What are the associated factors of low husbands/partners independent decision-maker in women's contraceptive use decision-making process in Ethiopia? Multilevel analysis.

BACKGROUND: Many married women of reproductive age with husbands or partners are less cooperative in using contraceptives, often resulting in unintended pregnancies or secret contraceptive use. This private use of contraceptives causes women to suffer from side effects without proper support, and many women in Ethiopia die due to unintended pregnancies. However, the involvement of husbands or partners in the contraceptive decision-making process in Ethiopia is often neglected. There is also a lack of evidence regarding the determinants of husbands' or partners' decision-making power on contraceptive use in Ethiopia. OBJECTIVE: This study aimed to assess the determinants of low involvement of husbands/partners in women's contraceptive use decision-making processes in Ethiopia. METHODS: This study was based on Ethiopian Demographic and Health Survey data, collected from January 18 to June 27, 2016. Weighted samples of 3,669 reproductive-age women were included. Husbands'/partners' independent decision-making was measured by whether the husband/partner decided independently or alone about contraceptive use, categorized as "Yes" or "No". A multilevel logistic regression model was fitted, and ICC (Intra-class Correlation Coefficient), MOR (Median Odds Ratio), PCV (Proportion Change in Variance), and deviance were used to assess model fitness and comparison. Variables with a p-value of ≤ 0.2 in the bivariate analysis were considered candidates for multivariable multilevel analysis. An adjusted odds ratio with a 95% confidence interval was used to determine both the direction and strength of the association, and a p-value of < 0.05 was used to declare statistical significance. RESULTS: Husbands'/partners' independent decision-making in women's contraceptive use was found to be 5.41% [4.72-6.19%]. Significant factors associated with this included: Husbands/partners aged 31-59 years (Adjusted Odds Ratio (AOR) = 1.3; Confidence Interval (CI) 2.3-5.4) and over 59 years (AOR = 2.3; CI 1.2-4.3), Educational level of husbands/partners: primary education (AOR = 3.2; CI 2.9-4.3), secondary education (AOR = 3.9; CI 2.7-4.4), and higher education (AOR = 4.3; CI 2.8-5.0), Media exposure (AOR = 4.5; CI 2.2-5.4), History of pregnancy termination (AOR = 3.3; CI 2.6-4.1), Perception that distance to health facilities is not a significant problem (AOR = 3.0; CI 1.7-4.7) and Urban residency (AOR = 3.5; CI 1.6-4.2). CONCLUSIONS: In Ethiopia, the involvement of husbands/partners in the contraceptive use decision-making process is low. To increase their decision-making power, attention should be given to factors such as age, educational level, media exposure, history of pregnancy termination, distance to health facilities, and urban residency.

Hypertriglyceridemia-Induced Acute Pancreatitis Exacerbated by Combined Oral Contraceptive Use: A Case Report.

Acute pancreatitis can be induced by a vast variety of etiologies including its more common causes such as cholelithiasis and alcohol abuse, but in certain cases it can also be secondary to hypertriglyceridemia. Additionally, combined oral contraceptive use can enhance the severity of hypertriglyceridemia-induced acute pancreatitis (HTG-AP). The data between this association is much more limited than the more common causes of acute pancreatitis. In this case, we aim to highlight the onset of hypertriglyceridemia-induced acute pancreatitis due to recent combined oral contraceptive use in a 34-year-old Hispanic female patient with a family history of hypertriglyceridemia. With the initiation of a low-fat diet, insulin regimen, and lipid-lowering medications, she was able to significantly improve her elevated triglyceride levels from 3772 to 440 throughout the duration of her six-day hospital stay. Due to the less commonly known relationship between combined oral contraceptive use and HTG-AP, this case serves to enhance understanding of the pathophysiology of this condition, the appropriate diagnostic evaluation, and the associated treatment options to optimize patient care and create efficacious management plans. By increasing awareness of this association, patients with familial hypertriglyceridemia can be made aware of the risks of combined oral contraceptive use to accordingly prevent complications and improve clinical outcomes.

The Impact of Hormonal Contraceptives on the Incidence and Progression of Cardiovascular Diseases in Women: A Systematic Review.

