OBJECTIVE: Combined oral contraceptives (COCs) have some adverse effects on the serum lipid profile. Because hyperlipidemia is one of the risk factors in cardiovascular diseases, lipid abnormalities should be evaluated in women consuming COCs. Vitamins E and C are known to have beneficial effects on serum lipid profiles. Therefore, in this study, we evaluated the effects of vitamins E and C on serum lipids in women using COCs. METHODS: The study compared changes in lipid parameters with and without vitamin therapy in women consuming COCs compared to those of a control group (40 non-contraceptive users or NCU) for 4 weeks. Total cholesterol and triglyceride, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels along with HDL/LDL ratios were measured for all participants. RESULTS: COC users experienced significantly higher increases in the levels of triglycerides and LDL than non-users (p<0.05). However, no significant differences were noted in the total cholesterol and HDL levels. In the treated COC group receiving vitamins E and C, the HDL level and the HDL/LDL ratio increased and the LDL and triglycerides levels decreased significantly compared with those of the other groups. CONCLUSION: The results of our study indicate that supplementation with antioxidant vitamins E and C restores a normal lipid profile in COC users.
Cardiovascular Diseases ; Cholesterol ; Contraceptives, Oral* ; Contraceptives, Oral, Combined ; Female ; Humans ; Hyperlipidemias ; Lipoproteins ; Risk Factors ; Triglycerides ; Vitamins*

This study assesses the efficacy and safety of a 24-day regimen of drospirenone-containing combined oral contraceptive, and demonstrates that it is an effective and safe option for contraception, releasing symptom of premenstrual dysphoric disorder and acne in Korean women.
Acne Vulgaris ; Contraception ; Contraceptives, Oral, Combined ; Female ; Humans ; Korea

combined oral contraceptives (COCs) on polycystic ovarian morphology (PCOM) and serum anti-Müllerian hormone (AMH) levels in Korean women with polycystic ovary syndrome (PCOS).METHODS: This university hospital study enrolled 36 Korean women who were newly diagnosed with PCOS based on the Rotterdam criteria and were treated with COCs for at least 1 year. We retrospectively evaluated the ovarian volume and number of antral follicles using ultrasonography and assessed serum AMH levels at baseline and after 1 year of COC treatment.RESULTS: Significant decreases in ovarian volume and antral follicle count were observed after 1 year of COC treatment. Compared to baseline, serum AMH levels were significantly decreased after 1 year.CONCLUSION: COC treatment significantly affects ultrasound-assessed PCOM and serum AMH levels of patients with PCOS.]]>
Contraceptives, Oral, Combined ; Female ; Humans ; Polycystic Ovary Syndrome ; Retrospective Studies ; Ultrasonography

Venous thromboembolism is well known as one of the rare but serious adverse effects of combined oral contraceptives (COCs). The COCs with third and fourth generation progestogens were found to have higher risk of venous thrombosis than those with second generation progestogens. We present a case of pulmonary embolism in a 23-year-old nulligravid woman who was using COCs containing the third generation progestogen (desogestrel). At the time of presentation of the adverse effect, she had been using the COCs for 4 months. She had no additional risk factors for thrombosis such as smoking, surgery, tumor as well as genetic factors. This case demonstrates even young women in otherwise good health may be at risk of venous thromboembolism from low-dose formulations of COCs as an over-the-counter drug. We describe this case with a brief review of literatures.
Contraceptives, Oral* ; Contraceptives, Oral, Combined ; Desogestrel* ; Female ; Humans ; Progestins ; Pulmonary Embolism* ; Risk Factors ; Smoke ; Smoking ; Thrombosis ; Venous Thromboembolism ; Venous Thrombosis ; Young Adult

