Beyond Contraception: The Medical Necessity of Hormonal Contraceptives for Optimal Health and Well-being of Women in the UAE

Abstract

Introducing contraception as a method of treatment of many diseases is essential in order to optimize health and well-being of women in the UAE. The aim of the presented study was to analyze the non-contraceptive benefits and possible methods of using hormonal contraception in cultural context of the country. We reviewed articles concerning non-contraceptive use of contraception. Authors conducted their search in Pubmed/Medline, Scopus, Web of Science, EMBASE, CINAHL, National Library of Medicine, and Google Scholar. Hormonal contraceptives offer several health and wellness benefits that can improve the overall quality of life for women. These benefits encompass mood stabilization, reduction of premenstrual symptoms, acne relief, recurrent functional ovarian cysts, and luteal hemorrhagic cysts prevention, positive impact on bone mineral density, treatment of abnormal uterine bleeding, menstrual cycle abnormalities dysmenorrhea, ovarian and endometrial cancer prevention. It can also be used as a symptomatic method of treatment of PCOS and endometriosis. Moreover, it can guarantee appropriate birth spacing and can be prescribed for women with certain medical conditions where pregnancy poses significant risks to their health. Expanding access to hormonal contraceptives for non-contraceptive medical purposes requires a multi-faceted approach, including policy changes, regulatory reforms, insurance coverage adjustments, and educational initiatives for healthcare providers and the general public

Keywords:

Hormonal contraception benefits, Treatment with contraception, Non-contraceptive indication for contraception, Medical indication for contraception, Non-contraceptive benefits

References
[1] Abdulrahman, M., Farajallah, H. M., Kazim, M. N., AlHammadi, F. E., AlZubaidi, A. S., & Carrick, F. R. (2019). Pattern and determinants of contraceptive usage among women of reproductive age in the United Arab Emirates. Journal of Family Medicine and Primary Care, 8(6), 1931–1940. https://doi.org/10.4103/jfmpc.jfmpc_390_19

[2] Abrams, L. S., Skee, D. M., Natarajan, J., Wong, F. A., & Lasseter, K. C. (2001). Multipledose pharmacokinetics of a contraceptive patch in healthy women participants. Contraception, 64(5), 287–294. https://doi.org/10.1016/S0010-7824(01)00273-6

[3] ACOG Committee on Practice Bulletins–Gynecology. (2000). ACOG practice bulletin: No 15: Premenstrual syndrome. Obstetrics and Gynecology, 95(4), suppl 1–9.

[4] Adam, K. (2017). Pregnancy in women with cardiovascular diseases. Methodist DeBakey Cardiovascular Journal, 13(4), 209. https://doi.org/10.14797/mdcj-13-4-209

[5] Ahmed, S., Li, Q., Liu, L., & Tsui, A. O. (2012). Maternal deaths averted by contraceptive use: An analysis of 172 countries. The Lancet, 380(9837), 111–125. https://doi.org/10.1016/S0140-6736(12)60478-4

[6] Allen, R. H., Cwiak, C. A., & Kaunitz, A. M. (2013). Contraception in women over 40 years of age. Canadian Medical Association Journal, 185(7), 565–573. https://doi.org/10.1503/cmaj.121280

[7] Arowojolu, A. O., Gallo, M. F., Lopez, L. M., & Grimes, D. A. (2012). Combined oral contraceptive pills for treatment of acne. In The Cochrane Collaboration (Ed.), Cochrane Database of Systematic Reviews (p. CD004425.pub5). John Wiley & Sons, Ltd. https://doi.org/10.1002/14651858.CD004425.pub5

[8] Azziz, R. (2003). The evaluation and management of hirsutism. Obstetrics and Gynecology, 101(5 Pt 1), 995–1007. https://doi.org/10.1016/s0029-7844(02)02725-4

[9] Azziz, R. (2018). Polycystic ovary syndrome. Obstetrics & Gynecology, 132(2), 321– 336. https://doi.org/10.1097/AOG.0000000000002698

[10] Azziz, R., Carmina, E., Dewailly, D., Diamanti-Kandarakis, E., Escobar-Morreale, H. F., Futterweit, W., Janssen, O. E., Legro, R. S., Norman, R. J., Taylor, A. E., & Witchel, S. F. (2009). The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: The complete task force report. Fertility and Sterility, 91(2), 456–488. https://doi.org/10.1016/j.fertnstert.2008.06.035

