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Effect of Village Midwife Program on Contraceptive Prevalence and Method Choice in Indonesia  

PubMed Central

Indonesia established its Village Midwife Program in 1989 to combat high rates of maternal mortality. The program’s goals were to address gaps in access to reproductive health care for rural women, increase access to and use of family planning services, and broaden the mix of available contraceptive methods. In this study, we use longitudinal data from the Indonesia Family Life Survey to examine the program’s effect on contraceptive practice. We find that the program did not affect overall contraceptive prevalence but did affect method choice. Over time, for women using contraceptives, midwives were associated with increased odds of injectable contraceptive use and decreased odds of oral contraceptive and implant use. Although the Indonesian government had hoped that the Village Midwife Program would channel women into using longer-lasting methods, the women’s “switching behavior” indicates that the program succeeded in providing additional outlets for and promoting the use of injectable contraceptives. PMID:24323659

Weaver, Emily H.; Frankenberg, Elizabeth; Fried, Bruce J.; Thomas, Duncan; Wheeler, Stephanie B.; Paul, John E.



Estimating the contribution of a service delivery organisation to the national modern contraceptive prevalence rate: Marie Stopes International's Impact 2 model  

PubMed Central

Background Individual family planning service delivery organisations currently rely on service provision data and couple-years of protection as health impact measures. Due to the substitution effect and the continuation of users of long-term methods, these metrics cannot estimate an organisation's contribution to the national modern contraceptive prevalence rate (CPR), the standard metric for measuring family planning programme impacts. Increasing CPR is essential for addressing the unmet need for family planning, a recognized global health priority. Current health impact estimation models cannot isolate the impact of an organisation in these efforts. Marie Stopes International designed the Impact 2 model to measure an organisation's contribution to increases in national CPR, as well as resulting health and demographic impacts. This paper aims to describe the methodology for modelling increasing national-level CPR as well as to discuss its benefits and limitations. Methods Impact 2 converts service provision data into estimates of the number of family planning users, accounting for continuation among users of long-term methods and addressing the challenges of converting commodity distribution data of short-term methods into user numbers. These estimates, combined with the client profile and data on the organisation's previous year's CPR contribution, enable Impact 2 to estimate which clients maintain an organisation's baseline contribution, which ones fulfil population growth offsets, and ultimately, which ones increase CPR. Results Illustrative results from Marie Stopes Madagascar show how Impact 2 can be used to estimate an organisation's contribution to national changes in the CPR. Conclusions Impact 2 is a useful tool for service delivery organisations to move beyond cruder output measures to a better understanding of their role in meeting the global unmet need for family planning. By considering health impact from the perspective of an individual organisation, Impact 2 addresses gaps not met by other models for family planning service outcomes. Further, the model helps organisations improve service delivery by demonstrating that increases in the national CPR are not simply about expanding user numbers; rather, the type of user (e.g. adopters, provider changers) must be considered. Impact 2 can be downloaded at PMID:23902699



Prevalence and factors affecting use of long acting and permanent contraceptive methods in Jinka town, Southern Ethiopia: a cross sectional study  

PubMed Central

Introduction In Ethiopia, knowledge of contraceptive methods is high though there is low contraceptive prevalence rate. This study was aimed to assess prevalence and associated factors of long acting and permanent contraceptive methods in Jinka town, southern Ethiopia. Methods Community based cross sectional survey was conducted to assess the prevalence and factors affecting long acting and permanent methods of contraceptives utilization from March to April 2008. Eight hundred child bearing age women were participated in the quantitative study and 32 purposively selected focus group discussants were participated in the qualitative study. Face to face interview was used for data collection. Data were analyzed by SPSS version 13.0 statistical software. Descriptive statistics and logistic regression were computed to analyze the data. Results The prevalence of long acting and permanent contraceptive method was 7.3%. Three fourth (76.1%) of the women have ever heard about implants and implant 28 (50%) were the most widely used method. Almost two third of women had intention to use long acting and permanent methods. Knowledge of contraceptive and age of women have significant association with the use of long acting and permanent contraceptive methods. Conclusion The overall prevalence of long acting and permanent contraceptive method was low. Knowledge of contraceptive and age of women have significant association with use of long acting and permanent contraceptive. Extensive health information should be provided.

Mekonnen, Getachew; Enquselassie, Fikre; Tesfaye, Gezahegn; Semahegn, Agumasie



Provision of long-acting reversible contraception in HIV-prevalent countries: results from nationally representative surveys in southern Africa  

PubMed Central

Objective To analyse the current provision of long-acting reversible contraception (LARC) and clinician training needs in HIV-prevalent settings. Design Nationally representative survey of clinicians. Setting HIV-prevalent settings in South Africa and Zimbabwe. Population Clinicians in South Africa and Zimbabwe. Methods Nationally representative surveys of clinicians were conducted in South Africa and Zimbabwe (n = 1444) to assess current clinical practice in the provision of LARC in HIV-prevalent settings. Multivariable logistic regression was used to analyse contraceptive provision and clinician training needs. Main outcome measure Multivariable logistic regression of contraceptive provision and clinician training needs. Results Provision of the most effective reversible contraceptives is limited: only 14% of clinicians provide copper intrauterine devices (IUDs), 4% levonorgestrel-releasing IUDs and 16% contraceptive implants. Clinicians’ perceptions of patient eligibility for IUD use were overly restrictive, especially related to HIV risks. Less than 5% reported that IUDs were appropriate for women at high risk of HIV or for HIV-positive women, contrary to evidence-based guidelines. Only 15% viewed implants as appropriate for women at risk of HIV. Most clinicians (82%), however, felt that IUDs were underused by patients, and over half desired additional training on LARC methods. Logistic regression analysis showed that LARC provision was largely restricted to physicians, hospital settings and urban areas. Results also showed that clinicians in rural areas and clinics, including nurses, were especially interested in training. Conclusions Clinician competency in LARC provision is important in southern Africa, given the low use of methods and high rates of unintended pregnancy among HIV-positive and at-risk women. Despite low provision, clinician interest is high, suggesting the need for increased evidence-based training in LARC to reduce unintended pregnancy and associated morbidities. PMID:23721413

Morse, J; Chipato, T; Blanchard, K; Nhemachena, T; Ramjee, G; McCulloch, C; Blum, M; Saleeby, E; Harper, CC



Contraception continuation rates and reasons for discontinuation in Zahedan, Islamic Republic of Iran.  


We evaluated contraception continuation rates and discontinuation reasons in Zahedan among 1741 women from 1998-2000. By Kaplan-Meier technique continuation rates were 92% for low dose combined hormonal oral contraceptives (OC), 86% for a levonorgestrel-releasing implant, 82% for intrauterine devices (IUD) and 53% for medroxyprogesterone acetate at the first year. After 3 years, continuation was 78% for levonorgestrel implant, 70% for OC, 60% for IUD and 44% for medroxyprogesterone acetate. The commonest reason for discontinuing OC and medroxyprogesterone acetate was changing method; for IUD and levonorgestrel-releasing implant, the commonest reason was side-effects. By Cox regression model, continuation rate and contraceptive type were significantly related to health centre. PMID:16212200

Rakhshani, F; Mohammadi, M




Microsoft Academic Search

Objective: To provide guidelines for health-care providers on the use of contraceptive methods to prevent pregnancy and sexually transmitted diseases. Outcomes: Overall efficacy of cited contraceptive methods, assessing reduction in pregnancy rate, risk of infection, safety, ease of use, and side effects; the effect of cited contraceptive methods on sexual health and general well-being; and the cost and availability of

Amanda Black; Diane Francoeur; Montréal QC; Timothy Rowe; Thomas Brown; Michèle David; Sheila Dunn; William A. Fisher; Nathalie Fleming; Claude A. Fortin; Edith Guilbert; Louise Hanvey; Chelsea QC; André Lalonde; Ruth Miller; Margaret Morris; Teresa O'Grady; Helen Pymar; Thirza Smith; John Collins; Dianne Miller; Elke Henneberg; QC CANADIAN; CONTRACEPTION CONSENSUS



Contraception for adolescents.  


Contraception is a pillar in reducing adolescent pregnancy rates. The American Academy of Pediatrics recommends that pediatricians develop a working knowledge of contraception to help adolescents reduce risks of and negative health consequences related to unintended pregnancy. Over the past 10 years, a number of new contraceptive methods have become available to adolescents, newer guidance has been issued on existing contraceptive methods, and the evidence base for contraception for special populations (adolescents who have disabilities, are obese, are recipients of solid organ transplants, or are HIV infected) has expanded. The Academy has addressed contraception since 1980, and this policy statement updates the 2007 statement on contraception and adolescents. It provides the pediatrician with a description and rationale for best practices in counseling and prescribing contraception for adolescents. It is supported by an accompanying technical report. PMID:25266430



Hormonal Contraceptives and Adherence  

Microsoft Academic Search

\\u000a Hormonal contraceptives are among the most widely used reversible methods of preventing pregnancy. In 2002, oral contraceptive\\u000a pills (OCPs) were the most popular contraceptive method, used by 11.6 million women in the USA [1]. Unfortunately, for methods\\u000a such as OCPs, which depend on adherence in order to be effective, there is a large difference in failure rates between perfect\\u000a use

Jeanette R. Chin; Geeta K. Swamy; Serina E. Floyd; Lori A. Bastian


Prevalence Rates of Refractive Errors in Sumatra, Indonesia  

Microsoft Academic Search

PURPOSE. To determine the prevalence rates of myopia, hyper- opia, astigmatism, and anisometropia in a prevalence survey of adults in Sumatra, Indonesia. METHODS. A population-based prevalence survey of 1043 adults 21 or more years of age was conducted in five rural villages and one provincial town of the Riau Province, Sumatra, Indonesia. A one-stage household cluster sampling procedure was used

Seang-Mei Saw; Gus Gazzard; David Koh; Mohamed Farook; Daniel Widjaja; Jeanette Lee; Donald T. H. Tan


Falling fertility and increase in use of contraception in Zimbabwe.  


Zimbabwe does not feature much on the current debate of fertility transition in sub-Saharan Africa. This article is trying to fill this gap by analysing the ZDHS data. The total fertility rate of Zimbabwe was close to 7 births during independence in 1980. However, it has declined to 3.8 in 2006. This does not only show that fertility in Zimbabwe has been declining over the years, but it is one of the lowest in the region. The fertility trend observed is mainly explained by use of contraception. The contraceptive prevalence rate was 60 percent in 2006. It is noted that the contraceptive uptake has continued to increase even during the years when Zimbabwe was going through serious political, economic, social and health challenges. This is because the groundwork done on the family planning programme soon after independence put a solid foundation in motivating women to use contraception. PMID:22590891

Mturi, Akim; Joshua, Kembo



Intrauterine contraception.  


This article is presented to give an idea as to how far the IUD can fulfill the purpose of population control. For the couple, this intrauterine method is most ideal. The main drawback is the side effect of bleeding, which is the cause of the high drop out rate. The other handicaps are spontaneous expulsion and pregnancy with the IUD in situ. It is also unsuited to nulliparous women. The general practitioner needs to become concerned with the gravity of the problem of overpopulation, and he must encourage his patients into the use of contraceptives. At the moment, the IUD is the method of choice. PMID:12338659

Soonawalla, R P



Contraceptive Development.  

ERIC Educational Resources Information Center

This report provides an overview of research activities and needs in the area of contraceptive development. In a review of the present state, discussions are offered on the effectiveness and drawbacks of oral contraceptives, intrauterine devices, barrier methods, natural family planning, and sterilization. Methods of contraception that are in the…

Troen, Philip; And Others


Immaculate contraception.  


