Association Between Use of Oral Contraceptives and Folate Status: A Systematic Review and Meta-Analysis

Shere, Mahvash; Bapat, Priya; Nickel, Cheri; Kapur, Bhushan; Koren, Gideon

doi:10.1016/s1701-2163(15)30258-9

Cited by 32 publications

(37 citation statements)

References 38 publications

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“…For decades it was suspected that the oral contraceptives decrease systemic levels of folic acid. This has been recently confirmed through meta‐analysis of 27 studies, indicating that women on oral contraceptives may need higher doses of folic acid to achieve the needed protective concentrations …”

Section: Methodsmentioning

confidence: 77%

Folic acid supplementation for pregnant women and those planning pregnancy: 2015 update

Chitayat

Matsui

Amitai

et al. 2015

The Journal of Clinical Pharma

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During the last decade critical new information has been published pertaining to folic acid supplementation in the prevention of neural tube defects (NTDs) and other folic acid–sensitive congenital malformations. These new data have important implications for women, their families, and health care professionals. We performed a review looking for the optimal dosage of folic acid that should be given to women of reproductive age who are planning or not avoiding conception to propose updated guidelines and thus help health care providers and patients. In addition to fortification of dietary staples with folic acid, women of reproductive age should supplement before conception with 0.4‐1.0 mg of folic acid daily as part of their multivitamins. In the United States all enriched rice is also fortified with folic acid at 0.7 mg per pound of raw rice. However, this is not the case in many countries, and it has been estimated that only 1% of industrially milled rice is fortified with folic acid. In countries where rice is the main staple (eg, China), this does not allow effective folate fortification. Whereas the incidence of NTDs is around 1/1000 in the United States, it is 3‐ to 5‐fold higher in Northern China and 3‐fold higher in India. A recent population‐based US study estimated that the reduction in NTD rates by folic acid is more modest than previously predicted. The potential of NTD prevention by folic acid is underutilized due to low adherence with folic acid supplementation, and calls for revising the policy of supplementation have been raised. We identified groups of women of reproductive age who may benefit from higher daily doses of folic acid, and this should be considered in current practice. These include women who have had previous pregnancies with NTDs, those who did not plan their pregnancy and hence did not supplement, and women with low intake or impaired adherence to daily folic acid supplementation. In addition, women with known genetic variations in the folate metabolic cycle, those exposed to medications with antifolate effects, smokers, diabetics, and the obese may benefit from higher doses of folic acid daily during the first trimester.

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Section: Methodsmentioning

confidence: 77%

Folic acid supplementation for pregnant women and those planning pregnancy: 2015 update

Chitayat

Matsui

Amitai

et al. 2015

The Journal of Clinical Pharma

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“…20,21 Both OC use and alcohol consumption can decrease folate levels, but research suggests that folate reduces or increases risk for colorectal cancer depending on the presence of polyps, so the timing of these exposures may be integral in carcinogenesis. [22][23][24][25]…”

Section: Discussionmentioning

confidence: 99%

Modification of the Associations Between Duration of Oral Contraceptive Use and Ovarian, Endometrial, Breast, and Colorectal Cancers

et al. 2018

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“…Depression occurs due to estrogen interference in the production of tryptophan; in these cases, it is better to discontinue OCP and treat depression. Also, this effect can be reduced by adding pyridoxine (36).…”

Section: Resultsmentioning

confidence: 99%

A Review of Recent Findings for Obstetricians about Combined Oral Contraceptive Pills

Aminimoghaddam

2017

J Obstet Gynecol Cancer Res

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Combined oral contraceptive pills (OCPs) contain estrogen (ethinylestradiol) and progesterone (first-generation levonorgestrel and fourthgeneration drospirenone). Progesterone has peripheral effects on the endometrium, fallopian tubes, and cervix and can promote contraception. These pills are used to prevent pain caused by Mittelschmerz syndrome and endometriosis and to treat hyperandrogenism. To prescribe contraceptives, it is adequate to take the patient's medical history and blood pressure. In the absence of risk factors, patients should be followed-up by history-taking, blood pressure measurement, urinalysis, Pap smear test, and examination of breasts, pelvis, and liver. The risk of venous thrombosis in new OCPs is twice higher than that of older generations and usually occurs in the first year of consumption. The only absolute contraindications for the use of new OCPs include chronic and acute cholestatic liver diseases. In fact, use of new OCPs increases the risk of liver adenoma, but not hepatocellular carcinoma. On the other hand, in female patients with genital tract cancers, risk of endometrial and ovarian epithelial cancers decreases following the use of OCPs. However, the risk of cervical adenocarcinoma increases after 5 years of consumption due to cervical eversion and impaired vitamin metabolism. These pills are contraindicated in women above 35 years who smoke more than 15 cigarettes daily or have uncontrolled hypertension, venous thromboembolism, migraine aura, severe hyperglycemia, breast cancer (diagnosed or suspected), or diabetes mellitus associated with cardiovascular diseases.

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Association Between Use of Oral Contraceptives and Folate Status: A Systematic Review and Meta-Analysis

Abstract: Because of the reduction in blood folate concentrations associated with the use of oral contraceptives, it is critical for women of childbearing age to continue folate supplementation during oral contraceptive use.

Cited by 32 publications

References 38 publications

Folic acid supplementation for pregnant women and those planning pregnancy: 2015 update

Folic acid supplementation for pregnant women and those planning pregnancy: 2015 update

Modification of the Associations Between Duration of Oral Contraceptive Use and Ovarian, Endometrial, Breast, and Colorectal Cancers

A Review of Recent Findings for Obstetricians about Combined Oral Contraceptive Pills

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