of Oral Contraceptives among North Korean Defector Women in Republic of Korea

OBJECTIVE: This study attempts to gauge the necessity of contraceptive education for women defecting from North Korea (NKDWs). METHODS: We conducted in-depth interviews with six NKDWs who had lived in the Republic of Korea (ROK) for more than three years, to understand the subjects' perceptions, experiences, and opinions regarding contraception. Thematic analyses were performed using qualitative data provided in the survey results. RESULTS: Before their defections from North Korea, none of the NKDWs had received any sex education. Loop is the only contraceptive method available to married women in ROK. After defection, NKDWs were provided information about contraceptive options available in China, but they could not fully understand this information. Furthermore, the information they received was not accurate. Thus, NKDWs had a high need for contraceptive sex education. As per our survey, their preferred education method was at least 3 lessons plus 1 : 1 counseling, as necessary. CONCLUSION: This study indicates that a necessity exists for development of a sex education program for NKDWs to enhance their contraceptive knowledge. Thus, government and health managers have a role to play in developing such a program.

Diferencias en la conducta de emparejamiento entre mujeres jóvenes universitarias de Santiago de Chile en relación con el consumo de píldoras anticonceptivas orales / Differences in mating behavior among university young women of Santiago de Chile in relation to the consumption of oral contraceptive pills

Durante los últimos años en Chile se ha detectado una masificación en el uso de anticonceptivos orales. Sin embargo, en Chile y al igual que en casi todos los países latinoamericanos prácticamente no se han investigado sus implicancias sobre la conducta humana. Específicamente, este estudio evaluó el impacto del uso de estos anticonceptivos sobre la conducta de emparejamiento en un grupo de 164 mujeres jóvenes universitarias, con una media de edad igual a 19 años y provenientes de cuatro universidades chilenas. Para ello se utilizó la adaptación chilena del Cuestionario de Componentes del Valor de Pareja que está compuesto por 22 ítems que se responden en una escala Likert de siete valores. Los resultados señalan diferencias entre las mujeres que consumen píldoras anticonceptivas (PA) y las que no lo hacen. Las consumidoras presentan los mayores valores del índice general del cuestionario sobre los componentes del valor de pareja y las subescalas de historia de relaciones de pareja, apreciación desde el sexo opuesto y apariencia. Estos resultados indican que las mujeres consumidoras de la PA se autoperciben y creen que el sexo contrario las evalúa como atractivas y muestran una vida sexual más diversificada, no mostrando diferencias en los otros aspectos relevantes para el valor de pareja no vinculados centralmente al atractivo físico. En definitiva, los resultados parecen indicar que el consumo de anticonceptivos hormonales no modifica la conducta social y parental de las mujeres, aunque su uso parece estar asociado con una mayor autopercepción de atractivo y mayor diversidad sexual.

Oral contraceptives, also known as birth control pills (PAs from now on), have been available on the world market for five decades. At present, the use of PA is massifier worldwide, being consumed by more than 100 million women on the planet. In recent years, in Latin America has been detected a dramatic increase in the use of oral contraceptives, and Chile is not the exception. In this sense, it is probable that the increase in the consumption of PAs in Chile is linked to the increase of women who decide to pursue higher studies and to develop professional careers. Concurrently, a wide field of research has been focused on the physiological and psychological effect of the consumption of oral contraceptives on human behavior, being mating behavior one of the main topics of research. However, in Chile as in most Latin American countries there is a lack of studies on the implications of the consumption of oral contraceptives on human behavior. In the present study, we investigated in a group of 164 university young women (Mean ± Standard Deviation: 19.27± 2.88 years) of Chile the impact of the use of oral contraceptives on mating behavior. Accordingly, we have applied a validated psychometric test to assessed mate value, one of the more relevant components of mating behavior i.e., the Mate Value Questionnaire. Mate value can be defined as a construct that incorporates a number of physical, psychological, and social dimensions that are related to an individual's ability to find, attract, and successfully retain a partner. This questionnaire is composed by 22 items and 7 subscales that are answered in a Likert Scale of 7 values. The Mate Value Questionnaire showed a high reliability (α = .85). According with previous studies that showed a decrease in sexual satisfaction and desire on women that consume oral contraceptives, we predicted a decrease of mating behavior and, then, a decrease on Mate Value for those women that use oral contraceptives. This effect was expected for all subscales of this questionnaire with the exception of relationship history subscale since women that consume oral contraceptives reported to have more diverse sexual partners on previous studies. The results show differences between women who use oral contraceptives (n = 87 women: 19.60 ± 2.89 years) in comparison to those who do not (n = women: 18.90 ± 2.84 years). However, the differences were, in general, opposed to our expectations being the consumers of oral contraceptives who presented the highest values of the general index of the Mate Value Questionnaire, and, concretely, for the subscales of relationship history, views of the opposite sex, and looks. In addition, we have failed into found any differences between groups in subscales that were not associated to physical appearance, such as wealth, sociality and fear of failure. The results suggest that the use of hormonal contraceptives does not modify the social and parental behavior of the women, although their use seems to be associated with a greater self-perception of attractiveness and greater diversity in sexual life. This study provides new information that will increase the understanding and discussion about the hypothetical effect that would or would not, the consumption of the PA on the pairing behavior. It is important to point out that the field of research on changes in the sexual preferences of women, derived from hormonal states, is in an important discussion process. Therefore, we believe that it is critical to carry out research in the future in order to elucidate the real robustness of this phenomenon, improving our understanding about the behavioral effects of consuming oral contraceptives.

