title: Supplementation with vitamin B6 reduces side effects in Cambodian women using oral contraception.
abstract: Hormonal contraceptives may produce side effects that deter women from their use as a method of family planning. In nutritionally vulnerable populations these effects may be more pronounced due to micronutrient deficiencies and health status. Previous studies have been unable to resolve whether micronutrient supplementation may reduce such side effects.
  
  
  OBJECTIVE
  In a longitudinal study, 1011 women obtaining oral contraception through the public health system in rural Cambodia were allocated to either intervention or control groups, receiving either daily Vitamin B6 supplement or care as usual (without placebo).
  
  
  RESULTS
  The intervention participants (n = 577) reported fewer side effects in three categories: nausea/no appetite, headache, and depression compared with control group participants (n = 434).
  
  
  CONCLUSIONS
  Women taking Vitamin B6 supplement were less likely to report side effects in a nutritionally vulnerable population. Underlying nutrition status should be considered by clinicians and reproductive health policy makers in the context of providing contraceptive services. Further investigation into micronutrient supplementation, particularly with B6, in reproductive-aged women using hormonal contraception should be conducted in other settings to determine the potential for widespread adoption.
authors.affiliation: Reproductive Health Association of Cambodia, No. 14, St. 335, Phnom Penh 12151, Cambodia. chivorn@rhac.org.kh.
authors.forename: Chivorn
authors.initials: C
authors.lastname: Var
authors.affiliation: Reproductive Health Association of Cambodia, No. 14, St. 335, Phnom Penh 12151, Cambodia. sheryl@ksc.th.com.
authors.forename: Sheryl
authors.initials: S
authors.lastname: Keller
authors.affiliation: National Center for Maternal Child Health, Ministry of Health, Royal Government of Cambodia, No. 31A, St.47, Phnom Penh 12151, Cambodia. rathavy@online.com.kh.
authors.forename: Rathavy
authors.initials: R
authors.lastname: Tung
authors.affiliation: Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St, New Orleans, LA 70112, USA. dfreel@gmail.com.
authors.forename: Dylan
authors.initials: D
authors.lastname: Freeland
authors.affiliation: Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St, New Orleans, LA 70112, USA. abazzano@tulane.edu.
authors.forename: Alessandra N
authors.initials: AN
authors.lastname: Bazzano
mesh_terms: D000328:Adult; D000855:Anorexia / Q000209:etiology / Q000517:prevention & control; D002160:Cambodia; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects*; D003677:Deficiency Diseases / Q000150:complications* / Q000188:drug therapy; D003863:Depression / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006261:Headache / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008137:Longitudinal Studies; D018977:Micronutrients / Q000172:deficiency*; D009325:Nausea / Q000209:etiology / Q000517:prevention & control; D009752:Nutritional Status; D025101:Vitamin B 6 / Q000627:therapeutic use*; D014803:Vitamin B Complex / Q000627:therapeutic use*
chemical_list: D003278:Contraceptives, Oral, Hormonal; D018977:Micronutrients; D014803:Vitamin B Complex; D025101:Vitamin B 6