The city of Dundee has the highest teen pregnancy and abortion rate in Scotland. In the heart of the city, The Corner is a health and information drop-in center for people aged 12-25 years which has provided a range of health promotion activities, contraception services, and general information and advice since April 1996. 8000 inquiries were posed from young people in Dundee and the surrounding areas in The Corner's first full year of operation, one-third on sexual health. A survey conducted last December found that 55% of the center's clients were aged 12-15. Young people helped to design the center, creating a cafe atmosphere in the main drop-in area with tables, chairs, and loungers. Reference literature is on display, music plays, and a series of computers is linked to health information databases. In this environment, clients can hang out, ask questions, and receive condoms or other contraceptive services without the embarrassment of attending a local family planning clinic. The examination and counseling rooms are also relaxed and warmly-appointed. The Corner has also offered emergency contraception since January, one of the few places in Scotland where nurses can provide it. While The Corner has received some local criticism, it is operating within the laws and codes of professional practices. The center is jointly funded by Tayside Health Board, Dundee City Council, and the Scottish Office. Finally, the center has a travel program which offers a package of activities based upon a different foreign country each week. PMID:9326014

Smith, K


Effects of oral contraceptives on daily self-ratings of positive and negative affect  

Microsoft Academic Search

Objectives: The relationship between affect and duration of oral contraceptive (OC) use was investigated. Method: Ninety-six women (17 first-time OC users, 34 long-time users, and 45 never-users) completed the Positive and Negative Affect Schedule (PANAS) and the Menstrual Distress Questionnaire (MDQ) daily for 35 days. This study was the first to examine positive affect variability; and personal family psychiatric history;

Kirsten A Oinonen; Dwight Mazmanian



Obesity and hormonal contraceptive efficacy  

PubMed Central

Obesity is a major public health concern affecting an increasing proportion of reproductive-aged women. Avoiding unintended pregnancy is of major importance, given the increased risks associated with pregnancy, but obesity may affect the efficacy of hormonal contraceptives by altering how these drugs are absorbed, distributed, metabolized or eliminated. Limited data suggest that long-acting, reversible contraceptives maintain excellent efficacy in obese women. Some studies demonstrating altered pharmacokinetic parameters and increased failure rates with combined oral contraceptives, the contraceptive patch and emergency contraceptive pills suggest decreased efficacy of these methods. It is unclear whether bariatric surgery affects hormonal contraceptive efficacy. Obese women should be offered the full range of contraceptive options, with counseling that balances the risks and benefits of each method, including the risk of unintended pregnancy. PMID:24007251

Robinson, Jennifer A; Burke, Anne E




E-print Network

GROWTH RATES AND PREVALENCE OF PERKINSUS MARINUS PREVALENCE IN RESTORED OYSTER POPULATIONS, Solomons, MD 20688; 2 Department of Biology, University of Maryland, College Park, MD 20742; 3 Oyster-produced juvenile oysters have been planted on numerous natural oyster bars in Maryland in an effort to restore

Paynter, Kennedy T.



E-print Network

, the prevalence rate was lower (28.3 %) than in more restrictive farrowing pens with tethered sows and perforated, straw bedding, concrete floor). Also, feces were obtained from different weaner units, including

Paris-Sud XI, Université de


Emergency Contraception  


... expected period after taking it. Continue Protection Against STDs Emergency contraception does not protect against sexually transmitted diseases (STDs) . Couples having sex must always use condoms ...


Contraceptive Evaluation.  

ERIC Educational Resources Information Center

The objective of research in contraceptive evaluation is to improve the ability of individuals to choose contraceptive methods best suited to their needs and circumstances and to provide information that will lead to the development of safer and more effective methods. There are usually three considerations in judging the importance of a method of…

Hulka, Barbara S.; And Others


[Male contraception].  


Except for condoms, male contraception is very slightly utilized in France. Several male experimental methods are under study. A synthetic luteinizing hormone-releasing hormone (LHRH) analog has been used successfully in women and offers promise in men of blocking LHRH and thus blocking spermatogenesis. Several nonsteroid substances such an hypertensives and adrenaline would suppress follicle stimulating hormone and luteinizing hormone release, but are too toxic for use. The combination of 40 mcg ethinyl estradiol and 20 mg of methyltestosterone inhibits gonadotropin release and produces azoospermia in men, but at the risk of loss of libido, constant gynecomastia, and testicular atrophy. Several combinations of androgens and progestins have been evaluated. Percutaneous testosterone and medroxyprogesterone acetate appears to be the most effective, with good metabolic tolerance and maintenance of libido and sexual performance. Injections of inhibine, a testicular factor that controls secretion of follicle stimulating hormone by feedback, offer promise of suppressing spermatogenesis without affecting other systems. Numerous substances are known to inhibit spermatogenesis but are to toxic for use or entail an unacceptable loss of libido. Gossypol has been employed as a contraceptive by the Chinese for its action in inhibiting protein synthesis, but it is known to have serious secondary effects. Among male methods currently in use, the condom had a Pearl index of .4-1.6 in the most recent British studies. Coitus interruptus can seriously interfere with sexual pleasure and has a failure rate of 25-30%. Vasectomy is safe, effective, and easy to perform, but is not a reversible method. The combination of 20 mg of medroxyprogesterone acetate in 2 daily doses and 100 mg of testosterone applied in an abdominal spray has given very promising results in 2 small studies in France and merits further development and diffusion. PMID:3648976

Demery, A



Prevalence Rates of Mental Disorders in Chilean Prisons  

PubMed Central

Objective High rates of mental disorders have been reported for prison populations worldwide, particularly in low- and middle-income countries (LMICs). The present study aimed to establish prevalence rates of mental disorders in Chilean prisoners. Method A nationwide random sample of 1008 prisoners was assessed in 7 penal institutions throughout Chile. Twelve-month prevalence rates were established using the Composite International Diagnostic Interview (CIDI) and compared to the prevalence rates previously published for the general population. Results Prevalence rates were 12.2% (95% CI, 10.2-14.1) for any substance use disorder, 8.3% (6.6-10.0) for anxiety disorders, 8.1% (6.5-9.8) for affective disorders, 5.7% (4.4-7.1) for intermittent explosive disorders, 2.2% (1.4-3.2) for ADHD of the adult, and 0.8% (0.3-1.3) for non-affective psychoses. Significantly higher prevalence rates among prisoners as compared to the general population in Chile were seen for major depression (6.1% vs. 3.7% males, Z=2.58, p<0.05) and illicit drug use (3.3% vs. 0.6% males with drug abuse, Z=2.04, p<0.05; 2.6% vs. 0.1% females with drug abuse, Z=5.36, p<0.001; 3.4% vs. 1.1% males with drug dependence, Z=3.70; p<0.001). Dysthymia (6.5% vs. 15.6%, Z=-2.39, p<0.05), simple (3.3% vs. 11.5%, Z=-3.13, p<0.001) and social phobias (3.9% vs. 9.7%, Z=2.38, p<0.05) were significantly less frequent in the female prison population than in the general population. One-year prevalence rates of alcohol abuse (2.3% vs. 3.9%; Z=-2.04; p<0.05) and dependence (2.7% vs. 8.2%; Z=-5.24; p<0.001) were less prevalent in the male prison population than in the general population. Conclusions Service provision for prison populations in Chile should acknowledge high rates of depression and illicit drug use. Overall prevalence rates are lower than reported in other LMICs. Previous research in prison populations in LMICs might have overestimated prevalence rates of mental disorders. PMID:23894415

Mundt, Adrian P.; Alvarado, Rubén; Fritsch, Rosemarie; Poblete, Catalina; Villagra, Carolina; Kastner, Sinja; Priebe, Stefan



Contraceptive Equity  

PubMed Central

The Equity in Prescription Insurance and Contraceptive Coverage Act, introduced in Congress in 1997 and still unpassed, seeks to redress health insurers’ failure to pay for birth control as they pay for other prescription drugs, most paradoxically Viagra. In 1936 the International Workers Order (IWO), a fraternal society, became the first insurer to include contraception in its benefits package. A forerunner in the movement for prepaid medical care, the IWO offered its members primary care and contraceptive services for annual flat fees. Founded at a time when the legal status of contraception was in flux, the IWO’s Birth Control Center was the only such clinic to operate on an insurance system. Recent state laws and judicial actions have revived the IWO’s groundbreaking view of contraception as a basic preventive service deserving of insurance coverage. PMID:17761562

Temkin, Elizabeth



Factors affecting the use and non use of contraception.  


Data from the 1982 Jakarta Modular Survey were used to study the factors affecting the use and nonuse of contraception. Specific study objectives were: to present some characteristics of contraceptors and noncontraceptors; to identify the major factors affecting contraceptive use; to determine the causal structure between the factors and contraceptive use; and to understand the relationship among these factors. The data collected were organized into 4 modules: socioeconomic and migration module; contraceptive prevalence and fertility module; mortality, morbidity, nutrition, and health practice module; and contraceptive continuation module. The first 3 modules were used for collecting information from all currently married women aged 15-49 years. The last module was used for collecting information from women who used some contraceptive method through the services of a family planning clinic during the 1977-82 period. Data on 2727 women were analyzed. Users and nonusers distributed differently depending on their characteristics. The characteristics selected included age, respondent's education, husband's education, working status of the respondent, age at 1st marriage, number of living children, and experience of abortion. These variables were considered to be associated with use and nonuse of contraceptives. Compared to the nonusers, the current users were slightly older in age more educated (and had husbands who were more educated), were older when 1st married, had more living children, and had more experience in abortion. Log-linear analysis was performed on 2 groups of women. Group I included all currently married women aged 15-49 years; Group II included only "high risk" women, i.e., currently married women aged 15-34 years, not pregnant, not in menopausal stage, and have had at least 1 live birth. Contraceptive use rates were lower in Group I than in Group II. Within both groups, the users rates differed significantly according to age, age at marriage, number of living children, education, and media exposure. There were no significant differences in contraceptive use rates according to experience of abortion and working status. The analysis on the selection of a model suggests that there were 4 independent major factors affecting the use and nonuse of contraception: number of living children, frequency of exposure to mass media, level of education, and current age. There also was a relationship among the following factors: age with number of living children and with media exposure; number of living children with level of education; and education with media exposure and with age. Although the experience of abortion did not affect contraceptive use, it was strongly associated with age. Among these 4 factors, education had the strongest effects, followed consecutively by number of living children, current age, and media exposure. PMID:12280177

Utomo, B; Alimoeso, S; Park, C B



Helicobacter pylori in sleeve gastrectomies: prevalence and rate of complications.  


HELICOBACTER PYLORI IN SLEEVE GASTRECTOMIES: Prevalence & Rate of Complications. Prevalence of Helicobacter pylori has not been established in sleeve gastrectomy specimens and yet initial observations indicate that it is significant. The aim is to determine prevalence of Helicobacter pylori and correlate with rate of post-operative complications. A total of 89 Sleeve gastrectomies were identified. Pathology reports and slides were re-examined. Warthin Starry special stain and clinical history were obtained. 38 cases were Helicobacter pylori positive (44%). 33 (39%) cases initially reported negative for Helicobacter pylori on routine hematoxylin and eosin stained slide; were positive when Warthin starry stain was employed. The presence of neutrophils in tissue was strongly associated with presence of Helicobacter pylori on Warthin stain (p<0.001). Post-operative complications were observed in 8 patients (9%). Complications were not significantly associated with Warthin-Starry special stain status (p=0.98). PMID:23386918

Albawardi, Alia; Almarzooqi, Saeeda; Torab, Fawaz Chikh



Contraceptive Implants  

Microsoft Academic Search

Subdermal contraceptive implants offer women long-acting, controlled release of progestins. Over the past 20 years, they have\\u000a been approved in more than 60 countries and used by more than 11 million women worldwide. Their high efficacy along with ease\\u000a of use make them a good contraceptive option for women who require progestin-only methods because they should not use estrogen,\\u000a teens

Philip D. Darney


[Contraceptive methods].  


Discussions with groups of women in several Latin American countries revealed that most agreed on the need for family planning. Most reported they were somewhat informed and had used a method, but the Bolivian women stated they lacked knowledge of how to prevent pregnancy. Most of the women had little confidence in the natural methods recommended by the Catholic Church. Several of the groups stated they did not believe the contraceptive methods to be abortifacient. Some of the women had no problems using contraception, while others regarded method use as aggression against the female body and wished that men would assume responsibility. All the groups desired more information on contraception, even those with experience in use of several methods. Misinformation about the effects of contraceptives was a source of concern. The desire of the partners for many children or for control of the woman's sexuality was a serious impediment to contraceptive use. The opposition of the Catholic Church did not appear to influence women greatly in their use of contraception, but it caused feelings of guilt in some women. PMID:12348502



College Students' Perceived Disease Risk versus Actual Prevalence Rates  

ERIC Educational Resources Information Center

Objective: To compare college students' perceived disease risk with disease prevalence rates. Methods: Data were analyzed from 625 college students collected with an Internet-based survey. Paired t-tests were used to separately compare participants' perceived 10-year and lifetime disease risk for 4 diseases: heart disease, cancer, diabetes, and…

Smith, Matthew Lee; Dickerson, Justin B.; Sosa, Erica T.; McKyer, E. Lisako J.; Ory, Marcia G.



