Hormonal Contraception. Guideline of the DGGG, OEGGG and SGGG (S3 Level, AWMF Registry Number 015/015, January 2020)

Franik, Sebastian; Bauersachs, Rupert; Beyer‐Westendorf, Jan; Buchholz, Tina; Diener, Hans‐Christoph; Erath, A.; Fischer, R.; Förderreuther, Stefanie; Franz, H. B. G.; Hach-Wunderle, V.; Hadji, P.; Harlfinger, Werner; Jaursch-Hancke, Cornelia; König, Klaus; Naumann, Gert; Neulen, Joseph; Oppelt, Patricia G.; Pliefke, Jutta; Rimbach, S.; Rott, Hannelore; Schroll, E.; Schumann, Claudia; Segerer, Sabine; Seyler, Helga; Tempfer, Clemens; Thonke, Ines; Tóth, Bettina; Wildt, L.; Zotz, Rainer B.; Stute, Petra; Kiesel, L.

doi:10.1055/a-1259-1609

Cited by 14 publications

(5 citation statements)

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“…LARCs are associated with high satisfaction and continuation rates as well as improved quality of life [ 3 – 9 ]. LARCs, particularly intrauterine contraceptives, are recommended in various international guidelines [ 10 – 13 ], including a joint guideline of the German, Austrian, and Swiss Societies for Gynecology and Obstetrics [ 14 ]. Despite these recommendations, intrauterine contraception accounts for only 14% of all contraceptive users worldwide [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

The use of LNG-IUS-19.5 mg in daily gynecological routine practice in Germany: data from the Kyleena™ Satisfaction Study (KYSS)

Römer,

Frenz,

Dietrich-Ott

et al. 2024

Arch Gynecol Obstet

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Purpose The Kyleena™ Satisfaction Study (KYSS) provided the first data on 19.5 mg levonorgestrel-releasing intrauterine system (LNG-IUS-19.5 mg) use in routine clinical practice. Here we report results from the German participants in KYSS. Methods This prospective, observational, single-arm cohort study recruited women who independently chose to use LNG-IUS-19.5 mg during routine counseling in Germany. Overall satisfaction and bleeding profile satisfaction, continuation rates, and safety profile were evaluated at 12 months or premature end of observation (EoO). Results In the German study population, LNG-IUS-19.5 mg placement was attempted in 508 women and successful in 506 women. Mean age was 32.3 years, and 60.0% (n = 305/508) were parous. Placement was considered easy and associated with no more than mild pain, even in younger and nulliparous participants. Of those with satisfaction data available, 87.6% (n = 388/443) were satisfied with LNG-IUS-19.5 mg at 12 months/EoO. Satisfaction was similar for parous (86.9%, n = 238/274) and nulliparous (88.8%, n = 150/169) women, and was independent of age, prior contraceptive method, or reason for choosing LNG-IUS-19.5 mg. Most participants (73.6%, n = 299/406) were also satisfied with their bleeding profile at 12 months/EoO, independent of parity, age, prior contraceptive method, presence of amenorrhea or dysmenorrhea severity. The 12-month continuation rate was 84.1% (n = 427/508). Most discontinuations were due to loss to follow-up (8.5%, n = 43/508) or treatment-emergent adverse events (TEAEs) (4.7%, n = 24/508). TEAEs were reported in 12.6% (n = 64) of participants, with 9.3% (n = 47) considered to have an LNG-IUS-19.5 mg-related TEAE. Conclusion Our real-world findings on LNG-IUS-19.5 mg use in German KYSS participants reflected its suitability for a broad population, including young and nulliparous women. Clinical trial registration NCT03182140 (date of registration: June 2017).

