Why It’s Important to Know All the Facts: Hormonal Birth Control

 What is Birth Control?

Hormonal Contraception, also known as birth control, is a drug therapy used to prevent pregnancies in women at childbearing age. Hormonal contraception can come in the form of pills, patches, Intrauterine devices, shots, and injections. While birth control is primarily used to prevent pregnancy, it may have other uses such as to regulate periods and to help with endometriosis pain. Women that suffer from PCOS may also take birth control to reduce some of the symptoms they experience and keep their monthly cycles.

 

What Can Happen with Prolonged Use of Birth Control?

 While many women stay on birth control for years at a time, it may be beneficial to take breaks periodically over the years to prevent increased risk of cancer. It has been argued that there is an increased risk of breast cancer, ovarian cancer, and cervical cancer with prolonged use of birth control. However, this does not mean that birth control is a damaging medication, but there are warnings with all medication taken. Scientists are still trying to distinguish exactly how much influence hormonal contraception may have on risk of cancer in patients overall.

https://www.womanlog.com/sex/hormonal-birth-control

According to an article by the National Cancer Institute, “Oral Contraceptives and Cancer Risk”, women that use oral contraceptives are at a greater risk of developing cervical cancer after 5-9 years of consistent birth control pills use. The risk was doubled with 10 years or more consistent use. In a similar situation, when looking at breast cancer studies in an article titled “ Oral Contraceptive Use and Breast Cancer : A Prospective Study of Young Women”, the amount of estrogen component called levonorgestrel and ingredient formulation may account for an increased risk of developing breast cancer in comparison to other manufactured brands.

 It is important to notice however that cervical cancer was noticed to have an increase in patients that have a history of HPV. While there is noticed increase in cervical cancer with prolonged use of oral contraception, it is also important to consider that HPV may develop into cervical cancer on its own regardless of integration of other medications according to Dr. Natasha Rafter, a public health professor at Auckland University.

 On the contrary, other cancer risk may decline with longer contraceptive use. The effects of birth control may have long term effects on the body that prevent endometrial cancer from forming in patients that have endometriosis. It is also mentioned in “Oral Contraceptives and Cancer Risk” that “risk is reduced by at least 30%, with a greater risk reduction the longer oral contraceptives were used”.

 The Bottom Line

 Although there have been many studies on hormonal contraception and cancer risk, it is not conclusive whether or not birth control has substantial effect on developing carcinogenic effects. All this is to say that there is much more information to consider when talking about the link of birth control to cancer. One specific type of birth control may not be ideal for a patient based on their medical history, family history, and estrogen content. The truth is scientists are still trying to learn more everyday about the cause of cancer. It is important to discuss concerns with your doctor and decide what exactly may be the most beneficial means of contraception, whether that is a low dose estrogen birth control, progesterone only option, or abstinence until further research.

  By SaBrea Cowan, An Undergraduate Biology Student at the University of Kentucky

Resources

 Hunter, Colditz, G. A., Hankinson, S. E., Malspeis, S., Spiegelman, D., Chen, W., Stampfer, M. J., & Willett, W. C. (2010). Oral contraceptive use and breast cancer: A prospective study of young women. Cancer Epidemiology, Biomarkers & Prevention, 19(10), 2496–2502. https://doi.org/10.1158/1055-9965.EPI-10-0747

 MEDSAFE. Oral Contraceptives, HPV and Risk of Cervical Cancer. (n.d.). Retrieved October 20, 2022, from https://medsafe.govt.nz/profs/PUarticles/OCHPV.htm

 Mørch, Lina S et al. “Contemporary Hormonal Contraception and the Risk of Breast Cancer.” The New England journal of medicine 377.23 (2017): 2228–2239. Web.

 Oral contraceptives (birth control pills) and cancer risk. National Cancer Institute. (n.d.). Retrieved October 19, 2022, from https://www.cancer.gov/about-cancer/causes- prevention/risk/hormones/oral-contraceptives-fact- sheet#:~:text=The%20longer%20a%20woman%20uses,years%20of%20use%20(9).

Trick or Treat! or Tweak? Should we hand out Narcan kits to our neighbors this Halloween?

 

As Halloween quickly approaches and our nation’s fentanyl crisis continues to escalate parents fear their kids may be vulnerable to an accidental overdose. This fear only increased with the new development of ‘rainbow fentanyl’ (pictured below) which the DEA claims are marketed to children (1). While this may be questioned on the internet, the goal of this blog is to educate everyone on the dangers of fentanyl and its multiple disguises.

From: npr.org

What is fentanyl?

