Thesis (M.S.)--Brock University, 2009. / Includes bibliographical references (leaves 73-83).

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.

Class of 2005 Abstract / Objectives: Describe the prevalence of alcohol and tobacco use in college women who use emergency contraception (EC) or oral contraceptives. Methods: This study was a descriptive, retrospective study that utilized patient charts to obtain clinical data including emergency contraception utilization, hormonal contraception utilization, alcohol and tobacco use. The primary dependent variables were smoking status and alcohol use. The overall prevalence of alcohol and tobacco use was calculated by counting the total number and percentage for each substance. Determining if descriptive variables vary according to type of contraception, groups were compared using a t-test for independent groups and a Chi square, respectively. The a priori alpha level is 0.05. Results: The most important finding in this study is students that obtained EC reported drinking alcohol at a significantly higher level than students who used hormonal contraception. 49% of students who used EC reported drinking 5 or more drinks a week. The data for the alcohol use was the only data that was found to be statistically significant (p<0.05). In this study 22% of students who requested EC had unprotected sex. A positive result seen in this study was that only 2% of the EC students requested EC more than once in the spring semester. Freshman composed 54% of the students that used EC during this study. Other data that was of interest was that 33% of students that used EC were currently using oral contraception but only 25% claimed that oral contraception incompliance was the reason for EC utilization. Implications: Prevalence of alcohol use is significantly higher in students who use EC than students who used hormonal contraception. This leads to the conclusion that students that use alcohol are more likely to engage in unprotected sex and therefore request EC. This study also has shown that nurses and physicians need to get more accurate information from students regarding tobacco and alcohol use.

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome, cardiogenic shock, and sudden cardiac death in women of reproductive age who have no traditional risk factors for coronary artery disease. The etiology, prognosis, and treatment of SCAD remain poorly defined. Coronary angiography is the gold standard for diagnosis. Management includes medical therapy and revascularization procedures using percutaneous intervention and coronary artery bypass grafting. Possible mechanisms of SCAD include rupture of atherosclerotic plaque or vasa vasorum, hemorrhage between the outer media and external lamina with intramedial hematoma expansion, and compression of the vessel lumen. We report a case of SCAD in a 39-year-old woman presenting with ST-elevation myocardial infarction midway through her menstrual cycle. Her medications included fenfluramine for obesity and hydrochlorothiazide, amlodipine, and atenolol for hypertension.

Acne vulgaris is an extremely common disease, affecting large numbers of adolescents and adults, with substantial physical and psychosocial impacts. Antibiotics have been used for many years in the anti-microbial and anti-inflammatory treatment of acne, and have generated reasonable success rates. In recent years, along with a growing popularity of oral contraceptives to reduce unwanted pregnancies, they have also been applied in acne treatment because of their overall anti-androgenic effects. Very little direct comparisons between these two methods have been published, and this study serves as a preliminary measure for the effectiveness of both treatments against each other. Using an extensive literature search of PUBMED and MEDLINE for randomized clinical trials involving antibiotics or oral contraceptives, data were taken and used in an analysis to assess efficiency of both drug groups in the reduction of lesion counts and percentage reduction in inflammatory acne lesions, non-inflammatory lesions, and total lesions based off original baseline counts in each study. A total of 15 studies were used in the analysis. Antibiotics, oral contraceptives, and placebo treatment groups were evaluated at three months’ time, while oral contraceptives and placebo treatments were also continued out to six months to reflect longer trial durations. In all cases, antibiotics were superior to placebo at three months. Oral contraceptives were also superior to all placebo arms at both three and six months, except for in the average percent reduction of total lesions where the placebo at six months is not significantly different than the contraceptives at three months. Antibiotics and contraceptives showed no significant difference between each other at three or six months times, except for the lesion number reduction at three months for inflammatory lesions compared to antibiotics. All comparisons used the average percentage or number reduction, and 95% confidence intervals to determine significance. After three months, antibiotics showed a 45.40% weighted mean reduction in total lesion counts, compared to 36.41% for oral contraceptives at three months and 43.76% at six months. With the confidence intervals, the ranges for significance are 38.40%-52.40%, 31.92%-40.90%, and 33.87%-53.64% respectively, corresponding to an insignificant difference between all three treatments. Percentage changes for both inflammatory and non-inflammatory lesion reductions were also similar in their confidence intervals overlapping. The study showed a surprising similarity between antibiotics and contraceptives in their ability to treat acne, in both inflammatory and non-inflammatory lesions. With the exception of the three month antibiotics out-performing the oral contraceptives at three months’ time for reduction of inflammatory lesions, the percentage reduction was not significantly different, indicating discrepancies with starting numbers. Overall, both treatments were effective in the treatment of acne lesions, but the limitations of oral contraceptives including their utility is confined to women, and the relatively short recommended treatment time for oral antibiotics each have their drawbacks. Oral contraceptives seem to represent a better long term treatment plan for women who are comfortable taking birth control.

