Progress in Reproductive Health Research |
Recommendations for Further Research
The Scientific Group made a number of recommendations regarding areas of future research related to the risk of cardiovascular disease and the use of steroid contraception:
Further research is needed on the prevalence of risk factors predisposing women of reproductive age to cardiovascular disease in developing and developed countries.
More research is needed on the pathogenesis of arterial disease in women of reproductive age.
The effect of the use of steroid contraceptives by women with diabetes on their risk of cardiovascular disease needs to be studied, perhaps using surrogate end-points.
More epidemiological research about the risks of cardiovascular disease among users of combined oral contraceptives in developing countries is required because current conclusions about the effects of the various formulations are based on only one study which finished data collection in 1993. Many developing countries, moreover, are experiencing rapid changes in the prevalence of risk factors that affect the incidence of cardiovascular disease.
The effects of different oral contraceptives on endothelial function requires study. This might involve measuring plasma levels of biological markers of endothelial function as well as using non-invasive techniques in human subjects.
Further studies are required on the influence of steroid hormones on systems regulating blood pressure and on the mechanisms by which these hormones affect the interplay between plasma lipoproteins and haemostatic factors.
The role of the structure of the progestogen molecule in determining haemostatic effects needs to be elucidated.
More data are needed on the risk of cardiovascular disease among users of progestogen-only preparations, especially injectables and implants, in developed as well as developing countries.
Further research is needed in different health settings to determine the levels of blood pressure at which steroid hormones can be used safely, and to evaluate the optimal frequency of monitoring of blood pressure during use of steroid contraceptives.