Fentanyl is a synthetic opioid developed to help patients manage their pain (2). Fentanyl has been found to be 50 to 100 times more effective than morphine (3). When prescribed fentanyl can be given as a shot, skin patch, or cough drop. Illegally obtained fentanyl has been found in powder form, in eye drops, as a nasal spray, or in pill form. Fentanyl interacts with the areas of the brain that are responsible for our emotions and detecting pain. The effects of fentanyl are euphoria, drowsiness, nausea, confusion, constipation, sedation, difficulty breathing, and loss of consciousness.

What is an overdose?

Approximately 56,516 people overdosed on synthetic opioids, primarily fentanyl in 2020 (4). Overdose occurs when a large amount of a drug is taken, causing the drug’s effects to become harmful and even deadly. Symptoms of an overdose include: loss of consciousness, lack of responsiveness, pinpoint pupils, difficulty breathing, and blue or purple lips or fingertips (5). If you suspect someone is overdosing, first you should call 911. Second, it is recommended that you administer Narcan in the event of a possible opioid overdose. And lastly you should stay with the person until help arrives. Narcan is especially important because it can reverse the effects of an opioid overdose including a fentanyl overdose (6). Narcan is available at most pharmacies and does not require a prescription in several states.

 From: narcan.com

How are people accidentally overdosing on fentanyl?

Many drug users believe they are purchasing heroin or cocaine when instead they are given fentanyl, which produces a greater overall effect (2). This sadly often results in death caused by an overdose. It was found in one study analyzing overdoses in 10 states determined that approximately 57% of people who died from an overdose tested positive for fentanyl along with an additional drug such as cocaine heroin or meth (5). The majority of children overdosing from fentanyl occur through accidental exposure to prescribed fentanyl patches (7). However, adolescents are more prone and vulnerable to the ‘rainbow fentanyl’ marketing and at risk for other recreational drugs being laced with fentanyl. More drugs are being laced with fentanyl because it is reportedly cheaper to produce and more addictive than other street drugs (2).

What to look out for this Halloween?

With the rise in fentanyl overdoses and alleged marketing to adolescents, it is important to be aware of what your children are doing and what they receive in their baskets this Halloween. Here are some recommendations to make sure your kids are safe this Halloween (8).

• Check to make sure all treats are sealed

• Throw out candy with packages that have been opened or torn.

• Discard any homemade treats that weren’t made by someone you know.

• Visit familiar houses or houses in your neighborhood

• Examine toys that children are given while trick or treating

• Throw away candy that is not in its original packaging.

From: greenvillejournal.com

By Catherine (Lainie) Hew, a Master's Student in the Medical Sciences Program at the University of Kentucky

Resources:

1) Dea warns of brightly-colored fentanyl used to target young Americans.    DEA. https://www.dea.gov/press-releases/2022/08/30/dea-warns-  brightly-   colored- fentanyl- used- target-young-americans

  2) Fentanyl. DEA. https://www.dea.gov/factsheets/fentanyl

 3) U.S. Department of Health and Human Services. (2022, June 3).  Fentanyl.                            National Institutes of Health. https://nida.nih.gov/research-topics/fentanyl

 4) U.S. Department of Health and Human Services. (2022, July 21). Overdose death rates.  National Institutes of Health. https://nida.nih.gov/research-topics/trends-statistics/overdose-      death-rates

5) Drug overdose symptoms, risks & treatment. American Addiction Centers. (2022, September 13). https://americanaddictioncenters.org/overdose

6) Miller, L. (2022, October 7). "Rainbow fentanyl" and Halloween – how to keep kids safe. Breakthough Recovery Outreach. https://my-breakthrough.com/blog/rainbow-fentanyl-and- halloween-how-to- keep-kids-safe/

7) Stoecker, W. V., Madsen, D. E., Cole, J. G., & Woolsey, Z. (2016). Boys at   Risk: Fatal Accidental Fentanyl Ingestions in Children: Analysis of Cases Reported to the FDA 2004-2013. Missouri medicine, 113(6), 476–479.

  8)  Cronan, K. M. Halloween safety tips (for parents). KidsHealth.                          https://kidshealth.org/en/parents/halloween.html.

 

To Drink, or Not to Drink Caffeine?

 

When you think of college, what are the first few things that come to mind? Parties? Endless nights in the library? Tough courses? A tremendous amount of caffeine? If your first thought was the latter, you’ve gotten a pretty good idea about college. About 92% of college students consume caffeine on college campuses (Mahoney et al.) whether in coffee, energy drinks, sodas, pre-workouts, tea, etc. The reasons for the mass consumption of caffeine are different: to stay awake during studying, to have more energy when working out at the gym, to decrease stress around exams, and/or just to enjoy the lovely taste of fresh coffee in the morning before 8 a.m. classes.

