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Oral Contraceptive


Presentation

  • A 13-year-old adolescent with a history of menorrhagia since menarche, presented to the pediatric emergency room with worsening abdominal pain and heavy vaginal bleeding stopping her oral contraceptive pill 10 days prior to presentation.[ncbi.nlm.nih.gov]
Galactorrhea
  • Oral contraceptive use has also been demonstrated to decrease incidence of galactorrhea.[glowm.com]
Nausea
  • A young female presented with acute left lower quadrant pain followed by nausea and vomiting. She was found to have haematuria and elevated serum creatine.[ncbi.nlm.nih.gov]
  • You may have slight nausea the first month, but this usually goes away with time.[youngwomenshealth.org]
  • […] your tag names separated by a space and hit enter Links Publisher Full Text Authors Source MeSH Adult Amenorrhea Clinical Trials as Topic Contraceptives, Oral Endometrium Ethinyl Estradiol Female Headache Humans Megestrol Menorrhagia Mucus Muscle Cramp Nausea[unboundmedicine.com]
  • Nausea and vomiting are common.[slideshare.net]
Abdominal Pain
  • The abdominal wall might be considered to be an unlikely source of prolonged abdominal pain, but one study reported that in 15% of patients with prolonged, nonspecific abdominal pain, the abdominal wall was the source of the complaint.[ncbi.nlm.nih.gov]
Hypertension
  • A meta-analysis was conducted to evaluate the association between duration of oral contraceptive use and risk of hypertension.[ncbi.nlm.nih.gov]
  • The relationship between these laboratory findings and the development of hypertension in susceptible individuals is not clearly defined.[annals.org]
  • Predictive value of routine blood pressure measurements in screening for hypertension. Am J Epidemiol . 1983 ; 117 :429-442. Crossref Medline Google Scholar 21 Woods JW. Oral contraceptives and hypertension.[ahajournals.org]
  • […] artery disease Carcinoma of the breast or other estrogen-dependent neoplasia Undiagnosed abnormal genital bleeding Known or suspected pregnancy Benign or malignant liver tumor Relative contraindications to contraceptives include: Age over 45 Diabetes Hypertension[library.med.utah.edu]
Corneal Opacity
  • A 23-year-old woman was referred for evaluation of bilateral corneal opacities. The location of the deposits deep in Descemet's membrane and appearance made copper deposition a likely consideration.[ncbi.nlm.nih.gov]
Corneal Deposit
  • With cessation of the oral contraceptive, her serum copper levels normalized, but the corneal deposits remained after 5 months of follow up.[ncbi.nlm.nih.gov]
Hirsutism
  • Certain types of progestins have more potent antiandrogenic properties and are more effective in treating acne, hirsutism, and polycystic ovary syndrome.[ncbi.nlm.nih.gov]
  • Acne and hirsutism may be improved with the use of more estrogenic formulations and the newest progestin formulations.[aafp.org]
  • The EMA reminded prescribers that these preparations should only be used for the treatment of moderate to severe acne related to androgen sensitivity or hirsutism in women of reproductive age.[who.int]
  • COCPs are preferred in women who also suffer from uncontrolled acne and symptoms of hirsutism, or male patterned hair growth, because COCPs can help treats these symptoms.[en.wikipedia.org]
Acne Vulgaris
  • Obstet Gynecol 89:615-622, 1997 41 Lucky AW, Henderson TA, Olson WH, et al: Effectiveness of norgestimate and ethinyl estradiol in treating moderate acne vulgaris.[glowm.com]
Alopecia
  • Myth: General Health Problems Some women believe that COCs cause hair loss (alopecia), asthma, and headaches.[ippf.org]
Chloasma
  • Chloasma (spotty darkening of the skin on the face). Darkening of the skin on the upper lip, cheeks, forehead, or under the eyes (chloasma). This may slowly fade after you stop taking the pills, but in most cases, it is permanent.[emedexpert.com]
Striae Distensae
  • A case of striae distensae (SD) of bilateral augmented breasts following oral contraceptive therapy is presented.[ncbi.nlm.nih.gov]
Decreased Libido
  • Some researchers question a causal link between COCP use and decreased libido; a 2007 study of 1700 women found COCP users experienced no change in sexual satisfaction.[en.wikipedia.org]
Stroke
  • RESULTS: Women with rs1256065 CC genotype were at a 1.59 fold increased risk of stroke. Subtype analyses showed that the risk genotype of rs1256065 was associated with ischemic stroke, but not with hemorrhagic stroke.[ncbi.nlm.nih.gov]
  • Obesity Is Risk Factor for Rare Type of Stroke in Women Using Oral Contraceptives Mar. 14, 2016 — Obese women who used oral contraceptives appeared to have increased risk for a rare type of stroke known as a cerebral venous thrombosis (CVT) compared with[sciencedaily.com]
  • […] in Women, Stroke, 45 :5, (1545-1588), Online publication date: 1-May-2014.[ahajournals.org]
Headache
  • KEYWORDS: Aetiology; Headache; Oral contraceptive; Patent foramen ovale[ncbi.nlm.nih.gov]
  • Viral Hepatitis, Cirrhosis ) Undiagnosed Vaginal Bleeding Pregnancy Breast Cancer Migraine Headache with aura See Migraine Headache in Women See Cerebrovascular Accident Risk in Women Also contraindicated in Migraine Headache without aura in women over[fpnotebook.com]
Amenorrhea
  • Type your tag names separated by a space and hit enter Links Publisher Full Text Authors Source MeSH Adult Amenorrhea Clinical Trials as Topic Contraceptives, Oral Endometrium Ethinyl Estradiol Female Headache Humans Megestrol Menorrhagia Mucus Muscle[unboundmedicine.com]
  • OCs may cause breakthrough bleeding (which may resolve with time or when the estrogen dose is increased) or amenorrhea; amenorrhea, if not acceptable, may resolve when the progestin dose is decreased.[merckmanuals.com]
  • Amenorrhea Amenorrhea (including hypothalmic amenorrhea) is a condition in which there is an absence of menstrual periods in a woman. There...[medicinenet.com]
  • . * P 0.001 statistically significant difference for asoprisnil 10 mg or 25 mg versus placebo for change from baseline, using the Hochberg multiple comparison procedure with an initial critical P 0.05 Percentage of women with incremental amenorrhea by[humrep.oxfordjournals.org]
Metrorrhagia
  • Premenstrual syndrome Hirsutism Ovarian and endometrial cancer Functional ovarian cysts Benign breast cysts Ectopic pregnancy Acne Endometriosis TABLE 2 Noncontraceptive Benefits of Oral Contraceptive Pills* Dysmenorrhea Mittelschmerz Metrorrhagia Premenstrual[aafp.org]

