<p>The objective of this research was to assess ultrasound image attributes of human dominant ovarian follicles in the final stages of development during natural and oral contraceptive (OC) cycles, as well as characterize ovarian follicular and endometrial development during and after continuous versus conventional dosing schemes. We utilized sophisticated computer algorithms to elucidate an association between image attributes and physiologic status of follicles in their final stage of development. We used transvaginal ultrasonography to quantify changes in the numbers and diameters of ovarian follicles and changes in endometrial thickness and pattern during and following discontinuation of two different regimens of OC. Developmental changes in ovarian follicles and corpora lutea were correlated with serum estradiol-17â and progesterone, respectively to provide a comprehensive approach to examining ovarian and uterine function. </p><p>We reported for the first time that follicles which develop during natural and OC cycles have similar image attributes, which provides preliminary evidence that image attributes of human follicles are associated with physiologic status during the growth phase. Further research should be performed to elucidate the exact correlation between image attributes during all stages of follicular development throughout the menstrual cycle, prediction of dysfunctional follicular development (i.e., hemorrhagic anovulatory follicles) and the effects of different OC formulations on follicle development. Once the association between image attributes and various scenarios of follicular development are determined, a computer program could be developed to assess follicular health with a single ultrasound examination, obviating many ethical constraints that currently prevent large scale progress in ovarian follicular research. We further documented that continuous OC administration schemes provide greater follicular suppression than conventional dosing schemes. No dominant follicles developed during three consecutive 28 day cycles of continuous OC use, whereas eight dominant follicles developed during the same time period of conventional OC use. We interpreted these findings to mean that continuous OC dosing schemes provide a more effective contraceptive with a decreased risk of escape ovulation compared to conventional dosing schemes. Most follicles ovulated in the immediate cycle following discontinuation of OC. We suggest that the delay to fertility following cessation of OC is not due to anovulation but other yet, unknown, biological factors. </p>

<p>The objective of this research was to assess ultrasound image attributes of human dominant ovarian follicles in the final stages of development during natural and oral contraceptive (OC) cycles, as well as characterize ovarian follicular and endometrial development during and after continuous versus conventional dosing schemes. We utilized sophisticated computer algorithms to elucidate an association between image attributes and physiologic status of follicles in their final stage of development. We used transvaginal ultrasonography to quantify changes in the numbers and diameters of ovarian follicles and changes in endometrial thickness and pattern during and following discontinuation of two different regimens of OC. Developmental changes in ovarian follicles and corpora lutea were correlated with serum estradiol-17â and progesterone, respectively to provide a comprehensive approach to examining ovarian and uterine function. </p><p>We reported for the first time that follicles which develop during natural and OC cycles have similar image attributes, which provides preliminary evidence that image attributes of human follicles are associated with physiologic status during the growth phase. Further research should be performed to elucidate the exact correlation between image attributes during all stages of follicular development throughout the menstrual cycle, prediction of dysfunctional follicular development (i.e., hemorrhagic anovulatory follicles) and the effects of different OC formulations on follicle development. Once the association between image attributes and various scenarios of follicular development are determined, a computer program could be developed to assess follicular health with a single ultrasound examination, obviating many ethical constraints that currently prevent large scale progress in ovarian follicular research. We further documented that continuous OC administration schemes provide greater follicular suppression than conventional dosing schemes. No dominant follicles developed during three consecutive 28 day cycles of continuous OC use, whereas eight dominant follicles developed during the same time period of conventional OC use. We interpreted these findings to mean that continuous OC dosing schemes provide a more effective contraceptive with a decreased risk of escape ovulation compared to conventional dosing schemes. Most follicles ovulated in the immediate cycle following discontinuation of OC. We suggest that the delay to fertility following cessation of OC is not due to anovulation but other yet, unknown, biological factors. </p>

