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Cindy Farquhar - One of the best experts on this subject based on the ideXlab platform.
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Oral Contraceptive Pill progestogen or oestrogen pretreatment for ovarian stimulation protocols for women undergoing assisted reproductive techniques
Cochrane Database of Systematic Reviews, 2017Co-Authors: Cindy Farquhar, Luk Rombauts, J A M Kremer, Anne Lethaby, Reuben Olugbenga AyelekeAbstract:Background Among subfertile women undergoing assisted reproductive technology (ART), hormone Pills given before ovarian stimulation may improve outcomes. Objectives To determine whether pretreatment with the combined Oral Contraceptive Pill (COCP) or with a progestogen or oestrogen alone in ovarian stimulation protocols affects outcomes in subfertile couples undergoing ART. Search methods We searched the following databases from inception to January 2017: Cochrane Gynaecology and Fertility Group Specialised Register, The Cochrane Central Register Studies Online, MEDLINE, Embase, CINAHL and PsycINFO. We also searched the reference lists of relevant articles and registers of ongoing trials. Selection criteria Randomised controlled trials (RCTs) of hormonal pretreatment in women undergoing ART. Data collection and analysis We used standard methodological procedures recommended by Cochrane. The primary review outcomes were live birth or ongoing pregnancy and pregnancy loss. Main results We included 29 RCTs (4701 women) of pretreatment with COCPs, progestogens or oestrogens versus no pretreatment or alternative pretreatments, in gonadotrophin-releasing hormone (GnRH) agonist or antagonist cycles. Overall, evidence quality ranged from very low to moderate. The main limitations were risk of bias and imprecision. Most studies did not describe their methods in adequate detail. Combined Oral Contraceptive Pill versus no pretreatment With antagonist cycles in both groups the rate of live birth or ongoing pregnancy was lower in the pretreatment group (OR 0.74, 95% CI 0.58 to 0.95; 6 RCTs; 1335 women; I2 = 0%; moderate quality evidence). There was insufficient evidence to determine whether the groups differed in rates of pregnancy loss (OR 1.36, 95% CI 0.82 to 2.26; 5 RCTs; 868 women; I2 = 0%; moderate quality evidence), multiple pregnancy (OR 2.21, 95% CI 0.53 to 9.26; 2 RCTs; 125 women; I2 = 0%; low quality evidence), ovarian hyperstimulation syndrome (OHSS; OR 0.98, 95% CI 0.28 to 3.40; 2 RCTs; 642 women; I2 = 0%, low quality evidence), or ovarian cyst formation (OR 0.47, 95% CI 0.08 to 2.75; 1 RCT; 64 women; very low quality evidence). In COCP plus antagonist cycles versus no pretreatment in agonist cycles, there was insufficient evidence to determine whether the groups differed in rates of live birth or ongoing pregnancy (OR 0.89, 95% CI 0.64 to 1.25; 4 RCTs; 724 women; I2 = 0%; moderate quality evidence), multiple pregnancy (OR 1.36, 95% CI 0.85 to 2.19; 4 RCTs; 546 women; I2 = 0%; moderate quality evidence), or OHSS (OR 0.63, 95% CI 0.20 to 1.96; 2 RCTs; 290 women, I2 = 0%), but there were fewer pregnancy losses in the pretreatment group (OR 0.40, 95% CI 0.22 to 0.72; 5 RCTs; 780 women; I2 = 0%; moderate quality evidence). There were no data suitable for analysis on ovarian cyst formation. One small study comparing COCP versus no pretreatment in agonist cycles showed no clear difference between the groups for any of the reported outcomes. Progestogen versus no pretreatment All studies used the same protocol (antagonist, agonist or gonadotrophins) in both groups. There was insufficient evidence to determine any differences in rates of live birth or ongoing pregnancy (agonist: OR 1.35, 95% CI 0.69 to 2.65; 2 RCTs; 222 women; I2 = 24%; low quality evidence; antagonist: OR 0.67, 95% CI 0.18 to 2.54; 1 RCT; 47 women; low quality evidence; gonadotrophins: OR 0.63, 95% CI 0.09 to 4.23; 1 RCT; 42 women; very low quality evidence), pregnancy loss (agonist: OR 2.26, 95% CI 0.67 to 7.55; 2 RCTs; 222 women; I2 = 0%; low quality evidence; antagonist: OR 0.36, 95% CI 0.06 to 2.09; 1 RCT; 47 women; low quality evidence; gonadotrophins: OR 1.00, 95% CI 0.06 to 17.12; 1 RCT; 42 women; very low quality evidence) or multiple pregnancy (agonist: no data available; antagonist: OR 1.05, 95% CI 0.06 to 17.76; 1 RCT; 47 women; low quality evidence; gonadotrophins: no data available). Three studies, all using agonist cycles, reported ovarian cyst formation: rates were lower in the pretreatment group (OR 0.16, 95% CI 0.08 to 0.32; 374 women; I2 = 1%; moderate quality evidence). There were no data on OHSS. Oestrogen versus no pretreatment In antagonist or agonist cycles, there was insufficient evidence to determine whether the groups differed in rates of live birth or ongoing