|WikiProject Medicine / Reproductive medicine||(Rated B-class, High-importance)|
Some of the recent edits seem problematic. Hormonal contraceptives require a prescription in the United States and most other countries because of potential health risks. This ignores that EC is over the counter in a handful of localities around the world. Furthermore, this phrasing seems either redundent (because why else would a drug require a prescription), or pushing the POV that hormonal contraceptions are unsafe.
i don't think that's a recent edit? (i didn't put that in). --it's from july 9th, "kbgeek." so is "even a slight deviation..." Cindery 16:29, 16 August 2006 (UTC)
Next, the laundry list of side effects. It clearly needs to be sourced, but it is confusing/misleading because it probably is combining side effects for different methods all into one list, and blurs the line of the unproven >2% side effects with known side effects. I think there could be a better way to work this informating into the article without sounding so scary (which seems POV to me). But I am coming to talk before doing anything else to make sure my concerns are warrented.--Andrew c 14:48, 16 August 2006 (UTC)
well, that's factor of glumping all the hormonal contraceptives together--separately and alone, they have alot of side effects and risks. i think what's there is about 1/10th of what could be there. i am not opposed to editing it down to most common/for most methods. but it seems like it would make more sense to separate them by type, since, for example, progestin-only and estrogen contraceptives sometimes have opposite side effects/risks, and the iud is in a category by itself regarding perforation/embedment/pid/ectopic, and implants alone in potential removal difficulty...maybe the long list/specificity of side effects and risks is an argument in favor of deleting advantages/disadvantages from a general article on hormonal bc? Cindery 15:31, 16 August 2006 (UTC)
I removed the comment that the post-fertilization mechanism of preventing implantation is unproven. Ortho Evra stipulates to it on their own site. http://www.orthoevra.com/html/pevr/about_how.jsp? Christiangoth 02:43, 26 January 2007 (UTC)
i removed that because it's been up there for a while needing citation. i'm not sure there can be a citation for it...i mean "easier to disrupt women's fertility"--easier for whom? would still be opinion, better suited to a controversy section, not the opening paragraph. also, women's fertility isn't disrupted only for their few fertile days per month by hormonal contraception--the whole cycle is disrupted all month. so, disrupting men's fertility all month/disrupting women's fertility all month--what would be the difference in convenience? what do fewer fertility days have to do with hormonal contraception which doesn't selectively disrupt fertility only during fertile days? Cindery 02:13, 29 August 2006 (UTC)
I have fleshed out this section. There were only 2 "advantages" listed, one of which was "spontaneous intercourse" - an advantage, but hardly a medical one. The disadvantage section is quite extensive, which would lead an uniformed reader to conclude hormonal contraception is unsafe, when a plethora of medical information shows it is possible the safest drug ever. No pill or drug is risk free, not asperin and not vitamin supplements, but there is 50 years of research into this.--FNV 14:16, 27 October 2006 (UTC)
- I agree that there is an unbalance. It seems as if the requirement established for inclusion is any side effect or disadvantage of any form of hormonal contraception can be listed, but only the advantages found in every single form of hormonal contraception can be included. And that seems biased, no? This was the previous list from a few months back, and I feel we may be able so salvage content (just not the graphic almost vulgar part). However, I do agree with Cindery that we can't simply confuse the bill with HC in general:
- Hormonal contraceptives are effective during the woman’s entire cycle, and unlike most other methods, they completely separate the act of contraception from sexual intercourse. The couple takes no birth control action either before, during, or after sex. Intercourse may thus be very spontaneous and natural-seeming, which can be highly pleasurable to both partners, and it may continue without any interruption until the man reaches orgasm and ejaculates within the woman’s vagina.
- Hormonal contraceptives may also have health or other benefits, among them reduction of the incidence of some types of cancer; they induce periods (withdrawal bleeding) at predictable intervals that can be controlled by the woman; periods that are shorter, lighter, or both; increased breast size; and reduced acne in younger women.
- --Andrew c 15:52, 27 October 2006 (UTC)
...i actually still think the whole advantages/disadvantages section should be removed from this article, as it is redundancy of specific disadvantages/advantages listed on page of each type of hormonal contraception. the problem with generalizing is that, for example, the same exact thing, say, "menstrual regularity" can be a positive side effect of one type of hormonal contraception (the pill) or a negative side effect of another (depo provera--"menstrual chaos"). but if the advantages/disadvantages are left here, please keep in mind that it is quality, not quantity that can make for balance--spontaniety and high effectiveness are pretty strong advantages. also, the advantages/disdvantages re cancers already has a separate section here, so need not be repeated. Cindery 16:07, 27 October 2006 (UTC)
- I think you have a good point about how hard it is to create an adv/disadv section for such a diverse group of pharmaceuticals. I would support removing both, and instead having a brief section that explains this.--Andrew c 16:42, 27 October 2006 (UTC)
good idea--let's do that. it seems unfair to the relatively low risk hormonal contraceptives to confuse them with the high risk ones, etc. Cindery 17:11, 27 October 2006 (UTC)
- I agree with removing the short incomplete list of Advantages section, the long list of Disadvantages and side effects section, and the Effects on rates of cancers section that only discusses combination oral contraceptives.
