Presentation by Kim Strifert The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum Disorder My Observation The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum Disorder ID: 259498
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Slide1
The Link between Oral Contraceptives Use and Increased Prevalence in Autism Spectrum Disorder
Presentation by: Kim
StrifertSlide2
The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum Disorder
My ObservationSlide3
The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum Disorder
Complex neurodevelopmental disorder
Social
impairments, communication difficulties, and restricted, repetitive, and stereotyped patterns of behavior
.
1-68 children
Increased prevalenceSlide4
The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum DisorderSlide5
The Link between Oral Contraceptive use and Increased Prevalence in Autism Spectrum Disorder
Identification, screening, diagnostic criteria, awareness
Genetic variation
EnvironmentSlide6
The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum Disorder
Preterm birth weight, low birth weight
Multiple birth, breech presentation, cesarean delivery
Assisted reproductive technology
Parental age
Socioeconomic inequalities
Parental exposure to occupational chemicals, pesticides
Living close to freeways
Folic acid
MMR
vaccine,
Thimerosal
Acetaminophen, excessive multivitamins
Dietary factorsSlide7
The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum DisorderSlide8
The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum DisorderSlide9
The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum DisorderSlide10
The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum Disorder
Method
No. of users (in 1000s)
% of all women 15-44
% of all contraceptive
users
Pill (COC’s
10,540
17.1
27.5
Tubal Ligation
10,200
16.5
26.6
Male Condom
6,280
10.2
16.3
Vasectomy
3,860
6.2
10.0
IUD
2,140
3.5
5.6
Withdrawal
1,990
3.2
5.2
Injectable
1,450
2.4
3.8
Vaginal Ring
830
1.3
2.2Patch290 0.5 0.7Implant180 0.3 0.5Fert. Awareness440 0.7 1.1Other Methods**200 0.3 0.5No Method23,36037.8 Total # women 15-4461,750100.0100.0Sexually active women who have ever used COC’s***50,6358282
Adapted from Guttmacher Organization, Mosher and Jones (2010) Vital Health StatisticsSlide11
The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum Disorder
How do oral contraceptives work?
Progestins
suppress ovulation, the release of the egg, and thicken the mucus of the cervix.
Estrogen augments the action of the
progestogenic
compound and stabilizes the endometrium.Slide12
The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum DisorderSlide13
The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum Disorder
Progestogen negative feedback reduces the pulse frequency of
GnRH
release by the hypothalamus which decreases the secretion of follicle-stimulating hormone (FSH) and significantly decreases the secretion of
luteninzing
hormone (LH) by the anterior pituitary. Diminished levels of FSH inhibit follicular development and prevent an increase in circulating blood levels of estradiol. Progestogen negative feedback and the absence of estrogen positive feedback on LH secretion inhibit LH surge in mid-cycle. Inhibition of follicle development and lack of LH surge prevents ovulation.Slide14
The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum Disorder
Ethinylestradiol
is an Endocrine Disrupting Compound (EDC)Slide15
The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum Disorder
EDCs have the same attributes as hormones:
Ability to be active at low concentrations
Ability to bind to receptors at very low concentrations
Ability to interact with multiple hormone receptors concurrently
Work simultaneously to create additive or synergistic effects not observed with individual compounds
Often not feasible to extrapolate low-dose effects from high-dose effects of EDCsSlide16
The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum Disorder
World Health Organization
State of the Science of Endocrine Disrupting Compounds 2012Slide17
The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum Disorder
Exposure Timing
Before Fertilization
After Fertilization
Transgenerational
transmission of modified epigenetic programmingSlide18
The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum Disorder
Oral Contraceptives are Marketed as Safe and Effective
But Are They ?Slide19
The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum DisorderSlide20
The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum Disorder
Lack of Comprehensive Research into Potential Neurodevelopmental effects of Contraceptives Slide21
The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum Disorder
Temporal correlation
between use of oral contraceptives and increased prevalence of ASD.
To
date no definitive cause or contributing factors for increase in ASD prevalence has been established.
Oral
contraceptives disrupt the endocrine system – COC’s are endocrine disruptors.
Oral
contraceptives directly and deleteriously affect both the ovaries and ova.
Likely
effects of oral contraceptives on progeny are an open question.
The
called-for further study and controlled follow-up of the possible
transgenerational
effects of oral contraceptive use has not been executed.Slide22
The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum Disorder
Multi-Hit Model of Autism Risk
Combined
Oral
Contra-
ceptives
Genetics
Environment
Epigenetics
?
Other
Factors
ASDSlide23
The Link between Oral Contraceptive Use and Increased Prevalence in Autism Spectrum Disorder