[11] Bancroft, J., & Rennie, D. (1993). The impact of oral contraceptives on the experience of perimenstrual mood, clumsiness, food craving and other symptoms. Journal of Psychosomatic Research, 37(2), 195–202. https://doi.org/10.1016/0022- 3999(93)90086-U

[12] Bearak, J., Popinchalk, A., Alkema, L., & Sedgh, G. (2018). Global, regional, and subregional trends in unintended pregnancy and its outcomes from 1990 to 2014: Estimates from a Bayesian hierarchical model. The Lancet Global Health, 6(4), e380– e389. https://doi.org/10.1016/S2214-109X(18)30029-9

[13] Belsey, E. (1988). The association between vaginal bleeding patterns and reasons for discontinuation of contraceptive use. Contraception, 38(2), 207–225. https://doi.org/10.1016/0010-7824(88)90039-X

[14] Berenson, A. B., Rahman, M., & Wilkinson, G. (2009). Effect of injectable and oral contraceptives on serum lipids. Obstetrics & Gynecology, 114(4), 786–794. https://doi.org/10.1097/AOG.0b013e3181b76bea

[15] Bhate, K., & Williams, H. C. (2013). Epidemiology of acne vulgaris: Epidemiology of acne vulgaris. British Journal of Dermatology, 168(3), 474–485. https://doi.org/10.1111/bjd.12149

[16] Biggs, W. S., & Demuth, R. H. (2011). Premenstrual syndrome and premenstrual dysphoric disorder. American Family Physician, 84(8), 918–924.

[17] Bitzer, J., Gemzell-Danielsson, K., Roumen, F., Marintcheva-Petrova, M., Van Bakel, B., & Oddens, B. J. (2012). The CHOICE study: Effect of counselling on the selection of combined hormonal contraceptive methods in 11 countries. The European Journal of Contraception & Reproductive Health Care, 17(1), 65–78. https://doi.org/10.3109/13625187.2011.637586

[18] Black, A., Guilbert, E., Costescu, D., Dunn, S., Fisher, W., Kives, S., Mirosh, M., Norman, W., Pymar, H., Reid, R., Roy, G., Varto, H., Waddington, A., Wagner, M.-S., & Whelan, A. M. (2016). Canadian contraception consensus (Part 3 of 4): Chapter 7 – Intrauterine contraception. Journal of Obstetrics and Gynaecology Canada, 38(2), 182–222. https://doi.org/10.1016/j.jogc.2015.12.002

[19] Branum, A. M., & Jones, J. (2015). Trends in long-acting reversible contraception use among U.S. women aged 15-44. NCHS Data Brief, 188, 1–8.

[20] Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R. L., Torre, L. A., & Jemal, A. (2018). Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 68(6), 394–424. https://doi.org/10.3322/caac.21492

[21] Brown, J., Pan, A., & Hart, R. J. (2010). Gonadotrophin-releasing hormone analogues for pain associated with endometriosis. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD008475.pub2

[22] Chakravarty, E. F., Colón, I., Langen, E. S., Nix, D. A., El-Sayed, Y. Y., Genovese, M. C., & Druzin, M. L. (2005). Factors that predict prematurity and preeclampsia in pregnancies that are complicated by systemic lupus erythematosus. American Journal of Obstetrics and Gynecology, 192(6), 1897–1904. https://doi.org/10.1016/j.ajog.2005.02.063

[23] Chan, W. Y., Yusoff Dawood, M., & Fuchs, F. (1981). Prostaglandins in primary dysmenorrhea. The American Journal of Medicine, 70(3), 535–541. https://doi.org/10.1016/0002-9343(81)90576-3

[24] Cheng, L., Gülmezoglu, A. M., Piaggio, G. G., Ezcurra, E. E., & Van Look, P. P. (2008). Interventions for emergency contraception. In The Cochrane Collaboration (Ed.), Cochrane Database of Systematic Reviews (p. CD001324.pub3). John Wiley & Sons, Ltd. https://doi.org/10.1002/14651858.CD001324.pub3