Workup

  • The diagnostic workup, therefore, often includes superfluous and expensive tests, as well as invasive procedures which do not contribute to the final diagnosis.[ncbi.nlm.nih.gov]
Estrogen Increased
  • Oral contraceptives containing high-dose estrogen increased breast cancer risk 2.7-fold, while those containing moderate-dose estrogen presented a 1.6-fold increased risk.[medicalnewstoday.com]
  • Thus, estrogen increases plasma concentrations of these clotting factors by increasing gene transcription.[ebmconsult.com]
  • Estrogens increase aldosterone production and cause sodium retention, which can cause dose-related, reversible increases in BP and in weight (up to about 2 kg). Weight gain may be accompanied by bloating, edema, and breast tenderness.[merckmanuals.com]
  • Estrogens increase the liver's ability to manufacture clotting factors. Because of this, patients receiving warfarin ( Coumadin ) need to be monitored for loss of anticoagulant (blood thinning) effect if an estrogen is begun.[medicinenet.com]
Hypertriglyceridemia
  • She developed severe worsening of preexisting hypertriglyceridemia after treatment with oral contraceptive pills (OCP) for polycystic ovary syndrome. Her hypertriglyceridemia improved upon OCP discontinuation.[ncbi.nlm.nih.gov]
  • The estrogen in OCs increases triglyceride levels and can exacerbate preexisting hypertriglyceridemia. Most alterations in serum levels of other metabolites are not clinically significant.[merckmanuals.com]
  • The status of hypertriglyceridemia as a risk factor for coronary heart disease . Clin Lab Med 1989 ; 9: 153 –68. 32. Kannel WB. . Metabolic risk factors for coronary heart disease in women: perspective from the Framingham Study .[nejm.org]
  • Severe hypercholesterolemia and hypertriglyceridemia are also currently contraindications, but the evidence showing that COCP's lead to worse outcomes in this population is weak. Obesity is not considered to be a contraindication to taking COCPs .[en.wikipedia.org]
Hypercholesterolemia
  • Severe hypercholesterolemia and hypertriglyceridemia are also currently contraindications, but the evidence showing that COCP's lead to worse outcomes in this population is weak. Obesity is not considered to be a contraindication to taking COCPs .[en.wikipedia.org]
  • The patient who is sedentary, is overweight, smokes heavily, is hypertensive, is diabetic, or has hypercholesterolemia is clearly at risk. Hepatocellular adenoma: These benign liver tumors have been associated with the use of oral contraceptives.[emedicine.medscape.com]
Hepatocellular Carcinoma
  • Hepatocellular carcinoma (HCC) is one of the most common malignancies in certain parts of the world, particularly in Africa and Asia, but it is less commonly encountered in the United States.[ncbi.nlm.nih.gov]

Treatment

Prognosis

  • The association between tumor cyclooxygenase 2 (COX-2) expression and breast cancer prognosis has been inconsistent.[ncbi.nlm.nih.gov]
  • Endometriosis (Symptoms, Causes, Treatments, and Prognosis) Endometriosis implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines,...[medicinenet.com]

Etiology

  • All under- went a complete etiological examination including assessment for the thermolabile C677T mutation in the methylenetetrahydrofolate reductase (MTHFR) gene mutation.[ncbi.nlm.nih.gov]
  • In rare cases in which myocardial infarcts have been found, the cause has been noted to be of thrombotic rather than of atherosclerotic etiology.[emedicine.medscape.com]

Epidemiology

  • Further, the significant association between OC use and reduced KynA as well as increased CRP, could conceivably partially account for the epidemiological association between OC use and depression.[ncbi.nlm.nih.gov]
  • Cancer Epidemiology, Biomarkers & Prevention 2013; 22(11):1931-1943. [PubMed Abstract] Collaborative Group on Epidemiological Studies on Endometrial Cancer.[cancer.gov]
Sex distribution
Age distribution

Pathophysiology

  • However, the patient had positive anti-basal ganglia antibodies, which supports an immunological basis for the pathophysiology of this chorea.[ncbi.nlm.nih.gov]

Prevention

  • There is no doubt about the preventive role of oral contraceptive pills (OCPs) in development of ovarian cancers.[ncbi.nlm.nih.gov]
  • Progestin-only pills primarily work by thickening the cervical mucus and less often they prevent ovulation. Taking birth control pills daily maintains the level of hormones that is needed to prevent pregnancy.[shcs.ucdavis.edu]
  • Oral contraceptives prevent pregnancy, but they do not prevent sexually transmitted diseases, such as HIV/AIDS.[uspharmacist.com]
  • Food & Drug Administration mandated a warning on the label that it would prevent ovulation. And women quickly learned that this pill would prevent pregnancy. By 1959 over 500,000 American women used Enovid for contraception.[case.edu]

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