This systematic review examines the impact of hormonal contraceptives on the incidence and progression of cardiovascular diseases in women. We analyzed 14 high-quality studies published between 1998 and 2018, including meta-analyses, cohort studies, case-control studies, and systematic reviews. The aim was to synthesize the current understanding of the relationship between various hormonal contraceptives and cardiovascular risks, focusing on outcomes such as venous thromboembolism, ischemic stroke, and myocardial infarction. The 14 selected studies represent a comprehensive and diverse body of evidence, allowing for a nuanced analysis of the topic. Our findings indicate that combined oral contraceptives are associated with an increased risk of cardiovascular events, with the magnitude of risk varying based on estrogen dose, progestogen type, and individual risk factors. The review of these studies highlights the importance of personalized risk assessment in contraceptive counseling and prescribing practices. By synthesizing data from these key studies, we provide a consolidated view of the current state of knowledge regarding hormonal contraceptives and cardiovascular health, offering valuable insights for both clinicians and researchers in the field.

Assessment of intention to use modern contraceptives among women of reproductive age in Benin: evidence from a national population-based survey.

BACKGROUND: Women's intentions to use any contraceptive method are critical for better understanding their future needs and making them more likely to act on that intention. This study assessed the factors associated with the intention to use modern contraceptives among women of reproductive age in Benin. METHODS: This was a cross-sectional study that used the 2017-2018 Benin Demographic and Health Survey (BDHS). The study analyzed a weighted sample of 13, 582 women of reproductive age who were non-users of contraceptives. The intention to use contraceptives was the outcome variable. Multivariate logistic regression analysis was conducted to determine the factors associated with the intention to use contraceptives among women of reproductive age. The results were estimated using an adjusted odds ratios (aOR) with a 95% confidence interval (CI) and statistical significance set at p < 0.05. RESULTS: Approximately 35.0% of the women had the intention to use modern contraception. We found that women aged between 30 and 34 (aOR = 0.70, 95%CI: 0.57, 0.86), 35-39 (aOR = 0.52, 95%CI: 0.42, 0.66), 40-44(aOR = 0.30, 95%CI: 0.22, 0.39) and 45-49 (aOR = 0.10, 95%CI: 0.07, 0.14), Muslim women (aOR = 0.68, 95%CI: 0.53, 0.85) and those who perceived the distance to a health facility not to be a big problem (aOR = 0.75, 95%CI: 0.67, 0.84) were less likely to have the intention to use modern contraceptives compared with their counterparts. On the other hand, women who attained primary (aOR = 1.21, 95%CI: 1.07, 1.36), secondary (aOR = 1.39, 95%CI: 1.21, 1.59), and higher education (aOR = 1.60, 95%CI: 1.13, 2.26), women who were employed (aOR = 1.39, 95%CI: 1.23, 1.57), women with no religion (aOR = 1.32, 95%CI: 1.04, 1.69), women whose partners were working (aOR = 1.69, 95%CI: 1.16, 2.44), women who heard about family planning in the media (aOR = 1.51, 95%CI: 1.16, 2.44), and women in the poorer (aOR = 1.31, 95%CI: 1.10, 1.54), middle (aOR = 1.42, 95%CI: 1.20, 1.67]), richer (aOR = 1.23, 95%CI: 1.03, 1.47), and richest households (aOR = 1.42, 95%CI: 1.15, 1.75) were more likely to have the intention to use contraceptives than their counterparts. CONCLUSION: The study provides valuable insights into the intention to use contraceptives among women of reproductive age in Benin. The findings indicate that the proportion of women who have intention to use contraceptives remains low. The findings of this study could inform the development of targeted interventions and policies to increase access to and uptake of contraceptives in Benin, with the ultimate aim of improving the reproductive health and well-being of women and their families.

Ischaemic Colitis from an Unusual Cause: Oral Contraceptives.

Ischaemic colitis is responsible for more than half of the presentations of gastrointestinal ischaemia and develops due to an interruption of intestinal blood flow. Risk factors include increasing age and conditions associated with decreased perfusion. Infrequently, ischaemic colitis may develop in young females prescribed oral contraceptives. Here, we present a case of ischaemic colitis secondary to oral contraceptives that resolved with medication discontinuation. LEARNING POINTS: Ischaemic colitis is due to insufficiency of intestinal blood flow and is responsible for half of the cases of gastrointestinal ischaemia.Oral contraceptives have an increased odd of 1.05 predisposing development of ischaemic colitis.Symptoms typically resolve with removal of the oral contraceptive.

Contextualizing family planning messages for the BornFyne-PNMS digital platform in Cameroon: a community-based approach.