[25] Choksey, R., Mangal, R. K., Stead, T. S., Jones, T., Flores, R., & Ganti, L. (2023). Quantifying the impact of dysmenorrhea symptoms on quality-of-life and access to oral contraceptives by income. Health Psychology Research, 11, 74120. https://doi.org/10.52965/001c.74120

[26] Cibula, D., Widschwendter, M., Majek, O., & Dusek, L. (2011). Tubal ligation and the risk of ovarian cancer: Review and meta-analysis. Human Reproduction Update, 17(1), 55–67. https://doi.org/10.1093/humupd/dmq030

[27] Class, Q. A., Lichtenstein, P., Långström, N., & D’Onofrio, B. M. (2011). Timing of prenatal maternal exposure to severe life events and adverse pregnancy outcomes: A population study of 2.6 million pregnancies. Psychosomatic Medicine, 73(3), 234– 241. https://doi.org/10.1097/PSY.0b013e31820a62ce

[28] Cleland, J., Shah, I. H., & Benova, L. (2015). A fresh look at the level of unmet need for family planning in the postpartum period, its causes and program implications. International Perspectives on Sexual and Reproductive Health, 41(03), 155–162. https://doi.org/10.1363/4115515

[29] Collaborative Group on Epidemiological Studies of Ovarian Cancer. (2008). Ovarian cancer and oral contraceptives: Collaborative reanalysis of data from 45 epidemiological studies including 23 257 women with ovarian cancer and 87 303 controls. The Lancet, 371(9609), 303–314. https://doi.org/10.1016/S0140- 6736(08)60167-1

[30] Conde-Agudelo, A., Rosas-Bermúdez, A., & Kafury-Goeta, A. C. (2006). Birth spacing and risk of adverse perinatal outcomes: A meta-analysis. JAMA, 295(15), 1809. https://doi.org/10.1001/jama.295.15.1809

[31] Curtis, K. M., Tepper, N. K., Jatlaoui, T. C., Berry-Bibee, E., Horton, L. G., Zapata, L. B., Simmons, K. B., Pagano, H. P., Jamieson, D. J., & Whiteman, M. K. (2016). U.S. Medical eligibility criteria for contraceptive use, 2016. MMWR. Recommendations and Reports, 65(3), 1–103. https://doi.org/10.15585/mmwr.rr6503a1

[32] DaVanzo, J., Hale, L., Razzaque, A., & Rahman, M. (2007). Effects of interpregnancy interval and outcome of the preceding pregnancy on pregnancy outcomes in Matlab, Bangladesh. BJOG: An International Journal of Obstetrics & Gynaecology, 114(9), 1079–1087. https://doi.org/10.1111/j.1471-0528.2007.01338.x

[33] Davis, A. R., & Westhoff, C. L. (2001). Primary dysmenorrhea in adolescent girls and treatment with oral contraceptives. Journal of Pediatric and Adolescent Gynecology, 14(1), 3–8. https://doi.org/10.1016/S1083-3188(00)00076-0

[34] Dawood, M. Y. (1988). Nonsteroidal anti-inflammatory drugs and changing attitudes toward dysmenorrhea. The American Journal of Medicine, 84(5), 23–29. https://doi.org/10.1016/0002-9343(88)90473-1

[35] Dawood, M. Y. (2006). Primary dysmenorrhea: Advances in pathogenesis and management. Obstetrics & Gynecology, 108(2), 428–441. https://doi.org/10.1097/01.AOG.0000230214.26638.0c

[36] Edelman, A., Micks, E., Gallo, M. F., Jensen, J. T., & Grimes, D. A. (2014). Continuous or extended cycle vs. Cyclic use of combined hormonal contraceptives for contraception. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD004695.pub3

[37] Endometrial cancer and oral contraceptives: An individual participant meta-analysis of 27 276 women with endometrial cancer from 36 epidemiological studies. (2015). The Lancet Oncology, 16(9), 1061–1070. https://doi.org/10.1016/S1470-2045(15)00212- 0

[38] Epperson, C. N., Steiner, M., Hartlage, S. A., Eriksson, E., Schmidt, P. J., Jones, I., & Yonkers, K. A. (2012). Premenstrual dysphoric disorder: Evidence for anew category for DSM-5. American Journal of Psychiatry, 169(5), 465–475. https://doi.org/10.1176/appi.ajp.2012.11081302

