Preservativos en población sexual activa / Condoms in sexually active population

Objetivo: Describir el uso de preservativos en población sexual activa. Método: Descriptivo documental con análisis bibliográfico de 15 documentos relacionados al tema, los cuales fueron tomados de la base de datos PubMed. Resultados: Es posible considerar que tener una vida sexual activa sea incorrecto, pero solo un mínimo de participantes siempre ha utilizado preservativos a lo largo de su vida por lo cual se considera que esta muestra de población no lleva una vida sexual responsable, pero hay que tomar en cuenta también que usan otros métodos anticonceptivos. Conclusión: La sociedad ha ido disminuyendo los estigmas de la adquisición de preservativos, pero también se recalca que cierta parte de la muestra manifestó que aún se sentían juzgados por su familia o por la persona que comercializa preservativos.

Objective: To describe the use of condoms in the sexually active population. Method: Descriptive documentary with bibliographic analysis of 15 documents related to the subject, which were taken from the PubMed database. Results: It is possible to consider that having an active sexual life is incorrect, but only a minimum of participants have always used condoms throughout their lives, so it is considered that this sample of the population does not lead a responsible sexual life, but it should also be taken into account that they use other contraceptive methods. Conclusion: Society has been decreasing the stigmas of acquiring condoms, but it is also emphasized that a certain part of the sample stated that they still felt judged by their family or by the person who markets condoms. Descriptors: contraceptive agents; contraceptive agents, female; contraceptive agents, male

Estetrol and drospirenone: a novel oral contraceptive.

Estetrol (E4) is a natural human estrogen produced during human pregnancy in the fetal liver with a unique mechanism of action that displays tissue-selective activity, and behaves as a natural selective estrogen receptor modulator. E4 acts as an estrogen agonist on the vagina, the uterus and the endometrium, and also shows bone-sparing activity. Its mechanism of action results in neutral impact on endocrine, metabolic and hemostatic parameters, compared with other oral contraceptives. In 2021, Health Canada approved the combination 15 mg E4/3 mg drospirenone (DRSP), the first and only combined oral contraceptive based on the native estrogen E4, which has been synthesized from plant-based sources. Shortly afterwards, the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA) also approved the combination 14.2 mg E4/3 mg DRSP as a female contraceptive.

Drospirenone: a novel progestogen used as an oral contraceptive without an estrogen component.

Drospirenone (DRSP) was synthesized as an analogue of spironolactone with the aim of producing a fourth-generation progestogen that differed from earlier progestogens in that it had antiandrogenic and little or no androgenic activity and lacked estrogenic effects while retaining some antimineralocorticoid activity. Since then, DRSP has been included in several oral contraceptive preparations together with an estrogen. However, increasing evidence has demonstrated that DRSP 4 mg on its own inhibits ovulation. It was thus a logical development to determine the efficacy of a tablet that only included DRSP 4 mg as an oral contraceptive. This proved successful and this product has now been approved by the Food and Drug Administration (FDA).

Contraceptive vaginal ring containing segesterone acetate and ethinyl estradiol: long-acting, patient-controlled, procedure-free, reversible prescription birth control.

The Food and Drug Administration (FDA) approved on August 10, 2018, a soft, reusable, flexible silicone ring (56 mm diameter) containing segesterone acetate and ethinyl estradiol as the first contraceptive vaginal ring (CVR) that can be used for a year and that is totally under the control of the woman using it. The vaginal ring releases segesterone and ethinyl estradiol at estimated rates of 150 mcg/day and 13 mcg/day, respectively. The CVR is inserted into the upper two-thirds of the vagina and left in place for 21 days, then removed for 7 days. The same ring can be used for 13 cycles for a total of a year's contraception. The CVR was found to be 97.5% effective in preventing pregnancy with a Pearl Index of 2.98. The adverse effects in women using the ring were similar in nature and frequency to those reported during the use of other hormonal contraceptives. The one exception was the occurrence of venous thromboembolism, which was reported more often than expected. Because of this, the FDA has required a postmarketing study to determine the true incidence of this adverse effect. The CVR was developed by the Population Council, is known as Annovera, and will be marketed by TherapeuticsMD in the U.S.

Effects of different hormonal contraceptives in women's blood pressure values / Efectos de los distintos anticonceptivos hormonales en los valores de presión arterial de la mujer / Efeitos dos diferentes anticoncepcionais hormonais nos valores de pressão arterial da mulher

ABSTRACT Objective: To identify evidence in the literature of the relationship between the use of different hormonal contraceptive methods and alterations in women's blood pressure values. Method: This is an integrative literature review, consisting of ten scientific articles published in PubMed and BVS, between 2012 and 2016, selected by keywords, available fully and free of charge, in English, Portuguese, or Spanish. Results: The articles showed that exogenous estrogen helps in the activation of the renin-angiotensin-aldosterone system causing hypertensive effects even in small doses; and that combined use with drospirenone reduces these effects. Routes of administration without passage through the liver and use of isolated progestin showed promising results in reducing the effects on blood pressure. Conclusion: There is evidence in the literature of pressure alterations associated with different hormonal contraceptives and that personal history of morbidities are to be considered in an attempt to reduce the effects on the cardiovascular system.

RESUMEN Objetivo: Identificar en la literatura evidencias sobre la relación entre el uso de distintos métodos anticonceptivos hormonales y las alteraciones en los valores de presión arterial en mujeres. Método: Se trata de la revisión integrativa de la literatura, constituida por diez artículos científicos publicados en PubMed y BVS, entre 2012 y 2016, seleccionados por medio de palabras-clave, disponibles en su totalidad, gratuitos, en inglés, en portugués o en español. Resultados: Los artículos han enseñado que el estrógeno exógeno aporta en la activación del sistema renina-angiotensina-aldosterona causando efectos hipertensivos aunque en pequeñas dosificaciones; y que el uso combinado con la drospirenona reduce esos efectos. Vías de administración sin pasaje por el hígado y el uso del progestágeno aislado han enseñado resultados promisores en la reducción de los efectos sobre la presión. Conclusión: Hay evidencias en la literatura de alteraciones presóricas asociadas a distintos anticonceptivos hormonales y de que antecedentes personales de morbilidades deben ser considerados en el intento de reducir los efectos sobre el sistema cardiovascular.

RESUMO Objetivo: Identificar na literatura evidências sobre a relação entre o uso de diferentes métodos anticoncepcionais hormonais e as alterações nos valores de pressão arterial em mulheres. Método: Trata-se de revisão integrativa da literatura, constituída por dez artigos científicos publicados no PubMed e BVS, entre 2012 e 2016, selecionados por meio de palavras-chave, disponíveis na íntegra, gratuitos, em inglês, português ou espanhol. Resultados: Os artigos mostraram que o estrogênio exógeno contribui na ativação do sistema renina-angiotensina-aldosterona causando efeitos hipertensores mesmo em pequenas dosagens; e que o uso combinado com a drospirenona reduz esses efeitos. Vias de administração sem passagem pelo fígado e uso do progestágeno isolado mostraram resultados promissores na redução dos efeitos sobre a pressão. Conclusão: Há evidências na literatura de alterações pressóricas associadas a diferentes anticoncepcionais hormonais e de que antecedentes pessoais de morbidades devem ser considerados na tentativa de reduzir os efeitos sobre o sistema cardiovascular.