Contraceptive use: socioeconomic correlates and method choices in rural Bangladesh.  


This article investigates socioeconomic correlates of contraceptive use and method choice in rural Bangladesh. To meet the objectives of the study, the authors used nationally representative 2004 Bangladesh Demographic and Health Survey data. The findings indicate that contraceptive prevalence rate among currently married nonpregnant women was 61%. The prevalence of modern methods was 49%. Oral pill and periodic abstinence were the most preferred modern and traditional methods, respectively. Both bivariate and multivariate analyses reveal that women's age, number of living children, having a male child, women's education, religion, NGO membership, and place of region are important determinants of contraceptive use and method choices. Findings suggest that discussion between husband and wife on family planning has the most single significant effect on both current contraceptive use (odds ratio [OR] = 4.45; confidence interval [CI] = 3.95-5.01) and modern method preference (OR = 1.57; CI = 1.28-1.93). The doorstep delivery service of modern methods should be strengthened to further increase effective family planning that is required to reduce the total fertility rate in Bangladesh. PMID:20659903

Kamal, S M Mostafa; Islam, Md Aynul



Gender of children and contraceptive use.  


In 1984, half of married/cohabiting Canadian women aged 18-49 years were using contraception, with sterilisation being the most prevalent method. This study, using data from the 1984 Canadian Fertility Survey of 5315 women aged 18-49 years, found that there was a preference for sons. Women with two sons are more likely to use contraception than those who have had two daughters; the gender of children may have a weak effect on contraceptive behaviour of Canadian couples at higher parities. Sociocultural factors (e.g. education, religion, religiosity) were also found to influence contraceptive behaviour. PMID:8478370

Krishnan, V



Contraceptive use dynamics of Asian women in Britain.  


In-depth interviews were conducted with married Asian women from Indian, Pakistani and Bangladeshi backgrounds, to investigate patterns of contraceptive use and influences on contraceptive decision making. The results show two distinctively different contraceptive 'lifecycles'. Non-professional women typically have little knowledge about contraception until after their marriage or first birth. Their patterns of contraceptive behaviour show low levels of contraceptive use until after their first birth, when condom use is most prevalent. Non-professional women are influenced by their extended family, religion and cultural expectations on their fertility and family planning decisions. Professional women show an entirely different pattern of contraceptive behaviour. They are more likely to have knowledge about contraception before marriage, use some method of contraception throughout their childbearing years (typically the pill) and cite personal, practical or economic considerations in their fertility decisions rather than religious, cultural or extended family influences. PMID:10581881

Hennink, M; Diamond, I; Cooper, P



Interspousal communication on family planning and its effect on contraceptive adoption in Bangladesh.  


This article explores the hypothesis that interspousal communication on family planning significantly influences the use of contraceptive method in Bangladesh using the nationally representative 2007 Bangladesh Demographic and Health Survey data. Both bivariate and multivariate statistical analyses were employed in the study. The findings are consistent with the hypothesis. Both cross-sectional and fixed-effect binary logistic regression models yielded quantitatively important and statistically reliable estimates of the positive effect of husband-wife discussion on family planning on the current use of contraceptive method. Son preference, current residence, region, and visitations by family planning workers are also important determinants of contraceptive use. Programs should be undertaken on behalf of the government to involve men in family planning to increase the contraceptive prevalence rate at the point that needs to achieve the replacement level of fertility in Bangladesh. PMID:21659331

Kamal, S M Mostafa; Islam, Md Aynul



Family Discussions About Contraception and Family Planning: A Qualitative Exploration of Black Parent and Adolescent Perspectives  

PubMed Central

CONTEXT Parent-adolescent communication is associated with increased adolescent contraceptive use. However, studies of this association are limited by their lack of examination of the communication process, reliance on cross-sectional designs and infrequent comparison of parent and adolescent perspectives. Examining communication in black families is particularly important, given the high pregnancy rate among black adolescents. METHODS Between December 2007 and March 2008, a total of 21 focus groups were conducted with 53 black families (68 parents and 57 adolescents) in Pennsylvania. Separate groups were held for males and females, and for parents and adolescents. The discussion guide explored family communication about sexual health topics, including contraception, family planning and abortion. Sessions were audio-recorded; data were transcribed and analyzed using a grounded theory approach to content analysis and the constant comparison method. RESULTS Five key themes emerged among both parents and adolescents. First, discussions about contraception were indirect and framed in terms of the need to avoid negative consequences of sex. Second, contraceptive knowledge was low. Third, parents more often reported helping male adolescents get condoms than helping females get contraceptives. Fourth, discussions emphasized planning for the future over contraception. Finally, negative attitudes toward abortion were prevalent. CONCLUSIONS Parent-adolescent communication interventions should improve contraceptive knowledge, help parents understand the harmful effects of gender biases in information dissemination, and provide mothers and fathers with communication skills tailored to enhance the role they play in their adolescents’ sexual development. PMID:20887285

Akers, Aletha Y.; Schwarz, Eleanor Bimla; Borrero, Sonya; Corbie-Smith, Giselle



Advances in Male Contraception  

PubMed Central

Despite significant advances in contraceptive options for women over the last 50 yr, world population continues to grow rapidly. Scientists and activists alike point to the devastating environmental impacts that population pressures have caused, including global warming from the developed world and hunger and disease in less developed areas. Moreover, almost half of all pregnancies are still unwanted or unplanned. Clearly, there is a need for expanded, reversible, contraceptive options. Multicultural surveys demonstrate the willingness of men to participate in contraception and their female partners to trust them to do so. Notwithstanding their paucity of options, male methods including vasectomy and condoms account for almost one third of contraceptive use in the United States and other countries. Recent international clinical research efforts have demonstrated high efficacy rates (90–95%) for hormonally based male contraceptives. Current barriers to expanded use include limited delivery methods and perceived regulatory obstacles, which stymie introduction to the marketplace. However, advances in oral and injectable androgen delivery are cause for optimism that these hurdles may be overcome. Nonhormonal methods, such as compounds that target sperm motility, are attractive in their theoretical promise of specificity for the reproductive tract. Gene and protein array technologies continue to identify potential targets for this approach. Such nonhormonal agents will likely reach clinical trials in the near future. Great strides have been made in understanding male reproductive physiology; the combined efforts of scientists, clinicians, industry and governmental funding agencies could make an effective, reversible, male contraceptive an option for family planning over the next decade. PMID:18436704

Page, Stephanie T.; Amory, John K.; Bremner, William J.



Lifetime Prevalence Rates of Sleep Paralysis: A Systematic Review  

PubMed Central

Objective To determine lifetime prevalence rates of sleep paralysis. Data Sources Keyword term searches using “sleep paralysis”, “isolated sleep paralysis”, or “parasomnia not otherwise specified” were conducted using MEDLINE (1950-present) and PsychINFO (1872-present). English and Spanish language abstracts were reviewed, as were reference lists of identified articles. Study Selection Thirty five studies that reported lifetime sleep paralysis rates and described both the assessment procedures and sample utilized were selected. Data Extraction Weighted percentages were calculated for each study and, when possible, for each reported subsample. Data Synthesis Aggregating across studies (total N = 36533), 7.6% of the general population, 28.3% of students, and 31.9% of psychiatric patients experienced at least one episode of sleep paralysis. Of the psychiatric patients with panic disorder, 34.6% reported lifetime sleep paralysis. Results also suggested that minorities experience lifetime sleep paralysis at higher rates than Caucasians. Conclusions Sleep paralysis is relatively common in the general population and more frequent in students and psychiatric patients. Given these prevalence rates, sleep paralysis should be assessed more regularly and uniformly in order to determine its impact on individual functioning and better articulate its relation to psychiatric and other medical conditions. PMID:21571556

Barber, Jacques P.



Impact of Social Franchising on Contraceptive Use When Complemented by Vouchers: A Quasi-Experimental Study in Rural Pakistan  

PubMed Central

Background Pakistan has had a low contraceptive prevalence rate for the last two decades; with preference for natural birth spacing methods and condoms. Family planning services offered by the public sector have never fulfilled the demand for contraception, particularly in rural areas. In the private sector, cost is a major constraint. In 2008, Marie Stopes Society – a local NGO started a social franchise programme along with a free voucher scheme to promote uptake of IUCDs amongst the poor. This paper evaluates the effectiveness of this approach, which is designed to increase modern long term contraceptive awareness and use in rural areas of Pakistan. Methodology We used a quasi-experimental study design with controls, selecting one intervention district and one control district from the Sindh and Punjab provinces. In each district, we chose a total of four service providers. A baseline survey was carried out among 4,992 married women of reproductive age (MWRA) in February 2009. Eighteen months after the start of intervention, an independent endline survey was conducted among 4,003 women. We used multilevel logistic regression for analysis using Stata 11. Results Social franchising used alongside free vouchers for long term contraceptive choices significantly increased the awareness of modern contraception. Awareness increased by 5% in the intervention district. Similarly, the ever use of modern contraceptive increased by 28.5%, and the overall contraceptive prevalence rate increased by 19.6%. A significant change (11.1%) was recorded in the uptake of IUCDs, which were being promoted with vouchers. Conclusion Family planning franchise model promotes awareness and uptake of contraceptives. Moreover, supplemented with vouchers, it may enhance the use of IUCDs, which have a significant cost attached. Our research also supports a multi-pronged approach- generating demand through counselling, overcoming financial constraints by offering vouchers, training, accreditation and branding of the service providers, and ensuring uninterrupted contraceptive supplies. PMID:24069287

Khurram Azmat, Syed; Tasneem Shaikh, Babar; Hameed, Waqas; Mustafa, Ghulam; Hussain, Wajahat; Asghar, Jamshaid; Ishaque, Muhammad; Ahmed, Aftab; Bilgrami, Mohsina



Understanding contraceptive failure  

PubMed Central

Contraceptive failure is a major source of unintended pregnancy. This chapter will review sources of data and measurement of contraceptive failure, summarize results from the literature on the risks of contraceptive failure during typical and perfect use for available methods of contraception, provide a tool for communicating risks of contraceptive failure to clients, examine determinants of contraceptive failure, and identify methodological pitfalls in the published literature. PMID:19223239

Trussell, James



Is Effective Contraceptive Use Conceived Prenatally in Florida? The Association Between Prenatal Contraceptive Counseling and Postpartum Contraceptive Use  

Microsoft Academic Search

The objective of this study is to describe the prevalence of postpartum contraceptive use among women experiencing a live\\u000a birth in Florida in 2004–2005. To examine the association between family planning counseling during prenatal care visits and\\u000a the use of effective contraceptive methods among postpartum women. Matched data from Florida PRAMS and Vital Statistics were\\u000a used (n = 3,962). Weighted logistic regression

Leticia E. Hernandez; William M. Sappenfield; David Goodman; Jennifer Pooler


Nigerians divided on AIDS prevalence. International / case rates.  


