What causes contraceptive side-effects? Testing the hormonal mismatch hypothesis in Ethiopia.

该项目旨在调查一种假设，即生活在农村贫困环境中的妇女所经历的荷尔蒙避孕的副作用是由于妇女的内源性激素水平与荷尔蒙避孕剂量之间的不匹配造成的。研究表明，生活在不同生态环境中的妇女之间存在着广泛的种群间差异，但大多数避孕措施仍然主要在西方人口中进行试验。这项研究将调查生活在营养/身体压力高的环境中的妇女是否内源性激素水平较低(例如黄体酮)，并经历更严重的荷尔蒙避孕副作用(例如注射剂)。它将分析荷尔蒙、副作用和社会人口学数据，这些数据将在埃塞俄比亚的两个社会生态环境(城市富人/农村穷人)中收集。通过牛津大学、伦敦卫生和热带医学院(LSHTM)和亚的斯亚贝巴大学的一个更大的跨学科项目，已经获得了实地工作和实验室分析的资金。该项目有可能刺激避孕设计和服务提供方面的创新，并改变避孕副作用的概念化，使其不仅仅是生殖健康政策中的“神话”。

This project aims to investigate the hypothesis that side-effects from hormonal contraception experienced by women living in rural poor environments result from a mismatch between women's levels of endogenous hormones and the dosage of hormonal contraception. Studies have shown that there is wide interpopulation variation between women living in different ecologies, yet most contraceptives are still trialled predominantly in Western populations. The research will investigate whether women living in environments with high nutritional/physical stress have lower levels of endogenous hormones (e.g. progesterone) and experience more severe side-effects from hormonal contraception (e.g. injectables). It will analyse hormonal, side-effects and sociodemographic data that will be collected across two socioecological settings in Ethiopia (urban rich/rural poor). Funding for fieldwork costs and laboratory analysis is already secured through a larger interdisciplinary project bringing together the University of Oxford, the London School of Hygiene and Tropical Medicine (LSHTM) and Addis Ababa University. This project has the potential to stimulate innovations in contraceptive design and service delivery and transform the conceptualisation of contraceptive side-effects as more tham merely ""myths"" in reproductive health policy.