- I know different types of hormonal contraceptives have different advantages and disadvantages and some different benefits and risks, but which are "relatively low risk" and which are "high risk"? Doesn't that depend on the individual woman?
- 184.108.40.206 18:43, 27 October 2006 (UTC)
well, for example, there are deaths associated with ortho--evra patch but not jadelle implant, bone density loss with depo provera but nothing else--regardless of particular woman. i would say norplant, ortho-evra and depo are in a a higher risk category than low dose oral contraceptives, regardless of the woman. one of the women who dropped dead from ortho--evra was 18 and in perfect health. but, it's not really relevant--i agree the relevant thing is the category is too broad for generalizations becuase some of the advantages/disadvantages are identical/opposite, making the generalizations not helpful/just confusing to readers, who would be better off reading individual articles for info about advantages/disadvantages. but mixing high-risk/low-risk is a factor in clarity, too, i think--just not the definitive factor. Cindery 20:21, 27 October 2006 (UTC)
Abortive effects and other things
I made some changes to the last paragraph of the first section (for example, it said "birth control may act in one or ways..." Of course it acts in one or more ways, there's no may about it! I basically reworked the paragraph to be more assertive. Hormonal contraception ALL does ALL THREE of those things. However, somebody changed it back just a few minutes later and I don't know why. Also, my change to the disadvantage section (see what I wrote above) was also reverted. I feel pretty confident about what I wrote... Christiangoth 03:06, 26 January 2007 (UTC)
- I am the one who reverted your changes, and I must apologize if it was jarring to have your contributions removed. There is controversy over the exact mechanisms of hormonal contraception. The current and longstanding version is concise and mentions the 3 possible mechanisms, without taking sides on the matter. Your edits was verbose, and introduced unnecessary and factually questionable elements. First of all, whenever you add new content to an article, you should supply a citation. For more information, see WP:CITE, WP:V and WP:RS. Specifically, your version introduced language to highlight perhaps giving undue weight to the failure rate "No HC prevents ovulations 100% of the time" and "but not impossible". This almost seems like editorialized comments or personal commentary added on to the existing content. But the biggest issue is that there is no hard evidence of the post-fertilization effect. I'd suggest reading Emergency_contraception#Emergency_contraception.2C_implantation.2C_and_abortion_politics and some of the talk archives there. Your edits seemed to ignore this controversy, while the current version, while not specifically mentions it, remains neutral to it. I believe the current version is fine, but I'd love to hear your specific concerns with it. Thanks for joinging the wikipedia community.-Andrew c 04:43, 26 January 2007 (UTC)
....In case anyone else is looking at this site: there are medical reasons to be on hormonal birth control. For example, dermatologists prescribe it for bad cases of acne, and girls who don't menstruate regularly can take it to "even out" a bit. This didn't really come up in the article itself, and someone might want to edit it to make it a bit more accurate, maybe? Just a suggestion.... 220.127.116.11 23:32, 5 November 2007 (UTC)yi qiu
- This article isn't about a specific chemical that may have multiple medical uses, but instead is about a class of contraception. That said, it may not hurt to mention briefly that some of the drugs used for contraception also are used for other purposes.-Andrew c [talk] 01:05, 6 November 2007 (UTC)
Hormonal Contraception and Effects on Mood
Does anyone have any good sources for information on this? Psychological effects from using hormonal contraception? Chupper 05:05, 21 February 2007 (UTC)
Weight gain parameter in infobox
I would like to treat this parameter the same on all the hormonal contraception articles. Please read my opinion and discuss this issue at Talk:Combined oral contraceptive pill#Weight parameter in infobox. LyrlTalk C 21:32, 20 August 2007 (UTC)
I find it strange that this article does not include these recent findings:
- Conclusions— Third-generation oral contraceptives (containing desogestrel or gestodene) confer the same risk of first ischemic stroke as second-generation oral contraceptives (containing levonorgestrel).
- An IARC Monographs Working Group has concluded that combined estrogen-progestogen oral contraceptives and combined estrogen-progestogen menopausal therapy are carcinogenic to humans (Group 1), after a thorough review of the published scientific evidence.At the same time, the Working Group stressed that there is also convincing evidence that oral contraceptives have a protective effect against some types of cancer.There are both beneficial and adverse effects for oral contraceptives and menopausal therapy. Each woman who uses these products should discuss the overall risks and benefits with her doctor. The Working Group, comprising 21 scientists from 8 countries, was convened by the IARC Monographs Programme of the International Agency for Research on Cancer (IARC), the cancer research agency of the World Health Organization.
- In conclusion, a rigorous meta-analysis of the literature suggests that current use of low-dose OCs significantly increases the risk of both cardiac and vascular arterial events, including a significant risk of vascular arterial complications with third generation OCs.