The World Health Organization (WHO) estimates that more than half a million people in Africa had AIDS in 1993 alone. According to the WHO, another 10 million Africans now carry HIV, including more than half a million in Nigeria. But some Nigerian scientists charge that their counterparts in the industrialized world deliberately inflate the figures to create the impression that Africa is as poor in health as it is economically. On the other hand, some feel AIDS has been killing more people in Nigeria than official reports show. Professor Akande Abdulkarim, a biochemist of the University of Khartoum, Sudan, argued that AIDS is not as pandemic as the Western scientists maintain. Abdulkarim wondered how AIDS, first discovered among homosexual communities in the United States, had suddenly become an African scourge. He added that body slimness as one of the manifestations of AIDS could be deceitful since Africa has about 11 diseases which cause weight loss, including tuberculosis. Since the discovery of AIDS, Nigerian health officials have alerted the nation, quoting very high figures even though not many people go for AIDS screening in the country. The Health and Social Services Minister announced early in 1994 that AIDS prevalence had risen from 300 reported cases in 1992 to 962 in 1993. More than 600,000 Nigerians had tested HIV-positive since 1986, when the disease was first diagnosed in the country. As of December 1993, only 100 Nigerians were officially deemed to have died from AIDS. But another scientist cautioned Nigerians against being deluded by the low AIDS-mortality figure reported; the low death rate was misleading because some deaths have been wrongly attributed to some other ailments. PMID:12288417



Microtia-Anotia: A Global Review of Prevalence Rates  

PubMed Central

Background There are few published studies on microtia-anotia frequency. Methods Using data from birth defects surveillance programs around the world, we conducted a systematic review on the frequency of microtia-anotia to further explore the differences in prevalence across countries. Ninety-two birth defects surveillance programs were evaluated with a total of 8,917 cases of microtia-anotia. We computed the prevalence per 10,000 births for each surveillance program for total cases of microtia-anotia (microtia types I to IV), microtia (types I to III), and anotia (type IV). Prevalence ratios were calculated by large geographical areas, race/ethnicity, and by surveillance methodologies. Results The overall prevalence were for microtia-anotia 2.06 (CI: 2.02–2.10), for microtia 1.55 (CI: 1.50–1.60), and for anotia 0.36 (CI: 0.34–0.38). Higher prevalence was observed in the Americas, Northern Europe and Asia, among Hispanics and Asians, and among active ascertainment and hospital-based surveillance programs. Conclusions We observed marked variation in the prevalence of microtia-anotia across surveillance programs and within countries. These results must be interpreted cautiously as this variability may be explained mainly by differences in surveillance methods. However, given the magnitude of some of the differences, other factors may also be involved. This study contributes to the knowledge on the prevalence of microtia-anotia by providing a critical analysis of the existing data. In addition, it supports the need for a coding system that allows complete phenotype characterization of microtia-anotia, including severity and laterality; as well as further studies on the variation of its frequency related to race and ethnicity. PMID:21656661

Luquetti, Daniela Varela; Leoncini, Emanuele; Mastroiacovo, Pierpaolo



Reported prevalence of urinary incontinence in women in a general practice  

Microsoft Academic Search

To determine the prevalence of urinary incontinence and other urinary symptoms a questionnaire was sent to all women aged 25 and over and to women under 21 taking oral contraceptives registered with a rural practice (n=937); the questionnaire was completed by 833 women (89%). The overall prevalence of urinary incontinence was 41% (343\\/833); rates were lower in nulliparous and postmenopausal

Jacqueline V Jolleys



Contraception and Birth Control  


... Resources and Publications En Español Contraception and Birth Control: Condition Information Skip sharing on social media links ... is the prevention of pregnancy. Contraception, or birth control, also allows couples to plan the timing of ...


Contraception for adolescents.  


A working knowledge of contraception will assist the pediatrician in both sexual health promotion as well as treatment of common adolescent gynecologic problems. Best practices in adolescent anticipatory guidance and screening include a sexual health history, screening for pregnancy and sexually transmitted infections, counseling, and if indicated, providing access to contraceptives. Pediatricians' long-term relationships with adolescents and families allow them to help promote healthy sexual decision-making, including abstinence and contraceptive use. Additionally, medical indications for contraception, such as acne, dysmenorrhea, and heavy menstrual bleeding, are frequently uncovered during adolescent visits. This technical report provides an evidence base for the accompanying policy statement and addresses key aspects of adolescent contraceptive use, including the following: (1) sexual history taking, confidentiality, and counseling; (2) adolescent data on the use and side effects of newer contraceptive methods; (3) new data on older contraceptive methods; and (4) evidence supporting the use of contraceptives in adolescent patients with complex medical conditions. PMID:25266435

Ott, Mary A; Sucato, Gina S



National Prevalence Rates of Bully Victimization among Students with Disabilities in the United States  

ERIC Educational Resources Information Center

This study examined the prevalence rates of bully victimization and risk for repeated victimization among students with disabilities using the Special Education Elementary Longitudinal Study and the National Longitudinal Transition Study-2 longitudinal datasets. Results revealed that a prevalence rate ranging from 24.5% in elementary school to…

Blake, Jamilia J.; Lund, Emily M.; Zhou, Qiong; Kwok, Oi-man; Benz, Michael R.



A Study on the Mental Disorder and Prevalence Rate of Physiological Disease of College Students  

Microsoft Academic Search

Objective: Explore the effect of mental health on the physiological disease susceptibility (prevalence rate) of college students and provide scientific basis for psychological counsel, physical and mental health education, disease prevention, psychological treatment of college students. Methods: The psychological health conditions and physiological diseases (prevalence rate) of college students were investigated by the method of questionnaire survey using self evaluation

Xia Zuying



[Contraception and neurology].  


The purpose of this article is to clarify interactions between oral contraception (using low- and high-dose oral contraceptives) and the main neurological diseases occurring in genitally active women. Vascular disorders predominate, since contraception is in itself a well-recognized a risk factor, especially in case of other intercurrent risk factors (high blood pressure, smoking, diabetes, history of vascular event) contradicting contraception. Low-dose oral contraception can be proposed for women free of these risk factors. There is however a formal contraindication for oral contraception, even with mini-dose contraceptives, for women with a history of cerebral venous thrombosis. In case of migraine headache, which is also a risk factor of vascular disease (especially in case of aura), oral contraceptives should be discussed on an individual basis, depending on the presence of other risk factors. Contraception has no effect on epilepsy but oral contraceptives may be inhibited by inducing anti-seizure drugs. Non-inducing drugs are preferable. The course of certain brain tumors known to express estrogen or progesterone receptors (particularly meningiomas and hemangioblastomas) may worsen with oral contraception, which is formally contradicted except when search for hormone receptors is negative. Oral contraception has no influence in other disease such as multiple sclerosis PMID:12486383

Combes, Caroline; Redondo, Aimée; Rey, Alain



Patterns of contraceptive use among urban women in Taiwan.  


Patterns of contraceptive use among married urban women in Taiwan were investigated. A convenience sample of 150 women attending health clinics for reasons other than contraceptive care were interviewed about their contraceptive use. The most prevalent contraceptive method used by these women was the intrauterine device, followed by the condom and birth-control pills. Participants had used only one or two contraceptive methods throughout their contraceptive careers, and many stated they were satisfied with their current method. Many participants were able to name the methods of birth control promoted by the Taiwan family-planning promotion program. Knowledge of alternative methods did not significantly relate to current method in use or to desire to change methods. PMID:1955408

Lethbridge, D J; Wang, R



[Contraception and society].  


Dramatic decreases in the birth rate between 1947 and 1955 in Japan is due to legalized abortion and wide-spread practice of contraception but is also to some socio-economic changes. In 1947, the birth rate in Japan reached its highest, 34.3/1000 but dramatically decreased by 50% over the next 8 years. The birth rate, which went down to 17.2/1000 in 1955, increased again gradually till 1974 but has been decreasing. Total fertility rate is 1.8 as of now. Eugenic Law was passed in 1948 in Japan. 30% had the experience of contraception in 1950; 52% in 1955; 63% in 1959; 72% in 1965. 15% experienced abortion in 1952; 27%, in 1955; 41% in 1961. A post war baby boom occurred amid shortage of food, shelter and employment, and the experience of poverty prompted people to limit the size of family. Post-war Japan no longer was obsessed with producing an heir. Neither was there a need to produce many children because of improved infant mortality rates. Due to the fast paced industrialization of Japan between 1950 and 1960 a potentially high fertility population migrated from rural to urban areas, where big families were not advantageous. Although the socio economic life of Japanese people greatly improved after 1960, the birth rate has not increased very much. Money is now used more for material comforts in daily life, leisure, and education of small number of children. There is also a trend among some part of population not to have children because of environmental deterioration. PMID:12283950

Miyahara, S



Estrogens and postcoital contraception.  


The contraceptive effect of large doses of estrogens administered postcoitally is not fully understood, although numerous reports have described the use of a 4 to 6 day course of high dose oral diethylstilbestrol (DES), ethinyl estradiol, conjugated estrogens, and combinations of estrogen and progestogen. Because estrogens are effective postovulatory rather than postcoital contraceptives, it is necessary to know the exact time of unprotected intercouse in relation to a woman's menstrual cycle. Depending on the frequency and timing of intercouse, a 5-day course of postcoital estrogen, introduced within 72 hours, yields a pregancy rate of .03-.3%. Failures are usually due to inadequate doses of estrogen, errors in timing, or multiple exposures. A lowering of basal body temperature after postovulatory administration of high doses of estrogen indicates successful intervention. Existence of various conditions such as hypertension and migraine contraindicate the use of postcoital estrogens. DES and possibly other estrogens are associated with teratogenic and potentially carcinogenic effects. 70 to 80% of women taking postcoital estrogens report side effects such as nausea, weight gain and headache. No randomized studies have compared the efficacy, side effects, or safety of the available estrogens. The use of informed coinsent procedures is advised because of the potency of high dose estrogens. PMID:12278953

Notelovitz, M



Should obesity be blamed for the high prevalence rates of hypertension in black South African women?  

Microsoft Academic Search

Hypertension is highly prevalent in South Africa, resulting in high stroke mortality rates. Since obesity is very common among South African women, it is likely that obesity contributes to the hypertension prevalence. The aims were to determine whether black African women have higher blood pressures (BPs) than Caucasian women, and whether obesity is related to their cardiovascular risk. African (N=102)

A E Schutte; H W Huisman; J M Van Rooyen; R Schutte; L Malan; M Reimann; J H De Ridder; A van der Merwe; P E H Schwarz; N T Malan



Contraceptive Practice in China: 1970-2004.  


Using large-scale data from the national conventional statistics and nationally representative sample surveys, the current study aims to assess the level, mode, and determinants of modern contraceptive use from 1970 to 2004 among married couples aged 20 to 49 years in China. A relatively stable Chinese mode of contraception has been established and maintained since the 1980s, characterized by prominent, long-acting contraceptive use and the highest overall prevalence in the world during the past 3 decades. In recent years, the composition of contraceptive use has changed, characterized by the increasing use of the intrauterine device and short-acting methods and a drastic decrease in male and female sterilization. However, the dominance of the long-acting methods has not undergone substantial change. The results from a multinomial logit model employed in this study indicate that family planning policy and socioeconomic and demographic factors jointly influence contraceptive choice. In particular, contraceptive choice is closely associated with the strength of family planning policy in China. PMID:23695542

Wang, Cuntong



Socioeconomic Correlates of Contraceptive Use among the Ethnic Tribal Women of Bangladesh: Does Sex Preference Matter?  

PubMed Central

Objective To examine the relationship between socioeconomic factors affecting contraceptive use among tribal women of Bangladesh with focusing on son preference over daughter. Materials and methods The study used data gathered through a cross sectional survey on four tribal communities resided in the Rangamati Hill District of the Chittagong Hill Tracts, Bangladesh. A multistage random sampling procedure was applied to collect data from 865 currently married women of whom 806 women were currently married, non-pregnant and had at least one living child, which are the basis of this study. The information was recorded in a pre-structured questionnaire. Simple cross tabulation, chi-square tests and logistic regression analyses were performed to analyzing data. Results The contraceptive prevalence rate among the study tribal women was 73%. The multivariate analyses yielded quantitatively important and reliable estimates of likelihood of contraceptive use. Findings revealed that after controlling for other variables, the likelihood of contraceptive use was found not to be significant among women with at least one son than those who had only daughters, indicating no preference of son over daughter. Multivariate logistic regression analysis suggests that home visitations by family planning workers, tribal identity, place of residence, husband's education, and type of family, television ownership, electricity connection in the household and number of times married are important determinants of any contraceptive method use among the tribal women. Conclusion The contraceptive use rate among the disadvantaged tribal women was more than that of the national level. Door-step delivery services of modern methods should be reached and available targeting the poor and remote zones. PMID:24971107

Hassan, Che Hashim



Combined oral contraceptives: health benefits beyond contraception.  


