Progestin-only contraception and thromboembolism: A systematic review

Tepper, Naomi K.; Whiteman, Maura K.; Marchbanks, Polly A.; James, Andra H.; Curtis, Kathryn M.

doi:10.1016/j.contraception.2016.04.014

Cited by 170 publications

(107 citation statements)

References 51 publications

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“…Regarding the risk of venous thrombo-embolism (VTE), the majority of studies did not suggest an increase in odds for venous or arterial events with progesterone treatment. However, a few studies suggested an increase of VTE with use of injectable progestins for therapeutic indications (26). One of them suggested that the odds of VTE are higher among smokers using high-dose of progestin compared with smokers who did not use this hormonal treatment (27).…”

Section: Discussionmentioning

confidence: 99%

Fertility Sparing Treatment in Patients With Early Stage Endometrial Cancer, Using a Combination of Surgery and GnRH Agonist: A Monocentric Retrospective Study and Review of the Literature

et al. 2018

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Objectives: To evaluate the efficacy and safety of gonadotropin-releasing hormone (GnRH) agonist after endometrial resection in women suffering early stage endometrial carcinoma (EC) and/or endometrial intra-epithelial neoplasia (EIN).Design: A retrospective review of clinical files between January 1999 and December 2016.Setting: University hospital.Patients: Eighteen women younger than 41 years with grade 1 endometrial carcinoma (G1EC) and/or Endometrial intra-epithelial neoplasia (EIN). Interventions: All patients received GnRH agonist for 3 months after an endometrial resection combined with a laparoscopy to exclude concomitant ovarian tumor and/or other extra-uterine disease. The patient underwent a follow-up of 3 months interval with endometrial sampling by hysteroscopy.Main Outcome Measure(s): The recurrence rate and the pregnancy rate after fertility sparing treatment.Results: We identified 9 patients with EIN (50%), 7 patients with G1EC (38.9%), 1 with combined histology (5.5%), and 1 with G2EC (5.5%). After a median follow-up of 40.7 months, 12 patients conserved their uterus (66.7%), and 8 (53.3%) patients were pregnant with a total of 14 pregnancies among those who tried to become pregnant. We observed a complete response rate in 12 patients (66.7%) but 3 of these patients relapsed (25%). We also found a stable disease in 6 patients (33.3%).Conclusions: Compared with other fertility sparing treatments, GnRH agonist after surgery is an effective fertility-sparing strategy for women with EIN and/or G1EC. We recommend hysterectomy once a family has been completed even if the literature does not clearly lead to radical surgery.

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Section: Discussionmentioning

confidence: 99%

Fertility Sparing Treatment in Patients With Early Stage Endometrial Cancer, Using a Combination of Surgery and GnRH Agonist: A Monocentric Retrospective Study and Review of the Literature

et al. 2018

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“…Progestin-only contraceptives are recommended for use in women in whom estrogen-containing formulations are contraindicated [1]. Their safety, effectiveness and low cost explain their worldwide use particularly in countries with limited healthcare access.…”

Section: Introductionmentioning

confidence: 99%

Thrombin impairs human endometrial endothelial angiogenesis; implications for progestin-only contraceptive-induced abnormal uterine bleeding

et al. 2017

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“…However, it should be noted that the use of progestogen-only contraceptives and non-hormonal contraceptives is recommended for women with cardiovascular risk factors, thereby avoiding the effects of increased cardiovascular risk generated by combined hormonal contraceptives [23]. The use of progestogen-only contraceptives has a lower risk of thromboembolic events [19,24], causes no changes in blood pressure [18] and may be indicated in most chronic diseases [23].…”

Section: Discussionmentioning

confidence: 99%

Effect of Coadministration of Etonogestrel Implant and Antiretroviral Therapies Containing Efavirenz or Lopinavir/Ritonavir on the Metabolism of Women Living with HIV/AIDS

Pr¹,

ini²,

Bahamondes³

et al. 2017

J AIDS Clin Res

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IntroductionUnplanned pregnancy is a health problem affecting all countries, particularly developing countries [1]. In vulnerable populations, the rate of unplanned pregnancies is even higher than that of general population. In Brazil, the rate of unplanned pregnancies among women living with HIV infection/AIDS exceeds 70% [2], whereas this rate is 55.4% among the general population [3]. Adequate contraception prevents unintended pregnancies, unsafe abortions, and maternal and newborn deaths, and helps to prevent vertical transmission of HIV infection [4].Family planning of women living with HIV infection/AIDS has a direct effect on their health and is a key strategy of the World Health Organization (WHO) to reduce vertical transmission [5]. In Brazil, the vertical transmission rate decreased to 33.3% in the last 10 years [6]. However, considering the high rates of unplanned pregnancy among these women, investment in family planning could contribute to further decrease vertical transmission rates. A 50% decrease in the number of births among women living with HIV infection/AIDS would be associated with a decrease from 27% to 5% in vertical transmission rate, resulting in an approximately 90% decrease in the number of children with HIV infection [7].In Brazil, since 2013, the number of people using antiretroviral therapy (ART) increased to 30%, and most of this population is of reproductive age [8]. Thus, the safety of hormonal contraceptive coadministration with the ARTs most often used by women living with HIV infection/AIDS must be known when prescribing hormonal contraceptives to these women. A recent study that evaluated the pharmacokinetic interaction between the two ART regimens most commonly used in Brazil showed that co-administration of etonogestrel (ENG) implant, the most effective contraceptive available, with ART containing lopinavir/ritonavir resulted in a 52% increase in ENG bioavailability, whereas co-administration with ART containing AbstractBackground: Concomitant use of antiretroviral therapy (ART) and hormonal contraceptives should be safe for women while maintaining medication efficacy without causing significant immunological or metabolic changes. However, the metabolic effect of the concomitant use of etonogestrel (ENG)-releasing implant and commonly used ARTs is not known.

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Progestin-only contraception and thromboembolism: A systematic review

Cited by 170 publications

References 51 publications

Fertility Sparing Treatment in Patients With Early Stage Endometrial Cancer, Using a Combination of Surgery and GnRH Agonist: A Monocentric Retrospective Study and Review of the Literature

Fertility Sparing Treatment in Patients With Early Stage Endometrial Cancer, Using a Combination of Surgery and GnRH Agonist: A Monocentric Retrospective Study and Review of the Literature

Thrombin impairs human endometrial endothelial angiogenesis; implications for progestin-only contraceptive-induced abnormal uterine bleeding

Effect of Coadministration of Etonogestrel Implant and Antiretroviral Therapies Containing Efavirenz or Lopinavir/Ritonavir on the Metabolism of Women Living with HIV/AIDS

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