BACKGROUND: Family planning (FP) is crucial for reducing maternal and infant mortality and morbidity, particularly through the prevention of unsafe abortions resulting from unwanted pregnancies. Despite Cameroon's commitment to increasing the adoption of modern FP strategies, rural and poor populations still exhibit low demand due to limited access to healthcare services. This study documents the approach in developing family planning messages for the BornFyne prenatal management system as a platform to improve family planning awareness and enhance uptake. METHOD: This is a mixed-methods study that employed the Health Belief Model (HBM). The study included a cross-sectional survey and focus group discussions in four districts of Cameroon. The survey explored household perspectives of FP and the use of mobile phone. Focus group discussions involved women, men, and community health workers to gain in-depth insights. Thematic analysis using themes from the HBM guided the analysis, focusing on perceived benefits, barriers, and cues to action. RESULTS: The survey included 3,288 responses. Thematic analysis of focus group discussions highlighted knowledge gaps and areas requiring additional information. Identified gaps informed the development of targeted FP messages aligned with BornFyne objectives and the Health Belief Model. Results revealed that most respondents recognized the benefits of FP but faced knowledge barriers related to side effects, cultural influences, and communication challenges between partners. Focus group discussions further highlighted the need for education targeting both men and women, dispelling misconceptions, and addressing adolescent and youths' ignorance. The study emphasized the importance of tailored messaging for specific demographic groups and culture. CONCLUSION: Developing effective FP intervention messages requires a nuanced understanding of community perspectives. The BornFyne-PNMS family planning feature, informed by the Health Belief Model, addresses knowledge gaps by delivering educational messages in local dialects via mobile phones. The study's findings underscore the importance of community-based approaches to contextualizing and developing FP content targeting specific populations to generate tailored messages to promote awareness, acceptance, and informed decision-making. The contextualized and validated messages are uploaded into the BornFyne-family planning feature.

Family Planning for Patients With Inflammatory Bowel Disease in the Post-Dobbs Era.

Federal protections for abortion care in the United States ended in June 2022. For people with inflammatory bowel disease (IBD) who are capable of pregnancy, the implications of an unwanted or mistimed conception, particularly in the setting of active disease flares or teratogenic treatment, are precarious and geographically variable. Prioritizing evidence-based and person-centered counseling for preconception health and contraceptive care needs is important during health care visits and not limited to reproductive health providers. Development of multidisciplinary clinics or complex contraception clinics in high-volume IBD centers can support time-sensitive counseling and services for patients. This article reviews reproductive considerations for people with IBD, particularly in the setting of legislative restrictions in the post-Dobbs landscape.

A Review of Concordance and Quality in Clinical Guidelines for Hormonal Contraceptives to Mitigate Drug-Drug Interactions in Women With Epilepsy.

PURPOSE: Concomitant use of hormonal contraceptive agents (HCAs) and enzyme-inducting antiepileptic drugs (EIAEDs) may lead to contraceptive failure and unintended pregnancy. This review identified and evaluated concordance and quality of clinical treatment guidelines related to the use of HCAs in women with epilepsy (WWE) receiving EIAEDs. METHODS: Relevant clinical guidelines were identified across four databases and were independently evaluated for quality utilizing the AGREE-II protocol instrument. Quality in this context is defined as the rigor and transparency of the methodologies used to develop the guideline. Guidelines were further assessed in terms of concordance and discordance with the latest body of knowledge concerning the use of hormonal contraception in the presence of EIAEDs. RESULTS: A total of n = 5 guidelines were retrieved and evaluated. Overall guideline scores ranged from 17% to 92%, while individual domain scores ranged from 0% to 100%. Contraceptive guidelines consistently recommended the use of intrauterine systems and long-acting injectables in the presence of EIAEDs, recommended against the use of oral, transdermal, and vaginal ring contraceptives, and differed regarding recommendations related to implants. Guidelines agreed regarding recommendations that women treated with EIAEDs should receive intrauterine systems and long-acting injectables; however, the suggested frequency of administration of injectable contraceptives differed. The use of intrauterine systems in this population is supported by evidence, but there is uncertainty surrounding the use of long-acting injectables and contraceptive implants. CONCLUSIONS: To mitigate the risk of unintended pregnancy and its consequences, recommendations related to implants and long-acting injectable contraceptives should be evidence-based.

Association between oral contraceptives and cervical cancer: A retrospective case-control study based on the National Health and Nutrition Examination Survey.