It has been recognized for over 50 years that combined oral contraceptives (COCs) are also capable of offering health benefits beyond contraception through the treatment and prevention of several gynaecological and medical disorders. During the last years a constant attention was given to the adverse effects of COCs, whereas their non-contraceptive benefits were underestimated. To date, most women are still unaware of the therapeutic uses of hormonal contraceptives, while on the contrary there is an extensive and constantly increasing of these non-contraceptive health benefits. This review summarizes the conditions of special interest for physicians, including dysmenorrhoea, menorrhagia, hyperandrogenism (acne, hirsutism, polycystic ovary syndrome), functional ovarian cysts, endometriosis, premenstrual syndrome, myomas, pelvic inflammatory disease, bone mineral density, benign breast disease and endometrial/ovarian and colorectal cancer. The benefits of COCs in rheumatoid arthritis, multiple sclerosis, menstrual migraine and in perimenopause have also been treated for more comprehensive information. Using COCs specifically for non-contraceptive indications is still outside the product licence in the majority of cases. We strongly believe that these aspects are not of minor relevance and they deserve a special consideration by health providers and by the mass media, which have the main responsibility in the diffusion of scientific information. Thus, counseling and education are necessary to help women make well-informed health-care decisions and it is also crucial to increase awareness among general practitioners and gynaecologists. PMID:25056245

Caserta, D; Ralli, E; Matteucci, E; Bordi, G; Mallozzi, M; Moscarini, M



Reversible Contraception Update: The Importance of Long-Acting Reversible Contraception  

PubMed Central

The past several years have seen an expansion in contraception options. Emerging data support the use of long-acting reversible contraception (LARC) such as the intrauterine device and subdermal implant as the most effective methods of contraception with the highest continuation rates and very high levels of patient satisfaction. In addition, the appropriate target population for the use of the intrauterine device now includes nulliparous women and adolescents. When a patient considers initiating a new contraceptive method, it is important to consider the characteristics of each method, including the side effects, effectiveness, and patient acceptability. Additionally, medical comorbidities must also be evaluated prior to choosing a method. In this article, we provide a brief overview of available reversible contraceptive methods, with an emphasis on LARC. PMID:19641264

Mestad, Renee E.; Kenerson, Jessica; Peipert, Jeffrey F.



Fertility and contraception in Puerto Rico.  


A contraceptive service was established in Puerto Rico in 1937. Detailed study of the reproductive history of low income families admitted to the service provides information for the basis of the present high fertility of the population and the likelihood of its continuance. The experience of these families following admission to the contraceptive service shows the impact of the service upon their fertility, testing the view that Puerto Rico might respond to an organized birth control effort. The sample consisted of 1962 families selected not randomly but on the basis of indigence and interest in contraceptive advice. 1/3 of the couples reported some previous effort at contraception, with most of the contraceptive practice depending on withdrawal. Residence, education, occupation, and income are all associated with the marked variation in the proportions who reported contraceptive experience. The percentages are 26 and 52 for rural and urban residence; 21, 27, 44, and 59 for the educational groupings with less than 5 to 7 and 8 or more completed grades. For the low, medium, and high occupational groups, the percentages are 20, 45, and 69, and for the corresponding income classes they are 22, 42, and 66. Women aged 25 to 29 and 30 to 34 report contraceptive practice with much greater relative frequency than younger women. Clearly marked differences are found in the rates for contraceptors of different social and economic classes. Although the reason for high fertility in Puerto Rico is due to lack of cultural and economic pressure to limit families, there is evidence to suggest that use of birth control has begun. It appears that fertility reduction would be implemented if the population possessed better knowledge of birth control measures and readier access to contraceptive materials, particularly condoms. A clinical program to encourage the use of contraception might also prove effective. PMID:12275792

Beebe, G W; Belaval, J S



Contraceptive vaginal ring — a rising star on the contraceptive horizon  

Microsoft Academic Search

Two studies were carried out at AIIMS to judge efficacy, side-effects and acceptability of the contraceptive vaginal ring, a Silastic ring with an inner core containing 6.0 mg levonorgestrel mixed with Silastic and an outer core of Silastic only. It releases levonorgestrel at a constant rate of 20 µg\\/day and remains effective for 90 days. The first study of 50

K. Buckshee; S. Kumar; L. Sarava



Unexpected sequelae of contraception.  


Dissident Roman Catholic theologians who promote the use of contraception have ignored the fact that contraception separates the loving aspect of sex from its fertile nature (which does not imply fecundity). While there is no obligation for Roman Catholics to achieve pregnancy, no interference with fertility is allowed. The importance of this seeming technicality can be seen when considering that contraception offers sex without babies and in vitro fertilization allows babies to be conceived without sexual intercourse. Barrier methods of contraception make sexual intercourse impure in a way similar to masturbation, oral contraceptives generally suppress ovulation but may also act as an abortifacient, and the IUD is an abortifacient, as are other hormonal methods and menstrual extraction. Sterilization and abortion are serious moral faults. Contraception is the first step towards the prevailing antinatalism that will cause demographic collapse in rich countries because there is a progression from contraception to sterilization to abortion. Rather than leading to fewer abortions, acceptance of contraception leads to more. This distressing sequence can be extended to include masturbation at one end and homosexuality at the other. Acceptance of contraception encourages all premarital and extramarital sexual intercourse and has depreciated the value of marriage. Rejection of child-bearing has exacerbated the estrangement of teenagers from parents who chose sterile sex and money over siblings for their children. Contraception fuels fears about a population explosion when people should be regarded as important resources. Finally, contraception has contributed to the shortage of those choosing religious vocations because it has demeaned their sacrifice of celibacy. The only permitted method of family limitation, therefore, is ovulation detection. PMID:12320545

Dunn, H P



Understanding Incidence and Prevalence Rates in Mixed Dementia  

Microsoft Academic Search

Countries throughout the world are reporting increased life-spans and lower birth rates. These sociodemographic changes result\\u000a in the elderly, particularly the oldest old, comprising an increasingly larger segment of the population (1). Consequently, dementia is projected to be one of the major health-care problems of future decades (2).

John Gunstad; Jeffrey Browndyke


The impact of high-flux dialysis on mortality rates in incident and prevalent hemodialysis patients  

PubMed Central

Background/Aims The effect of high-flux (HF) dialysis on mortality rates could vary with the duration of dialysis. We evaluated the effects of HF dialysis on mortality rates in incident and prevalent hemodialysis (HD) patients. Methods Incident and prevalent HD patients were selected from the Clinical Research Center registry for end-stage renal disease (ESRD), a Korean prospective observational cohort study. Incident HD patients were defined as newly diagnosed ESRD patients initiating HD. Prevalent HD patients were defined as patients who had been receiving HD for > 3 months. The primary outcome measure was all-cause mortality. Results This study included 1,165 incident and 1,641 prevalent HD patients. Following a median 24 months of follow-up, the mortality rates of the HF and low-flux (LF) groups did not significantly differ in the incident patients (hazard ratio [HR], 1.046; 95% confidence interval [CI], 0.592 to 1.847; p = 0.878). In the prevalent patients, HF dialysis was associated with decreased mortality compared with LF dialysis (HR, 0.606; 95% CI, 0.416 to 0.885; p = 0.009). Conclusions HF dialysis was associated with a decreased mortality rate in prevalent HD patients, but not in incident HD patients. PMID:25378976

Kim, Hyung Wook; Kim, Su-Hyun; Kim, Young Ok; Jin, Dong Chan; Song, Ho Chul; Choi, Euy Jin; Kim, Yong-Lim; Kim, Yon-Su; Kang, Shin-Wook; Kim, Nam-Ho; Yang, Chul Woo



High HIV prevalence and diagnosis rates in New York City black men.  


We sought to identify population and subpopulation disparities in rates of HIV diagnosis and prevalence among black males 13 years and older in New York City. We used population-based data from the New York City HIV/AIDS surveillance registry and US Census 2000 to calculate HIV prevalence in 2006 and HIV diagnosis rates in 2007. Black males were the largest demographic group of new HIV diagnoses (n = 1,161, 33%) and persons living with HIV/AIDS in New York City (n = 24,294, 29%) and had the highest diagnosis rates (1.7 per 1,000 population) and prevalence (3.7%). Prevalence and diagnosis rates among black males were higher in higher-poverty neighborhoods than in lower-poverty neighborhoods (p < 0.01). However, very high prevalence (19.3%) was found among black males in three adjacent Manhattan neighborhoods with relatively low poverty rates, and where overall diagnosis rates among black males (7.4 per 1,000) and proportions attributable to men who have sex with men (60.0%) were high. HIV-related disparities exist not only between black males and other groups but also within black males. Success addressing the citywide HIV epidemic will be linked to success in the various portions of this highly affected, heterogeneous population. PMID:20574776

Wiewel, Ellen W; Hanna, David B; Begier, Elizabeth M; Torian, Lucia V



Modeling white-tailed deer Odocoileus virginianus population control by contraception  

Microsoft Academic Search

Large populations of white-tailed deer Odocoileus virginianus present conservation problems in suburban landscapes because of limited population control options. We used the GAPPS II modeling system to simulate temporal effects of contraception on deer population control and the interaction between contraception and uncertain immigration rates. Contraception rates less than 50% of female deer curbed population growth with a long (30

Steven W. Seagle; John D. Close



Mortality among contraceptive pill users: cohort evidence from Royal College of General Practitioners’ Oral Contraception Study  

PubMed Central

Objective To see if the mortality risk among women who have used oral contraceptives differs from that of never users. Design Prospective cohort study started in 1968 with mortality data supplied by participating general practitioners, National Health Service central registries, or both. Setting 1400 general practices throughout the United Kingdom. Participants 46?112 women observed for up to 39 years, resulting in 378?006 woman years of observation among never users of oral contraception and 819?175 among ever users. Main outcome measures Directly standardised adjusted relative risks between never and ever users for all cause and cause specific mortality. Results 1747 deaths occurred in never users of oral contraception and 2864 in ever users. Compared with never users, ever users of oral contraception had a significantly lower rate of death from any cause (adjusted relative risk 0.88, 95% confidence interval 0.82 to 0.93). They also had significantly lower rates of death from all cancers; large bowel/rectum, uterine body, and ovarian cancer; main gynaecological cancers combined; all circulatory disease; ischaemic heart disease; and all other diseases. They had higher rates of violent deaths. No association between overall mortality and duration of oral contraceptive use was observed, although some disease specific relations were apparent. An increased relative risk of death from any cause between ever users and never users was observed in women aged under 45 years who had stopped using oral contraceptives 5-9 years previously but not in those with more distant use. The estimated absolute reduction in all cause mortality among ever users of oral contraception was 52 per 100?000 woman years. Conclusion Oral contraception was not associated with an increased long term risk of death in this large UK cohort; indeed, a net benefit was apparent. The balance of risks and benefits, however, may vary globally, depending on patterns of oral contraception usage and background risk of disease. PMID:20223876



New hormonal methods of contraception.  


Three types of new contraceptive delivery system have been discussed in this chapter. Each have novel methods of delivery and may be acceptable to certain groups of women. It is clear that subdermal contraceptive implants are extremely useful as a long-term method of contraception, and provided insertion occurs correctly, removal will then be easy. The second-generation implants using a single rod, compared with the first-generation ones using six capsules, would appear to offer advantages both to the patient and in relation to the training of medical and paramedical personnel who have to fit the subdermal implant. The main disadvantage is the incidence of irregular bleeding, which, by and large, can be overcome by pre-insertion counselling and by time. The second method of delivery, vaginal rings, offers high patient acceptability, but a usable ring for contraception has as yet to be developed. Two approaches appear to be the use of a continuous progestogen-only ring, or a combined ring releasing oestrogen and progestogen with a 21-day-in, 7-day-out cycle of use. Ongoing studies will indicate whether vaginal lesions are significant or related to the flexibility of the ring. If these studies prove satisfactory, further development of the vaginal rings, both as an alternative method for interval use or as a specific postpartum form of contraception using progesterone-releasing rings, will be developed. Significant developments in the use of a combined monthly injectable have led to the release of two preparations, Cyclofem and Mesigyna, which are now available in many countries. This combined approach offers a significant reduction in amenorrhoea rates and unacceptable bleeding, the majority of women having acceptable menstrual patterns even during the first 3 months of use. All three methods have low and acceptable rates of pregnancy, the lowest being seen with the subdermal implants and with combined monthly injectables. Due to the length of action of subdermal implants, these may find a niche for women wishing to use a long-acting method and not wishing to be sterilized. They also provide a useful method where medical intervention is not available on a regular basis. Monthly injectable preparations can be given by paramedical personnel, and introductory studies have indicated that in developing and developed countries, they are highly acceptable. All three methods offer an increased choice for women and safe and effective methods of contraception. PMID:8736724

Newton, J R



Lifetime sexual assault prevalence rates and reporting practices in an emergency department population  

Microsoft Academic Search

Study Objective: Studies suggest significant rates of female sexual assault (SA); the majority of SAs remain unreported, and few victims receive medical care. The purpose of this study was to determine lifetime prevalence rates of SA in an emergency department population and to assess reporting patterns to police, physicians, and social service agencies. Methods: A verbally administered survey was given

Kim M. Feldhaus; Debra Houry; Robin Kaminsky



The 1998 Canadian Contraception Study.  

