Contraception最新文献

{"title":"Society of Family Planning Committee Statement: Contraceptive considerations for individuals with cancer and cancer survivors part 1 – Key considerations for clinical care Joint with the Society of Gynecologic Oncology","authors":"Pelin Batur ,&nbsp;Ashley Brant ,&nbsp;Carolyn McCourt ,&nbsp;Eleanor Bimla Schwarz ,&nbsp;with the assistance of Anitra Beasley; Jessica Atrio; and Danielle Gershon, on behalf of the Clinical Affairs Committee, and Neil A. Nero","doi":"10.1016/j.contraception.2025.110870","DOIUrl":"10.1016/j.contraception.2025.110870","url":null,"abstract":"<div><div>With increasing trends in both cancer diagnosis and survivorship, a growing number of individuals impacted by cancer need high-quality contraceptive counseling. Individuals with cancer and cancer survivors have individualized needs with respect to sexual activity, fertility desires, and contraceptive preferences. Clinicians should provide person-centered contraceptive care that supports individual autonomy in decision-making, is tailored to the individual’s expressed preferences and values, and includes cancer-specific considerations<em>.</em> While pregnancy prevention is generally recommended during cancer treatment, pregnancy may occur before or during treatment and require person-centered counseling<em>.</em> No test reliably rules out pregnancy potential in cancer survivors; clinicians should offer to discuss contraception with individuals who are pregnancy-capable before cancer treatment. Clinicians should counsel individuals about common risks and complications that may impact contraceptive choice, as cancer and chemotherapy can cause (1) vascular injury, which can increase the risk of venous thromboembolism, (2) anemia, and (3) bone loss increasing the risk of fractures. Clinicians should counsel individuals with cancer that it is safe for them to use emergency contraception. Clinicians should be aware that individuals experiencing intimate partner violence and other marginalized populations, including adolescents and young adults and gender-diverse individuals, have unique needs requiring a person-centered approach to contraceptive care complicated by cancer. Access to the full spectrum of contraceptive methods should be prioritized for individuals with cancer and cancer survivors, accommodating individual preferences and health status. This document is part 1 of a three-part series that updates the Society of Family Planning’s 2012 <em>Cancer and contraception</em> clinical guidance. Its companion documents, <em>Society of Family Planning Clinical Recommendation: Contraceptive considerations for individuals with cancer and cancer survivors part 2 – Breast, ovarian, uterine, and cervical cancer</em> and <em>Society of Family Planning Clinical Recommendation: Contraceptive considerations for individuals with cancer and cancer survivors part 3 – Skin, blood, gastrointestinal, liver, lung, central nervous system, and other cancers</em><strong>,</strong> build upon this document and focus on actionable, clinical recommendations.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"147 ","pages":"Article 110870"},"PeriodicalIF":2.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Society of Family Planning Clinical Recommendation: Contraceptive considerations for individuals with cancer and cancer survivors part 3 – Skin, blood, gastrointestinal, liver, lung, central nervous system, and other cancers: Joint with the Society of Gynecologic Oncology","authors":"Pelin Batur ,&nbsp;Ashley Brant ,&nbsp;Carolyn McCourt ,&nbsp;Eleanor Bimla Schwarz ,&nbsp;with the assistance of Anitra Beasley; Jessica Atrio; and Danielle Gershon, on behalf of the Clinical Affairs Committee, and Neil A. Nero","doi":"10.1016/j.contraception.2025.110869","DOIUrl":"10.1016/j.contraception.2025.110869","url":null,"abstract":"<div><div>This Clinical Recommendation provides evidence-informed, person-centered, and equity-driven recommendations to facilitate the management of and access to contraception care for individuals who are diagnosed with, being actively treated for, or who have previously been treated for skin, blood, gastrointestinal, liver, lung, central nervous system, and other cancers. For individuals with a history of nonmelanoma skin cancers, we recommend clinicians provide access to all available contraceptive methods utilizing a person-centered approach (GRADE 1B). Based on expert opinion, for individuals with a history of melanoma who are considering hormonal contraception, we suggest shared decision-making