[39] Evrard, J. R., Buxton, B. H., & Erickson, D. (1976). Amenorrhea following oral contraception. American Journal of Obstetrics and Gynecology, 124(1), 88–91. https://doi.org/10.1016/0002-9378(76)90017-X

[40] Farquhar, C. (2007). Endometriosis. BMJ, 334(7587), 249–253. https://doi.org/10.1136/bmj.39073.736829.BE

[41] Ferlay, J., Colombet, M., Soerjomataram, I., Mathers, C., Parkin, D. M., Piñeros, M., Znaor, A., & Bray, F. (2019). Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. International Journal of Cancer, 144(8), 1941–1953. https://doi.org/10.1002/ijc.31937

[42] Finer, L. B., & Zolna, M. R. (2016). Declines in unintended pregnancy in the United States, 2008–2011. New England Journal of Medicine, 374(9), 843–852. https://doi.org/10.1056/NEJMsa1506575

[43] Fraser, I. S., Critchley, H. O. D., Munro, M. G., & Broder, M. (2007). Can we achieve international agreement on terminologies and definitions used to describe abnormalities of menstrual bleeding? Human Reproduction, 22(3), 635–643. https://doi.org/10.1093/humrep/del478

[44] Fraser, I., & Weisberg, E. (2015). Contraception and endometriosis: Challenges, efficacy, and therapeutic importance. Open Access Journal of Contraception, 105. https://doi.org/10.2147/OAJC.S56400

[45] Freeman, E. W., Kroll, R., Rapkin, A., Pearlstein, T., Brown, C., Parsey, K., Zhang, P., Patel, H., & Foegh, M. (2001). Evaluation of a unique oral contraceptive in the treatment of premenstrual dysphoric disorder. Journal of Women’s Health & Gender- Based Medicine, 10(6), 561–569. https://doi.org/10.1089/15246090152543148

[46] Ghazal-Aswad, S., Rizk, D. E., Al-Khoori, S. M., Shaheen, H., & Thomas, L. (2001). Knowledge and practice of contraception in United Arab Emirates women. Journal of Family Planning and Reproductive Health Care, 27(4), 212–216. https://doi.org/10.1783/147118901101195786

[47] Giudice, L. C. (2010). Endometriosis. New England Journal of Medicine, 362(25), 2389–2398. https://doi.org/10.1056/NEJMcp1000274

[48] Glasier, A., Edelman, A., Creinin, M. D., Han, L., Matulich, M. C., Brache, V., Westhoff, C. L., & Hemon, A. (2022). Mechanism of action of norgestrel 0.075 mg a progestogen-only pill. I. Effect on ovarian activity. Contraception, 112, 37–42. https://doi.org/10.1016/j.contraception.2022.03.022

[49] Glasier, A., & Gebbie, A. (1996). 8 Contraception for the older woman. Baillière’s Clinical Obstetrics and Gynaecology, 10(1), 121–138. https://doi.org/10.1016/S0950- 3552(96)80066-6

[50] Gorenoi, V., Schönermark, M. P., & Hagen, A. (2007). Benefits and risks of hormonal contraception for women. GMS Health Technology Assessment, 3, Doc06.

[51] Haider, Z., & D’Souza, R. (2009). Non-contraceptive benefits and risks of contraception. Best Practice & Research Clinical Obstetrics & Gynaecology, 23(2), 249–262. https://doi.org/10.1016/j.bpobgyn.2008.12.003

[52] Halbreich, U., Borenstein, J., Pearlstein, T., & Kahn, L. S. (2003). The prevalence, impairment, impact, and burden of premenstrual dysphoric disorder (PMS/PMDD). Psychoneuroendocrinology, 28, 1–23. https://doi.org/10.1016/S0306- 4530(03)00098-2

[53] Harada, T., Momoeda, M., Taketani, Y., Hoshiai, H., & Terakawa, N. (2008). Low-dose oral contraceptive pill for dysmenorrhea associated with endometriosis: A placebocontrolled, double-blind, randomized trial. Fertility and Sterility, 90(5), 1583–1588. https://doi.org/10.1016/j.fertnstert.2007.08.051

[54] Iacovides, S., Avidon, I., & Baker, F. C. (2015). What we know about primary dysmenorrhea today: A critical review. Human Reproduction Update, 21(6), 762– 778. https://doi.org/10.1093/humupd/dmv039