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Background: The objective of this thesis was to measure oxidative stress (OS) in women with Bipolar Disorder (BD) who used combined oral contraceptives (OCU). Based on our literature review, it was predicted that OCU would increase OS levels relative to non-contraceptive users (NCU) in women. Methods: Thirty-five participants (BD n=25; Control n=10) were recruited from an ongoing study based in British Columbia ‘The Systematic Treatment Optimization Program in Early Mania.’ Participants were administered psychological screening tools (Young Mania Rating Scale (YMRS), Montgomery-Åsberg Depression Rating Scale, Mini International Neuropsychiatric Interview and Hamilton Depression Rating Scale) and provided a blood sample for the assays (Lipid Hydroperoxide (LPH), Protein Carbonylation, 4-Hydroxynonenal, 3-Nitrotyrosine (3-NT) and 17-Beta Estradiol). Results: In our primary analysis we did not find differences in OS between BD and controls relative to OCU. Within our remaining analyses, only BD women (n=17) and who gave smoking status were included. We found 3-NT to be increased in OCU compared to NCU (F (1, 12) = 5.639, p = 0.035). With respect to mood stabilizer use, 3-NT was increased in OCU relative to NCU (F (1, 10) = 6.33, p=0.031). As for atypical antipsychotics, 3-NT was heightened in OCU adjunctive users compared to NCU who did not use atypical antipsychotics (F (3, 10) = 4.822, p = 0.025). As for our correlation analyses, YRMS correlated with 3-NT and LPH in OCU BD women (r(11)= 0.711, p=0.014 and r(11) = 0.676, p=0.022, respectively) and 17-Beta Estradiol correlated with LPH (r(17) = 0.598, p = 0.001). Our results are preliminary and are limited by our small sample size and various other factors (i.e. controls). Conclusion: The association between hormones and oxidative stress still remains controversial. Here we showed, after controlling for smoking, BMI and age the use of a COC significantly increased 3-NT in women with BD. Moreover, hormones may influence the relationship between OS and mood episodes. / Thesis / Master of Science (MSc)

Osteoporosis is a debilitating and costly disease of the skeleton characterized by low bone mass and structural deterioration of bone tissue leading to bone fragility and an increased susceptibility to fractures of the hip, spine, and wrist. Current data suggest that at present time, 7.8 and 21.8 million women have osteoporosis and osteopenia respectively. The development of osteoporosis and related fracture in later life depends not only on the rate of bone loss in adulthood, but also on the amount of bone present at skeletal maturity. Oral contraceptives (OC), because of their capacity to diminish concentrations of free testosterone and estrogen, have been purported to affect bone mass in young adult women, but results have proven inconsistent. Further, positive skeletal effects of exercise training are thought to be compromised by use of OCs in skeletally immature females. PURPOSE: To assess the independent and synergistic effects of OC use on bone mineral density (BMD) and long bone mechanical bending stiffness (EI) in college-aged females after unilateral isokinetic resistance training. METHODS: Forty six females (age 20 +/- 1.4 yr, height 163.8 +/- 6.2cm, weight 58.9 +/- 8.6kg, fat 27.9 +/- 4.8%) were categorized as OC users (OC, N=22) or non-users (NOC, N=24). Subjects participated in 32 weeks (3 d/wk) of unilateral arm and leg training at an angular velocity of 60 degrees/s using isokinetic dynamometers. BMD and EIMRTA were assessed using dual-energy x-ray absorptiometry (DXA) and mechanical response tissue analysis (MRTA), respectively. RESULTS: Total leg and arm muscular strength of the trained limb increased by 16% and 15%, respectively (p < 0.001), beyond changes observed in the control limbs. Total body BMD increased from baseline for NOC subjects (p < 0.05), but not for OC users. This difference failed to show significance (p = 0.069) when comparisons were run between NOC and OC groups. Increases in ulnar BMD (p < 0.01 for all limbs) and BMD of the trained total hip (OC, p < 0.001; NOC, p < 0.05) occurred irrespective of contraceptive status. Positive changes in EI were conflicting, occurring in the trained ulna for the NOC group (p < 0.05), and trained tibia for OC users (p < 0.05). Tibial BMD increased only for the untrained leg in NOC subjects (p < 0.01). No between group differences were found to be significant, nor were differences between trained vs. untrained, and weight bearing (tibia) vs. non-weight-bearing (ulna) limbs found to be significant. CONCLUSION: These results suggest that oral contraceptives may limit attainment of total body peak bone mass in young adult females. Skeletal maturation in the ulna appeared to be unaffected by exercise training and OC use. Positive effects of exercise training on the total hip were seen in both groups, irrespective of OC status. Conversely, exercise training and use of OCs use may limit the attainment of bone mass in the tibia. Further studies are needed to determine the interactive effects of OC use and isokinetic resistance training on measures of total body and site-specific bone status. / Master of Science