The purpose of this study was to attain an understanding of knowledge, attitudes and use of contraception amongst learners attending a high school in Mdantsane. A quantitative, descriptive survey was conducted. Data were collected using a semi-structured questionnaire which was self-administered by 150 female learners. These learners were doing grade 10-12 and were aged between 18-20 years. The findings indicated that 86.67% of the learners understood contraception as prevention of pregnancy, only 8.67% understood contraception as prevention of sexually transmitted diseases. The 66.3% of learners had positive attitude towards contraceptives. The 77.27% of the learners were using injectable contraceptives. The main reason for stopping use of contraception was side effects. Majority of learners had basic knowledge of contraceptives, but knew few types and did not know their mechanism of action. Most learners had positive attitude and were using contraceptives. / Health Studies / M.A. (Health Studies)

Osteoporosis is a skeletal disease affecting 44 million Americans. A primary strategy to prevent osteoporosis is to develop a high peak bone mass in youth. Oral Contraceptives (OCs) alter hormones in women and could affect bone mass development. The interaction between OCs and skeletal mineralization is poorly understood. PURPOSE: Our aims were to 1) compare bone mineral density (BMD) of young women who had a history of OC use with regularly menstruating controls, 2) compare changes in BMD in controls, women who initiate OC use, and those who have a history of use, and 3) to evaluate predictive capabilities of physical activity and years of oral contraceptives use on changes in BMD. METHODS: We recruited women, 18 to 25 years of age, with a history of OC use and controls. BMD at the hip, whole-body, and spine (AP, g/cm�� and width-adjusted lateral, g/cm��) was measured by dual-energy x-ray absorptiometry. Physical activity (METs) was measured via questionnaire and grip strength was evaluated using an isometric dynamometer. RESULTS: Groups were similar in body mass index (BMI), fat mass, grip strength, calcium intake and physical activity but controls were slightly older than OC users. In analysis of covariance (ANCOVA), controlling for age and BMI, controls had significantly greater BMD than OC users at baseline at the AP and lateral spine, hip, and whole-body (p<0.05). By ANCOVA (covariates = age at baseline, change in weight), oral contraceptive users had greater bone loss at L��� in the lateral view than controls whereas, controls had greater increases in L��� volumetric BMD, BMD of the total hip, and whole body than OC users (p<0.05). Stepwise regression results did not reveal years of oral contraceptive use, grip strength, or METs to be a significant predictor of changes in BMD at any site. CONCLUSIONS: We conclude that, in the cross-sectional analysis, oral contraceptive use by young women may compromise bone health during a time when mineral is still accruing. In the prospective analysis, regularly menstruating controls had greater BMD accrual or less bone loss over a 12-month time period than women with a history of oral contraceptive use. / Graduation date: 2005

The purpose of this study was to attain an understanding of knowledge, attitudes and use of contraception amongst learners attending a high school in Mdantsane. A quantitative, descriptive survey was conducted. Data were collected using a semi-structured questionnaire which was self-administered by 150 female learners. These learners were doing grade 10-12 and were aged between 18-20 years. The findings indicated that 86.67% of the learners understood contraception as prevention of pregnancy, only 8.67% understood contraception as prevention of sexually transmitted diseases. The 66.3% of learners had positive attitude towards contraceptives. The 77.27% of the learners were using injectable contraceptives. The main reason for stopping use of contraception was side effects. Majority of learners had basic knowledge of contraceptives, but knew few types and did not know their mechanism of action. Most learners had positive attitude and were using contraceptives. / Health Studies / M.A. (Health Studies)