[55] James, A. H. (2009). Venous thromboembolism in pregnancy. Arteriosclerosis, Thrombosis, and Vascular Biology, 29(3), 326–331. https://doi.org/10.1161/ATVBAHA.109.184127

[56] Jatoi, A., Foster, N. R., Kalli, K. R., Vierkant, R. A., Zhang, Z., Larson, M. C., Fridley, B., & Goode, E. L. (2015). Prior oral contraceptive use in ovarian cancer patients: Assessing associations with overall and progression-free survival. BMC Cancer, 15(1), 711. https://doi.org/10.1186/s12885-015-1774-z

[57] Joffe, H., & Petrillo, L. F. (2007). Treatment of premenstrual worsening of depression with adjunctive oral contraceptive pills: A preliminary report. The Journal of Clinical Psychiatry, 68(12), 1954–1962. https://doi.org/10.4088/JCP.v68n1218

[58] Kaunitz, A. M. (2000). Injectable contraception. Obstetrics and Gynecology Clinics of North America, 27(4), 741–780. https://doi.org/10.1016/S0889-8545(05)70171-6

[59] Kriplani, A., Periyasamy, A. J., Agarwal, N., Kulshrestha, V., Kumar, A., & Ammini, A. C. (2010). Effect of oral contraceptive containing ethinyl estradiol combined with drospirenone vs. Desogestrel on clinical and biochemical parameters in patients with polycystic ovary syndrome. Contraception, 82(2), 139–146. https://doi.org/10.1016/j.contraception.2010.02.009

[60] Legro, R. S., Arslanian, S. A., Ehrmann, D. A., Hoeger, K. M., Murad, M. H., Pasquali, R., & Welt, C. K. (2013). Diagnosis and treatment of polycystic ovary syndrome: An endocrine society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 98(12), 4565–4592. https://doi.org/10.1210/jc.2013-2350

[61] Li, Z., Patton, G., Sabet, F., Zhou, Z., Subramanian, S. V., & Lu, C. (2020). Contraceptive use in adolescent girls and adult women in low- and middle-income countries. JAMA Network Open, 3(2), e1921437. https://doi.org/10.1001/jamanetworkopen.2019.21437

[62] Lindsay, R., Tohme, J., & Kanders, B. (1986). The effect of oral contraceptive use on vertebral bone mass in pre- and post-menopausal women. Contraception, 34(4), 333–340. https://doi.org/10.1016/0010-7824(86)90086-7

[63] Lopez, L. M., Kaptein, A. A., & Helmerhorst, F. M. (2012). Oral contraceptives containing drospirenone for premenstrual syndrome. The Cochrane Database of Systematic Reviews, 2, CD006586. https://doi.org/10.1002/14651858.CD006586.pub4

[64] Lucky, A. W., Koltun, W., Thiboutot, D., Niknian, M., Sampson-Landers, C., Korner, P., & Marr, J. (2008). A combined oral contraceptive containing 3-mg drospirenone/20- microg ethinyl estradiol in the treatment of acne vulgaris: A randomized, doubleblind, placebo-controlled study evaluating lesion counts and participant selfassessment. Cutis, 82(2), 143–150.

[65] Lukes, A. S., Reardon, B., & Arepally, G. (2008). Use of the levonorgestrel-releasing intrauterine system in women with hemostatic disorders. Fertility and Sterility, 90(3), 673–677. https://doi.org/10.1016/j.fertnstert.2007.07.1315

[66] MacGregor, B., Allaire, C., Bedaiwy, M. A., Yong, P. J., & Bougie, O. (2023). Disease burden of dysmenorrhea: Impact on life course potential. International Journal of Women’s Health, 15, 499–509. https://doi.org/10.2147/IJWH.S380006

[67] Mansour, D., Gemzell-Danielsson, K., Inki, P., & Jensen, J. T. (2011). Fertility after discontinuation of contraception: A comprehensive review of the literature. Contraception, 84(5), 465–477. https://doi.org/10.1016/j.contraception.2011.04.002

[68] Maxwell, G. L., Schildkraut, J. M., Calingaert, B., Risinger, J. I., Dainty, L., Marchbanks, P. A., Berchuck, A., Barrett, J. C., & Rodriguez, G. C. (2006). Progestin and estrogen potency of combination oral contraceptives and endometrial cancer risk. Gynecologic Oncology, 103(2), 535–540. https://doi.org/10.1016/j.ygyno.2006.03.046

[69] Maybin, J. A., & Critchley, H. O. D. (2016). Medical management of heavy menstrual bleeding. Women’s Health (London, England), 12(1), 27–34. https://doi.org/10.2217/whe.15.100

[70] McCann, M. F., & Potter, L. S. (1994). Progestin-only oral contraception: A comprehensive review. Contraception, 50(6 Suppl 1), S1-195.