ERIC Educational Resources Information Center

Describes the 1998 Canadian Contraception Study, a mailed survey which asked women about contraceptive practices past, present, and future (including use of oral contraceptives, condoms, and sterilization); familiarity with and opinion about different contraception methods; and general sexual and reproductive health. The paper also examines…

Fisher, William A.; Boroditsky, Richard; Bridges, Martha L.



What's wrong with contraception?  


A "reader's exchange" question solicited information on how readers respond when asked what is wrong with contraception. One correspondent couple wrote that their response is dependent upon their assessment of the questioner's perspective. Responses they use are 1) that the Catholic Church teaches that contraception is wrong and it is okay to accept this teaching in faith; 2) the Church teaches that every act of sexual intercourse must be open to life; 3) the God-given gift of intercourse involves pleasure and procreation, it is wrong to accept only part of the gift; 4) oral contraceptives have abortifacient properties; and 5) natural family planning involves temperance whereas contraception allows behavior which is similar to gluttony. A second correspondent wrote that the use of contraception makes humans behave like animals and allows them to be "takers" rather than "givers." A third letter-writer maintained that the use of contraception prohibits true love, total commitment, and complete acceptance on the part of a married couple. Contraception attempts to create a utopia and obviates the pain and suffering which are necessary in order to find true love and true happiness. PMID:12345571

Rice, L; Rice, B



Emergency contraception in Mexico City: what do health care providers and potential users know and think about it?  

Microsoft Academic Search

Emergency contraception promises to reduce Mexico’s high unwanted pregnancy and unsafe abortion rates. Because oral contraceptives are sold over-the-counter, several emergency contraceptive regimens are already potentially available to those women who know about the method. Soon, specially packaged emergency contraceptives may also arrive in Mexico. To initiate campaigns promoting emergency contraception, we interviewed health care providers and clients at health

Ana Langer; Cynthia Harper; Cecilia Garcia-Barrios; Raffaela Schiavon; Angela Heimburger; Batya Elul; Sofia Reynoso Delgado; Charlotte Ellertson



Out from behind the contraceptive Iron Curtain.  


In the early 1950s, the Soviet Union and several of its Eastern European satellites completed their transition from high to low fertility before the US and Western Europe. They did this even though there were not enough modern contraceptives available to meet the needs of its citizens. As late as 1990, the Soviet Union had no factories manufacturing modern contraceptives. A gynecologist in Poland described domestically produced oral contraceptives (OCs) as being good for horses, but not for humans. The Romanian government under Ceaucescu banned all contraceptives and safe abortion services. Therefore, women relied on abortion as their principal means of birth control, even in Catholic Poland. The legal abortion rates in the Soviet Union and Romania stood at 100/1000 (1985) and 91/1000 (1987) as compared to 18/1000 in Denmark and 13/1000 in France. All too often these abortion were prohibited and occurred under unsafe conditions giving rise to complications and death. Further, the lack of contraceptives in the region precipitated and increase in AIDS and other sexually transmitted diseases. On the other hand, abortion rates were minimalized in Czechoslovakia, East Germany, and Hungary due to the availability of modern contraceptives and reproductive health services. Hungary and East Germany even manufactured OCs. OC use in these 2 nations rated as among the world's highest. East Germany also treated infertility and sexually transmitted diseases. The region experienced a political opening in latecomer 1989. In 1989, IPPF gave approximately 15 million condoms and 3000 monthly OC packets to the Soviet Union to ease the transition. More international assistance for contraceptive supplies and equipment and training to modernize abortion practices is necessary. PMID:12283401

Jacobson, J L



Reaching the poor through community-based distributors of contraceptives: experiences from Muheza district, Tanzania.  


Community based distribution (CBD) programmes were introduced as a strategy to ensure access of contraceptives to the needy. The strategy is reported to increase contraceptive knowledge and use. Although CBD agents have the advantage of reaching the poor in rural areas, wealth gap does exist even in these settings. The objective of this study was to determine access to information and modern contraceptives services among people of different wealth status in a rural setting in Muheza, Tanzania. This cross-sectional study was conducted following a six year project in promotion of contraceptive using community-based agents. The study area was stratified into three socio-geographical strata from which one village was randomly selected. Through house-to-house visits, interviews were conducted using structured questionnaires until the required sample size was obtained. A community-led wealth ranking criteria was developed through consensus and used to classify respondents into wealth categories. A total of 1,420 respondents were interviewed. Contraceptive Prevalence Rate (CPR) for modern methods was 32.2%; injectables accounted for half (50.8%) followed by pills (32.7%). CBD agents accounted for one-third (34.3%) of the contraceptive use. There was no difference in the access to information (P=0.44) and to contraceptives (P=0.83) between the poorer and the less poor. Half of the respondents (49.4%; 214/431) reported paying for services, with no difference between the less poor and the poorer (P=0.75). Respondents receiving services from health facilities were more likely to pay for services (61.3%) compared to CBD agents (25.0%). However, the level of satisfaction was high (approximately 70%) in both health facilities and CBD agents. This study has shown that people in the rural settings of Muheza district were able to access information and contraceptives from CBD agents and health facilities, regardless of their wealth status. There is however, need to address the issue of informal payments lest it deters people in need from accessing the services. PMID:24409640

Simba, Daudi; Schuemer, Cordula; Forrester, Kate; Hiza, Merriment



Does Multimorbidity Influence the Occurrence Rates of Chronic Conditions? A Claims Data Based Comparison of Expected and Observed Prevalence Rates  

PubMed Central

Objective Multimorbidity is a complex phenomenon with an almost endless number of possible disease combinations with unclear implications. One important aspect in analyzing the clustering of diseases is to distinguish between random coexistence and statistical dependency. We developed a model to account for random coexistence based on stochastic distribution. We analyzed if the number of diseases of the patients influences the occurrence rates of chronic conditions. Methods We analyzed claims data of 121,389 persons aged 65+ using a list of 46 chronic conditions. Expected prevalences were simulated by drawing without replacement from all observed diseases using observed overall prevalences as initial probability weights. To determine if a disease occurs more or less frequently than expected by chance we calculated observed-minus-expected deltas for each disease. We defined clinical relevance as |delta| ? 5.0%. 18 conditions were excluded because of a prevalence < 5.0%. Results We found that (1) two chronic conditions (e.g. hypertension) were more frequent than expected in patients with a low number of comorbidities; (2) four conditions (e.g. renal insufficiency) were more frequent in patients with many comorbidities; (3) six conditions (e.g. cancer) were less frequent with many comorbidities; and (4) 16 conditions had an average course of prevalences. Conclusion A growing extent of multimorbidity goes along with a rapid growth of prevalences. This is for the largest part merely a stochastic effect. If we account for this effect we find that only few diseases deviate from the expected prevalence curves. Causes for these deviations are discussed. Our approach also has methodological implications: Naive analyses of multimorbidity might easily be affected by bias, because the prevalence of all chronic conditions necessarily increases with a growing extent of multimorbidity. We should therefore always examine and discuss the stochastic interrelations between the chronic conditions we analyze. PMID:23028979

Schafer, Ingmar



Evaluative Indices Assigned to Contraceptive Methods by University Undergraduates  

ERIC Educational Resources Information Center

Background: Preordinate attitudes and beliefs about contraception may influence acceptance or rejection of a particular method. Purpose: We examined the attitudes about contraception methods held by undergraduate students (N=792) at two large southeastern universities in the United States. Methods: Twelve methods were rated on 40 semantic…

McDermott, Robert J.; Malo, Teri L.; Dodd, Virginia J.; Daley, Ellen M.; Mayer, Alyssa B.



Male hormonal contraceptives.  


As the world human population continues to explode, the need for effective, safe and convenient contraceptive methods escalates. Historically, women have borne the brunt of responsibility for contraception and family planning. Except for the condom, there are no easily reversible, male-based contraceptive options. Recent surveys have confirmed that the majority of men and women would consider using a hormonal male contraceptive if a safe, effective and convenient formulation were available. Investigators have sought to develop a male hormonal contraceptive based on the observation that spermatogenesis depends on stimulation by gonadotropins, follicle-stimulating hormone (FSH) and luteinising hormone (LH). Testosterone (T) and other hormones such as progestins suppress circulating gonadotropins and spermatogenesis and have been studied as potential male contraceptives. Results from two large, multi-centre trials demonstrated that high-dosage T conferred an overall contraceptive efficacy comparable to female oral contraceptives. This regimen was also fully reversible after discontinuation. However, this regimen was not universally effective and involved weekly im. injections that could be painful and inconvenient. In addition, the high dosage of T suppressed serum high-density lipoprotein (HDL) cholesterol levels, an effect that might increase atherogenesis. Investigators have attempted to develop a hormonal regimen that did not cause androgenic suppression of HDL cholesterol and that was uniformly effective by suppressing spermatogenesis to zero in all men. Studies of combination regimens of lower-dosage T and a progestin or a gonadotropin-releasing hormone analogue have demonstrated greater suppression of spermatogenesis than the WHO trials of high-dosage T but most of these regimens cause modest weight gain and suppression of serum HDL cholesterol levels. Overall, the data suggest that we are close to developing effective male hormonal contraceptives. The focus is now on developing effective oral regimens that could be safely taken daily or long-acting depot formulations of a male hormonal contraception that could be conveniently injected every 3 - 6 months. In this article, we shall review the exciting new developments in male hormonal contraception. PMID:11585019

Anawalt, B D; Amory, J K



Patterns of Contraceptive Use Within Teenagers' First Sexual Relationships  

PubMed Central

CONTEXT Teenagers have a high unintended pregnancy rate, in part because of inconsistent use or nonuse of contraceptives. It is important to determine how partner and relationship characteristics are related to contraceptive use and consistency within adolescents’ first sexual relationships. METHODS Logistic and multinomial logistic regression analyses of data from 1,027 participants in the first two waves of the National Longitudinal Study of Adolescent Health examined the influence of relationship and partner characteristics on ever-use and consistent use of contraceptive methods during teenagers’ first sexual relationships. RESULTS Teenagers who had waited a longer time between the start of a relationship and first sex with that partner, discussed contraception before first having sex or used dual contraceptive methods had significantly increased odds of ever or always using contraceptives. Adolescents who had taken a virginity pledge, had an older partner, had a greater number of close friends who knew their first partner, or reported having a relationship that was not romantic but that involved holding hands, kissing and telling their partners they liked or loved them had decreased odds of contraceptive use or consistency. As relationship length increased, teenagers were more likely to ever have used a method, but less likely to always have used a method. CONCLUSIONS Parents and programs should encourage teenagers to delay sexual intercourse, discuss contraception with partners before initiating sex and be vigilant about contraceptive use, particularly in long-term sexual relationships and in relationships with older partners. PMID:14744656

Manlove, Jennifer; Ryan, Suzanne; Franzetta, Kerry



Prevalence Rates of Depression, Anxiety, and Somatization among Rural Southwestern Native American Children.  

ERIC Educational Resources Information Center

Internalizing symptoms, which include anxiety and depression, may be the most common pattern of psychopathology found in children. However, the knowledge base targeting internalizing symptomology in Native American children of the Southwest is surprisingly limited. This paper reports on a study of prevalence rates of internalizing disorders among…

Morris, Carolyn T.; Morris, Christopher; Crowley, Susan L.


Attitude toward contraception and abortion among Cura?ao women. Ineffective contraception due to limited sexual education?  

