New progestogens in oral contraception

Fotherby, K.; Caldwell, Amy

doi:10.1016/0010-7824(94)90106-6

Cited by 105 publications

(29 citation statements)

References 105 publications

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“…In fact, the increase noted in FVII levels represents a well-documented effect of OCs, 14,[25][26][27][28][29][30][31] as does that of chol, TGs, HDL-chol, and apoA1 levels. 32,59 -62 Most of the studies 14,28,[61][62][63] and a recent review 31 have described an increase in FVIIc and FVIIAg levels that was roughly related to the estrogen dose. In a recent report, 30 FVIIa was also assayed, and it was found to be increased.…”

Section: Discussionmentioning

confidence: 99%

Oral Contraceptives Highlight the Genotype-Specific Association Between Serum Phospholipids and Activated Factor VII

Mariani

Conard

Bernardi

et al. 1999

ATVB

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Abstract-The present analysis was undertaken to study the effect of oral contraceptive (OC) use on activated factor VII (FVIIa) in subjects characterized by FVII genotypes, with the further aim of evaluating the role of lipids in this pharmacological interaction. In OC users (nϭ42) and nonusers (nϭ130) Key Words: factor VII Ⅲ activated factor VII Ⅲ phospholipids Ⅲ factor VII genotype S ince the introduction of oral contraceptives (OCs) in the 1960s, epidemiological studies have revealed an association between their use and an increase in the risk of cardiovascular disease (CVD). [1][2][3][4][5][6] The most important cardiovascular complications noted were venous thromboembolism, myocardial infarction, and thrombotic stroke, 6 -11 with higher risk and susceptibility in female smokers in the 35ϩ age range. 12 The increased CVD risk has been attributed to the estrogenic component 7,13 : in fact, it was found to be reduced after the introduction of OCs containing a lower estrogen dose, [13][14][15][16][17][18] but recently venous thromboembolism was found to be higher in women using contraceptives containing third-generation compared with second-generation progestogens. 19 -22 The effect of OCs on hemostatis is an increase in the levels of some coagulation factors (factors II, VII [FVII], IX, X, XI, and VIII; von Willebrand factor; and fibrinogen), of protein C, and of protein complexes and fragments related to the activation of coagulation (thrombin-antithrombin complexes and D-dimer); these enhance fibrinolysis and decrease the levels of antithrombin III, protein S, and C4b-binding protein. [23][24][25][26][27][28][29][30][31] Concerning FVII, a relationship between FVII levels, the dose of estrogen, [23][24][25][26][27][28]31 and progestogen (norethisterone but not D-norgestrel 32 ) was consistently found. It is difficult, though, to pinpoint whether these changes are due to the estrogen or the progestative compound, and it is still a matter of debate whether the excess CVD risk after the use of OCs is related to the resulting dyslipidemia, the hemostasis changes, or both. Recently, a meta-analysis 33 pointed out the absence of an association between the duration of OC administration and CVD risk; the same analysis showed that the increased risk was limited to the period of OC administration.Because FVII has attracted attention owing to its association with lipids (namely triglycerides [TGs] and cholesterol

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Section: Discussionmentioning

confidence: 99%

Oral Contraceptives Highlight the Genotype-Specific Association Between Serum Phospholipids and Activated Factor VII

Mariani

Conard

Bernardi

et al. 1999

ATVB

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“…8,9 It was hypothesized that these oral contraceptive pills might reduce the risk of arterial thrombosis. 9,10 In 1995, several articles reported that users of thirdgeneration oral contraceptives had an at least 2-fold increased risk of venous thrombosis. [11][12][13][14] More recently, a similar increase was reported for venous sinus thrombosis.…”

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confidence: 99%

Risk of Arterial Thrombosis in Relation to Oral Contraceptives (RATIO) Study

Kemmeren

Tanis

Bosch

et al. 2002

Stroke

200

144

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Background and Purpose-Epidemiological studies have shown an increased risk of venous thrombosis in women takingthird-generation oral contraceptives, ie, those containing the progestogens desogestrel or gestodene. This study assesses the risk of ischemic stroke with several types of oral contraceptives. Methods-A multicenter, population-based, case-control study was performed in 9 Dutch centers in women aged 18 to 49 years. Women with a first ischemic stroke were compared with control women without vascular diseases. The control subjects were recruited by random-digit dialing and were stratified by age, area of residence, and year of stroke. All patients and control subjects filled in a questionnaire about the use of oral contraceptives and risk factors for ischemic stroke. Odds ratios were adjusted for the stratification factors. Results-Two hundred three women with an ischemic stroke and 925 control women were included. The risk of stroke in women using any type of oral contraceptives versus none was 2.3 (95% CI 1.6 to 3.3). Current users of first-generation oral contraceptives had an odds ratio of 1.7 (95% CI 0.7 to 4.4). Low-dose second-generation oral contraceptives increased the risk of stroke 2.4 times (95% CI 1.6 to 3.7), and third-generation oral contraceptives increased the risk of stroke 2.0 times (95% CI 1.2 to 3.5). The risk of stroke in women using third-generation oral contraceptives was not different from that in women using second-generation oral contraceptives (odds ratio 1.0, 95% CI 0.6 to 1.8). Conclusions-Third-generation oral contraceptives (containing desogestrel or gestodene) confer the same risk of first ischemic stroke as second-generation oral contraceptives (containing levonorgestrel).

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“…A recent review of seven of the low dose combined pills showed that on ultrasound examination and serum hormone estimations ovarian suppression occurred in only 50% of cycles. 34 The efficacy in terms of preventing pregnancy remained high with tablet related pregnancy, as distinct from patient error pregnancy, remaining at less than one per hundred women years. 3S In those circumstances the endometrial and cervical factors are essential for the prevention of the development of pregnancy.…”

Section: Triphasic and Biphasic Pillsmentioning

confidence: 99%

The Pill: Abortifacient or Contraceptive? A Literature Review

Tonti-Filippini¹

1995

Linacre Q

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New progestogens in oral contraception

Cited by 105 publications

References 105 publications

Oral Contraceptives Highlight the Genotype-Specific Association Between Serum Phospholipids and Activated Factor VII

Oral Contraceptives Highlight the Genotype-Specific Association Between Serum Phospholipids and Activated Factor VII

Risk of Arterial Thrombosis in Relation to Oral Contraceptives (RATIO) Study

The Pill: Abortifacient or Contraceptive? A Literature Review

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