[71] Milsom, I., Andersson, K., Andersch, B., & Rybo, G. (1991). A comparison of flurbiprofen, tranexamic acid, and a levonorgestrel-releasing intrauterine contraceptive device in the treatment of idiopathic menorrhagia. American Journal of Obstetrics and Gynecology, 164(3), 879–883. https://doi.org/10.1016/S0002-9378(11)90533-X

[72] Ministry of Health and Prevention (MOHAP). (2023). Healthcare system in the UAE. https//www.mohap.gov.ae/en/Aboutus/Pages/Health-System-in-UAE.aspx

[73] Mosorin, M.-E., Piltonen, T., Rantala, A. S., Kangasniemi, M., Korhonen, E., Bloigu, R., Tapanainen, J. S., & Morin-Papunen, L. (2023). Oral and vaginal hormonal contraceptives induce similar unfavorable metabolic effects in women with PCOS: A randomized controlled trial. Journal of Clinical Medicine, 12(8), 2827. https://doi.org/10.3390/jcm12082827

[74] O’Brien, E. C., Alberdi, G., & McAuliffe, F. M. (2018). The influence of socioeconomic status on gestational weight gain: A systematic review. Journal of Public Health, 40(1), 41–55. https://doi.org/10.1093/pubmed/fdx038

[75] Oinonen, K. A., & Mazmanian, D. (2002). To what extent do oral contraceptives influence mood and affect? Journal of Affective Disorders, 70(3), 229–240. https://doi.org/10.1016/S0165-0327(01)00356-1

[76] Ormesher, L., Simcox, L., Tower, C., & Greer, I. A. (2016). Management of inherited thrombophilia in pregnancy. Women’s Health, 12(4), 433–441. https://doi.org/10.1177/1745505716653702

[77] Ortiz, M. E., & Croxatto, H. B. (2007). Copper-T intrauterine device and levonorgestrel intrauterine system: Biological bases of their mechanism of action. Contraception, 75(6), S16–S30. https://doi.org/10.1016/j.contraception.2007.01.020

[78] Poromaa, I. S., & Segebladh, B. (2012). Adverse mood symptoms with oral contraceptives. Acta Obstetricia et Gynecologica Scandinavica, 91(4), 420–427. https://doi.org/10.1111/j.1600-0412.2011.01333.x

[79] Qadir, M. A., Rashid, N., Mengal, M. A., Hasni, M. S., Kakar, S. U. D., Khan, G. M., Shawani, N. A., Ali, I., Sheikh, I. S., & Khan, N. (2022). Iron-deficiency anemia in women of reproductive age in urban areas of Quetta District, Pakistan. BioMed Research International, 2022, 1–5. https://doi.org/10.1155/2022/6677249

[80] Randeva, H. S., Tan, B. K., Weickert, M. O., Lois, K., Nestler, J. E., Sattar, N., & Lehnert, H. (2012). Cardiometabolic Aspects of the Polycystic Ovary Syndrome. Endocrine Reviews, 33(5), 812–841. https://doi.org/10.1210/er.2012-1003

[81] Rapkin, A. J., & Winer, S. A. (2007). Drospirenone: A novel progestin. Expert Opinion on Pharmacotherapy, 8(7), 989–999. https://doi.org/10.1517/14656566.8.7.989

[82] Regitz-Zagrosek, V., Roos-Hesselink, J. W., Bauersachs, J., Blomström-Lundqvist, C., Cífková, R., De Bonis, M., Iung, B., Johnson, M. R., Kintscher, U., Kranke, P., Lang, I. M., Morais, J., Pieper, P. G., Presbitero, P., Price, S., Rosano, G. M. C., Seeland, U., Simoncini, T., Swan, L., … Nelson-Piercy, C. (2018). 2018 ESC guidelines for the management of cardiovascular diseases during pregnancy. European Heart Journal, 39(34), 3165–3241. https://doi.org/10.1093/eurheartj/ehy340

