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Combined Oral Contraceptive Utilizat...

Hoffman, Sarah Ruth.

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Combined Oral Contraceptive Utilization and Uterine Fibroid Incidence and Prevalence in The Study of Environment, Lifestyle, and Fibroids (SELF).

Record Type:	Electronic resources : Monograph/item
Title/Author:	Combined Oral Contraceptive Utilization and Uterine Fibroid Incidence and Prevalence in The Study of Environment, Lifestyle, and Fibroids (SELF)./
Author:	Hoffman, Sarah Ruth.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2019,
Description:	122 p.
Notes:	Source: Dissertations Abstracts International, Volume: 81-09, Section: B.
Contained By:	Dissertations Abstracts International81-09B.
Subject:	Pharmaceutical sciences. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=22620224
ISBN:	9781392842942

Combined Oral Contraceptive Utilization and Uterine Fibroid Incidence and Prevalence in The Study of Environment, Lifestyle, and Fibroids (SELF).
Hoffman, Sarah Ruth.

Combined Oral Contraceptive Utilization and Uterine Fibroid Incidence and Prevalence in The Study of Environment, Lifestyle, and Fibroids (SELF). - Ann Arbor : ProQuest Dissertations & Theses, 2019 - 122 p.

Source: Dissertations Abstracts International, Volume: 81-09, Section: B.

Thesis (Ph.D.)--The University of North Carolina at Chapel Hill, 2019.

This item must not be sold to any third party vendors.

Estrogen and progesterone play complex, interrelated roles in fibroid tumor development. Hormonal contraceptives are composed of progestin (synthetic progesterone) and may also include estrogen. The most common form of hormonal contraception used in the United States is combined oral contraception. To date, existing published literature regarding the association between combined oral contraceptives (COC) use and uterine fibroid development have yielded mixed findings, limited by lack of baseline ultrasounds that could establish temporality, and often restricted to outcome ascertainment among symptomatic women seeking treatment. In addition, existing literature largely excluded black women, the population most burdened by symptomatic fibroids.The Study of Environment, Lifestyle, and Fibroids (SELF) was the first prospective, ultrasound-based study of risk factors for uterine fibroids. SELF consists of 1,696 young (23-34 years), black women living in the Detroit, Michigan area in 2010-2017. We examined associations between different levels of COC use and the 40-month cumulative risk of uterine fibroids, and baseline fibroid prevalence. Specifically, we examined ever use of COCs, and age at first use, duration of use, and time since last use among ever COC users. Inverse probability weights were constructed for all exposures, and censoring. Standardized mortality ratio weights were constructed for ever COC use. At ~40-months' follow-up, we observed a possible protective association between ever use of COCs and cumulative fibroid incidence among women who were without fibroids at study enrollment (wRR: 0.78; 95% CI: 0.60, 1.00). When restricting the "Never" comparator group to ever hormonal contraceptive (HC) users, the observed association between COC use and fibroid incidence was attenuated (wRR: 0.92; 95% CI: 0.60, 1.40). The protective association re-emerged when restricting the "Never" group to women with no history of HC use (wRR: 0.72; 95% CI: 0.51, 1.01). No associations were found between fibroid prevalence or incidence and the remaining exposures. It remains unclear how differing levels of COC use among ever COC users might confer differing levels of protection or harm, if any.

ISBN: 9781392842942Subjects--Topical Terms:

3173021
Pharmaceutical sciences.
Subjects--Index Terms:

Hormonal contraceptives

Combined Oral Contraceptive Utilization and Uterine Fibroid Incidence and Prevalence in The Study of Environment, Lifestyle, and Fibroids (SELF).
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245 1 0 $a Combined Oral Contraceptive Utilization and Uterine Fibroid Incidence and Prevalence in The Study of Environment, Lifestyle, and Fibroids (SELF).
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500 $a Source: Dissertations Abstracts International, Volume: 81-09, Section: B.
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520 $a Estrogen and progesterone play complex, interrelated roles in fibroid tumor development. Hormonal contraceptives are composed of progestin (synthetic progesterone) and may also include estrogen. The most common form of hormonal contraception used in the United States is combined oral contraception. To date, existing published literature regarding the association between combined oral contraceptives (COC) use and uterine fibroid development have yielded mixed findings, limited by lack of baseline ultrasounds that could establish temporality, and often restricted to outcome ascertainment among symptomatic women seeking treatment. In addition, existing literature largely excluded black women, the population most burdened by symptomatic fibroids.The Study of Environment, Lifestyle, and Fibroids (SELF) was the first prospective, ultrasound-based study of risk factors for uterine fibroids. SELF consists of 1,696 young (23-34 years), black women living in the Detroit, Michigan area in 2010-2017. We examined associations between different levels of COC use and the 40-month cumulative risk of uterine fibroids, and baseline fibroid prevalence. Specifically, we examined ever use of COCs, and age at first use, duration of use, and time since last use among ever COC users. Inverse probability weights were constructed for all exposures, and censoring. Standardized mortality ratio weights were constructed for ever COC use. At ~40-months' follow-up, we observed a possible protective association between ever use of COCs and cumulative fibroid incidence among women who were without fibroids at study enrollment (wRR: 0.78; 95% CI: 0.60, 1.00). When restricting the "Never" comparator group to ever hormonal contraceptive (HC) users, the observed association between COC use and fibroid incidence was attenuated (wRR: 0.92; 95% CI: 0.60, 1.40). The protective association re-emerged when restricting the "Never" group to women with no history of HC use (wRR: 0.72; 95% CI: 0.51, 1.01). No associations were found between fibroid prevalence or incidence and the remaining exposures. It remains unclear how differing levels of COC use among ever COC users might confer differing levels of protection or harm, if any.
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