Thesis (MSc (Biomedical Technology))--Cape Peninsula University of Technology, 2019 / Introduction: The provision of access to safe and effective contraception is a critical element in the health of women that enables them to make choices about their fertility. This element of control empowers them and indirectly enables them to access better social and economic opportunities. Hormonal contraceptives are a convenient, effective and relatively safe method of fertility control. Extensive research has been done on the effects of hormonal contraceptives on undesirable metabolic and haemostatic changes, but data on the relationship between oxidative stress and oral contraceptives is scarce and remains subject to debate. Aging of the skin due to oestrogen loss at menopause is thought to include atrophy, decreased collagen content, water content, and sebaceous secretions, loss of elasticity, wrinkling, poor wound healing and manifestations of hyperandrogenism. A number of studies have shown that oestrogens serve many important beneficial and protective functions in skin physiology. Despite extensive clinical experience, many metabolic effects of oral contraceptive treatment remain to be explored. The effects of progesterone on body weight and composition are of interest from several standpoints. Since hormonal contraceptives are widely used, it is important to investigate the effect thereof on oxidative status, skin parameters and anthropometric indicators, to enable women make informed choices about the use of contraceptives, or to adapt their lifestyle if necessary. The aim of the present study was therefore, to assess certain effects of contraceptives in a student population at the Cape Peninsula University of Technology (CPUT). Objectives of the study: To determine the differences in skin health, anthropometric \parameters and oxidative stress status in female university students using various hormonal contraceptives versus non-contraceptive users. Research design: The study adopted a quantitative approach to examine a crosssectional research sample in order to provide a snapshot of the population at a particular time. Concenting participants were selected through the use of questionnaires aimed at ascertaining the type of contraceptive used as well as general health and lifestyle patterns. Blood samples were collected and the antioxidant status was determined. Body composition and skin analysis was conducted on each of the participants in the selected groups and the results were compared to determine the differences between contraceptive and non-contraceptive users. Results: With regards to oxidative stress status, the results indicated a significant increase in superoxide dismutase (SOD) activities within the triphasic contraceptive group compared to the monophasic contraceptive group, suggesting higher levels of oxidative stress in monophasic contraceptive groups. There was also an increase in lipid peroxidation (TBARS) for the triphasic contraceptive group when compared to the control, monophasic contraceptive and injectable contraceptive groups respectively, indicative of increased oxidative stress levels in the triphasic contraceptive group. In this study, skin parameters evaluation revealed that there was a general increase in the presence of erythema in the monophasic contraceptive group compared to the control; injectable contraceptive; implant contraceptive and triphasic contraceptive groups, symptomatic of higher vascular activity in the monophasic group. Melanocyte activity measured in the forehead, cheek and chin areas were also significantly increased when the monophasic contraceptive group was compared to the control and other contraceptive groups, characterised by the pigmentation pattern of chloasma/melasma known to be caused by hormones. The hydration measurements were significantly increased in the implant contraceptive group compared to the control and monophasic contraceptive groups. Furthermore, a significant increase in hydration was evident in the injectable contraceptive group when compared to the control and monophasic contraceptive groups. Injectable contraceptives and implant contraceptives mainly contain progesterone which has been proven to combat signs of aging and increase collagen and elastin in the skin. With respect to anthropometric measurements, there was a significant increase in the measurement of waist to hip ratio in the implant contraceptive group compared to the control group (non-contraceptive). Progesterone influence on adipose tissue distribution indicated a more significant increase of adipose tissue in the abdominal region. Conclusion: In this study there was some evidence that the type of hormonal contraceptive used does have significant effects on the variables tested in the population sample. These effects are dependent on the composition of the contraceptive and the levels of progesterone and/or oestrogen.

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