[83] Rivera, R., Yacobson, I., & Grimes, D. (1999). The mechanism of action of hormonal contraceptives and intrauterine contraceptive devices. American Journal of Obstetrics and Gynecology, 181(5), 1263–1269. https://doi.org/10.1016/S0002- 9378(99)70120-1

[84] Rocca, M. L., Palumbo, A. R., Visconti, F., & Di Carlo, C. (2021). Safety and benefits of contraceptives implants: A systematic review. Pharmaceuticals (Basel, Switzerland), 14(6), 548. https://doi.org/10.3390/ph14060548

[85] Roumen, F. J. M. E., & Dieben, T. O. M. (1999). Clinical acceptability of an ethylene-vinyl-acetate nonmedicated vaginal ring. Contraception, 59(1), 59–62. https://doi.org/10.1016/S0010-7824(98)00145-0

[86] Schindler, A. E. (2012). Non-contraceptive benefits of oral hormonal contraceptives. International Journal of Endocrinology and Metabolism, 11(1). https://doi.org/10.5812/ijem.4158

[87] Seracchioli, R., Mabrouk, M., Frascà, C., Manuzzi, L., Savelli, L., & Venturoli, S. (2010). Long-term oral contraceptive pills and postoperative pain management after laparoscopic excision of ovarian endometrioma: A randomized controlled trial. Fertility and Sterility, 94(2), 464–471. https://doi.org/10.1016/j.fertnstert.2009.03.083

[88] Sitruk-Ware, R. (2006). New progestagens for contraceptive use. Human Reproduction Update, 12(2), 169–178. https://doi.org/10.1093/humupd/dmi046

[89] Sitruk-Ware, R. (2008). Reprint of pharmacological profile of progestins. Maturitas, 61(1–2), 151–157. https://doi.org/10.1016/j.maturitas.2008.11.011

[90] Skouby, S. (2004). Contraceptive use and behavior in the 21st century: A comprehensive study across five European countries. The European Journal of Contraception & Reproductive Health Care, 9(2), 57–68. https://doi.org/10.1080/13625180410001715681

[91] Slopien, R., Milewska, E., Rynio, P., & Meczekalski, B. (2018). Use of oral contraceptives for management of acne vulgaris and hirsutism in women of reproductive and late reproductive age. Menopausal Review, 17(1), 1–4. https://doi.org/10.5114/pm.2018.74895

[92] Smet, M., & McLennan, A. (2018). Rotterdam criteria, the end. Australasian Journal of Ultrasound in Medicine, 21(2), 59–60. https://doi.org/10.1002/ajum.12096

[93] Solymoss, S. (2011). Risk of venous thromboembolism with oral contraceptives. Canadian Medical Association Journal, 183(18), E1278–E1279. https://doi.org/10.1503/cmaj.111614

[94] Stamilio, D. M., DeFranco, E., Paré, E., Odibo, A. O., Peipert, J. F., Allsworth, J. E., Stevens, E., & Macones, G. A. (2007). Short interpregnancy interval: Risk of uterine rupture and complications of vaginal birth after cesarean delivery. Obstetrics & Gynecology, 110(5), 1075–1082. https://doi.org/10.1097/01.AOG.0000286759.49895.46

[95] Stevens, G. A., Finucane, M. M., De-Regil, L. M., Paciorek, C. J., Flaxman, S. R., Branca, F., Peña-Rosas, J. P., Bhutta, Z. A., & Ezzati, M. (2013). Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: A systematic analysis of population-representative data. The Lancet Global Health, 1(1), e16–e25. https://doi.org/10.1016/S2214-109X(13)70001-9

[96] Stouffer, R. L., & Woodruff, T. K. (2017). Nonhuman primates: A vital model for basic and applied research on female reproduction, prenatal development, and women’s health. ILAR Journal, 58(2), 281–294. https://doi.org/10.1093/ilar/ilx027

[97] Thomas, S. V. (2015). Controversies in contraception for women with epilepsy. Annals of Indian Academy of Neurology, 18(3), 278–283. https://doi.org/10.4103/0972- 2327.162261