pregnancy (antagonist versus antagonist: OR 0.79, 95% CI 0.53 to 1.17; 2 RCTs; 502 women; I2 = 0%; low quality evidence; antagonist versus agonist: OR 0.88, 95% CI 0.51 to 1.50; 2 RCTs; 242 women; I2 = 0%; very low quality evidence), pregnancy loss (antagonist versus antagonist: OR 0.16, 95% CI 0.02 to 1.47; 1 RCT; 49 women; very low quality evidence; antagonist versus agonist: OR 1.59, 95% CI 0.62 to 4.06; 1 RCT; 220 women; very low quality evidence), multiple pregnancy (antagonist versus antagonist: no data available; antagonist versus agonist: OR 2.24, 95% CI 0.09 to 53.59; 1 RCT; 22 women; very low quality evidence) or OHSS (antagonist versus antagonist: no data available; antagonist versus agonist: OR 1.54, 95% CI 0.25 to 9.42; 1 RCT; 220 women). Ovarian cyst formation was not reported. Head-to-head comparisons COCP was compared with progestogen (1 RCT, 44 women), and with oestrogen (2 RCTs, 146 women), and progestogen was compared with oestrogen (1 RCT, 48 women), with an antagonist cycle in both groups. COCP in an agonist cycle was compared with oestrogen in an antagonist cycle (1 RCT, 25 women). Data were scant but there was no clear evidence that any of the groups differed in rates of live birth or ongoing pregnancy, pregnancy loss or other adverse events. Authors' conclusions Among women undergoing ovarian stimulation in antagonist protocols, COCP pretreatment was associated with a lower rate of live birth or ongoing pregnancy than no pretreatment. There was insufficient evidence to determine whether rates of live birth or ongoing pregnancy were influenced by pretreatment with progestogens or oestrogens, or by COCP pretreatment using other stimulation protocols. Findings on adverse events were inconclusive, except that progesterone pretreatment may reduce the risk of ovarian cysts in agonist cycles, and COCP in antagonist cycles may reduce the risk of pregnancy loss compared with no pretreatment in agonist cycles.
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Oral Contraceptive Pill for primary dysmenorrhoea
Cochrane Database of Systematic Reviews, 2009Co-Authors: Chooi L Wong, Cindy Farquhar, Helen Roberts, Michelle ProctorAbstract:BACKGROUND: Dysmenorrhoea (painful menstrual cramps) is common. Combined OCPs are recommended in the management of primary dysmenorrhoea. OBJECTIVES: To determine the effectiveness and safety of combined Oral Contraceptive Pills for the management of primary dysmenorrhoea. SEARCH STRATEGY: We conducted electronic searches for randomised controlled trials (RCTs) in the Cochrane Menstrual Disorders and Subfertility Group Register of controlled trials CENTRAL CCTR MEDLINE EMBASE and CINAHL (first conducted in 2001 updated on 5 November 2008). SELECTION CRITERIA: RCTs comparing all combined OCPs with other combined OCPs placebo no management or management with nonsteroidal anti-inflammatories (NSAIDs) were considered. DATA COLLECTION AND ANALYSIS: Twenty three studies were identified and ten were included. Six compared the combined OCP with placebo and four compared different dosages of combined OCP. MAIN RESULTS: One study of low dose oestrogen and four studies of medium dose oestrogen combined OCPs compared with placebo for a combined total of 497 women reported pain improvement. For the outcome of pain relief across the different OCPs the pooled OR suggested benefit with OCPs compared to placebo (7 RCTs: Peto OR 2.01 [95% CI 1.32 3.08]).The Chi-squared test for heterogeneity showed there is significant heterogeneity with an I(2) statistic of 64% and a significant chi-square test (14.06 df=5 p=0.02). A sensitivity analysis removing the studies with inadequate allocation concealment suggested significant benefit of treatment with the pooled OR of 2.99 (95% CI 1.76 5.07) and heterogeneity no longer statistically significant and I(2) statistic of 0%.Three studies reported adverse effects (Davis 2005; Hendrix 2002; GPRG 1968) The adverse effects were nausea headaches and weight gain. Two studies reported if women experienced any side effect and no evidence of an effect was found (3 RCTs: OR = 1.45 (95% 0.71 2.94). There was no evidence of statistical heterogeneity.There were no studies identified that compared combined OCP versus non steroidal anti-inflammatory drugsThere was no evidence of a difference for the pooled studies for 3rd generation pro gestagens (OR = 1.11 (95% CI 0.79 - 1.57)). For the 2nd generation versus 3rd generation the OR was 0.44 (95% CI 0.23-0.84) suggesting benefit of the 3rd generation OCP but this was for a single study (Winkler 2003). AUTHORS CONCLUSIONS: There is limited evidence for pain improvement with the use of the OCP (both low and medium dose oestrogen) in women with dysmenorrhoea. There is no evidence of a difference between different OCP preparations.
