{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T15:33:11Z","timestamp":1792251191249,"version":"4.4.0"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["23AA2003"],"award-info":[{"award-number":["23AA2003"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["25gk0210042h0001"],"award-info":[{"award-number":["25gk0210042h0001"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Combined oral contraceptives (COCs) for dysmenorrhea management have been covered by the Japanese universal health insurance system since 2008. Several public awareness events regarding COC prescriptions for dysmenorrhea were implemented between 2013 and 2015, including media reports on COC\u2010related fatalities in 2013, drug safety alerts in 2014, and new clinical guidelines in 2015. This study aimed to examine the trends in patient characteristics, coagulation testing, and thromboembolism incidence before and after these events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used the JMDC claims database to identify patients with dysmenorrhea prescribed COCs between 2009 and 2021. We evaluated the annual trends in guideline\u2010listed thromboembolism risk factors (age\u2009\u2265\u200940\u2009years, obesity, and smoking), frequency of patients undergoing coagulation testing among patients prescribed COCs, and thromboembolism incidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 860\u2009840 patients with dysmenorrhea, 173\u2009502 received COCs. The proportion of patients prescribed COCs decreased temporarily from 12.2% to 11.2% in 2014. The proportion of new COC prescriptions increased for women aged &lt;40\u2009years and decreased for those aged \u226540\u2009years. The proportions of patients with obesity and smokers remained stable from 2016. The frequency of coagulation testing increased annually, rising sharply from 15% to 22% in 2014. The incidence of thromboembolism with treatment decreased from 11.8 to 9.9 per 10\u2009000 person\u2010years from 2016 to 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although no direct causal relationship is clear, public health awareness events might have influenced clinical practices, including the preferential selection of lower\u2010risk patients and promotion of coagulation screening, possibly resulting in a decline in the incidence of thromboembolism.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70835","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T06:46:24Z","timestamp":1769496384000},"page":"299-308","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prescription trends for combined oral contraceptives and thromboembolism incidence in Japan before and after public awareness events in 2013\u20132015"],"prefix":"10.1002","volume":"174","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7476-4976","authenticated-orcid":false,"given":"Risa","family":"Ishida","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine The University of Tokyo  Tokyo Japan"},{"name":"Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7828-0549","authenticated-orcid":false,"given":"Yusuke","family":"Sasabuchi","sequence":"additional","affiliation":[{"name":"Department of Real\u2010World Evidence, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5057-4120","authenticated-orcid":false,"given":"Kaori","family":"Koga","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine The University of Tokyo  Tokyo Japan"},{"name":"Department of Obstetrics and Gynecology, Reproductive Medicine Chiba University  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1020-1701","authenticated-orcid":false,"given":"Shiori","family":"Itoi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine The University of Tokyo  Tokyo Japan"},{"name":"Department of Social Medicine National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4546-1084","authenticated-orcid":false,"given":"Gentaro","family":"Izumi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3483-6047","authenticated-orcid":false,"given":"Daisuke","family":"Shigemi","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0004-4743","authenticated-orcid":false,"given":"Hiroki","family":"Matsui","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6660-1066","authenticated-orcid":false,"given":"Yutaka","family":"Osuga","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine The University of Tokyo  Tokyo Japan"},{"name":"Department of Obstetrics and Gynecology Teikyo University School of Medicine  Tokyo Japan"},{"name":"Teikyo Academic Research Center Teikyo University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6017-469X","authenticated-orcid":false,"given":"Hideo","family":"Yasunaga","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,26]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"e757","article-title":"Half a century of the oral contraceptive pill: historical review and view to the future","volume":"58","author":"Liao PV","year":"2012","journal-title":"Can Fam Physician"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.15416"},{"key":"e_1_2_10_4_1","volume-title":"StatPearls","author":"Cooper DB","year":"2025"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2006.12.018"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.111614"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.14452"},{"key":"e_1_2_10_8_1","unstructured":"Pharmaceuticals and Medical Devices Agency.The yellow letter\/blue letter. 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Accessed August 30 2025.https:\/\/nobelpark.jp\/script\/druginfo\/drgDtl.php?id=16"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h2135"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD010813.pub2"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(02)00386-4"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.323.7305.119"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.70835","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.70835","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.70835","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T19:05:42Z","timestamp":1781809542000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.70835"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,26]]},"references-count":24,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/ijgo.70835"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.70835","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,26]]},"assertion":[{"value":"2025-10-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}