Contraception in autoimmune diseases

Benagiano, Giuseppe; Benagiano, Marisa; Bianchi, Paola; D’Elios, Mario Milco; Brosens, Ivo

doi:10.1016/j.bpobgyn.2019.05.003

Cited by 18 publications

(13 citation statements)

References 75 publications

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“…Our observations suggest that contraceptive administration that results in a non-physiological temporal endocrine pattern may act as "hormonal jetlag. " This evidence is consistent with previous evidence that hormonal contraceptive use is associated with elevated body temperature (Baker et al, 2001), decoupling of follicular maturation cycles within the ovary (Obruca et al, 2001;Landersoe et al, 2020), weight change (Lopez et al, 2016;Okunola et al, 2019), mental health risks (Skovlund et al, 2016(Skovlund et al, , 2018Fruzzetti and Fidecicchi, 2020), lasting luteal phase deficiency (Gnoth et al, 2002), and a variety of other off target effects (Barr, 2010;Benagiano et al, 2019). Furthermore, women under 21 are more likely to exhibit anovulatory cycles following birth control cessation than are older individuals (Pinkerton and Carey, 1976), suggesting that contraceptives taken during late adolescence may be more disruptive than in adulthood.…”

Section: Considerations Of Rhythmicity Perturbation Through Adolescent Contraceptive Usesupporting

confidence: 91%

Adolescent Development of Biological Rhythms in Female Rats: Estradiol Dependence and Effects of Combined Contraceptives

2021

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Adolescence is a period of continuous development, including the maturation of endogenous rhythms across systems and timescales. Although, these dynamic changes are well-recognized, their continuous structure and hormonal dependence have not been systematically characterized. Given the well-established link between core body temperature (CBT) and reproductive hormones in adults, we hypothesized that high-resolution CBT can be applied to passively monitor pubertal development and disruption with high fidelity. To examine this possibility, we used signal processing to investigate the trajectory of CBT rhythms at the within-day (ultradian), daily (circadian), and ovulatory timescales, their dependence on estradiol (E2), and the effects of hormonal contraceptives. Puberty onset was marked by a rise in fecal estradiol (fE2), followed by an elevation in CBT and circadian power. This time period marked the commencement of 4-day rhythmicity in fE2, CBT, and ultradian power marking the onset of the estrous cycle. The rise in circadian amplitude was accelerated by E2 treatment, indicating a role for this hormone in rhythmic development. Contraceptive administration in later adolescence reduced CBT and circadian power and resulted in disruption to 4-day cycles that persisted after discontinuation. Our data reveal with precise temporal resolution how biological rhythms change across adolescence and demonstrate a role for E2 in the emergence and preservation of multiscale rhythmicity. These findings also demonstrate how hormones delivered exogenously in a non-rhythmic pattern can disrupt rhythmic development. These data lay the groundwork for a future in which temperature metrics provide an inexpensive, convenient method for monitoring pubertal maturation and support the development of hormone therapies that better mimic and support human chronobiology.

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Section: Considerations Of Rhythmicity Perturbation Through Adolescent Contraceptive Usesupporting

confidence: 91%

Adolescent Development of Biological Rhythms in Female Rats: Estradiol Dependence and Effects of Combined Contraceptives

2021

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“…The increase in estrogen and progesterone levels during pregnancy was found to have a protective effect against both the development and activity of RA [27,28]. It is reported that combined oral contraceptives may have a tendency of controlling disease activity in RA patients [29]. Our findings revealed that using oral contraceptives significantly reduced the clinical manifestations.…”

Section: Discussionsupporting

confidence: 57%

Impact of oral contraceptives and breastfeeding on disease activity in a sample of Egyptian rheumatoid arthritis patients

