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Estrogen, progestin, and beyond: thrombotic risk and contraceptive choices.
Hematology Am Soc Hematol Educ Program
December 2024
Division of Hematology and Thromboembolism, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Hormonal contraceptive therapy (estrogens and/or progestogens) includes different formulations associated with varying venous thromboembolism (VTE) risks. The thrombogenicity of combined hormonal contraceptives (CHCs) is due at least in part to multiple changes in clotting factors and the vasculature and is dependent on both estrogen dose and type of progestin. Transdermal patch and vaginal ring users have similar or higher VTE risk as combined oral contraceptive users.
View Article and Find Full Text PDFEndometrial Proliferation and Heavy Menstrual Bleeding Associated With Continuous Oral Contraceptive Use.
Cureus
October 2024
Obstetrics and Gynecology, New Tampa OBGYN, Tampa, USA.
Continuous oral contraceptives are intended for three months of levonorgestrel/ethinylestradiol use followed by 10 days of low-dose ethinylestradiol. When taken for extended periods without withdrawal bleeds, side effects may include heavy menstrual bleeding and endometrial proliferation. A 41-year-old female presented to the OB-GYN clinic with two months of heavy menstrual bleeding after 10 years of Seasonique use without withdrawal bleeds (10 days of low-dose ethinylestradiol).
View Article and Find Full Text PDFEffect of various contraceptives on oocyte yield and maturation in patients undergoing planned oocyte cryopreservation.
Reprod Biomed Online
September 2024
Reproductive Medicine Associates of New York, New York, NY, USA; Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Research Question: Do the various forms of hormonal and non-hormonal contraceptives have any association with ovarian stimulation outcomes, such as oocyte yield and maturation, in patients undergoing planned oocyte cryopreservation (POC)?
Design: This retrospective cohort study included all patients who underwent POC cycles between 2011 and 2023. The use of types of contraception before a POC cycle was recorded. The study evaluated the median number of cumulus-oocyte complexes obtained after vaginal oocyte retrieval and the proportion of metaphase II oocytes that underwent vitrification among all the cohorts.
Association Between Intrauterine System Hormone Dosage and Depression Risk.
Am J Psychiatry
September 2024
Neurobiology Research Unit (Larsen, Ozenne, Frokjaer) and Department of Gynecology, Fertility, and Obstetrics, Juliane Marie Center (Mikkelsen, Lidegaard), Copenhagen University Hospital, Rigshospitalet, Copenhagen; Department of Clinical Medicine (Larsen, Lidegaard, Frokjaer) and Department of Public Health, Section of Biostatistics (Ozenne), University of Copenhagen, Copenhagen; Department of Gynecology and Obstetrics, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark (Mikkelsen); Psychiatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense (Munk-Olsen); National Center for Register-Based Research, Aarhus University, Aarhus, Denmark (Munk-Olsen); Psychiatric Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen (Frokjaer).
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.
Fertility-sparing re-treatment for endometrial cancer and atypical endometrial hyperplasia patients with progestin-resistance: a retrospective analysis of 61 cases.
World J Surg Oncol
June 2024
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, National Clinical Research Center for Obstetric & Gynecologic Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
Objective: This study aimed to evaluate the oncological and reproductive outcomes of fertility-preserving re-treatment in progestin-resistant endometrial carcinoma (EC) and atypical endometrial hyperplasia (AEH) women who desire to maintain their fertility.
Methods: Our study included 61 progestin-resistant EC/AEH patients. These patients underwent treatment with gonadotropin-releasing hormone agonist (GnRHa) solely or a combination of GnRHa with levonorgestrel-releasing intrauterine system (LNG-IUD) or aromatase inhibitor (AI).
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