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Section: Introductionmentioning

confidence: 99%

The use of LNG-IUS-19.5 mg in daily gynecological routine practice in Germany: data from the Kyleena™ Satisfaction Study (KYSS)

Römer,

Frenz,

Dietrich-Ott

et al. 2024

Arch Gynecol Obstet

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“…91 Once OCPs are started, BP should be monitored at follow-up or routine visits with the frequency of recommended checks ranging from every 6 months to annually, depending on the society guideline (Table 2). 92,94,95,101,103 If BP increases significantly without another identifiable cause, ACOG recommends that the CHC be discontinued. 92 BP monitoring is not generally recommended during POP use.…”

Section: Clinical Recommendations For Oral Contraceptive Pill Usementioning

confidence: 99%

Oral Contraceptive Pills and Hypertension: A Review of Current Evidence and Recommendations

2023

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Oral contraceptive pills (OCPs) have been used as effective and popular forms of contraception since the middle of the last century. By 2019, over 150 million reproductive-aged individuals were using OCPs to prevent unintended pregnancies worldwide. Safety concerns regarding the effects of OCPs on blood pressure were reported soon after these pills gained approval. Although OCP doses were subsequently reduced, epidemiologic evidence continued to support a smaller, but significant association between OCPs and hypertension. Given the rising prevalence of hypertension, as well as the adverse effects of cumulative exposure to blood pressure elevations on cardiovascular disease risk, understanding the nature of the association between OCPs and hypertension is important for clinicians and patients to assess the risks and benefits of use, and make individualized decisions regarding contraception. Therefore, this review summarizes the current and historical evidence describing the association between OCP use and blood pressure elevations. Specifically, it identifies the pathophysiologic mechanisms linking OCPs to hypertension risk, describes the magnitude of the association between OCPs and blood pressure elevations, and distinguishes the effects of various OCP types on blood pressure. Finally, it describes current recommendations regarding hypertension and OCP use, as well as identifies strategies, such as over-the-counter OCP prescribing, to safely and equitably improve access to oral contraception.

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“…Estrogen-containing pills should be discontinued approximately 6 weeks prior to cessation of the anticoagulation in women having experienced at least one thrombotic episode. 27 Progestin-only pills can also be used with reports of success in reducing HMB. 28 POCs have the advantage that they can be continued after stop of anticoagulation due to their lower venous thrombotic risk.…”

Section: Therapeutic Approaches To Treat Aub and Hmb In Women Under O...mentioning

confidence: 99%

“…Estrogen-containing pills should be discontinued approximately 6 weeks prior to cessation of the anticoagulation in women having experienced at least one thrombotic episode. 27…”

Section: Introductionmentioning

confidence: 99%

Bleeding Issues in Women Under Oral Anticoagulation

Kalmanti

Lindhoff-Last

2022

Hamostaseologie

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In premenopausal women treatment with direct oral anticoagulants (DOACs) can be associated with an increased risk of heavy menstrual bleeding (HMB) compared with vitamin K antagonists. These findings come from retrospective or prospective single-center studies and post hoc analysis of regulatory studies in which HMB was not a predefined safety outcome. In most of these publications, there is a lack of information about the use of different contraceptive methods which can influence HMB. Another limitation is the various definitions of HMB, which makes comparison between studies regarding the incidences of HMB difficult.Therefore, prospective studies are urgently needed to investigate the severity and duration of unaffected menstrual bleeding under oral anticoagulation independently of oral contraceptives or intrauterine devices. An ongoing multicenter German registry is aiming to compare the incidence of unaffected HMB in consecutive women of reproductive age (18–50 years) treated with different DOACs because of venous thromboembolism.When HMB occurs during oral anticoagulation, management includes interruption or dose reduction of anticoagulation with the danger of recurrent venous thrombosis, switch to another oral anticoagulant, or additional use of the antifibrinolytic agent tranexamic acid with the potential risk of thrombosis. Concomitant use of either oral hormonal contraceptive therapy or hormone-releasing intrauterine systems can also reduce HMB.

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Hormonal Contraception. Guideline of the DGGG, OEGGG and SGGG (S3 Level, AWMF Registry Number 015/015, January 2020)

Cited by 14 publications

References 0 publications

The use of LNG-IUS-19.5 mg in daily gynecological routine practice in Germany: data from the Kyleena™ Satisfaction Study (KYSS)

The use of LNG-IUS-19.5 mg in daily gynecological routine practice in Germany: data from the Kyleena™ Satisfaction Study (KYSS)

Oral Contraceptive Pills and Hypertension: A Review of Current Evidence and Recommendations

Bleeding Issues in Women Under Oral Anticoagulation

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