[98] Torgerson, D. J., & Bell-Syer, S. E. M. (2001). Hormone replacement therapy and prevention of nonvertebral fractures: A meta-analysis of randomized trials. JAMA, 285(22), 2891. https://doi.org/10.1001/jama.285.22.2891

[99] Trivedi, M. K., Shinkai, K., & Murase, J. E. (2017). A review of hormone-based therapies to treat adult acne vulgaris in women. International Journal of Women’s Dermatology, 3(1), 44–52. https://doi.org/10.1016/j.ijwd.2017.02.018

[100] Trussell, J. (2011). Contraceptive failure in the United States. Contraception, 83(5), 397–404. https://doi.org/10.1016/j.contraception.2011.01.021

[101] Van Der Vange, N., Blankenstein, M. A., Kloosterboer, H. J., Haspels, A. A., & Thijssen, J. H. H. (1990). Effects of seven low-dose combined oral contraceptives on sex hormone binding globulin, corticosteroid binding globulin, total and free testosterone. Contraception, 41(4), 345–352. https://doi.org/10.1016/0010- 7824(90)90034-S

[102] Van Zuuren, E. J., Fedorowicz, Z., Carter, B., & Pandis, N. (2015). Interventions for hirsutism (excluding laser and photoepilation therapy alone). Cochrane Database ofSystematic Reviews, 2017(5). https://doi.org/10.1002/14651858.CD010334.pub2

[103] Vercellini, P., Crosignani, P., Somigliana, E., Vigano, P., Frattaruolo, M. P., & Fedele, L. (2011). “Waiting for Godot”: A commonsense approach to the medical treatment of endometriosis. Human Reproduction, 26(1), 3–13. https://doi.org/10.1093/humrep/deq302

[104] Vercellini, P., Frontino, G., De Giorgi, O., Pietropaolo, G., Pasin, R., & Crosignani, P. G. (2003). Continuous use of an oral contraceptive for endometriosis-associated recurrent dysmenorrhea that does not respond to a cyclic pill regimen. Fertility and Sterility, 80(3), 560–563. https://doi.org/10.1016/S0015-0282(03)00794-5

[105] WHO (World Health Organization). (2007). Report of a WHO technical consultation on birth spacing Geneva, Switzerland 13–15 June 2005. WHO. https://www.who.int/publications/i/item/WHO-RHR-07.1

[106] Winner, B., Peipert, J. F., Zhao, Q., Buckel, C., Madden, T., Allsworth, J. E., & Secura, G. M. (2012). Effectiveness of long-acting reversible contraception. New England Journal of Medicine, 366(21), 1998–2007. https://doi.org/10.1056/NEJMoa1110855

[107] Wong, C. L., Farquhar, C., Roberts, H., & Proctor, M. (2009). Oral contraceptive pill for primary dysmenorrhoea. The Cochrane Database of Systematic Reviews, 2009(4), CD002120. https://doi.org/10.1002/14651858.CD002120.pub3

[108] World Health Organization. (2008). Worldwide prevalence of anaemia 1993-2005: WHO global database on anaemia. Edited by Bruno de Benoist, Erin McLean, Ines Egli and Mary Cogswell. 40.

[109] Yonkers, K. A., O’Brien, P. S., & Eriksson, E. (2008). Premenstrual syndrome. The Lancet, 371(9619), 1200–1210. https://doi.org/10.1016/S0140-6736(08)60527-9

[110] Zaenglein, A. L., Pathy, A. L., Schlosser, B. J., Alikhan, A., Baldwin, H. E., Berson, D. S., Bowe, W. P., Graber, E. M., Harper, J. C., Kang, S., Keri, J. E., Leyden, J. J., Reynolds, R. V., Silverberg, N. B., Stein Gold, L. F., Tollefson, M. M., Weiss, J. S., Dolan, N. C., Sagan, A. A., … Bhushan, R. (2016). Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology, 74(5), 945-973.e33. https://doi.org/10.1016/j.jaad.2015.12.037

[111] Zhu, B.-P., Rolfs, R. T., Nangle, B. E., & Horan, J. M. (1999). Effect of the Interval between Pregnancies on Perinatal Outcomes. New England Journal of Medicine, 340(8), 589–594. https://doi.org/10.1056/NEJM199902253400801