Cervical mucus and contraception: what we know and what we don't

Han, Leo; Taub, Rebecca; Jensen, Jeffrey T.

doi:10.1016/j.contraception.2017.07.168

Cited by 48 publications

(41 citation statements)

References 106 publications

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“…The primary mechanism of action is to inhibit ovulation. Similar to the progestin-containing IUD, it also thins the endometrial lining and thickens the cervical mucus [30,46]. The etonogestrel implant has an extremely low failure rate, comparable to that for permanent sterilization [28].…”

Section: Most Effective With Fewest Contraindications: Intrauterine mentioning

confidence: 99%

Contraception for the Cardiac Patient: a Cardiologist’s Primer

Florio

Kao

Johnson

et al. 2020

Curr Treat Options Cardio Med

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Purpose of review Cardiovascular disease (CVD) is the number one cause of maternal mortality in the USA. There are many cardiac conditions which pose significant risk to maternal health, and these women should be offered options to avoid unwanted pregnancies. Individualized contraceptive counseling focusing on woman’s desire for future pregnancy, comorbid conditions, and desire for hormone or non-hormonal (contraceptive) options is paramount to avoid adverse or unwanted side effects. The purpose of this review is to give general guidance on prescribing both hormonal and non-hormonal contraceptives for providers caring for women with heart disease. Recent findings Specific recommendation for the use of either non-hormonal or hormonal contraception requires knowledge of the types of contraceptive options available, cost, failure rates, and contraindications to use. Newer progestin-only options have become available and should be considered first-line therapy for women with cardiovascular disease. Summary The physiologic burden of pregnancy on the cardiovascular system can cause significant maternal morbidity and mortality for women with underlying CVD. These women should be offered safe and effective options for birth control, and both cardiology and obstetrical providers alike should possess fundamental knowledge of appropriate options.

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Section: Most Effective With Fewest Contraindications: Intrauterine mentioning

confidence: 99%

Contraception for the Cardiac Patient: a Cardiologist’s Primer

Florio

Kao

Johnson

et al. 2020

Curr Treat Options Cardio Med

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“…Additionally, different HC delivery methods may have different mechanisms of action (e.g., systemic versus local), and consequently the required HC target dose levels will depend on the specific administration mode. While some HCs such as oral contraceptives, intravaginal rings or injectables largely function systemically by suppressing ovulation, other topically administered methods such as vaginal films and IUDs may work by creating unfavourable local conditions for sperm penetration, sperm capacitation and fertilisation [34].…”

Section: Action Area 4: Selecting An Effective Target Dose For Hcmentioning

confidence: 99%

“…In addition to relying on the Pearl Index for measuring contraceptive efficacy, other pharmacodynamic surrogate markers have been tested to evaluate whether ovulation or changes in cervical mucus quality might be reliable future predictors of pregnancy risk [34]. This work targets the development of new, reliable local and systemic surrogate markers that could predict contraceptive efficacy.…”

Section: Progress To Datementioning

confidence: 99%

A strategic action framework for multipurpose prevention technologies combining contraceptive hormones and antiretroviral drugs to prevent pregnancy and HIV

Holt

Dellplain

Creinin

et al. 2018

The European Journal of Contraception & Reproductive Health

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Objective: Multipurpose prevention technologies (MPTs) are an innovative class of products that deliver varied combinations of human immunodeficiency virus (HIV) prevention, other sexually transmitted infection (STI) prevention, and contraception. Combining separate strategies for different indications into singular prevention products can reduce the stigma around HIV and STI prevention, improve acceptability of and adherence to more convenient products, and be more cost-effective by addressing overlapping risks. Methods: This article outlines a strategic action framework developed as an outcome of a series of expert meetings held between 2014 and 2016. The meetings focused on identifying opportunities and challenges for MPTs that combine hormonal contraception (HC) with antiretroviral drugs into single products. The framework aims to present an actionable strategy, by addressing key research gaps and outlining the key areas for progress, to guide current and future HC MPT development. Results: We identified eight primary action areas for the development of impactful HC MPTs, and includes aspects from epidemiology, pharmacology, clinical trial design, regulatory requirements, manufacturing and commercialisation, behavioural science, and investment needs for research and development. Conclusion: Overall, the challenges involved with reconciling the critical social-behavioural context that will drive MPT product use and uptake with the complexities of research and development and regulatory approval are of paramount importance. To realise the potential of MPTs given their complexity and finite resources, researchers in the MPT field must be strategic about the way forward; increased support among policy-makers, advocates, funders and the pharmaceutical industry is critical.

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“…Although a study examining cervical mucus in 28 women throughout 7-, 9- and 11-day CFIs in four cycles reported that cervical mucus remained unfavourable to sperm penetration, the authors remark on the individual variation in response 23. A recent review found the existing evidence base to be very limited for the contribution of progestogen-affected mucus to contraceptive efficacy 24. Furthermore, any such effect of the progestogen component of COCs must be at its lowest if a fertile ovulation is pending, whether due to a true ‘pill-failure’ after a 7-day CFI or after a lengthened CFI, as it will be at least 168 hours since the progestogen was last ingested.…”

Section: Contraceptive Effectivenessmentioning

confidence: 99%