Skip to main content Accessibility help
×
Hostname: page-component-77c89778f8-fv566 Total loading time: 0 Render date: 2024-07-16T22:50:45.878Z Has data issue: false hasContentIssue false

Chapter 11 - Combined Hormonal Contraception

from Section 2A - Sexual and Reproductive Healthcare: Contraception

Published online by Cambridge University Press:  16 January 2024

Johannes Bitzer
Affiliation:
University Women's Hospital, Basel
Tahir A. Mahmood
Affiliation:
Victoria Hospital, Kirkcaldy
Get access

Summary

Combined hormonal contraceptives (CHCs) contain a combination of an oestrogen and a progestin. On the European market they are available as a pill, vaginal ring or patch. Researchers recognised decades ago that the oestrogen component in the form of ethinylestradiol (EE) has a significant impact on the coagulation system which causes an increase in the risk of arterial and venous thromboembolic events. To reduce this risk, low-dose CHC have been developed containing ≤ 35 µg of EE. Higher-dose preparations should not be used anymore.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2024

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Sitruk-Ware, R, Nath, A. Characteristics and metabolic effects of estrogen and progestins contained in oral contraceptive pills. Best Pract Res Clin Endocrinol Metab. 2013;27(1):1324.CrossRefGoogle ScholarPubMed
Godsland, IF, Crook, D, Simpson, R et al. The effects of different formulations of oral contraceptive agents on lipid and carbohydrate metabolism. N Engl J Med. 1990;323(20):1375–81.CrossRefGoogle ScholarPubMed
Dragoman, M, Curtis, KM, Gaffield, ME. Combined hormonal contraceptive use among women with known dyslipidemias: A systematic review of critical safety outcomes. Contraception. 2016;94(3):280–7.CrossRefGoogle ScholarPubMed
Speroff, L. Clinical gynecologic endocrinology and infertility. 8th edition. Philadelphia, PA: Lippincott, Williams and Wilkins, 2010.Google Scholar
Petersen, KR, Skouby, SO, Vedel, P, Haaber, AB. Hormonal contraception in women with IDDM: Influence on glycometabolic control and lipoprotein metabolism. Diabetes Care. 1995;18(6):800–6.CrossRefGoogle ScholarPubMed
Trussell, J, Portman, D. The creeping pearl: Why has the rate of contraceptive failure increased in clinical trials of combined hormonal contraceptive pills? Contraception. 2013;88(5):604–10.CrossRefGoogle ScholarPubMed
European Society for Contraception Teaching and Training tool CHC session. 2019. https://escrheu/education/training-improvement-programme/tt-tool-sessions-eng.Google Scholar
Merki-Feld, GS, Bitzer, J. Contraception in adolescents with anorexia nervosa: Is there evidence for a negative impact of combined hormonal contraceptives on bone mineral density and the course of the disease? Eur J Contracept Reprod Health Care. 2020;25(3):213–20.CrossRefGoogle Scholar
Fernandez, E, La Vecchia, C, Balducci, A et al. Oral contraceptives and colorectal cancer risk: A meta-analysis. Br J Cancer. 2001;84(5):722–7.CrossRefGoogle ScholarPubMed
Iversen, L, Sivasubramaniam, S, Lee, AJ, Fielding, S, Hannaford, PC. Lifetime cancer risk and combined oral contraceptives: The Royal College of General Practitioners’ Oral Contraception Study. Am J Obstet Gynecol. 2017;216(6):580e581–580e589.CrossRefGoogle ScholarPubMed
Combined hormonal contraceptives (CHCs) and the risk of cardiovascular disease endpoints. CHC-CVD final report 111022v2. 2011.Google Scholar
Dragoman, MV, Tepper, NK, Fu, R. A systematic review and meta-analysis of venous thrombosis risk among users of combined oral contraception. Int J Gynaecol Obstet. 2018;141(3):287–94.CrossRefGoogle ScholarPubMed
VTE risk with CHC. European medical agency. 2013. bit.ly/3DoQFLC.Google Scholar