- I worked the newer IARC reference in a bit more smoothly (and more neutrally). I went back to using the quote from the older IARC item because the quotations said the same thing, but the older one was shorter. Since the message doesn't seem to have changed much, didn't see need to specify years. Not sure what the NPOV issue is here since the newer IARC conclusions RE cancer seem to be similar to the older (i.e., it's a mixed bag). Zodon (talk) 07:36, 29 September 2010 (UTC)
I removed the addition about cardiovascular risk and brought it here for improvement.
The Journal of Clinical Endocrinology & Metabolism concluded in 2005 that "a rigorous meta-analysis of the literature suggests that current use of low-dose OCs significantly increases the risk of both cardiac and vascular arterial events."
- The summary given is not particularly useful - it doesn't give perspective on the magnitude of risk increase vs. overall risk, vs. other risks. It also overemphasizes one aspect, while missing much of the conclusion.
- The "significantly" in the quote was statistical significance, not necessarily clinically significant.
- Minor note - this was the conclusion of Baillargeon et al., (at least the abstract gives no indication that the conclusion was endorsed by or the position of the journal).
- Reference could be improved - i.e. what is the actual significance of this finding to OC. (If covered by contraceptive tech or such, would be a better source).
"The modern use of low-dose OCs, limited to healthy women and restricted in time, should not increase noticeably the incidence of these adverse outcomes, which might be outweighed by the benefits of contraception. However, prolonged exposure to low-dose OCs in a population at higher risk may significantly increase the incidence of cardiovascular outcomes and prompt consideration of alternative therapeutic or contraceptive interventions." Zodon (talk) 07:36, 29 September 2010 (UTC)
synthetic hormones released into the environment and spreading
this page needs all that new research into these (synthetic) birth control pills ending up in the water and animals. and possible mixing with pesticides!
Mechanism of action
Pharmacologists list preventing implantation as one of the mechanisms of action of hormonal contraception.Bertram G. Katzung, Basic and Clinical Pharmacology, 2012
This topic is already addressed in more detail in this Wikipedia article by current, authoritative medical reference textbooks about contraception.
20 editions (7 editions of Meyers, Jawetz & Goldfien’s Review of Medical Pharmacology, 13 editions of Katzung’s Basic & Clinical Pharmacology) over 47 years of this undergraduate health sciences general pharmacology textbook have the same misleading, unsubstantiated, unsourced four-sentence "Mechanism of Action" paragraph:
• Meyers, Frederick H.; Jawetz, Ernest; Goldfien, Alan (1968). "37. The Gonadal Hormones and Inhibitors" in Review of Medical Pharmacology, 1st edition. Los Altos, Calif.: Lange Medical Publications, p. 391:
A. Mechanism of
The combinations of estrogens and progestins
and the sequential agents appear toexert their effect largely through inhibition of ovulation.
The combination agents
containing estrogens and progestinsalso produce a change in the cervical mucus, in the uterine endometrium, and in themotility and secretion in the fallopiantubes, all of which decrease the likelihood of conception and implantation.
The continuous use of progestins alone does not inhibit ovulation.
The other factors mentioned, therefore, play a major role in the prevention of pregnancy when these agents are used.
◦ Goldfien, Alan (1982). "38. The Gonadal Hormones & Inhibitors" in Katzung, Bertram G. (ed.) Basic & Clinical Pharmacology, 1st edition
fallopian" with: "uterine"
◦ Goldfien, Alan (1987). "39. The Gonadal Hormones & Inhibitors" in Katzung, Bertram G. (ed.) Basic & Clinical Pharmacology, 3rd edition
and the sequential agents appear to" and " containing estrogens and progestins" and added: "always"
◦ Chrousos, George P.; Zoumakis, Emmanouil N.; Gravanis, Achille (2001). "40. The Gonadal Hormones & Inhibitors" in Katzung, Bertram G. (ed.) Basic & Clinical Pharmacology, 8th edition
Contraceptive" and added: "contraceptive" and "selective inhibition of pituitary function that results in" and removed: " the"
• Chrousos, George P. (2015). "40. The Gonadal Hormones & Inhibitors" in Katzung, Bertram G.; Trevor, Anthony J. (eds.) Basic & Clinical Pharmacology, 13th edition. New York: McGraw-Hill Education. ISBN 9780071825054, p. 708:
(Oral, Parenteral, & Implanted Contraceptives)
A. Mechanism of Action
The combinations of estrogens and progestins exert their contraceptive effect largely through selective inhibition of pituitary function that results in inhibition of ovulation.
The combination agents also produce a change in the cervical mucus, in the uterine endometrium, and in motility and secretion in the uterine tubes, all of which decrease the likelihood of conception and implantation.
The continuous use of progestins alone does not always inhibit ovulation.
The other factors mentioned, therefore, play a major role in the prevention of pregnancy when these agents are used.
The paragraph's original author, the late Alan Goldfien, MD, was an adult endocrinologist with no special expertise in contraception;
the paragraph’s current author, George P. Chrousos, MD, is a pediatric endocrinologist with no special expertise in contraception.
BC07 (talk) 05:51, 21 February 2016 (UTC)