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combined Oral Contraceptive Pill ocp as treatment for primary dysmenorrhoea
Cochrane Database of Systematic Reviews, 2001Co-Authors: Michelle Proctor, Helen Roberts, Cindy FarquharAbstract:Background Dysmenorrhoea refers to the occurrence of painful menstrual cramps and is a common gynaecological complaint. Research as early as 1937 has shown that dysmenorrhoea responds favourably to ovulation inhibition and that the synthetic hormones in the combined Oral Contraceptive Pill can be used to treat dysmenorrhoea. These hormones act by suppressing ovulation and lessening the endometrial lining of the uterus. Therefore menstrual fluid volume decreases along with the amount of prostaglandins produced in turn effectively reducing dysmenorrhoea by decreasing uterine motility and thus uterine cramping. The use of combined Oral Contraceptive Pills (OCP) has been advocated as a treatment for primary dysmenorrhoea since their introduction for general use in 1960. There is evidence from epidemiological studies of general populations that combined OCPs can effectively treat dysmenorrhoea. Objectives The objective of this review is to determine the efficacy of combined Oral Contraceptive Pills for the treatment of primary dysmenorrhoea. Search Strategy Electronic searches for relevant randomised controlled trials (RCTs) of the Cochrane Menstrual Disorders and Subfertility Group Register of controlled trials CCTR MEDLINE EMBASE and CINAHL were performed. Attempts were also made to identify trials from the National Research Register the Clinical Trials Register and the citation lists of review articles and included trials. Selection Criteria The inclusion criteria were RCTs that compared all types of combined Oral Contraceptives (oestrogen/progestogen) with other combined Oral Contraceptives placebo no treatment or treatment with nonsteriodal anti-inflammatory drugs (NSAIDs) in the treatment of primary dysmenorrhoea. The main outcome measures were pain relief adverse effects additional analgesics required and time off work or school. Data collection and analysis Nine trials were identified that appeared to fulfill the initial criteria for this review. Of these nine trials four were excluded two at further investigation revealed a lack of randomisation and two included combined Oral Contraceptives that are now discontinued due to very high oestrogen content. Of the remaining five RCTs four were included in the meta-analysis (Buttram 1969; Cullberg 1972; GPRG 1968; Nakano 1971). The results of the other trial (Matthews 1968) were included in the text of the review for discussion because data were not available in a form that allowed it to be combined in a meta-analysis. Data for all outcomes were in dichotomous form and the Peto odds ratio was used in the meta-analysis for all comparisons. Main Results Combined OCPs with medium dose oestrogen (>35 mcg) and 1st/2nd generation progestogens were shown to be more effective than placebo for pain relief. However there was significant heterogeneity in the results from different studies and when data were analysed with a random effects model the confidence intervals increased and the results became statistically non-significant. For the other outcomes there was a significant difference in favour of OCPS when compared to placebo for the outcome of absence from work or school and there was no difference between the treatment groups and placebo in the number of adverse effects experienced. Reviewers conclusions No conclusions can be made about the efficacy of commonly used modern lower dose combined Oral Contraceptives for dysmenorrhoea. While there is some evidence from four RCTs that combined OCPs with medium dose oestrogen and 1st/2nd generation progestogens are more effective than placebo it should be emphasised that the studies were small of poor quality and all included much higher doses of hormones that those commonly prescribed today. Therefore no recommendations can be made regarding the efficacy of modern combined Oral Contraceptives.(authors)
Philip D Darney - One of the best experts on this subject based on the ideXlab platform.