PubMed Central

Background In Curaçao is a high incidence of unintended pregnancies and induced abortions. Most of the induced abortions in Curaçao are on request of the woman and performed by general practitioners. In Curaçao, induced abortion is strictly prohibited, but since 1999 there has been a policy of connivance. We present data on the relevance of economic and socio-cultural factors for the high abortion-rates and the ineffective use of contraception. Methods Structured interviews to investigate knowledge and attitudes toward sexuality, contraception and abortion and reasons for ineffective use of contraceptives among women, visiting general practitioners. Results Of 158 women, 146 (92%) participated and 82% reported that their education on sexuality and about contraception was of good quality. However 'knowledge of reliable contraceptive methods' appeared to be - in almost 50% of the cases - false information, misjudgements or erroneous views on the chance of getting pregnant using coitus interruptus and about the reliability and health effects of oral contraceptive pills. Almost half of the interviewed women had incorrect or no knowledge about reliability of condom use and IUD. 42% of the respondents risked by their behavior an unplanned pregnancy. Most respondents considered abortion as an emergency procedure, not as contraception. Almost two third experienced emotional, physical or social problems after the abortion. Conclusions Respondents had a negative attitude toward reliable contraceptives due to socio-cultural determined ideas about health consequences and limited sexual education. Main economic factors were costs of contraceptive methods, because most health insurances in Curaçao do not cover contraceptives. To improve the effective use of reliable contraceptives, more adequate information should be given, targeting the wrong beliefs and false information. The government should encourage health insurance companies to reimburse contraceptives. Furthermore, improvement of counseling during the abortion procedure is important. PMID:21699701



Contraceptive discontinuation and switching among couples receiving integrated HIV and family planning services in Lusaka, Zambia  

PubMed Central

Objective To describe predictors of contraceptive method discontinuation and switching behaviors among HIV positive couples receiving couples' voluntary HIV counseling and testing services in Lusaka, Zambia. Design Couples were randomized in a factorial design to two family planning educational intervention videos, received comprehensive family planning services, and were assessed every 3-months for contraceptive initiation, discontinuation and switching. Methods We modeled factors associated with contraceptive method upgrading and downgrading via multivariate Andersen-Gill models. Results Most women continued the initial method selected after randomization. The highest rates of discontinuation/switching were observed for injectable contraceptive and intrauterine device users. Time to discontinuing the more effective contraceptive methods or downgrading to oral contraceptives or condoms was associated with the women's younger age, desire for more children within the next year, heavy menstrual bleeding, bleeding between periods, and cystitis/dysuria. Health concerns among women about contraceptive implants and male partners not wanting more children were associated with upgrading from oral contraceptives or condoms. HIV status of the woman or the couple was not predictive of switching or stopping. Conclusions We found complicated patterns of contraceptive use. The predictors of contraception switching indicate that interventions targeted to younger couples that address common contraception-related misconceptions could improve effective family planning utilization. We recommend these findings be used to increase the uptake and continuation of contraception, especially long acting reversible contraceptive (LARC) methods, and that fertility-goal based, LARC-focused family planning be offered as an integral part of HIV prevention services. PMID:24088689

Haddad, Lisa; Wall, Kristin M; Vwalika, Bellington; Htee Khu, Naw; Brill, Ilene; Kilembe, William; Stephenson, Rob; Chomba, Elwyn; Vwalika, Cheswa; Tichacek, Amanda; Allen, Susan



Male contraception: history and development.  


Although the twentieth century has seen great strides in the development of female contraception, not a single new agent has been introduced as an approved method for common use for male contraception. Condoms (considered uncomfortable by some) and vasectomy (a permanent invasive procedure) are the only options provided to men, leaving an undue burden on women to bear contraceptive responsibility. Significant developments have, however, been made with regard to hormonal and nonhormonal contraception, and minor, reversible, procedural contraception. This article reviews the currently available, soon to be available, and theoretically possible methods of male contraception. PMID:24286773

Kogan, Paul; Wald, Moshe



Contraceptive Utilization and Pregnancy Termination Among Female Sex Workers in Afghanistan  

PubMed Central

Abstract Background To determine the prevalence and correlates of prior pregnancy termination and unmet need for contraception among female sex workers (FSWs) in Afghanistan. Methods FSWs in Jalalabad, Kabul, and Mazar-i-Sharif were recruited between June 2006 and December 2007 through outreach programs. Participants completed an interviewer-administered survey describing demographics, behaviors associated with risk of sexually transmitted infections (STIs) and unplanned pregnancy, and medical history. Correlates of prior pregnancy termination and current unmet need for contraception were assessed with logistic regression analysis, controlling for site. Results Of 520 FSWs, most (82.3%) had been pregnant at least once (mean 4.9?±?2.7, range 1–17), among whom unplanned pregnancy (36.9%) and termination (33.2%) were common. Jalalabad participants were more likely to report both prior unplanned pregnancy (60.6% vs. 48.3% in Kabul or 20.7% in Mazar, p?contraception. Unmet need for contraception (14.7% of participants) was positively associated with having sold sex outside their city of residence (adjusted odds ratio [AOR] 1.88, 95% confidence interval [CI] 1.28-2.77) and inversely associated with illicit drug use (AOR 0.41, 95% CI 0.31-0.53). Conclusions Although FSWs in Afghanistan report high rates of contraceptive use, unplanned pregnancy is common. Reproductive health services should be included in programming for FSWs to reduce unplanned pregnancies and to reduce HIV/STI risks. PMID:20879869

Nasir, Abdul; Raza Stanekzai, Mohammad; Scott, Paul T.; Strathdee, Steffanie A.; Botros, Boulos A.; Tjaden, Jeffrey



Effects of pretreatment with an oral contraceptive on the time required to achieve pituitary suppression with gonadotropin-releasing hormone analogues and on subsequent implantation and pregnancy rates  

Microsoft Academic Search

Objective: To assess the effect of pretreatment with an oral contraceptive (OC) on ovarian cyst formation during pituitary suppression with buserelin acetate.Design: Prospective randomized trial.Setting: Academic medical center.Patient(s): Eighty-three patients who were undergoing IVF-ET treatment.Intervention(s): Patients in the study group were pretreated with an OC for 14 days starting on the first day of menstruation. The administration of SC buserelin

Marinko M Biljan; Neal G Mahutte; Nicola Dean; Robert Hemmings; Francois Bissonnette; Seang Lin Tan



Contraceptive problems unique to the United States.  


An overview of the distinctive milieu regarding contraceptive methods available in the U.S. considers declining method options, future prospects, reasons for the poor current climate, factors affecting future options, global ramifications, and proposed reforms that may improve the U.S. situation. In the last 3 years, the U.S. lost 3 safe IUDs, and lawsuits now threaten the existence of both spermicides and their associated barrier methods. Meanwhile 2 new IUDs and the cervical cap have been introduced. Future possible methods include Norplant, transdermal patches and a disposable spermicide-releasing diaphragm. The chief reason for loss of contraceptives is the legal system in the U.S. which permits peer juries to evaluate a method's side effects relative to the claimant's former health, rather than actual risk- benefit ratios or medical data. Adverse legal decisions have escalated or eliminated liability insurance. The public is ignorant of the benefits of contraceptives, but misinformed by prominent coverage in the media of preliminary adverse findings. Even the F.D.A., for unstated political reasons, has failed on 2 occasions to approve Depo-Provera, used safely in over 80 countries and approved by the drug agencies of most western nations. Other political factors have cut government funding for contraceptive development steadily for 15 years. Apathy for contraceptive research extends from congress to donor support to numbers of new Ph.D.s entering the field. Ramifications include the highest unplanned pregnancy rate, abortion rate and adolescent pregnancy rate in the developed world in the U.S., and a suspicious stance on the part of developed countries toward U.S. contraceptives, especially those not approved here. Proposed ways of reversing the legal and insurance blocks include reform of tort law and no-fault compensation decided by arbitration. PMID:2743644

Tyrer, L B; Salas, J E



Emergency contraception: a review.  


Emergency contraceptives (EC) are forms of contraception that women can use after intercourse to prevent pregnancy. EC use is safe for women of all ages, and there are no medical contraindications to its use. There are two types of emergency contraceptive pills currently available: ulipristal acetate (UPA) and levonorgestrel. UPA is the most effective oral option for EC. In the United States, levonorgestrel containing ECPs are available without prescription to women and men without age restrictions. However, the more effective UPA pills require a prescription. ECPs do not cause abortion or harm an established pregnancy. Placement of a copper intrauterine device (IUD) is more effective EC than either UPA or levonorgestrel, and requires a timely visit with a trained clinician. EC pills are less effective for women who are overweight or obese, therefore such women should be offered a copper IUD or ulipristal rather than levonorgestrel pills. Any woman requesting EC after unprotected intercourse should be offered treatment within 120 hours of intercourse, as should all women who are victims of sexual assault. Women requesting EC should be offered information and services for ongoing contraception. Although levonorgestrel EC is now available over-the-counter, ongoing need exists to educate women about emergency contraception to encourage prompt use of EC when it is needed. PMID:25313947

Corbelli, J; Bimla Schwarz, E



An update on emergency contraception.  


Emergency contraception decreases the risk of unintended pregnancy after unprotected sexual intercourse or after suspected failure of routine contraception (e.g., a condom breaking). Oral methods include combined contraceptive pills (i.e., Yuzpe method), single- or split-dose levonorgestrel, and ulipristal. The Yuzpe method and levonorgestrel are U.S. Food and Drug Administration-approved for use 72 hours postcoitus, whereas the newest method, ulipristal, is approved for up to 120 hours postcoitus. The copper intrauterine device may be used as emergency contraception up to seven days after unprotected intercourse. It is nonhormonal and has the added benefit of long-term contraception. Advanced provision of emergency contraception may be useful for all patients, and for persons using ulipristal because it is available only by prescription. Physicians should counsel patients on the use and effectiveness of emergency contraception, the methods available, and the benefits of routine and consistent contraception use. PMID:24695600

Bosworth, Michele C; Olusola, Patti L; Low, Sarah B



High Lifetime Pregnancy and Low Contraceptive Usage Among Sex Workers Who Use Drugs- An Unmet Reproductive Health Need  

PubMed Central

Background The objective of this study was to describe levels of pregnancy and contraceptive usage among a cohort of street-based female sex workers (FSWs) in Vancouver. Methods The study sample was obtained from a community-based prospective cohort study (2006-2008) of 211 women in street-based sex work who use drugs, 176 of whom had reported at least one prior pregnancy. Descriptive statistics were used to estimate lifetime pregnancy prevalence, pregnancy outcomes (miscarriage, abortion, adoption, child apprehension, child custody), and contraceptive usage. In secondary analyses, associations between contraceptive usage, individual and interpersonal risk factors and high number of lifetime pregnancies (defined as greater than the sample mean of 4) were examined. Results Among our sample, 84% reported a prior pregnancy, with a mean of 4 lifetime pregnancies (median = 3; IQR: 2-5). The median age of women reporting 5+ pregnancies was 38 years old [interquartile range (IQR): 25.0-39.0] compared to 34 years [IQR: 25.0-39.0] among women reporting 4 or fewer prior pregnancies. 45% were Caucasian and 47% were of Aboriginal ancestry. We observed high rates of previous abortion (median = 1;IQR:1-3), apprehension (median = 2; IQR:1-4) and adoption (median = 1; IQR:1-2) among FSWs who reported prior pregnancy. The use of hormonal and insertive contraceptives was limited. In bivariate analysis, tubal ligation (OR = 2.49; [95%CI = 1.14-5.45]), and permanent contraceptives (e.g., tubal ligation and hysterectomy) (OR = 2.76; [95%CI = 1.36-5.59]) were both significantly associated with having five or more pregnancies. Conclusion These findings demonstrate high levels of unwanted pregnancy in the context of low utilization of effective contraceptives and suggest a need to improve the accessibility and utilization of reproductive health services, including family planning, which are appropriately targeted and tailored for FSWs in Vancouver. PMID:21851622



A Continuation of the Paradigm Wars? Prevalence Rates of Methodological Approaches across the Social/Behavioral Sciences  

ERIC Educational Resources Information Center

A new line of research has emerged that examines the prevalence rates of mixed methods within disciplines in the social/behavioral sciences. Research presented in this article is unique in that it examines prevalence rates across multiple disciplines using an established cross-disciplinary classification scheme. Results indicate that there are…

Alise, Mark A.; Teddlie, Charles



Intrauterine Contraceptive Devices  

PubMed Central

Although the ideal contraceptive has not been found, intrauterine contraceptive devices offer distinct advantages and provide adequate contraception. Unfortunately, they have side-effects, complications and failures. Their use is contraindicated in pregnancy, abnormalities of the uterine cavity, uterine hypoplasia, infection and abnormal uterine bleeding. Patients who have had an ectopic pregnancy, who are prone to endocarditis, who have allergies to copper, or who are taking anticoagulants also should not use IUCDs, Insertion is best performed during menstruation, and the patient should be seen in follow up to assess placement and any side-effects, including cramps, bleeding, vaginal discharge, or discomfort during intercourse. Pregnancy may occur when the IUCD is in place, and prompt diagnosis is mandatory. Depending on the type of IUCD used, replacement time varies from one to three years. PMID:21283376

Cardoso, Reynaldo



Depression and anxiety in prostate cancer: a systematic review and meta-analysis of prevalence rates  