Background: Cervical cancer is the fourth most common cancer among females globally, with a high incidence and high mortality among females in developing countries. This retrospective case-control study aimed to investigate the association between oral contraceptives and cervical cancer, on which insufficient evidence still exists. Material and Methods: To examine the association between oral contraceptives and cervical cancer based on 7,496 females aged over 20 years from the National Health and Nutrition Examination Survey, multivariable logistic regression conducted from 1999 to 2016 was used. Results: Contraceptive use was positively associated with cervical cancer risk. In model 1 (unadjusted), a 195% increased risk of cervical cancer was observed among those who used oral contraceptives (odds ratio [OR] = 2.27, 95% confidence interval [CI] = 1.39-3.98, p = 0.002) compared to those who did not. In addition, the ORs for the exposed population were 1.74 (95% CI = 1.05-3.08, p = 0.041) and 1.93 (95% CI = 1.16-3.44, p = 0.017) in model 2 (adjusted for age, race, and body mass index [BMI]) and model 3 (adjusted for education level, ratio of family income to poverty, drinking status, smoking status, number of pregnancies, age at first sex, number of sexual partners, and whether to receive the human papillomavirus (HPV) vaccine in addition to model 2), respectively. Furthermore, subgroup analyses stratified by age, smoking status, BMI, age at first sex, number of sexual partners, and whether to receive the HPV vaccine also revealed that oral contraceptives were significantly associated with cervical cancer. Conclusion: This study demonstrated that oral contraceptive use increased the risk of cervical cancer. In addition, the higher risk, including individuals older than 45 years, having a high BMI (≥30 kg/m2), being current smokers, and having more than five sexual partners, may contribute to the development of cervical cancer.

Self-Reported Menstrual Health, Symptomatology, and Perceived Effects of the Menstrual Cycle for Elite Junior and Senior Football Players.

PURPOSE: To describe the self-reported menstrual health, symptomatology, and perceived effects of the menstrual cycle on athletic performance for national and international Australian football (soccer) players. METHODS: Players from national and domestic teams were invited to complete an online questionnaire regarding menstrual health, use of hormonal contraceptives (HCs), negative symptomatology, and perceived disruption of the menstrual cycle to performance. Descriptive statistics and binomial regressions with odds ratios (OR) were used to report the relationship of menstrual-related variables with perceived performance disruption. RESULTS: A total of 199 players (20.9 [5.1] y) completed the questionnaire, with 18% of players reporting using HCs. One primary amenorrhea case was detected, and 26% of players reported menarche at age ≥15 years. For non-HC users, the prevalence of secondary amenorrhea was 2%, oligomenorrhea was 19%, and heavy menstrual bleeding was 11%. Ninety-seven percent of players reported experiencing physical or affective menstrual symptoms (5 [1.3] per player), and 40% of all players reported that menstrual symptoms impacted their ability to work, study, train, or compete. Furthermore, 40% of players perceived their training or performance to be disrupted by the menstrual cycle. Increasing number of menstrual symptoms (OR = 1.43; 95% CI, 1.28-1.62; P < .001), heavy menstrual bleeding (OR = 12.73; 95% CI, 3.4-82.8; P < .001), and pelvic pain (OR = 3.40; 95% CI, 1.7-7.2; P < .001) increased the likelihood of perceiving the menstrual cycle to disrupt performance. CONCLUSION: Heavy menstrual bleeding and HC use were low among this cohort of national and international footballers, whereas amenorrhea and oligomenorrhoea were comparable with other football populations. Nearly all players reported menstrual symptoms, and increased symptomatology was associated with greater perceived effects on performance.

Estrogen Hormones' Implications on the Physiopathology of Temporomandibular Dysfunction.

Background/Objectives: Temporomandibular dysfunction syndrome consists of several disorders of the masticatory system, namely those of the muscles, the joint itself, as well as the dental and periodontal system. This syndrome is often characterized by pain and an inability to perform functions within the dental-maxillary apparatus, which creates a certain degree of disability in patients. Women are more susceptible to this syndrome than men and hormonal factors, particularly estrogen, are central to its etiology and physiopathology. Methods: A comprehensive literature search was conducted using PubMed/MEDLINE, Scopus, Embase, and Web of Science databases regarding articles published from January 2008 to December 2023. Two authors conducted searches in the mentioned databases based on a pre-established search strategy using agreed-upon keywords. Additionally, each review author performed the selection process of eligible studies based on established inclusion criteria. The Newcastle-Ottawa scale and Risk of Bias tool 2 were used to assess each article for its methodological quality. Results: Of the 1030 records found in the four bibliographic databases, 22 studies were included in this review. Polymorphism in the alpha estrogen receptor appears to be significantly more prevalent in women with temporomandibular dysfunction, suggesting a genetic predisposition. There is a significant role of estrogen in the physiopathology of TMD-related pain. Women with polycystic ovary syndrome (PCOS) have a significantly higher incidence of TMD, accompanied by elevated inflammatory factors and decreased progesterone levels. In premenopausal women, there is scientific relevance to the association between beta-estradiol levels and TMD development and progression. The effects of estrogen hormones on temporomandibular dysfunction remain highly debated and challenging. Conclusions: These findings emphasize the importance of considering hormonal factors, genetic predisposition, and reproductive life stages in understanding and managing temporomandibular dysfunction. Further research is needed to elucidate the specific mechanisms underlying these associations.

