Update on the contraceptive contraindications

Serfaty, D.

doi:10.1016/j.jogoh.2019.02.006

Cited by 38 publications

(27 citation statements)

References 41 publications

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“…Pregnancy rates were also considered moderate in contraceptives containing BKC [18], but mainly because of the lack of information and/or mistakes in the application of the spermicide rather than due to their poor contraceptive ability. Indeed, the success of local contraceptives not only depends on their complete/incomplete vaginal coverage but also on the information of users, their compliance with the usage rules and their personal motivation [3,14,15].…”

Section: Differences and Similarities In Relation To Other Studiesmentioning

confidence: 99%

“…However, the lack of interest and innovation in this field coupled with the introduction of oral contraceptive pills and intrauterine devices in the 1960s made the available vaginal contraceptives somewhat outdated, resulting in poor efficacy and acceptability [1]. Nevertheless, local contraceptives can be preferred over other contraceptive methods by women after medical counselling [2,3,6]. Nowadays, FSRH supports the use of hormonal contraception and intrauterine devices to a large extent, but women may opt for vaginal contraceptives inclusively when rarer sexual intercourse occurs and/or when a decline in fertility has been associated.…”

Section: Strenghts and Weaknessesmentioning

confidence: 99%

“…Nevertheless, women are starting to prefer non-hormonal methods, avoiding oral contraceptives due to their side-effects and inconvenient daily intake [2]. Additionally, a careful choice must be taken having in mind the specific medical history, her particular risks in case of pregnancy and her own personal preference [3]. To this extent, when well-advised and informed, barrier methods such as spermicides may represent an alternative option for women.…”

Section: Introductionmentioning

confidence: 99%

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Comparative in vitro study on the local tolerance and efficacy of benzalkonium chloride, myristalkonium chloride and nonoxynol-9 as active principles in vaginal contraceptives

Alfaiate

Santos

Silva

et al. 2021

The European Journal of Contraception & Reproductive Health

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Background: Spermicides have been identified as a potentially attractive alternative to hormonal contraceptives and/or intrauterine devices. Thus, this study aimed evaluating the efficacy and local tolerance of benzalkonium chloride (BKC) and myristalkonium chloride (MKC) contained in Pharmatex V R vaginal formulations and compare them with nonoxynol-9 (N-9), the most common active ingredient in topical vaginal contraceptives. Methods: Human normozoospermic samples were assessed for motility, viability, acrosome status and penetration ability after exposure to control, N-9 or different BKC and MKC doses for 0 and 10 minutes. Local tolerance on HeLa cells was evaluated by the Trypan-blue and MTT assays. Results: Exposure to BKC and MKC reduced acrosome integrity while promoting total immobilisation and complete loss of sperm viability (p < .001, n ¼ 15). Both compounds also compromised sperm penetration ability upon exposure (p < .001, n ¼ 15). N-9 induced the same outcomes (p < .001, n ¼ 15); nevertheless, it was more toxic to HeLa cells than BKC and MKC (p < .05, n ¼ 14). Conclusions: BKC and MKC present strong in vitro spermicidal activity at lower doses than N-9 and were better tolerated after immediate exposure than N-9. Available Pharmatex V R galenic formulations were as effective as products based on N-9.

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Section: Differences and Similarities In Relation To Other Studiesmentioning

confidence: 99%

Section: Strenghts and Weaknessesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparative in vitro study on the local tolerance and efficacy of benzalkonium chloride, myristalkonium chloride and nonoxynol-9 as active principles in vaginal contraceptives

Alfaiate

Santos

Silva

et al. 2021

The European Journal of Contraception & Reproductive Health

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“…An increase in breast cancer is controversial; some data suggest a slight but significant increase in women using COCs (Gierisch 2013: OR 1.08; 95% CI 1.00-1.17 [56]), most frequently in triple-negative forms. The incidence of breast cancer decreases 5-10 years after a woman stops taking birth control pills [49,[56][57][58][59][60][61][62][63][64][65][66][67][68][69].…”