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number of Oral Contraceptive Pill packages dispensed and subsequent unintended pregnancies
Obstetrics & Gynecology, 2011Co-Authors: Diana Greene Foster, Denis Hulett, Mary Bradsberry, Philip D Darney, Michael PolicarAbstract:OBJECTIVE: To estimate how number of Oral Contraceptive Pill packages dispensed relates to subsequent pregnancies and abortions. METHODS: We linked 84,401 women who received Oral Contraceptives through the California family planning program in January 2006 to Medi-Cal pregnancy events and births conceived in 2006. We compared pregnancy rates for women who received a 1-year supply of Oral Contraceptive Pills, three packs, and one pack. RESULTS: Women who received a 1-year supply were less likely to have a pregnancy (1.2% compared with 3.3% of women getting three cycles of Pills and 2.9% of women getting one cycle of Pills). Dispensing a 1-year supply is associated with a 30% reduction in the odds of conceiving an unplanned pregnancy compared with dispensing just one or three packs (confidence interval [CI] 0.57–0.87) and a 46% reduction in the odds of an abortion (95% CI 0.32–0.93), controlling for age, race or ethnicity, and previous Pill use. CONCLUSION: Making Oral Contraceptives more accessible may reduce the incidence of unintended pregnancy and abortion. Health insurance programs and public health programs may avert costly unintended pregnancies by increasing dispensing limits on Oral Contraceptives to a 1-year supply.
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number of Oral Contraceptive Pill packages dispensed method continuation and costs
Obstetrics & Gynecology, 2006Co-Authors: Diana Greene Foster, Mary Bradsberry, Ram Parvataneni, Heike Thiel De Bocanegra, Carrie Lewis, Philip D DarneyAbstract:The objective was to estimate the effect of the number of cycles of Oral Contraceptive Pills (OCPs) dispensed per visit on method continuation Pill wastage use of services and health care costs. We used paid claims data for 82319 women dispensed OCPs through the California Family PACT (Planning Access Care and Treatment) Program in January 2003 to examine Contraceptive continuation and service use. Women who received 13 cycles at their first visit in January 2003 received 14.5 cycles over the course of 2003 compared with 9.0 cycles among women receiving three cycles at first visit. When client characteristics are controlled women who received 13 cycles were 28% more likely to have OCPs on hand and twice as likely to have sufficient OCP cycles for 15 months of continuous use compared with women who received three cycles. Oral Contraceptive Pill wastage was higher among women initially dispensed 13 cycles (6.5% of the cycles dispensed) than among women who received three cycles (2% of cycles). Despite having one fewer clinician visit women dispensed 13 cycles were more likely to receive Pap and Chlamydia tests and less likely to have a pregnancy test than women initially dispensed fewer cycles. Over the course of the year Family PACT paid $99 more for women who received three cycles and $44 more for women who received only one cycle than it did for women who received 13 cycles at their first visits of 2003. Dispensing a years supply of OCP cycles to women is associated with higher method continuation and lower costs than dispensing fewer cycles per visit. (authors)
Diana Greene Foster - One of the best experts on this subject based on the ideXlab platform.
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number of Oral Contraceptive Pill packages dispensed and subsequent unintended pregnancies
Obstetrics & Gynecology, 2011Co-Authors: Diana Greene Foster, Denis Hulett, Mary Bradsberry, Philip D Darney, Michael PolicarAbstract:OBJECTIVE: To estimate how number of Oral Contraceptive Pill packages dispensed relates to subsequent pregnancies and abortions. METHODS: We linked 84,401 women who received Oral Contraceptives through the California family planning program in January 2006 to Medi-Cal pregnancy events and births conceived in 2006. We compared pregnancy rates for women who received a 1-year supply of Oral Contraceptive Pills, three packs, and one pack. RESULTS: Women who received a 1-year supply were less likely to have a pregnancy (1.2% compared with 3.3% of women getting three cycles of Pills and 2.9% of women getting one cycle of Pills). Dispensing a 1-year supply is associated with a 30% reduction in the odds of conceiving an unplanned pregnancy compared with dispensing just one or three packs (confidence interval [CI] 0.57–0.87) and a 46% reduction in the odds of an abortion (95% CI 0.32–0.93), controlling for age, race or ethnicity, and previous Pill use. CONCLUSION: Making Oral Contraceptives more accessible may reduce the incidence of unintended pregnancy and abortion. Health insurance programs and public health programs may avert costly unintended pregnancies by increasing dispensing limits on Oral Contraceptives to a 1-year supply.
