The obesity 'epidemic' continues to increase, mostly but not only in developed countries. As overweight and obese women are at an increased risk for venous thromboembolism (VTE) at baseline and at a much higher risk during pregnancy, it is essential to help these women to plan pregnancies carefully and to use contraceptives with a positive ratio of benefits versus risks. The Expert Group on hormonal and molecular contraception of the European Society of Contraception convened to review the existing evidence and propose recommendations to the prescribers in line with most recent studies and with the Medical Eligibility Criteria of the World Health Organisation.
Combined oral contraceptives (COCs) are among the most widely used effective and reversible means of family planning. Their beneficial effects are well documented, but many questions are still raised concerning a possible association between the use of COCs and the development of cancer. The authors provide a broad and up-to-date review of the literature regarding the relation between COC use and carcinogenesis in different organs. Studies have not unequivocally confirmed that such a relation exists with regard to breast cancer. Much research focused on the influence COC use could have on the incidence of cervical cancer; most of it was analyzed by J. Smith and co-workers. These authors confirmed the existence of a weak relation between COC use and the development of cervical carcinoma, especially in women using COCs for longer periods. Ovarian carcinoma has the worst prognosis of all cancers of reproductive organs in women. The risk of developing ovarian cancer in women using COCs is at least 40% smaller than in other women; the degree of protection given by COCs is directly proportional to the duration of use of this form of contraception. Reliable scientific data prove convincingly that the risk of endometrial cancer is smaller in women who used COCs than in women who never took them.
TitleStatement on combined hormonal contraceptives containing third-or fourth-generation progestogens or cyproterone acetate, and the associated risk of thromboembolism.
Permalinkhttps://escholarship.org/uc/item/2g26x0v0
JournalThe journal of family planning and reproductive health care, 39(3)
The first-ever written prescription for a contraceptive (barrier method) tampon can be found in the Ebers Papyrus, a compendium of medical practices written in 1550 BC. Modern spermicides are produced in a variety of formulations, including gels, foams, creams, suppositories, pessaries, capsules, foaming tablets and films. Spermicides are relatively inexpensive and widely available over the counter. Most of the currently used spermicides contain the chemical agent (non-ionic detergent) nonoxynol-9. The spermicide 'as a commonly used method' has a very high failure rate (one pregnancy in every four women using this method of contraception for 1 year). Implementation of other, much more effective methods of contraception has made spermicides less and less popular, but recently their potential properties against HIV and STI pathogens (a cause of sexually transmitted diseases) have led to new attention for these products. These properties have been widely evaluated in clinical trials, but the final conclusion does not favor spermicides as the tool for the global fight against HIV/AIDS. There is an urgent need for the invention of a chemical product that, for dual protection, would be administered vaginally before sexual intercourse to kill HIV and other STI pathogens, and at the same time disable or kill sperm. The new era for barrier methods should begin from the development of novel microbicides.
The first-ever written prescription for a contraceptive (barrier method) tampon can be found in the Ebers Papyrus, a compendium of medical practices written in 1550 BC. Modern spermicides are produced in a variety of formulations, including gels, foams, creams, suppositories, pessaries, capsules, foaming tablets and films. Spermicides are relatively inexpensive and widely available over the counter. Most of the currently used spermicides contain the chemical agent (non-ionic detergent) nonoxynol-9. The spermicide 'as a commonly used method' has a very high failure rate (one pregnancy in every four women using this method of contraception for 1 year). Implementation of other, much more effective methods of contraception has made spermicides less and less popular, but recently their potential properties against HIV and STI pathogens (a cause of sexually transmitted diseases) have led to new attention for these products. These properties have been widely evaluated in clinical trials, but the final conclusion does not favor spermicides as the tool for the global fight against HIV/AIDS. There is an urgent need for the invention of a chemical product that, for dual protection, would be administered vaginally before sexual intercourse to kill HIV and other STI pathogens, and at the same time disable or kill sperm. The new era for barrier methods should begin from the development of novel microbicides.
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