Why it is timely to bring a new hormonal male contraceptive to the public - A 35-year perspective of the authors.

This perspective provides an overview of issues needed to bring a testosterone-progestogen combined transdermal male hormonal contraceptive to the market. Large-scale phase 2b trials are near completion and a pivotal trial to confirm efficacy and safety has been designed. We believe we are close to accomplishing the steps necessary to bring the first male-directed effective, safe, and reversible pharmaceutical contraceptive approach to the public. If successful, we believe it will provide a new option for couples to consider in their family planning.

Association Between Intrauterine System Hormone Dosage and Depression Risk.

OBJECTIVE: The authors compared the associated risk of incident depression between first-time users of low-, medium-, and high-dose levonorgestrel-releasing intrauterine systems (LNG-IUSs). METHODS: This national cohort study was based on Danish register data on first-time users of LNG-IUSs, 15-44 years of age, between 2000 and 2022. Cox regression and a G-formula estimator were used to report 1-year average absolute risks, risk differences, and risk ratios of incident depression, defined as initiation of an antidepressant or receipt of a depression diagnosis, standardized for calendar year, age, education level, parental history of mental disorders, endometriosis, menorrhagia, polycystic ovary syndrome, dysmenorrhea, leiomyoma, and postpartum initiation. RESULTS: In total, 149,200 women started using an LNG-IUS, among whom 22,029 started a low-dose one (mean age, 22.9 years [SD=4.5]), 47,712 a medium-dose one (mean age, 25.2 years [SD=6.2]), and 79,459 a high-dose one (mean age, 30.2 years [SD=5.6]). The associated subsequent 1-year adjusted absolute risks of incident depression were 1.21% (95% CI=1.06-1.36), 1.46% (95% CI=1.33-1.59), and 1.84% (95% CI=1.72-1.96), respectively. For the users of high-dose LNG-IUSs, the risk ratios were 1.52 (95% CI=1.30-1.74) and 1.26 (95% CI=1.10-1.41) compared with users of the low- and medium-dose LNG-IUSs, respectively. For users of medium-dose LNG-IUSs, the risk ratio was 1.21 (95% CI=1.03-1.39) compared with users of low-dose LNG-IUSs. CONCLUSIONS: First-time use of an LNG-IUS was positively associated with incident depression in an LNG-dose-dependent manner across low-, medium-, and high-dose LNG-IUSs. Although the observational design of the study does not permit causal inference, the dose-response relationship contributes to the body of evidence suggesting a relationship between levonorgestrel exposure and risk of depression.

The male birth control pill - A new approach to family planning and population control.

With the increase in the world's population, contraception is crucial in population control strategies. Majority of contraceptives produced today are targeted at women; many of whom experience side effects, leading to the discontinuation of these contraceptives after a year of use. As the use of condoms and vasectomies has been subjected to scrutiny, it is necessary for the development of male birth control (BC). Attempts to achieve this include hormonal and non-hormonal contraception. Hormonal contraception prevents the production of the sperm in the testes; but this mode of BC has been found to be ineffective while also causing behavioural changes in men. In contrast, non-hormonal male contraception focuses on rendering the sperm immotile to prevent fertilization post-copulation. Soluble adenylate cyclase is an area of research that has shown promise in this field. Furthermore, two inhibitors, TDI-10299 and TDI-11861, have been developed and tested, with the latter, showing greater potency and longer activity, in mice models. Overall, by developing non-hormonal male contraceptives, men will have more control over their reproductive health. Nonetheless, before such contraceptives can be made widely available, it is important that further research takes place to ensure the safety and effectiveness of these methods.

Hormonal contraceptives and behavior: Updating the potent state of the nascent science.