with the individual and their oncologist (GRADE 2C). For individuals with a history of myeloproliferative neoplasms, lymphatic or hematopoietic cancer, and hematopoietic stem cell transplantation, we recommend clinicians provide access to all contraceptive methods (GRADE 1B); we suggest shared decision-making in those with follicular lymphoma subtype of non-Hodgkin lymphoma who are considering hormonal contraception (GRADE 2C). For individuals with a history of colorectal, pancreatic, esophageal, and gastric cancer, we recommend clinicians provide access to all available contraceptive methods (GRADE 1C). We recommend clinicians provide access to all available contraceptive methods in individuals with a history of primary hepatocellular carcinoma with normal liver function (GRADE 1C); with severely altered liver function, we recommend nonhormonal and progestin-only contraceptives as first-line contraceptive methods (GRADE 1B). For individuals with a history of glioma, we recommend clinicians provide access to all available contraceptives (GRADE 1B). For individuals with a history of meningioma who request hormonal contraception, we recommend shared decision-making with the individual and their oncologist (GRADE 2B). We recommend clinicians provide access to all available contraceptive options for individuals with a history of or active bladder, kidney, thyroid, head and neck squamous cell, and soft tissue sarcomas (GRADE 1B). This document is part 3 of a three-part series that updates the Society of Family Planning’s 2012 <em>Cancer and contraception</em> clinical guidance. It builds upon the considerations outlined in the <em>Society of Family Planning Committee Statement: Contraceptive considerations for individuals with cancer and cancer survivors part 1 – Key considerations for clinical care</em> and parallels recommendations outlined in the <em>Society of Family Planning Clinical Recommendation: Contraceptive considerations for individuals with cancer and cancer survivors part 2 – Breast, ovarian, uterine, and cervical cancer</em>. Readers are encouraged to review parts 1 and 2 for this additional context.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"147 ","pages":"Article 110869"},"PeriodicalIF":2.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Society of Family Planning Clinical Recommendation: Prevention of infection after abortion and pregnancy loss","authors":"Terri Cheng ,&nbsp;Nimisha Kumar ,&nbsp;Laura Laursen ,&nbsp;Sharon L. Achilles ,&nbsp;Matthew F. Reeves ,&nbsp;with the assistance of Jessica Atrio, Sarita Sonalkar on behalf of the Clinical Affairs Committee","doi":"10.1016/j.contraception.2025.110895","DOIUrl":"10.1016/j.contraception.2025.110895","url":null,"abstract":"&lt;div&gt;&lt;div&gt;This Clinical Recommendation serves as a revision to the Society of Family Planning’s 2010 &lt;em&gt;Prevention of infection after induced abortion&lt;/em&gt; guidance. It examines infection risk, identifiable risk factors, and prophylactic measures for the prevention of infection associated with procedural and medication management of abortion and pregnancy loss to make evidence-based recommendations for the clinical care of patients. The following are the Society of Family Planning’s recommendations: We recommend clinicians (1) test and treat patients empirically for gonorrhea and chlamydia at the time of abortion if there is high clinical suspicion, (2) treat the patient if they have a known diagnosis of gonorrhea or chlamydia but have not received treatment, or (3) provide routine annual screening for gonorrhea and chlamydia for patients under 25 years and others at increased risk due for screening based on the US Preventive Services Task Force recommendations, and, if positive, treat according to the Centers for Disease Control and Prevention's guidelines; clinicians should not delay abortion while awaiting diagnosis or treatment (GRADE 1C). We recommend against screening for bacterial vaginosis before abortion (GRADE 1C). Since the rate of infection is low for nonprocedural abortion and the number needed to treat is high, coupled with inherent risks associated with antibiotic use, we recommend against the use of universal antibiotic prophylaxis in the setting of medication abortion, medication management of early pregnancy loss, or self-managed abortion (GRADE 1C). We recommend universal antibiotic prophylaxis for patients undergoing procedural abortion across all gestational durations (GRADE 1A). For procedural management of pregnancy loss, we recommend antibiotic prophylaxis (GRADE 1A). We recommend clinicians initiate antibiotic prophylaxis for procedural abortion and procedural management of pregnancy loss before instrumentation to maximize efficacy (GRADE 1B). Antibiotics should be given with adequate time for absorption, but data on the optimal timing for prophylaxis are lacking. In the setting of osmotic cervical dilator use, there is insufficient evidence to recommend for or against routine antibiotic prophylaxis before osmotic cervical dilator placement. We recommend discontinuing antibiotic prophylaxis after the procedure is completed (GRADE 1B). We recommend a single dose of doxycycline 200 mg orally or azithromycin 500 mg orally before a procedural abortion or procedural management of pregnancy loss (GRADE 1B). Metronidazole is a second-line option as it has evidence to suggest a prophylactic effect despite being less effective than doxycycline or azithromycin against aerobic bacteria. We recommend against the use of fluoroquinolones for prophylaxis in the setting of procedural abortion or procedural management of pregnancy loss due to the increased risk of side effects and complications (GRADE 1B). There is insufficient evidence ","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"148 ","pages":"Article 110895"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Society of Family Planning Clinical Recommendation: Management of undesired pregnancy of unknown location and abortion at less than 42 days of gestation","authors":"Siripanth Nippita ,&nbsp;Catherine Cansino ,&nbsp;Alisa B. Goldberg ,&nbsp;Neena Qasba ,&nbsp;Katharine White ,&nbsp;Vinita Goyal ,&nbsp;Angeline Ti ,&nbsp;on behalf of the Clinical Affairs Committee,&nbsp;Christy Boraas","doi":"10.1016/j.contraception.2025.110865","DOIUrl":"10.1016/j.contraception.2025.110865","url":null,"abstract":"<div><div>Pregnancy of unknown location is a condition in which a pregnancy test is positive, but no intrauterine or extrauterine pregnancy is visualized using transvaginal ultrasonography. We recommend using standardized nomenclature and definitions to describe intrauterine pregnancy (IUP), probable IUP, pregnancy of unknown location (PUL), probable ectopic pregnancy (probable EP), and ectopic pregnancy (EP) (Best Practice). Among abortion-seeking patients found to have a PUL, the incidence of EP is 4% to 8%. We recommend clinical judgment in assessing the risk for EP in the setting of PUL; the absence of an intrauterine gestational sac (GS) or yolk sac should not delay care (GRADE 1B). In asymptomatic individuals with an undesired PUL who prefer to proceed with immediate treatment (medication or procedural management without delay) and have a low risk of EP, as determined by the clinician based on history, symptoms, and all other available data, we recommend medication management with mifepristone and misoprostol or procedural management via uterine aspiration and clear plans for ensuring pregnancy resolution in a timely fashion (GRADE 1B). While both medication and procedural management of undesired PUL are associated with earlier pregnancy resolution and identification of EP, the two main risks of inadequate follow-up include ongoing pregnancy and missing or delaying a subsequent diagnosis of EP. For individuals with PUL choosing immediate treatment with medication management, we recommend clinicians obtain a baseline serum quantitative human chorionic gonadotropin (hCG) at the time of medication provision to aid in diagnosis and follow-up (GRADE 1A). Following medication management of PUL with mifepristone and misoprostol, we suggest a repeat serum quantitative hCG level, with pregnancy resolution defined as either a 50% decline or greater at 48 to 72 hours after misoprostol or an 80% decline or greater at 7 days after mifepristone or 5 to 10 days after misoprostol (GRADE 2B). We recommend against direct extrapolation of follow-up recommendations from no-test abortion clinical protocols to individuals with a documented PUL treated with mifepristone and misoprostol, given the higher risk of EP among individuals with a known PUL (GRADE 1C). When uterine aspiration is performed at less than 42 days of gestation, including for individuals with PUL or probable IUP, and both chorionic villi and GS are not visualized, we recommend repeat ultrasonography (if an IUP or probable IUP was seen initially), serum quantitative hCG follow-up, or both (GRADE 1B). When both chorionic villi and GS are not visualized after uterine aspiration and serial serum hCG follow-up is warranted, we recommend testing on the day of the procedure and 24 to 72 hours later, with pregnancy resolution defined as greater than 50% decline 24 hours after aspiration, greater than 70% by 48 hours, or greater than 80% by approximately 72 hours (GRADE 1B).