Shorter pill-free interval in combined oral contraceptives decreases follicular development

Spona, J; Elstein, Max; Feichtinger, Wilfried; Sullivan, Helen; Lüdicke, Frank; Müller, UA; Düsterberg, B.

doi:10.1016/0010-7824(96)00137-0

Cited by 175 publications

(79 citation statements)

References 22 publications

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“…This concept is erroneous, as OCP agents do not produce complete ovarian suppression. Residual ovarian activity has been observed in women taking preparations containing 50 mg ethinyl estradiol, and lower estrogen doses have been associated with even less ovarian suppression (5,9,27). Coupled with the secondary effects of residual metabolites in other tissues (e.g., the kidney), fluid dynamics of this placebo week are still unknown.…”

mentioning

confidence: 99%

Endogenous and exogenous female sex hormones and renal electrolyte handling: effects of an acute sodium load on plasma volume at rest

Sims¹,

Rehrer²,

Bell³

et al. 2008

Journal of Applied Physiology

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Sims ST, Rehrer NJ, Bell ML, Cotter JD. Endogenous and exogenous female sex hormones and renal electrolyte handling: effects of an acute sodium load on plasma volume at rest. J Appl Physiol 105: 121-127, 2008. First published April 24, 2008 doi:10.1152/japplphysiol.01331.2007.-This study was conducted to investigate effects of an acute sodium load on resting plasma volume (PV) and renal mechanisms across the menstrual cycle of endurancetrained women with natural (NAT) or oral contraceptive pill (OCP) controlled cycles. Twelve women were assigned to one of two groups, according to their usage status: 1) OCP [n ϭ 6, 29 yr (SD 6), 59.4 kg (SD 3.2)], or 2) NAT [n ϭ 6, 24 yr (SD 5), 61.3 kg (SD 3.6)]. The sodium load was administered as a concentrated sodium chloride/ citrate beverage (164 mmol Na ϩ /l, 253 mosmol/kgH2O, 10 ml/kg body mass) during the last high-hormone week of the OCP cycle (OCP high) or late luteal phase of the NAT cycle (NAThigh) and during the low-hormone sugar pill week of OCP (OCP low) or early follicular phase of the NAT cycle (NAT low). The beverage (ϳ628 ml) was ingested in seven portions across 60 min. Over the next 4 h, PV expanded more in the low-hormone phase for both groups (timeaveraged change): OCP low 6.1% (SD 1.1) and NATlow 5.4% (SD 1.2) vs. OCP high 3.9% (SD 0.9) and NAThigh 3.5% (SD 0.8) (P ϭ 0.02). The arginine vasopressin increased less in the low-hormone phase [1.63 (SD 0.2) and 1.30 pg/ml (SD 0.2) vs. 1.82 (SD 0.3) and 1.57 pg/ml (SD 0.5), P ϭ 0.0001], as did plasma aldosterone concentration (ϳ64% lower, P ϭ 0.0001). Thus PV increased more and renal hormone sensitivity was decreased in the low-hormone menstrual phase following sodium/fluid ingestion, irrespective of OCP usage. oral contraceptive pill; citrate; hypervolemia; hyperhydration; estradiol; progesterone BODY WATER AND ELECTROLYTE balance are critical for normal cellular function and maintaining adequate blood and plasma volume (PV) and osmolality, yet natural and synthetic female sex hormones have various effects on water and electrolyte balance. Thus understanding the interactions of female sex hormones and their synthetic analogs and the fluid regulatory system is crucial. The two most influential female sex hormones are estrogen and progesterone, both of which change in concentration across the menstrual cycle and are governed by oral contraceptive pill (OCP) usage. These two hormones influence sodium and water distribution and thus fluid compartment volumes and dynamics. Primarily, it is known that estrogens favor fluid retention by activating the renin-angiotensin-aldosterone system and that progesterone is able to antagonize this event (21). Estrogen enhances vasodilation and capillary permeability and acts centrally to lower the operating set point of plasma osmolality (Posm) (a leftward shift in AVP sensitivity) (21,22,28,30,38). Progesterone competes directly with the same mineralocorticoid receptor as aldosterone, which may cause a transient natriuresis (20).Although the effects of estrogen and progesteron...