OBJECTIVE: To compare real-life clinical outcomes with the levonorgestrel-releasing intrauterine system (LNG-IUS) and conventional medical therapies (CMTs), including combined oral contraceptives and oral progestins in the treatment of idiopathic heavy menstrual bleeding (HMB) in South Korea. METHODS: This prospective, observational cohort study recruited a total of 647 women aged 18 to 45 years, diagnosed with HMB from 8 countries in Asia, including 209 women from South Korea (LNG-IUS, 169; CMTs, 40), who were followed up to one year. The primary outcome was cumulative continuation rate (still treated with LNG-IUS and CMTs) at 12 months. Secondary outcomes included bleeding pattern, assessment of the treatment efficacy by treating physician and safety profile. RESULTS: The continuation rate at 12 months was significantly higher with the LNG-IUS than CMTs (85.1% vs. 48.5%, respectively; P<0.0001). The 51.5% of CMTs patients discontinued treatment and 18.8% of LNG-IUS patients discontinued treatment. The most common reasons for discontinuation for CMTs were switching to another treatment and personal reasons. When compared to CMTs, the LNG-IUS offered better reduction in subjectively assessed menstrual blood loss and the number of bleeding days, tolerability and with better efficacy in HMB, as assessed by physician's final evaluation. CONCLUSION: This study provides novel information on the real-life treatment patterns of HMB in South Korea. The efficacy of CMTs was inferior compared to the LNG-IUS in the clinical outcomes measured in this study. Due to the better compliance with LNG-IUS, the cumulative continuation rate is higher than CMTs. We conclude that the LNG-IUS should be used as the first-line treatment for HMB in Korean women, in line with international guidelines.
Asia ; Asian Continental Ancestry Group* ; Cohort Studies ; Compliance ; Contraceptives, Oral, Combined ; Female ; Hemorrhage* ; Humans ; Korea ; Progestins ; Prospective Studies ; Treatment Outcome

In view of continuous clinical reports of liver damage following oral contraceptive use, morphologic changes of the liver following the administration of a combined type of oral contraceptive (Norinyle) were studied in guinea pigs by light and electron microscopic examinations. Two interesting changes, one in Kupffer cells and another in the hepatocytes were observed. The Kupffer cells were hyperplastic and enlarged due to the phagocytosis of a large amount of fibrin which were apparently formed intravascularly and were being cleared by Kupffer cells. It is thought that enlarged Kupffer cells and excessive fibrin formation beyond the clearing capacity of Kupffer cells may lead to blockage of sinusoids resulting in a Budd-Chiari like syndrome. The nucleus of the hepatocytes showed mild enlargement and a clear nucleolar segregation which is regarded as one of the ultrastructural evidences of chemical carcinogenesis. Therefore, it is speculated that this change may be related to tumorigenesis in the liver following oral contraceptive administration. Other changes consisted of ischemic necrosis and fatty changes in occasional animals, alteration of mitochondrial configuration and hyperplasia of smooth endoplasmic reticulum in hepatocytes.
Animal ; Blood Coagulation/drug effects ; Contraceptives, Oral/adverse effects* ; Contraceptives, Oral, Combined/adverse effects* ; Guinea Pigs ; Liver/drug effects ; Liver/pathology* ; Liver/ultrastructure ; Mestranol/adverse effects* ; Norethindrone/adverse effects*

Dysfunctional uterine bleeding (DUB) is the major cause of heavy menstrual bleeding during reproductive years and impacts on women's health both medically and socially. The pathophysiology of DUB is largely unknown but occurs in both ovulatory and anovulatory menstrual cycles. Medical treatments include tranexamic acid, nonsteroidal antiinflammatory drugs, combined oral contraceptives, progesterone, danazol, and GnRH analogue. Surgical treatments include endometrial ablation and hysterectomy. Since none of the treatments for DUB is superior to one of the others, and since all treatments have their advantages and disadvantages, counselling and management of patients with DUB should incorporate medical approach, levonorgestrel releasing IUD, endometrial ablation and hysterectomy.
Contraceptives, Oral, Combined ; Danazol ; Endometrial Ablation Techniques ; Female ; Gonadotropin-Releasing Hormone ; Hemorrhage ; Humans ; Hysterectomy ; Levonorgestrel ; Menstrual Cycle ; Metrorrhagia* ; Progesterone ; Tranexamic Acid ; Women's Health

While perimenopausal women have low fecundity, they are still capable of becoming pregnant and the majority of pregnancies occurring during perimenopause are unintended pregnancies. Therefore, even during perimenopause, contraception must be used if unintended pregnancies are to be avoided. However, many perimenopausal women and healthcare providers believe that older people should not take combined oral contraceptives (COC) because doing so may be dangerous. However, to date, there is no evidence that taking COC presents an increased risk of cardiovascular events or breast cancer for middle-aged women as compared to other age groups, and in their recommendations, the Centers for Disease Control and Prevention (CDC) also do not list age itself as a contraindication for COC. Perimenopausal women often experience menstrual irregularity, heavy menstrual bleeding, and vasomotor symptoms. Taking COCs can help control these symptoms and significantly reduce the risk of ovarian cancer, endometrial cancer, and colorectal cancer. The objective of the present review is to examine the usage methods of COC among perimenopausal women and the health issues that may arise from taking COC in perimenopausal women.
Breast Neoplasms ; Centers for Disease Control and Prevention (U.S.) ; Colorectal Neoplasms ; Contraception ; Contraceptives, Oral, Combined* ; Endometrial Neoplasms ; Female ; Fertility ; Health Personnel ; Hemorrhage ; Humans ; Ovarian Neoplasms ; Perimenopause ; Pregnancy ; Risk Factors