</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"150 ","pages":"Article 110865"},"PeriodicalIF":2.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tribute to Prof. Eberhard Nieschlag","authors":"Regine Sitruk-Ware","doi":"10.1016/j.contraception.2025.110868","DOIUrl":"10.1016/j.contraception.2025.110868","url":null,"abstract":"","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"145 ","pages":"Article 110868"},"PeriodicalIF":2.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary surgical planning for a patient with hyperthyroidism complicating a twin gestation of a complete hydatidiform mole and a coexisting fetus","authors":"Gillian Piltch ,&nbsp;Charit Taneja ,&nbsp;Justin Feit ,&nbsp;Elizabeth O. Schmidt","doi":"10.1016/j.contraception.2025.110866","DOIUrl":"10.1016/j.contraception.2025.110866","url":null,"abstract":"<div><div>This case report demonstrates hyperthyroidism complicating a twin gestation consisting of a complete hydatidiform mole and coexisting fetus. The patient underwent medical optimization of hyperthyroidism with a thionamide and beta blocker prior to undergoing uncomplicated dilation and evacuation under spinal anesthesia. She was cared for by a multidisciplinary team.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"146 ","pages":"Article 110866"},"PeriodicalIF":2.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of denying abortion access to patients with chronic kidney disease: A cost-effectiveness analysis","authors":"Sydney McCarthy,&nbsp;Julia Tasset,&nbsp;Olivia Curl,&nbsp;Sarah Dzubay,&nbsp;Aaron B. Caughey","doi":"10.1016/j.contraception.2025.110863","DOIUrl":"10.1016/j.contraception.2025.110863","url":null,"abstract":"<div><h3>Objectives</h3><div>The current study focuses on how abortion access affects people who are pregnant, have chronic kidney disease (CKD), and desire an abortion. From the perspective of the pregnant patient, we will examine the outcomes and costs associated with providing or refusing in-state access to abortion for this population.</div></div><div><h3>Study design</h3><div>A decision-analytic model was built to compare the outcomes and costs associated with providing abortions in-state compared to those associated with a complete statewide abortion ban. The model includes outcomes of pregnancy with CKD and considers the progression of disease. The model also considers the likelihood and costs associated with traveling to another state for an abortion.</div></div><div><h3>Results</h3><div>In a cohort of 31,243 pregnant people with CKD desiring an abortion, providing abortions resulted in 1350 fewer cases of preeclampsia, 2703 fewer preterm births, 4837 fewer cases of CKD stage progression, 841 fewer cases of end-stage renal disease requiring dialysis, and nine fewer deaths per year. An absence of in-state abortion access was associated with an increased cost of $533,874,448 and a decrease of 6873 quality adjusted life years (QALYs) compared to states with abortion access.</div></div><div><h3>Conclusion</h3><div>Providing in-state abortion access to pregnant people with chronic kidney disease is a cost-effective strategy, due to the direct decrease in preeclampsia, preterm birth, mortality, and progression of kidney disease.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"146 ","pages":"Article 110863"},"PeriodicalIF":2.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Copyright info/Contents","authors":"","doi":"10.1016/S0010-7824(25)00036-8","DOIUrl":"10.1016/S0010-7824(25)00036-8","url":null,"abstract":"","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"144 ","pages":"Article 110845"},"PeriodicalIF":2.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143547841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uses of ulipristal acetate beyond emergency contraception: A narrative review","authors":"Ashley M. Ebersole ,&nbsp;Abigail Liberty ,&nbsp;Alison Edelman ,&nbsp;Elizabeth Lyman ,&nbsp;Kelly Cleland","doi":"10.1016/j.contraception.2025.110862","DOIUrl":"10.1016/j.contraception.2025.110862","url":null,"abstract":"<div><h3>Objectives</h3><div>Ulipristal acetate (UPA) is a selective progesterone receptor modulator and the most effective oral emergency contraceptive (EC) method available in the United States. The aim of this review is to identify and describe uses of UPA beyond EC and to further discuss the concerns regarding the possible off-target liver effects.