Elsayed

Henry

Elfadl

2020

Egypt Rheumatol Rehabil

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Background Women are more affected by rheumatoid arthritis (RA) than men and the incidence of RA in women increases around the age of menopause indicating that hormonal factors may have a role in disease pathogenesis and progression. Despite several studies on the role of sex hormones and oral contraceptives (OCs) in RA patients, the effect of combined oral contraceptives on RA disease activity is still controversial, and since few studies have been performed in Egypt on this issue so we aimed to study the effect of OCs, breastfeeding, and prolactin on disease activity and their relation to the titer of autoantibodies in female Egyptian RA patients. Results One hundred twenty married female RA patients were classified into three groups based on the OCs use (n = 40 each); current, past and non-users and according to lactation into three groups; lactating using OCs (n = 22), lactating not using OCs (n = 30), and non-lactating (n = 68). Our patients were using combined estrogen-progestin oral contraceptives. Clinical manifestations, disease activity, and laboratory findings were determined. The clinical manifestations including arthritis, and morning stiffness were significantly reduced in current users in comparison to past and non-users. Mean DAS28 was reduced significantly (p < 0.05) in current and past users of OCs. Also, using OCs during lactation reduced the clinical manifestations significantly. Lactating women who were not using OCs had significantly high DAS28 and ESR (p < 0.05) in comparison to lactating using OCs and non-lactating. On the other hand, using OCs reduced serum prolactin significantly. Lactating women not using OCs had significantly high serum prolactin (p < 0.05) and (p < 0.001) in comparison to lactating using OCs and non-lactating respectively which was correlated with DAS28 score. Conclusion Oral contraceptives may be considered in RA female patients not only as a suitable birth control method but also it has a controlling effect on disease activity even during lactation. Message Oral contraceptives ameliorate disease activity in RA patients

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“…11 The current unmet need among MWRA in Pakistan is 17%, including 33% MWRA who are not using contraception but intend to use in the future. 2 Other factors influencing a woman's access to FP information and services include her desire to use contraception, age, education, occupation, socio-economic status, region of residence, number of living children, underlying medical conditions [12][13][14] and exposure to mass media. [15][16][17] However, less is known about the reasons for discordance between knowledge and behaviour.…”

mentioning

confidence: 99%

The family planning “know–do” gap among married women of reproductive age in urban Pakistan

Yameen

Nausheen

Hussain

et al. 2021

public health action

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OBJECTIVE: To examine the prevalence and predictors of family planning (FP) know-do gaps among married women of reproductive age (MWRA) in low socio-economic urban areas of Karachi, Pakistan.DESIGN: This was a cross-sectional survey of randomly selected 7288 MWRA (16–49 years) to identify predictors of the know-do gap in FP using a logistic regression model.RESULTS: More than one third (35.5%) of MWRA had FP know-do gap, i.e., despite having a knowledge of contraceptives and desire to limit or delay childbearing, they were not using contraceptives. Women were less likely to use FP if they were getting older (25–35 years: OR 1.45, 95% CI 1.09–1.94; >35 years: OR 3.02, 95% CI 1.90–4.80), from certain ethnicities (Sindhi: OR 1.64, 95% CI 1.11–2.42; Saraiki: OR 1.66, 95% CI 1.01–2.71; other minorities: OR 2.37, 95% CI 1.63–3.44); did not receive FP counselling: OR 1.43, 95% CI 1.13–1.80; and had not made a joint decision on FP: OR 1.44, 95% CI 1.06–1.98). Conversely, women were more likely to use contraceptives if they had >10 years of schooling (OR 0.66, 95% CI 0.46–0.94), with each increasing number of a living child (OR 0.68, 95% CI 0.62–0.75) and each increasing number of contraceptive method known (OR 0.93, 95% CI 0.88–0.98).CONCLUSION: The predictors associated with the FP know-do gap among MWRA should be considered when planning future strategies to improve the contraceptive prevalence rate in Pakistan.

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Contraception in autoimmune diseases

Cited by 18 publications

References 75 publications

Adolescent Development of Biological Rhythms in Female Rats: Estradiol Dependence and Effects of Combined Contraceptives

Adolescent Development of Biological Rhythms in Female Rats: Estradiol Dependence and Effects of Combined Contraceptives

Impact of oral contraceptives and breastfeeding on disease activity in a sample of Egyptian rheumatoid arthritis patients

The family planning “know–do” gap among married women of reproductive age in urban Pakistan

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