 

Caffeine acts as a stimulant and stimulates the central nervous system. Caffeine is primarily used to increase alertness, alleviate pain, and treat respiratory conditions in premature babies (who knew?). It is water soluble, metabolized through the liver, and then excreted through urine. Caffeine improves athletic performance by relaxing the smooth muscle and contracting the cardiac muscle. Caffeine acts as an antagonist of adenosine receptors in the central nervous system. “Adenosine is a neuromodulator…when it binds to its receptors, neural activity slows down, and you feel sleepy” (How Drugs Affect Neurotransmitters).  When we consume caffeine, it binds to adenosine receptors, blocking its effects, and increases dopamine flow, resulting in an improved mood and energy. However, it can also have adverse effects on the body. Caffeine can cause physical and psychiatric issues, like restlessness and agitation, and can increase or worsen symptoms like anxiety, excitement, and insomnia (yikes). Caffeine contributes to our ability to stay awake longer by delaying the release of melatonin in our system, which pushes our natural body’s alarm clock (circadian rhythm) back. For people who may be sensitive to caffeine, it can induce side effects like a rapid heartbeat. I see why our parents said we couldn’t have soda before bed when we were younger. The recommended amount of caffeine consumption is 400mg or less; it is the safe and suggested daily dose. So, it’s the best idea to drink less than 400mg…the very best. 

Caffeine is considered an addictive drug among those who habitually take any form of caffeine. (Hence the never-ending orders of ‘venti caramel mocha, extra caramel’ at 10 in the morning or the guy riding a scooter at the break of dawn with a Monster in hand. I doubt he even ate a banana). It can be challenging to give up caffeine, and those who try to switch up their habits can experience severe withdrawals, such as fatigue, depression, and difficulty concentrating. It’s crazy to think that a stimulant meant to help us can also harm us. Overusing caffeine can eventually block your adenosine receptors for so long that you can become dependent on caffeine. Caffeine has a half-life of about 5 hours, but it can vary depending on sensitivity or possible underlying conditions. Once you’ve become dependent on a substance, your tolerance increases, which may be dangerous since you take more than your body can safely handle. Caffeine can cause inotropic effects, which is why our hearts beat faster when we consume caffeine. There is a risk of a caffeine overdose. An overdose is more likely to occur in people who drink energy drinks rather than coffee or any other intake form. Signs of an overdose can include nausea, vomiting, and tachycardia; in some cases, death can happen if too much caffeine is consumed. In a severe overdose, drugs such as benzodiazepine can be used and administered to prevent seizures. In addition, using beta-blocking drugs or activated charcoal can be helpful in the event of arrhythmias during an overdose. 

 

As a college student, or just a human being in this world, school is hard, life is tiring, and when you need a pick-me-up, coffee will always be there. I mean, it’s a better choice than drugs. However, if you, or someone you know, are habitual caffeine drinkers, a good suggestion would be to try and find ways to ensure your safely consuming caffeine: be mindful about how much you are putting in your body, always be sure to never exceed the safe amount of caffeine intake, and give your body a rest in between consumption, to ensure that your body does not become dependent on caffeine. 

By Nyla M. Swain, A Post-Baccalaureate Student at the University of Kentucky

Resources

 “Caffeine.” Uses, Interactions, Mechanism of Action | DrugBank Online, go.drugbank.com/drugs/DB00201. 

“How Drugs Affect Neurotransmitters.” The Brain from Top to Bottom, thebrain.mcgill.ca/flash/i/i_03/i_03_m/i_03_m_par/i_03_m_par_cafeine.html. 

Lu, Stacy. “Too Much Coffee?” American Psychological Association, American Psychological Association, 2015, www.apa.org/gradpsych/2015/11/coffee. 

Mahoney, Caroline R, et al. “Intake of Caffeine from All Sources and Reasons for Use by College Students.” Clinical Nutrition (Edinburgh, Scotland), U.S. National Library of Medicine, 10 Apr. 2018, pubmed.ncbi.nlm.nih.gov/29680166/. 

“Yes Coffee.” Coffee Memes, 2020, www.universitystudent.org/memes/coffee. 

Zunick, Monica. “Trial and Error.” 5 Stages of Withdrawal Every Coffee Addict Can Expect When Quitting Caffeine, 2015, spoonuniversity.com/lifestyle/5-stages-of-withdrawal-every-coffee-addict-can-expect-when-quitting-caffeine.