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number of Oral Contraceptive Pill packages dispensed method continuation and costs
Obstetrics & Gynecology, 2006Co-Authors: Diana Greene Foster, Mary Bradsberry, Ram Parvataneni, Heike Thiel De Bocanegra, Carrie Lewis, Philip D DarneyAbstract:The objective was to estimate the effect of the number of cycles of Oral Contraceptive Pills (OCPs) dispensed per visit on method continuation Pill wastage use of services and health care costs. We used paid claims data for 82319 women dispensed OCPs through the California Family PACT (Planning Access Care and Treatment) Program in January 2003 to examine Contraceptive continuation and service use. Women who received 13 cycles at their first visit in January 2003 received 14.5 cycles over the course of 2003 compared with 9.0 cycles among women receiving three cycles at first visit. When client characteristics are controlled women who received 13 cycles were 28% more likely to have OCPs on hand and twice as likely to have sufficient OCP cycles for 15 months of continuous use compared with women who received three cycles. Oral Contraceptive Pill wastage was higher among women initially dispensed 13 cycles (6.5% of the cycles dispensed) than among women who received three cycles (2% of cycles). Despite having one fewer clinician visit women dispensed 13 cycles were more likely to receive Pap and Chlamydia tests and less likely to have a pregnancy test than women initially dispensed fewer cycles. Over the course of the year Family PACT paid $99 more for women who received three cycles and $44 more for women who received only one cycle than it did for women who received 13 cycles at their first visits of 2003. Dispensing a years supply of OCP cycles to women is associated with higher method continuation and lower costs than dispensing fewer cycles per visit. (authors)
Jeffrey T. Jensen - One of the best experts on this subject based on the ideXlab platform.
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Treatment of Heavy Menstrual Bleeding with the Estradiol Valerate and Dienogest Oral Contraceptive Pill
Advances in Therapy, 2013Co-Authors: Elizabeth A. Micks, Jeffrey T. JensenAbstract:The new estradiol valerate and dienogest Oral Contraceptive Pill recently received U.S. Food and Drug Administration (FDA) approval to treat heavy menstrual bleeding in women without diagnosed uterine conditions. This Oral Contraceptive formulation combines estradiol valerate, which is metabolically identical to natural estradiol, with the potent new progestin, dienogest. The four-phasic Pill is effective for pregnancy prevention and leads to significantly decreased menstrual bleeding among women with heavy periods, and shorter and lighter periods among women with normal periods. Studies indicate that this formulation may be associated with decreased hepatic activation compared to Contraceptive Pills that contain ethinyl estradiol. However, whether these findings translate to a decreased risk of thrombotic events has not been determined, and the Pill carries the same contraindications as all other combined hormonal Contraceptives. At least 10–15% of women suffer from heavy menstrual bleeding, defined as ≥80 mL of blood loss per cycle. In large clinical trials of women with heavy menstrual bleeding, the estradiol valerate and dienogest Pill decreased blood loss volume by a median of 81%. Women with heavy menstrual bleeding treated with this Contraceptive Pill can expect a significant reduction in bleeding after just one cycle of use. This therapy leads to a decrease in bleeding that may be greater than that achieved by different Oral Contraceptive Pills or other medical therapies, including tranexamic acid and nonsteroidal anti-inflammatory drugs.
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Estradiol valerate and dienogest: a novel four-phasic Oral Contraceptive Pill effective for pregnancy prevention and treatment of heavy menstrual bleeding
Women's health (London England), 2011Co-Authors: Elizabeth A. Micks, Jeffrey T. JensenAbstract:Estradiol valerate and dienogest have been combined to create a novel four-phasic Oral Contraceptive Pill effective for both pregnancy prevention and treatment of heavy menstrual bleeding. This formulation represents the only Oral Contraceptive Pill available in the USA containing an estrogen component that is biologically active as the endogenous estrogen 17β-estradiol. This medication was developed out of efforts to replace the most common estrogen in Contraceptive Pills, ethinyl estradiol, which is known to be a potent inducer of hepatic protein synthesis. Estradiol valerate has been available since the 1970s in Oral and injectable forms indicated for the treatment of menopausal climacteric symptoms. Dienogest has been used in other Oral Contraceptive Pills for over 10 years. Previous attempts to develop an Oral Contraceptive Pill with natural estradiol or estradiol valerate were unsuccessful due to poor cycle control. A novel dynamic-dosing regimen was devised to improve the bleeding pattern. This med...