OBJECTIVE: The aim of this study was to investigate the impact of pretreatment with transdermal estradiol (E₂) compared to oral contraceptive pills (OCPs) on controlled ovarian stimulation (COS) response in normal responders undergoing fresh in vitro fertilization (IVF)-embryo transfer (ET) cycles. METHODS: A retrospective cohort study was performed of normal responders undergoing fresh IVF-ET cycles who received pretreatment with transdermal E₂ versus OCPs prior to fresh IVF-ET. The total days of ovarian stimulation, total dosage of gonadotropins, total number of oocytes, and mature oocytes retrieved were noted. Pregnancy outcomes after ET were also recorded. RESULTS: A total of 2,092 patients met the inclusion criteria: 1,057 and 1,035 patients in the transdermal E₂ and OCP groups, respectively. Patients in the OCP group had a longer duration of COS (10.7±1.63 days, p<0.01) than the E₂ group (9.92±1.94 days). Patients in the OCP group also required higher cumulative doses of gonadotropins (2,657.3±1,187.9 IU) than those in the E₂ group (2,550.1±1,270.2 IU, p=0.002). No statistically significant differences were found in the total and mature oocytes retrieved or in the rates of biochemical pregnancy, clinical pregnancy, spontaneous miscarriage, and live birth between the groups. CONCLUSION: Our findings suggest that compared to OCPs, pretreatment with transdermal E₂ is associated with a shorter duration of ovarian stimulation and lower gonadotropin utilization, without compromising the oocyte yield or pregnancy outcomes in normal-responder patients undergoing fresh IVF.
Abortion, Spontaneous ; Cohort Studies ; Contraceptives, Oral, Combined ; Estradiol* ; Female ; Fertilization in Vitro* ; Gonadotropins ; Humans ; In Vitro Techniques* ; Live Birth ; Oocytes ; Ovulation Induction ; Pregnancy ; Pregnancy Outcome ; Reproductive Techniques, Assisted ; Retrospective Studies ; Superovulation ; Transdermal Patch

OBJECTIVE: To evaluate the effectiveness of oral contraceptive pill (OCP) as therapy for endometrial hyperplasia (EH) without atypia in reproductive-aged women compared with oral progestin. METHODS: A retrospective cohort study was carried out in our reproductive center. Consecutive patients diagnosed with infertility and non-atypical EH identified through electronic database who met inclusion criteria (n=309). Patients were assigned to two treatment groups: OCP (n=216) and oral progestin (n=93); clinical and reproductive outcomes were recorded. RESULTS: Reversal of EH to normal endometrium, clinical pregnancy, live birth and miscarriage rate. Women in OCP group were younger, had higher prevalence of Polycystic Ovary Syndrome and other uterine pathology and longer duration of infertility than women in progestin group. Reversal of EH was observed in 93.52% women on OCP and in 86.02% women on progestin (p=0.032; adjusted odds ratio [aOR]= 2.35; 95% confidence interval [CI]=1.06-5.21) after the initial course of treatment for 2 to 6 months. Cyclic OCP (n=184) resulted in better response to treatment compared to continuous OCP (n=32) (95.11% vs. 84.38%; p=0.039; aOR =3.60; 95% CI =1.12-11.55). Clinical pregnancy rate in OCP group was marginally higher than progestin group (87/208, 41.83% vs. 27/90, 30.00%; p=0.054). Miscarriage (25.29% vs. 29.63%; p=0.654) and live birth rate (31.25% vs. 21.11%; p=0.074) were comparable between the groups. CONCLUSION: For the first time we demonstrate that OCP is an effective therapy for non-atypical EH and is associated with higher remission rate compared with oral progestin. Reproductive outcomes are reassuring and comparable between the two groups.
Abortion, Spontaneous ; Cohort Studies ; Contraceptives, Oral, Combined ; Drug Therapy ; Endometrial Hyperplasia ; Endometrium ; Female ; Humans ; Infertility ; Live Birth ; Odds Ratio ; Pathology ; Polycystic Ovary Syndrome ; Pregnancy ; Pregnancy Rate ; Prevalence ; Progestins ; Reproductive History ; Retrospective Studies