Transdermal Contraception as a Model for Adolescent Use of New Methods

Sucato, Gina S.; Bhatt, Suraj K.; Murray, Pamela J.; Ott, Mary A.

doi:10.1016/j.jadohealth.2011.01.008

Cited by 17 publications

(21 citation statements)

References 19 publications

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“…Previous research has highlighted the role of the media in promoting interest in the patch. 26 We agree with other authors who have asserted that women who choose a nondaily method over the pill may have different behavioral characteristics or expectations that could interfere with method continuation and perfect use. 11,27 Nonetheless, the 57% one-year patch continuation rate reported by Bakhru (participant average age 21 years) is higher than the 25e50% that has been found in other yearlong studies of adolescent patch users 25,28 or in our study at nine months (38%).…”

Section: Discussionsupporting

confidence: 86%

“…Our anecodotal observations that patch users are concerned about the visibility as well as the potential health risks associated with the patch have been substantiated in the literature. 26,45 With regard to the risk of venous thromboembolism which has prompted the FDA to approve label changes for the patch, we concur with other authors that the baseline risk in healthy adolescents is low, and that the patch remains a safe and viable contraceptive option for young women. 45 The findings of our study highlight the fact that, despite apparent advantages of the patch over the pill, the patch does not meet the challenges of achieving perfect and sustained contraceptive use.…”

Section: Discussionsupporting

confidence: 83%

See 1 more Smart Citation

Adolescents’ Experiences Using the Contraceptive Patch versus Pills

Sucato

Land

Murray

et al. 2011

Journal of Pediatric and Adolescent Gynecology

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Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 83%

Adolescents’ Experiences Using the Contraceptive Patch versus Pills

Sucato

Land

Murray

et al. 2011

Journal of Pediatric and Adolescent Gynecology

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“…183 Side effects of the patch are largely similar to other combined methods, with the addition of local adverse effects, such as dislodged patches and hyperpigmentation, 175,176 contact dermatitis and other skin irritation, 184 and concerns about the visibility and appearance of the patch. 185,186 Investigations into the patch' s effect on bone health have yielded inconsistent results, with findings in adults 150,151 more reassuring than those in adolescents. 187 However, this limited work is far from conclusive.…”

Section: Pediatrics Volume 134 Number 4 October 2014 E1267mentioning

confidence: 99%

Contraception for Adolescents

Ott

Sucato²

2014

Pediatrics

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244

133

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A working knowledge of contraception will assist the pediatrician in both sexual health promotion as well as treatment of common adolescent gynecologic problems. Best practices in adolescent anticipatory guidance and screening include a sexual health history, screening for pregnancy and sexually transmitted infections, counseling, and if indicated, providing access to contraceptives. Pediatricians’ long-term relationships with adolescents and families allow them to help promote healthy sexual decision-making, including abstinence and contraceptive use. Additionally, medical indications for contraception, such as acne, dysmenorrhea, and heavy menstrual bleeding, are frequently uncovered during adolescent visits. This technical report provides an evidence base for the accompanying policy statement and addresses key aspects of adolescent contraceptive use, including the following: (1) sexual history taking, confidentiality, and counseling; (2) adolescent data on the use and side effects of newer contraceptive methods; (3) new data on older contraceptive methods; and (4) evidence supporting the use of contraceptives in adolescent patients with complex medical conditions.

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“…There is evidence for cognitive benefits of tonic estrogen delivery; in randomized, placebo-controlled studies on women with mild-moderate probable Alzheimer’s disease, transdermal E2 positively affects multiple measures of cognition (Asthana et al, 1999; Wharton et al, 2011). A study evaluating transdermal versus oral contraceptives found no difference in quality of life, side effects or regularity of the menses; however, more patch users reported a favorable impact on “daily activities” (Sucato et al, 2011). Additionally, metabolism by the liver following oral estrogen administration is linked to increases in markers of thromboembolic side effects, whereas transdermal administration is not (Scarabin et al, 1997; Decensi et al, 2002; Post et al, 2003).…”

Section: 0 Introductionmentioning

confidence: 99%

Understanding the cognitive impact of the contraceptive estrogen Ethinyl Estradiol: Tonic and cyclic administration impairs memory, and performance correlates with basal forebrain cholinergic system integrity

Mennenga

Gerson

Koebele

et al. 2015

Psychoneuroendocrinology

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Ethinyl estradiol (EE), a synthetic, orally bio-available estrogen, is the most commonly prescribed form of estrogen in oral contraceptives, and is found in at least 30 different contraceptive formulations currently prescribed to women as well as hormone therapies prescribed to menopausal women. Thus, EE is prescribed clinically to women at ages ranging from puberty to reproductive senescence. Here, in two separate studies, the cognitive effects of cyclic or tonic EE administration following ovariectomy (Ovx) were evaluated in young female rats. Study I assessed the cognitive effects of low and high doses of EE, delivered tonically via a subcutaneous osmotic pump. Study II evaluated the cognitive effects of low, medium, and high doses of EE administered via a daily subcutaneous injection, modeling the daily rise and fall of serum EE levels with oral regimens. Study II also investigated the impact of low, medium and high doses of EE on the basal forebrain cholinergic system. The low and medium doses utilized here correspond to the range of doses currently used in clinical formulations, and the high dose corresponds to doses prescribed to a generation of women between 1960 and 1970, when oral contraceptives first became available. Here, we evaluate cognition using a battery of maze tasks tapping several domains of spatial learning and memory and basal forebrain cholinergic integrity by using immunohistochemistry and unbiased stereology to estimate the number of choline acetyltransferase (ChAT)-producing cells in the medial septum and vertical/diagonal bands. At the highest dose, EE treatment impaired multiple domains of spatial memory relative to vehicle treatment, regardless of administration method. When given cyclically at the low and medium doses, EE did not impact working memory, but transiently impaired reference memory during the learning phase of testing. Of the doses and regimens tested here, only EE at the highest dose impaired several domains of memory; tonic delivery of low EE, a dose that corresponds to the most popular doses used in the clinic today, did not impact cognition on any measure. Both medium and high doses of EE reduced the number of cholinergic cells in the basal forebrain and cell population estimates in the vertical/diagonal bands negatively correlate with working memory errors.

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Transdermal Contraception as a Model for Adolescent Use of New Methods

Cited by 17 publications

References 19 publications

Adolescents’ Experiences Using the Contraceptive Patch versus Pills

Adolescents’ Experiences Using the Contraceptive Patch versus Pills

Contraception for Adolescents

Understanding the cognitive impact of the contraceptive estrogen Ethinyl Estradiol: Tonic and cyclic administration impairs memory, and performance correlates with basal forebrain cholinergic system integrity

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