</div></div><div><h3>Study design</h3><div>We conducted a literature search in August 2024, using Embase, Medline (PubMed), and Cochrane, utilizing a combination of MeSH and keywords for UPA, excluding animal studies, and limiting to English language publications. After excluding duplicates using covidence, two authors reviewed the remaining 610 results and identified 340 studies. We further excluded case reports and case series.</div></div><div><h3>Results</h3><div>UPA has shown significant promise for indications outside of EC, most notably treatment of uterine leiomyomas, but also ongoing contraception, prevention and treatment of breast cancer, and abnormal uterine bleeding. While UPA has extensive potential for use both within and beyond reproductive health, unfortunately any ongoing development is at a standstill due to concerns regarding its possible role in causing serious liver injury. The role of UPA in causing drug-induced liver injury is not confirmed and preclinical studies during development did not demonstrate a concern that UPA causes drug-induced liver injury.</div></div><div><h3>Conclusions</h3><div>Access to UPA is crucial not only for EC but for the treatment of many other gynecological and nongynecological conditions.</div></div><div><h3>Implications</h3><div>Ulipristal acetate (UPA) has shown significant promise for indications outside of EC, including uterine leiomyomas, prevention and treatment of breast cancer, and abnormal uterine bleeding. Access to UPA is crucial not only for EC but for the treatment of many other gynecologic and non-gynecologic conditions.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"146 ","pages":"Article 110862"},"PeriodicalIF":2.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estetrol/Drospirenone safety in a population with cardiovascular risk factors","authors":"Mitchell D. Creinin ,&nbsp;Jean Michel Foidart ,&nbsp;Kristina Gemzell-Danielsson ,&nbsp;Nina C. Flerin ,&nbsp;Ali Kubba ,&nbsp;Ulysse Gaspard ,&nbsp;Jonathan Douxfils","doi":"10.1016/j.contraception.2025.110861","DOIUrl":"10.1016/j.contraception.2025.110861","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate cardiovascular safety outcomes in estetrol 15 mg/drospirenone 3 mg users with cardiovascular risk factors.</div></div><div><h3>Study design</h3><div>We performed a secondary analysis of two open-label contraceptive phase-3 trials that enrolled participants 16 to 50 years to use estetrol/drospirenone for up to 13 cycles. Study exclusion criteria included &gt;35 years and smoking, body mass index &gt;35 kg/m², and baseline blood pressure (BP) &gt;140/90 mmHg. We compared adverse event rates in participants with and without cardiovascular risk factors and assessed discontinuation rates for cardiovascular adverse events.</div></div><div><h3>Results</h3><div>Of 3417 participants, 1410 (41.3%) had one or more, and 309 (9.0%) had two or more cardiovascular risk factors. We found no difference in discontinuation for any adverse events in participants with and without cardiovascular risk factors. Six (0.18%) participants discontinued for a cardiovascular complaint including four with risk factors: three (0.09%) due to hypertension (all had baseline BP ≥130/85 mmHg and one or more additional risk factors) and one due to venous thrombosis (BP ≥130/85 mmHg). Of 375 participants with baseline BP ≥130/85 mmHg, 0.8% (95% CI 0%–1.7%) discontinued for hypertension while among the 192 participants with baseline BP ≥130/85 mmHg and one or more additional cardiovascular risk factors, 1.6% (95% CI 0%–3.3%) discontinued for hypertension.</div></div><div><h3>Conclusions</h3><div>Among &gt;1400 study participants with cardiovascular risk factors using estetrol/drospirenone, only three (0.2%) discontinued for hypertension, all of whom had high-normal baseline BP and at least one other risk cardiovascular risk factor.</div></div><div><h3><strong>Implications</strong></h3><div>Estetrol/drospirenone use demonstrates excellent cardiovascular tolerance in study participants with normal and high-normal blood pressure, even in those with cardiovascular risk factors. The very low rate of hypertension, even when cardiovascular risk factors were present, provides evidence to warrant clinical trials of estetrol/drospirenone in patients with hypertension desiring contraception.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"146 ","pages":"Article 110861"},"PeriodicalIF":2.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}