The Link between Oral Contraceptives Use and Increased Prev - PowerPoint Presentation

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