Hundreds of millions of people worldwide use hormonal contraceptives (HCs), which have been an essential part of women's reproductive health care for decades. Throughout that time, however, research on the neural and behavioral consequences of HCs was minimal and plagued by poor methodology. HC effects - and users - were assumed to be homogenous. Fortunately, there has been a recent upswell in the number and quality of investigations, affording tentative conclusions about the roles of HCs in spatial cognition and mental health, particularly depression. Thus, this paper leverages findings from the past few years to highlight the heterogeneous aspects of use that seem to matter for behavior - ranging from variation in hormonal contraceptive formulations and routes of administration to individual differences among users linked to age and reproductive health history. This paper closes with five tips for future research that will help capture and clarify heterogeneity in potential relations between HCs and behavior, namely data collection, regional access, lifespan factors, gender, and collaboration. HCs are sociopolitically provocative and research on their potential behavioral neuroendocrine impacts is becoming increasingly popular. It is, therefore, imperative for scientists to conduct replicable and robust empirical investigations, and to communicate findings with the nuance that the heterogeneity among users and effects requires.

Comparative efficacy of combined oral contraceptives and the levonorgestrel 52 mg IUD.

The relative risk of pregnancy with the levonorgestrel 52 mg IUD is 3 times lower than with optimal combined oral contraceptive use.

Adult Female Acne: Managing the Hormones.

Acne is a common inflammatory condition of the skin worldwide. The skin is an endocrine organ and hormones are a key pathogenic factor in all types of acne with a particularly important role in adult female acne pathogenesis and management. In females, we have the unique opportunity to manipulate hormones systemically to successfully manage acne and, more recently with the approval of clascoterone 1% cream, we can target the hormones topically in both genders. The intent of this paper is to provide physicians with an up-to-date clinically relevant review of the role of hormones in acne, the impact of currently available contraceptives and therapies available to target hormones in acne.

The influence of oral contraceptives on the exercise pressor reflex in the upper and lower body.

Previous research has demonstrated that oral contraceptive (OC) users have enhanced cardiorespiratory responses to arm metaboreflex activation (i.e., postexercise circulatory occlusion, PECO) and attenuated pressor responses to leg passive movement (PM) compared to non-OC users (NOC). We investigated the cardiorespiratory responses to arm or leg metaboreflex and mechanoreflex activation in 32 women (OC, n = 16; NOC, n = 16) performing four trials: 40% handgrip or 80% plantarflexion followed by PECO and arm or leg PM. OC and NOC increased mean arterial pressure (MAP) similarly during handgrip, plantarflexion and arm/leg PECO compared to baseline. Despite increased ventilation (VE) during exercise, none of the women exhibited higher VE during arm or leg PECO. OC and NOC similarly increased MAP and VE during arm or leg PM compared to baseline. Therefore, OC and NOC were similar across pressor and ventilatory responses to arm or leg metaboreflex and mechanoreflex activation. However, some differences due to OC may have been masked by disparities in muscle strength. Since women increase VE during exercise, we suggest that while women do not display a ventilatory response to metaboreflex activation (perhaps due to not reaching a theoretical metabolite threshold to stimulate VE), the mechanoreflex may drive VE during exercise in women.

How can we better address the pharmacokinetics of antipsychotics in children and adolescents?

INTRODUCTION: Despite a steady increase of antipsychotic prescriptions in children and adolescents, knowledge about pharmacokinetics and dosing of antipsychotics in children and adolescents remains limited. AREAS COVERED: We discuss seven issues with major impact on the pharmacokinetics of antipsychotics in youth: estrogens, ii) obesity, iii) ethnicity, iv) smoking, v) inflammation, vi) drug-drug interactions (DDIs), and vii) pharmacogenetics. Despite their major impact, these issues have not been adequately considered in the context of dosing algorithms for antipsychotics in youth. A simple tool to quantify the impact of these pharmacokinetics issues on antipsychotics is therapeutic drug monitoring (TDM), which refers to the quantification of the prescribed medication in the blood of the patients, as a surrogate for the peripheral antipsychotic exposure. We also provide summary tables extrapolated from the adult literature on metabolism, therapeutic reference ranges (TRRs) and DDIs. EXPERT OPINION: Despite considerable experience with TDM for antipsychotics in the management of other patient subgroups, TDM use for antipsychotics in children and adolescents may be limited with TRRs invariably being extrapolated from adult patients. Advancing TDM knowledge is expected to help clinicians address the special properties of pharmacokinetics of antipsychotics and ultimately enable antipsychotic dose individualization in youth.