School of Kinesiology and Health Science, York University, 355 Bethune College, 4700 Keele St, Toronto, ON, M3J 1P3, Canada.
Library & Information Services, University Health Network, Toronto, ON, Canada.
Clin Auton Res. 2023 Dec;33(6):859-892. doi: 10.1007/s10286-023-00996-0. Epub 2023 Nov 16.
This systematic review aimed to summarize how oral contraceptives (OC) affect resting autonomic function and the autonomic response to a variety of physiological stressors.
A search strategy was created to retrieve citations investigating physiological responses comparing OC users to non-users (NOC) in response to autonomic reflex activation.
A total of 6148 citations were identified across databases from inception to June 2, 2022, and 3870 citations were screened at the abstract level after deduplication. Then, 133 texts were assessed at full-text level, and only 40 studies met eligibility requirements. Included citations were grouped by the aspect of autonomic function assessed, including autonomic reflex (i.e., baroreflex, chemoreflex, mechanoreflex, metaboreflex, and venoarterial reflex), or indicators (i.e., heart rate variability, pulse wave velocity, and sympathetic electrodermal activity), and physiological stressors that may alter autonomic function (i.e., auditory, exercise, mental or orthostatic stress, altitude, cold pressor test, sweat test, and vasodilatory infusions).
OC influence the physiological responses to chemoreflex, mechanoreflex, and metaboreflex activation. In terms of autonomic indices and physiological stressors, there are more inconsistencies within the OC literature, which may be due to estrogen dosage within the OC formulation (i.e., heart rate variability) or the intensity of the stressor (exercise intensity/duration or orthostatic stress). Further research is required to elucidate the effects of OC on these aspects of autonomic function because of the relatively small amount of available research. Furthermore, researchers should more clearly define or stratify OC use by duration, dose, and/or hormone cycling to further elucidate the effects of OC.
本系统评价旨在总结口服避孕药 (OC) 如何影响静息自主功能以及对各种生理应激的自主反应。
创建了一种搜索策略，以检索比较 OC 使用者和非使用者（NOC）对自主反射激活的生理反应的引文。
从数据库中检索到 6148 条引用文献，这些文献均在 2022 年 6 月 2 日之前发表，经过去重后在摘要层面筛选出 3870 条引用文献。然后，在全文层面评估了 133 篇论文，只有 40 项研究符合入选标准。纳入的引文按评估的自主功能方面分组，包括自主反射（即压力反射、化学反射、机械反射、代谢反射和静脉动脉反射）或指标（即心率变异性、脉搏波速度和交感皮肤电活动），以及可能改变自主功能的生理应激（即听觉、运动、精神或直立应激、海拔、冷加压试验、发汗试验和血管舒张输注）。
OC 影响化学反射、机械反射和代谢反射激活的生理反应。就自主指标和生理应激而言，OC 文献中存在更多的不一致，这可能是由于 OC 制剂中的雌激素剂量（即心率变异性）或应激强度（运动强度/持续时间或直立应激）不同所致。由于可用的研究相对较少，因此需要进一步研究阐明 OC 对这些自主功能方面的影响。此外，研究人员应更清楚地定义或分层 OC 的使用持续时间、剂量和/或激素循环，以进一步阐明 OC 的影响。