Magister Pharmaceuticae - MPharm / Background: The effectiveness of the combined oral contraceptive pill as a family planning method is dependent on its quality. The quality of medicines on the healthcare market is established through postmarket quality studies. Methods: The quality of the combined oral contraceptive pill was established through the collection of samples from 17 (62%) private retail pharmacies in the Nyeri town of Kenya. Their quality was then determined through the assay of content of levonorgestrel and ethinylestradiol and the levonorgestrel dissolution test at the National Quality Control Laboratory. Findings: 13 of the 17 pharmacies were licensed with the Pharmacy and Poisons Board while 4 were unlicensed. Femiplan® was available in all the 17 pharmacies while Microgynon® was available in only 4 pharmacies. 17 samples of Femiplan® and 4 samples of Microgynon® were collected. None of the samples was counterfeit or falsely labeled. All the samples passed the assay of content of levonorgestrel and ethinylestradiol and the levonorgestrel dissolution test. Conclusion: Notwithstanding the fact this study provides a snapshot in time, it is reasonable to conclude that the combined oral contraceptive pill (0.15mg levonorgestrel and 0.03mg ethinylestradiol) in the Nyeri town of Kenya private retail pharmacies is of the right quality with respect to the quality tests of assay of content of levonorgestrel and ethinylestradiol and the levonorgestrel dissolution test.

abstract: Oral contraceptives are one of the most frequently used forms of birth control among young women. However, research has shown that this type of medication can contribute to negative changes in mood and diminished vitamin status. In particular, women taking oral contraceptives are at an increased risk of vitamin B6 deficiency due to changes in enzyme activity with estrogen intake. Depressed mood is one of the known symptoms of vitamin B6 deficiency as this vitamin acts as an essential cofactor in converting tryptophan to the neurotransmitter, serotonin. Lack of adequate levels of vitamin B6 therefore contribute to decreased production of serotonin and subsequent changes in mood, including symptoms of depression. With vitamin B6 being the most common nutrient deficiency, and the ever increasing prevalence of depression in the United States, especially among young adults, it is crucial that researchers investigate ways to mitigate both of these undesirable side effects. Current research on the topic fails to directly connect supplementation of vitamin B6 to positive changes in mood in oral contraceptive users. This 12-week long double-blinded, placebo-controlled crossover trial examined the effects of daily supplementation of vitamin B6 as 100 mg of pyridoxine hydrochloride, on mood states in 8 healthy college women (18-25 y) that use combined oral contraceptives. Vitamin status was assessed via plasma pyridoxal 5’-phosphate (PLP). Plasma PLP levels significantly increased by >193% (p=0.003) with daily supplementation of 100 mg B6 over a four week period. Mood changes with supplementation were assessed using the Profile of Mood States (POMS). Although a small improvement in the POMS depression sub score was observed after 4 weeks of vitamin B6 supplementation (14.7%), the changes were insignificant (p>0.05). Furthermore, total mood disturbance scores did not significantly change with either the placebo or supplement periods. While mood states were not improved, a significant decrease in the presence of depressive symptoms as measured by the Beck Depression Inventory was observed after vitamin B6 supplementation, compared to placebo (p=0.047). The results of this study necessitate further investigation into the use of B6 supplementation as a means of reducing negative mood changes in oral contraceptive users. / Dissertation/Thesis / Masters Thesis Nutrition 2020

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Results of previous studies testing the influence of oral contraceptives on relationship satisfaction have produced mixed results. These discrepancies might be explained by the "Congruency hypothesis", which predicts that relationship satisfaction is determined by the congruency (or non-congruency) between current use of oral contraceptives and their use during relationship formation. This is because oral contraceptives appear to alter women's mate preferences, so that attraction to their partner may have changed in non-congruent women. Indeed, previous studies have shown that women in a non-congruent state were less sexually satisfied with their partner, even though they were more generally satisfied in the non- sexual aspects of the relationship. The aim of our study was to test the congruency hypothesis on two groups of couples (couples attending the Center of Assisted Reproduction, and a comparison group of pregnant women and their partners; note that in neither group were women currently using oral contraception). Based on previous studies, we expected that women who used oral contraceptives at the time of relationship formation would report lower sexual satisfaction with their partner than women who were non-users during relationship formation. The study involved a total of 660 couples from...