Section: Risks and Side Effects Of Chcsmentioning

confidence: 99%

Contraception in chronic kidney disease: a best practice position statement by the Kidney and Pregnancy Group of the Italian Society of Nephrology

et al. 2020

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Even though fertility is reduced, conception and delivery are possible in all stages of CKD. While successful planned pregnancies are increasing, an unwanted pregnancy may have long-lasting deleterious effects, hence the importance of birth control, an issue often disregarded in clinical practice. The evidence summarized in this position statement is mainly derived from the overall population, or other patient categories, in the lack of guidelines specifically addressed to CKD. Oestroprogestagents can be used in early, non-proteinuric CKD, excluding SLE and immunologic disorders, at high risk of thromboembolism and hypertension. Conversely, progestin only is generally safe and its main side effect is intramestrual spotting. Non-medicated intrauterine devices are a good alternative; their use needs to be carefully evaluated in patients at a high risk of pelvic infection, even though the degree of risk remains controversial. Barrier methods, relatively efficacious when correctly used, have few risks, and condoms are the only contraceptives that protect against sexually transmitted diseases. Surgical sterilization is rarely used also because of the risks surgery involves; it is not definitely contraindicated, and may be considered in selected cases. Emergency contraception with high-dose progestins or intrauterine devices is not contraindicated but should be avoided whenever possible, even if far preferable to abortion. Surgical abortion is invasive, but experience with medical abortion in CKD is still limited, especially in the late stages of the disease. In summary, personalized contraception is feasible, safe and should be offered to all CKD women of childbearing age who do not want to get pregnant.

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“…For women without contraceptive or fertility treatment use, 1 year of look-back would only be available if they had filled other prescriptions, thus introducing different selection criteria among the groups. Some conditions, including migraine with aura, hypertension, or a history of thromboembolic disorders, are considered contraindications for using hormonal contraceptives [30], and so women with these diagnoses are likely under-represented in our sample. We did not have information on migraine or thromboembolic disorders, but we found a similar prevalence of chronic hypertension in women on OC and women who were excluded from our study sample (Additional file 9).…”

Section: Limitationsmentioning

confidence: 99%

Fertility treatment and oral contraceptive discontinuation for identification of pregnancy planning in routinely collected health data – an application to analgesic and antibiotic utilisation

Hjorth

Wood

Tauqeer

et al. 2020

BMC Pregnancy Childbirth

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Background Women with unplanned pregnancies use folic acid less frequently, and more often use potentially teratogenic medications in the first trimester. Yet most studies based on routinely collected data lack information on pregnancy planning. Further, only pregnancies proceeding beyond a certain gestational age appear in routinely collected data, creating the possibility for collider-stratification bias. If pregnancy intention could be identified, pregnancies could be ascertained earlier. This study aimed to investigate fertility treatment and discontinuation of oral contraception (OC) as proxies for pregnancy planning by describing variations in patterns of prescription fills for antibiotics and analgesics during the peri-pregnancy period by these proxies of pregnancy intention. Methods Fertility treatment with clomiphene and discontinuation of OC were identified in the Norwegian Prescription Database (NorPD) and linked with data from the Medical Birth Registry of Norway for the years 2006 to 2017. Filled prescriptions for antibiotics and analgesics from NorPD were displayed for women on fertility treatment, women who discontinued OC before pregnancy, and women who discontinued during pregnancy. Results Of 172,585 included pregnancies, fertility treatment was identified in 19,449, and OC discontinuation before or during pregnancy in 153,136. Women who discontinued OC during pregnancy were less likely to use preconception folic acid (25.4%) than women who discontinued before pregnancy (32.9%), and women on fertility treatment (51.0%). Proportions of first trimester prescription fills were 4.9% (analgesics) and 12.8% (antibiotics) for women who discontinued OC during pregnancy, compared to 4.0 and 11.4% in women who discontinued OC before pregnancy, and 4.7 and 11.0% in women on fertility treatment. Conclusions There were no substantial differences in patterns of prescription fills for analgesics and antibiotics before or during pregnancy by fertility treatment and OC discontinuation. This suggests that there were few differences in medication use between women with planned and unplanned pregnancies, or that fertility treatment and timing of OC discontinuation from routinely collected health data cannot stand alone in the identification of unplanned pregnancies. A narrower definition of OC discontinuation during pregnancy seemed to be a better proxy, but this should be confirmed in other studies.

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Update on the contraceptive contraindications

Cited by 38 publications

References 41 publications

Comparative in vitro study on the local tolerance and efficacy of benzalkonium chloride, myristalkonium chloride and nonoxynol-9 as active principles in vaginal contraceptives

Comparative in vitro study on the local tolerance and efficacy of benzalkonium chloride, myristalkonium chloride and nonoxynol-9 as active principles in vaginal contraceptives

Contraception in chronic kidney disease: a best practice position statement by the Kidney and Pregnancy Group of the Italian Society of Nephrology

Fertility treatment and oral contraceptive discontinuation for identification of pregnancy planning in routinely collected health data – an application to analgesic and antibiotic utilisation

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