Influence of hormonal contraceptives and the occurrence of stroke: integrative review / Influencia de anticonceptivos hormonales y acaecimiento de accidente vascular cerebral: revisión integradora / Influência de anticoncepcionais hormonais e ocorrência de acidente vascular cerebral: revisão integrativa

ABSTRACT Objective: To identify scientific evidence regarding the influence of hormonal contraceptive use and the occurrence of stroke. Method: Integrative review of the literature, through database search using the descriptors "contraceptive agents", "contraceptive devices", "contraceptives, Oral" and "Stroke". Original studies in Portuguese, Spanish and English, published in full and available online were included. Studies that did not answer our guiding questions and duplicated studies were excluded. Results: Women using combined oral contraceptives have higher risk of stroke, even with a lower hormonal dosage and different types of progestogen, regardless of the duration of use. The use of contraceptives associated with smoking, hypertension, migraine, hypercholesterolemia, obesity and sedentary lifestyle increases the chance of stroke. Contraceptive patch and vaginal ring are associated to increased risk. Conclusion: Use of combined hormonal contraceptives, except for the injectable and the transdermal ones, increases the chance of occurrence of the event. Progestogen-only contraceptives were considered safe.

RESUMEN Objetivo: Estudiar las evidencias científicas acerca de la influencia del uso de anticonceptivos hormonales en el acaecimiento de accidentes cerebrales vasculares (ACV). Método: Revisión integradora de la literatura, realizada mediante investigación científica en bases de datos, utilizando los descriptores "anticonceptivos", "dispositivos anticonceptivos", "anticonceptivos orales" y "derrame cerebral". Se incluyeron artículos originales en los idiomas portugués, español e inglés, publicados en su totalidad y disponibles electrónicamente. Se excluyeron los artículos repetidos y aquéllos que no respondían a las cuestiones orientadoras. Resultados: Las usuarias de anticoncepcional oral combinado presentan un riesgo mayor de ACV, inclusive con dosis hormonal menor y diferentes tipos de progestágeno, independientemente del tiempo de utilización. La presencia del tabaquismo, hipertensión arterial, jaqueca, hipercolesterolemia, obesidad y sedentarismo aumenta la probabilidad de ese desenlace. El adhesivo anticonceptivo y el anillo vaginal están relacionados con el aumento de ese riesgo. Conclusión: La utilización de anticonceptivos hormonales combinados aumenta la probabilidad del acaecimiento del evento, excepto con el inyectable y el transdérmico. Los exclusivos de progestágeno se consideran seguros.