Dinger, J, Assmann, A, Mohner, S, Minh, TD. Risk of venous thromboembolism and the use of dienogest- and drospirenone-containing oral contraceptives: Results from a German case-control study. J Fam Plann Reprod Health Care. 2010;36(3):123–9.CrossRefGoogle ScholarPubMed
Van Vlijmen, EF, Wiewel-Verschueren, S, Monster, TB, Meijer, K. Combined oral contraceptives, thrombophilia and the risk of venous thromboembolism: A systematic review and meta-analysis. J Thromb Haemost. 2016;14(7):13931403.CrossRefGoogle ScholarPubMed
Bezemer, ID, Van der Meer, FJ, Eikenboom, JC, Rosendaal, FR, Doggen, CJ. The value of family history as a risk indicator for venous thrombosis. Arch Intern Med. 2009;169(6):610–15.CrossRefGoogle ScholarPubMed
Zoller, B, Li, X, Ohlsson, H, Sundquist, J, Sundquist, K. Age-and sex-specific seasonal variation of venous thromboembolism in patients with and without family history: A nationwide family study in Sweden. Thromb Haemost. 2013;110(6):1164–71.Google ScholarPubMed
Acute myocardial infarction and combined oral contraceptives: Results of an international multicentre case-control study. WHO Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Lancet. 1997;349(9060):1202–9.Google Scholar
Lidegaard, O, Lokkegaard, E, Jensen, A, Skovlund, CW, Keiding, N. Thrombotic stroke and myocardial infarction with hormonal contraception. N Engl J Med. 2012;366(24):2257–66.CrossRefGoogle ScholarPubMed
Curtis, KM, Mohllajee, AP, Peterson, HB. Use of combined oral contraceptives among women with migraine and nonmigrainous headaches: A systematic review. Contraception. 2006;73(2):189–94.Google ScholarPubMed
Tzourio, C, Kittner, SJ, Bousser, MG, Alperovitch, A. Migraine and stroke in young women. Cephalalgia. 2000;20(3):190–9.CrossRefGoogle ScholarPubMed
Merki-Feld, GS, Skouby, S, Serfaty, D. European society of contraception statement on contraception in obese women. Eur J Contracept Reprod Health Care. 2015;20(1):1928.CrossRefGoogle ScholarPubMed
Sacco, S, Merki-Feld, GS, Bitzer, J et al. Effect of exogenous estrogens and progestogens on the course of migraine during reproductive age: A consensus statement by the European Headache Federation (EHF) and the European Society of Contraception and Reproductive Health (ESCRH). J Headache Pain. 2018;19(1):76.CrossRefGoogle ScholarPubMed
Merki-Feld, GS, Imthurn, B, Langner, R, Seifert, B, Gantenbein, AR. Positive effects of the progestin desogestrel 75 mug on migraine frequency and use of acute medication are sustained over a treatment period of 180 days. J Headache Pain. 2015;16:522.CrossRefGoogle Scholar
Morch, LS, Skovlund, CW, Hannaford, PC et al. Contemporary hormonal contraception and the risk of breast cancer. N Engl J Med. 2017;377(23):2228–39.CrossRefGoogle ScholarPubMed
Loopik, DL, IntHout, J, Melchers, WJG et al. Oral contraceptive and intrauterine device use and the risk of cervical intraepithelial neoplasia grade III or worse: A population-based study. Eur J Cancer. 2020;124 :102–9.CrossRefGoogle ScholarPubMed
International Collaboration of Epidemiological Studies of Cervical Cancer, Appleby, P, Beral, V et al. Cervical cancer and hormonal contraceptives: Collaborative reanalysis of individual data for 16,573 women with cervical cancer and 35,509 women without cervical cancer from 24 epidemiological studies. Lancet. 2007;370(9599):1609–21.Google Scholar
Skovlund, CW, Morch, LS, Kessing, LV, Lidegaard, O. Association of hormonal contraception with depression. JAMA Psychiatry. 2016;73(11):1154–62.CrossRefGoogle ScholarPubMed
Hani, D, Imthurn, B, Merki-Feld, GS. [Weight gain due to hormonal contraception: Myth or truth?]. Gynakol Geburtshilfliche Rundsch. 2009;49(2):8793.Google ScholarPubMed
Gallo, MF, Lopez, LM, Grimes, DA et al. Combination contraceptives: Effects on weight. Cochrane Database Syst Rev. 201;1:CD003987.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×