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mentioning

confidence: 99%

Endogenous and exogenous female sex hormones and renal electrolyte handling: effects of an acute sodium load on plasma volume at rest

Sims¹,

Rehrer²,

Bell³

et al. 2008

Journal of Applied Physiology

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show abstract

“…As discussed earlier, research on the effect of COCs on ovarian, specifically follicular function, has demonstrated that there is sufficient follicular suppression during the days that active pills are being taken. But there is, particularly with low dose (20 mg EE) pills, a potential 'escape' from suppression as measured by increases in follicle stimulating hormone (FSH) and oestradiol as well as an increase in follicular development which occurs fairly quickly during the hormonefree interval 9,[18][19][20] . This shows that there is no ongoing interference with endocrine control mechanisms associated with the pharmacological suppression of ovarian function; indeed it demonstrates the extremely rapid reversibility of the aforementioned interference.…”

Section: Discussionmentioning

confidence: 99%

“…The authors commented that shortening the hormone-free interval by extending the active pill phase might also benefit patients on long-term treatment with enzyme-inducing drugs, particularly those with epilepsy, and patients with headaches, non-focal migraine, breast tension, and bleeding problems attributable to fluctuating high endogenous oestrogen levels 18 .…”

Section: Hormone Withdrawal Symptomsmentioning

confidence: 99%

“…This and other studies concluded that the degree of residual ovarian activity could be regarded as a useful measure of the effectiveness of oral contraceptives 51 . The scoring system combines ultrasound assessment of follicular size and appearance with the measurement of LH, FSH, oestradiol and progesterone levels 9,18,45 . A fascinating study into the question of missed pills and poor compliance randomised women to either a 21/7-or a 24/4 days-regimen of pills containing 20 mg EE and 3mg DRSP.…”

Section: What About Efficacy?mentioning

confidence: 99%

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New regimens with combined oral contraceptive pills – moving away from traditional 21/7 cycles

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2010

The European Journal of Contraception & Reproductive Health

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“…Condoms decrease the risk of sexually transmitted disease, but are rarely used as the sole contraceptive option in adolescents due to the high failure rate (Sucato et al, 2003). For women younger than 20 years of age contraceptive failure rate of condoms typically range between 10% to 53% during their first year (Spona et al, 1996). Diaphragms and cervical caps are rarely used by adolescents and have unacceptably high failure rates (Sucato & Murray, 2003).…”

Section: Physiological Outcomesmentioning

confidence: 99%

The New Normal: A Bourdieusian Examination of Living Into Young Adulthood Being a Paediatric Heart Transplant Recipient

Mauthner

Angus

Gastaldo

et al. 2014

The Journal of Heart and Lung Transplantation

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Improved success of paediatric cardiac transplantation has resulted in increased survival of recipients into young adulthood (19 to 29 years of age). Young adults who received a heart transplant during childhood have experienced multiple life sustaining procedures. As survival and longevity increase, it is clear that transplant recipients experience negative physiological, psychological and social sequelae. With heart transplant offering individuals a chance to extend life into young adulthood, recipients need lifelong care and at age 18 they will transition from paediatric to adult healthcare facilities. The study addressed young adults circumstances of existence and their competing interests within various social environments. This research project applied Pierre Bourdieu's theoretical concepts of habitus, field and capital, to conceptualize and engage with empirical knowledge production about young adults who have received a heart transplant during childhood. Using visual methodology, focused open-ended interviews were conducted with 12 young adults who had a heart transplant during childhood. Bourdieu's work iii provided a theoretical framework to investigate transplant recipients' identities and social repositioning in relation to dominant discourses of organ transplant and shifting relationships with health services providers. This study involved an iterative process to identify recipients' encounters and new compositions in relation with others, in order to answer the research objective. These findings highlight that young adult transplant recipients struggle with relational dispositions that excludes them from various fields of social engagement; their struggle and exclusion from various fields is symbolic and is embedded in the structure of the dominant social order of the field from where they become excluded; the social order is taken up and embodied, leading young transplant recipients to practices of accommodation and "normalization". Changes

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Shorter pill-free interval in combined oral contraceptives decreases follicular development

Cited by 175 publications

References 22 publications

Endogenous and exogenous female sex hormones and renal electrolyte handling: effects of an acute sodium load on plasma volume at rest

Endogenous and exogenous female sex hormones and renal electrolyte handling: effects of an acute sodium load on plasma volume at rest

New regimens with combined oral contraceptive pills – moving away from traditional 21/7 cycles

The New Normal: A Bourdieusian Examination of Living Into Young Adulthood Being a Paediatric Heart Transplant Recipient

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