RESUMO Objetivo: Identificar evidências científicas acerca da influência do uso de anticoncepcionais hormonais na ocorrência do acidente vascular cerebral (AVC). Método: Revisão integrativa da literatura, com pesquisa em bases de dados, utilizando os descritores "contraceptive agents", "contraceptive devices", "contraceptives, Oral" e "stroke". Foram incluídos artigos originais nos idiomas português, espanhol e inglês, publicados na íntegra e disponíveis eletronicamente. Foram excluídos artigos que não respondiam às questões norteadoras e repetidos. Resultados: Usuárias de anticoncepcional oral combinado apresentam risco maior de AVC, mesmo com dosagem hormonal menor e diferentes tipos de progestágeno, independente do tempo de uso. A presença associada de tabagismo, hipertensão arterial, enxaqueca, hipercolesterolemia, obesidade e sedentarismo aumenta a chance desse desfecho. Adesivo anticoncepcional e anel vaginal são relacionados ao aumento desse risco. Conclusão: A exposição aos anticoncepcionais hormonais combinados aumenta a chance de ocorrência do evento, exceto o injetável e o transdérmico. Os exclusivos de progestágeno foram considerados seguros.

Compound oral contraceptives (COC) application in missed abortion / 中国生化药物杂志

Objective To study the compound oral contraceptives(COC)application in patients with missed abortion after.Methods 600 cases of missed abortion from March 2016～2017 year in March in our hospital,were randomly divided into observation group(n=300)and control group(n=300),the observation group was treated with compound oral contraceptive therapy,the control group were given routine treatment,compared two groups of patients.Results The observation group of patients with vaginal bleeding time,menstrual recovery time was significantly shorter than the control group(P<0.05),endometrial thickness was significantly greater than the control group(P<0.05),the incidence of Intrauterine Residue and uterine cavity adhesion rate,pelvic infection rate was significantly lower than the control group(P<0.05); the two groups of patients with postoperative weight change in March the amount of vaginal bleeding,compared no significant difference,no statistical significance.Conclusion The application of compound oral contraceptives in the treatment of missed abortion patients after curettage,shorten the time of vaginal bleeding,reduce the amount of vaginal bleeding,reduce the incidence of postoperative complications and promote postoperative recovery of menses.

Experience of taking Oral Contraceptives in Adult Women

PURPOSE: The purpose of this study was to explore essences and meanings of using oral contraceptives among adult women. METHODS: The interview was conducted with 20 adult women who lived in Seoul, Gyeongi Province, Jeolla Province, Chungcheong Province, and Gangwon Province. Participants with the experience of using oral contraceptives for contraception were selected by convenience sampling. Semi-structured interviews were conducted for data collection. The data were analyzed using Colaizzi's method. RESULTS: Five themes revealed: ‘Lack of information and knowledge regarding oral contraceptives’, ‘Inconvenient and difficult purchase process of oral contraceptives’, ‘Pressure and fear regarding other people's reaction’, ‘Self-centered thinking toward the use of oral contraceptives’, ‘A need for a change in public awareness and policy’. CONCLUSION: A change in society's perception about oral contraceptives is required for safe contraceptives use. Therefore, it is necessary to educate the correct usage of oral contraceptives, and to develop a program for changing the paradigm of sex education.

Evaluación de tecnología sanitaria: anovulatorios orales combinados congestodeno comparados con los combinados con levonorgestre / Health technology assessment: combined oral contraceptives containing gestodene compared with those containing levonorgestrel

Esta evaluación de tecnología sanitaria compara un nuevo anovulatorio oral combinado con etinil estradiol 20µ más gestodeno 75µ, con el que contiene etinil estradiol 30µ más levonorgestrel 150µ, utilizado hasta ahora en el subsistema de salud pública de la provincia de Neuquén. De acuerdo a las evidencias halladas, en cuanto a equivalencia de eficacia y riesgos de seguridad –principalmente relativas al aumento significativo en el riesgo de presentar trombosis venosa y embolia pulmonar– se recomienda fuertementeno incorporarlo al vademécum provincial.

Oral contraceptives and oral health: an insight.

Oral contraceptive pills are a safe and effective means of avoiding pregnancy followed by women worldwide. These drugs were first introduced in 1960s and 70s and contained higher dose of estrogen and progesterone and were reported to cause unwanted side effects like gingival inflammation, localized osteitis, alterations in salivary flow rate, changes in salivary components and gingival melanosis in oral tissues. With the advent of new generation formulations of low dose oral contraceptive pills, the effects on oral health is minimized and presently users are not considered as risk group for developing gingival and periodontal disease. This review briefs the effects of oral contraceptive pills on general health and oral health in particular and controversies surrounding their use.