Larry Cahill - One of the best experts on this subject based on the ideXlab platform.
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Oral Contraceptive Pill use is associated with localized decreases in cortical thickness
Human Brain Mapping, 2015Co-Authors: Nicole Petersen, Alexandra Touroutoglou, Joseph M Andreano, Larry CahillAbstract:Oral Contraceptive Pills (OCs), which are used to prevent pregnancy by the majority of women in the United States, contain steroid hormones that may affect the brain's structure and function. In this investigation, we tested the hypothesis that OC use is associated with differences in brain structure using a hypothesis-driven, surface-based approach. In 90 women, (44 OC users, 46 naturally-cycling women), we compared the cortical thickness of brain regions that participate in the salience network and the default mode network, as well as the volume of subcortical regions in these networks. We found that OC use was associated with significantly lower cortical thickness measurements in the lateral orbitofrontal cortex and the posterior cingulate cortex. These regions are believed to be important for responding to rewards and evaluating internal states/incoming stimuli, respectively. Further investigations are needed to determine if cortical thinning in these regions are associated with behaviOral changes, and also to identify whether OC use is causally or only indirectly related to these changes in brain morphology.
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Oral Contraceptive Pill use and menstrual cycle phase are associated with altered resting state functional connectivity
NeuroImage, 2014Co-Authors: Nicole Petersen, Lisa A Kilpatrick, Azaadeh Goharzad, Larry CahillAbstract:At rest, brain activity can be characterized not by an absence of organized activity but instead by spatially and tempOrally correlated patterns of activity. In this experiment, we investigated whether and to what extent resting state functional connectivity is modulated by sex hormones in women, both across the menstrual cycle and when altered by Oral Contraceptive Pills. Sex hormones have been shown to have important effects on task-related activity, but few studies have investigated the extent to which they can influence the behavior of functional networks at rest. These hormones are dramatically altered by the use of hormonal contraception, which is used by approximately 100 million women worldwide. However, potential cognitive side effects of hormonal contraception have been given little attention. Here, we collected resting state data for naturally-cycling women (n=45) and women using combined Oral Contraceptive Pills (n=46) and evaluated the differences in resting state activity between these two groups using independent component analysis. We found that in the default mode network and in a network associated with executive control, resting state dynamics were altered both by the menstrual cycle and by Oral Contraceptive use. Specifically, the connectivity of the left angular gyrus, the left middle frontal gyrus, and the anterior cingulate cortex were different between groups. Because the anterior cingulate cortex and left middle frontal gyrus are important for higher-order cognitive and emotional processing, including conflict monitoring, changes in the relationship of these structures to the functional networks with which they interact may have important consequences for attention, affect, and/or emotion regulation.
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Oral Contraceptive Pill use and menstrual cycle phase are associated with altered resting state functional connectivity
NeuroImage, 2014Co-Authors: Nicole Petersen, Lisa A Kilpatrick, Azaadeh Goharzad, Larry CahillAbstract:At rest brain activity can be characterized not by an absence of organized activity but instead by spatially and tempOrally correlated patterns of activity. In this experiment we investigated whether and to what extent resting state functional connectivity is modulated by sex hormones in women both across the menstrual cycle and when altered by Oral Contraceptive Pills. Sex hormones have been shown to have important effects on task-related activity but few studies have investigated the extent to which they can influence the behavior of functional networks at rest. These hormones are dramatically altered by the use of hormonal contraception which is used by approximately 100 million women worldwide. However potential cognitive side effects of hormonal contraception have been given little attention. Here we collected resting state data for naturally-cycling women (n=45) and women using combined Oral Contraceptive Pills (n=46) and evaluated the differences in resting state activity between these two groups using independent component analysis. We found that in the default mode network and in a network associated with executive control resting state dynamics were altered both by the menstrual cycle and by Oral Contraceptive use. Specifically the connectivity of the left angular gyrus the left middle frontal gyrus and the anterior cingulate cortex were different between groups. Because the anterior cingulate cortex and left middle frontal gyrus are important for higher-order cognitive and emotional processing including conflict monitoring changes in the relationship of these structures to the functional networks with which they interact may have important consequences for attention affect and/or emotion regulation. Copyright (c) 2013 Elsevier Inc. All rights reserved.