PubMed Central

Objectives To systematically review the literature pertaining to the prevalence of depression and anxiety in patients with prostate cancer as a function of treatment stage. Design Systematic review and meta-analysis. Participants 4494 patients with prostate cancer from primary research investigations. Primary outcome measure The prevalence of clinical depression and anxiety in patients with prostate cancer as a function of treatment stage. Results We identified 27 full journal articles that met the inclusion criteria for entry into the meta-analysis resulting in a pooled sample size of 4494 patients. The meta-analysis of prevalence rates identified pretreatment, on-treatment and post-treatment depression prevalences of 17.27% (95% CI 15.06% to 19.72%), 14.70% (95% CI 11.92% to 17.99%) and 18.44% (95% CI 15.18% to 22.22%), respectively. Pretreatment, on-treatment and post-treatment anxiety prevalences were 27.04% (95% CI 24.26% to 30.01%), 15.09% (95% CI 12.15% to 18.60%) and 18.49% (95% CI 13.81% to 24.31%), respectively. Conclusions Our findings suggest that the prevalence of depression and anxiety in men with prostate cancer, across the treatment spectrum, is relatively high. In light of the growing emphasis placed on cancer survivorship, we consider that further research within this area is warranted to ensure that psychological distress in patients with prostate cancer is not underdiagnosed and undertreated. PMID:24625637

Watts, Sam; Leydon, Geraldine; Birch, Brian; Prescott, Philip; Lai, Lily; Eardley, Susan; Lewith, George



Air pollution, weather, and associated risk factors related to asthma prevalence and attack rate  

Microsoft Academic Search

Asthma is an important public health challenge. The objective of this research was to investigate the relationship of air pollution and weather to adolescent asthma prevalence and attack rate. A 6-month mass screening asthma study was conducted from October 1995 to March 1996 in Taiwan. The study population included junior high school students from throughout the country (1,139,452 students). Eighty-nine

Wen-Chao Ho; William R. Hartley; Leann Myers; Meng-Hung Lin; Yu-Sheng Lin; Chih-Hui Lien; Ruey-Shiung Lin



Association between prevalent care process measures and facility-specific mortality rates  

Microsoft Academic Search

Association between prevalent care process measures and facility-specific mortality rates.BackgroundMedical communities often develop practice guidelines recommending certain care processes intended to promote better clinical outcome among patients. Conformance with those guidelines by facilities is then monitored to evaluate care quality, presuming that the process is associated with and can be used reliably to predict clinical outcome. Outcome is often monitored

Edmund G. Lowrie; Ming Teng; Eduardo Lacson; Nancy Lew; J. Michael Lazarus; William F. Owen



Effects of steroidal contraceptives on gallbladder: a review.  


In regard to gallbladder disease and oral contraceptive use, more than ten controlled epidemiologic studies have been reported and reviewed in this paper. The findings presented concerning the association of oral contraceptive use with the development of a gallbladder disease are contradictory. Oral contraceptive use and use of estrogens in postmenopausal women have been reported to be associated with increased attack-rates of a gallbladder disease, but the increased risk is found higher in those using estrogens than progestin based oral contraceptives. Other studies, however, have reported little overall effect of oral contraceptive use on the risk of the gallbladder disease. Where increased risk has been documented, this has been more related to duration than overall. The increased risk of oral contraceptive use to gallbladder disease has been observed higher in the 6-12 months of usage. Only one study has reported increased risk of gallbladder disease in long-term users. The increased gallbladder disease in oral contraceptive users may be greater in multiparae than in nulliparae; pregnancy and obesity may also pose an increased risk to the disease in oral contraceptive users. However, these findings are not widely accepted. PMID:2253576

Kenya, P R



Use of the combined oral contraceptive pill by under 16s.  


The General Practice Research Database was used to examine prescribing of the combined oral contraceptive pill for females aged under 16 in England and Wales in 1997. From these data, calculations were made to estimate prevalence for these countries; family planning clinic return data were combined with the general practice estimates to give an overall figure of 4.2 per 100. This extent of use is low considering the amount of sexual activity now occurring. A weak effect of population density on prescribing was found, with higher rates in the more rural areas. PMID:12457541

Rowlands, S; Devalia, H; Lawrenson, R



[Contraception and sexuality].  


Earlier age at menarche, a longer reproductive life, and fewer desired births have been factors in the increasing importance of contraception in the life of women and couples. This work assesses the optimal contraceptive methods for different physiological phases of affective and sexual life and for various sexual problems. Contraception should prevent pregnancy, not promote sexually transmitted diseases and disorders of the genital tract, and preserve future fertility. The 1st gynecological consultation, even for very young girls, has 3 main objectives: detecting anomalies of the genital tract, ensuring that no physiological problems will arise in the 1st intercourse, and providing contraception if it will be needed in the relatively near future. The physician should speak directly to the young patient instead of to her mother. Hormonal contraception is preferred for adolescents with regular sexual activity, but for the majority who have episodic and irregular sexual relations other methods may be preferable. Condoms provide some protection against sexually transmitted diseases but require cooperation from the male partner. Vaginal sponges which can be left in place for 24 hours are easier to use than other vaginal methods. The "morning after" pill is available in case of unprotected coitus. The unplanned and unstable sexuality of adolescents is increasingly followed by a period of regular and continuous premarital sexual relations requiring reliable and continuous contraception. The pill remains the best choice for its efficacy, tolerance, and safety. Various formulations are available in case of contraindications to the classic combined pill. IUDs should be formally contraindicated because of the possibility of extrauterine pregnancy or salpingitis. Mechanical methods can be used for short periods but should not replace a more effective method on a permanent basis. The IUD may be a good choice for women who have completed their families. Oral contraceptives may be continued for premenopausal women without other cardiovascular risk factors. High dose progestins derived from 17 hydroxyprogesterone are recommended in case of luteal insufficiency. Premenopausal women whose sexual relations have become less frequent may prefer IUDs, local methods, or tubal ligation. Sexual difficulties of couples should be considered in selecting a method. Frigid women do not tolerate contraception well because fear of pregnancy is their excuse for avoiding sex. IUDs may be more satisfactory than pills in such cases because they do not require daily action. Pills may be the best choice in cases of premature ejaculation or impotence. PMID:12342527

Kahn-nathan, J



Hormonal contraception and pelvic girdle pain during pregnancy: a population study of 91 721 pregnancies in the Norwegian Mother and Child Cohort  

PubMed Central

STUDY QUESTION Is pre-pregnancy hormonal contraception use associated with the development of pelvic girdle pain during pregnancy? SUMMARY ANSWER In contrast to combined oral contraceptive pills, long lifetime exposure to progestin-only contraceptive pills or the use of a progestin intrauterine device during the final year before pregnancy were associated with pelvic girdle pain. WHAT IS ALREADY KNOWN Pelvic girdle pain severely affects many women during pregnancy. Smaller studies have suggested that hormonal contraceptive use is involved in the underlying mechanisms, but evidence is inconclusive. STUDY DESIGN, SIZE, DURATION A population study during the years 1999–2008. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 91 721 pregnancies included in the Norwegian Mother and Child Cohort Study. Data were obtained by two self-administered questionnaires during pregnancy weeks 17 and 30. MAIN RESULTS AND THE ROLE OF CHANCE Pelvic girdle pain was present in 12.9% of women who had used combined oral contraceptive pills during the last pre-pregnancy year, 16.4% of women who had used progestin-only contraceptive pills, 16.7% of women who had progestin injections and 20.7% of women who had used progestin intrauterine devices, compared with 15.3% of women who did not report use of hormonal contraceptives. After adjustment for other study factors, the use of a progestin intrauterine device was the only factor based on the preceding year associated with pelvic girdle pain [adjusted odds ratios (OR) 1.20; 95% confidence interval (CI): 1.11–1.31]. Long lifetime exposure to progestin-only contraceptive pills was also associated with pelvic girdle pain (adjusted OR 1.49; 95% CI: 1.01–2.20). LIMITATIONS, REASONS FOR CAUTION The participation rate was 38.5%. However, a recent study on the potential biases of skewed selection in the Norwegian Mother and Child Cohort Study found the prevalence estimates but not the exposure-outcome associations to be influenced by the selection. WIDER IMPLICATIONS OF THE FINDINGS The results suggest that combined oral contraceptives can be used without fear of developing pelvic girdle pain during pregnancy. However, the influence of progestin intrauterine devices and long-term exposure to progestin-only contraceptive pills requires further study. STUDY FUNDING/COMPETING INTEREST(S) The present study was supported by the Norwegian Research Council. None of the authors has a conflict of interest. PMID:23887071

Bjelland, E.K.; Kristiansson, P.; Nordeng, H.; Vangen, S.; Eberhard-Gran, M.



Updates in hormonal emergency contraception.  


In recent years, there have been many updates in hormonal emergency contraception. Levonorgestrel emergency contraception has been available for several years to prevent pregnancy when used within 72 hours after unprotected intercourse or contraceptive failure, and it was recently approved for nonprescription status for patients aged 17 years or older. Current research suggests that the primary mechanism of action is delaying ovulation. Ulipristal is the newest emergency contraception, available by prescription only, approved for use up to 120 hours after unprotected intercourse or contraceptive failure. The primary mechanism of action is delaying ovulation. When compared with levonorgestrel emergency contraception, ulipristal was proven noninferior in preventing pregnancy. Evidence suggests that ulipristal does not lose efficacy from 72-120 hours; however, more studies are warranted to support this claim. Many misconceptions and controversies about hormonal emergency contraception still exist. Research does not support that increased access to emergency contraception increases sexual risk-taking behavior. Several studies suggest that health care providers, including pharmacists, could benefit from increased education about emergency contraception. It is important for pharmacists to remain up-to-date on the most recent hormonal emergency contraception products and information, as pharmacists remain a major point of access to emergency contraception. PMID:21923590

Shrader, Sarah P; Hall, Larissa N; Ragucci, Kelly R; Rafie, Sally



Condom and oral contraceptive use and risk of cervical intraepithelial neoplasia in Australian women  

PubMed Central

Objective To assess the association between condom use and oral contraceptive consumption and the risk of cervical intraepithelial neoplasia (CIN). Methods A cross-sectional study was conducted in Perth clinics. A total of 348 women responded to the structured questionnaire. Information sought included demographic and lifestyle characteristics such as the use of condom for contraception, consumption of oral contraceptive, and duration of oral contraceptive usage. Crude and adjusted odds ratio (OR) and associated 95% confidence interval (CI) were calculated using unconditional logistic regression models and reported as estimates of the relative risk. Results The prevalence of CIN was found to be 15.8%. The duration of oral contraceptive consumption among women with abnormal Papanicolaou (Pap) smear result indicating CIN was significantly shorter than those without abnormal Pap smear result (mean±SD, 5.6±5.2 years vs. 8.2±7.6 years; p=0.002). Comparing to ?3 years usage, prolonged consumption of oral contraceptive for ?10 years reduced the risk of CIN (p=0.012). However, use of condom for contraception might not be associated with a reduced risk of CIN after accounting for the effects of confounding factors (adjusted OR, 0.52; 95% CI, 0.05 to 5.11; p=0.577). Conclusion Use of oral contraceptives, but not condoms, for contraception appeared to be inversely associated with CIN. Prolonged use of oral contraceptive demonstrated its benefits of reducing the risk of CIN. PMID:25045430

Lee, Andy H.; Colville, Linda; Xu, Daniel; Binns, Colin W.




E-print Network

the human dose and have revealed no evidence of impaired fertility or harm to the fetus due to (name of drug considered for participation in a research study where a possibility of harm to a fetus exists must practice a developing fetus. Appropriate contraceptive measures must be maintained until all known risks to the fetus


CUP: contraceptive users pamphlet.  


This pamphlet, edited by an ad hoc committee of several consultants, scientists, theologians, public health and family planning directors, and an international attorney, covers the following topics: contra-conception; choices of contraceptives; contraceptive package information; copper IUDs; pelvic inflammatory disease (PID); sexually transmitted diseases; and acquired immunodeficiency syndrome. It includes a questionnaire for sexually transmitted diseases (STDs). Professor Joseph Goldzieher describes the "Contra-Conception" database as "a synthesis of up-to-date literature and contemporary guidelines, designed to provide ready access for practicing physicians and medical students." It contains data on several types of hormonal contraception. "Contra-Conceptions" is designed to allow the physician to set his or her own pace when working with the computer, and no previous computer experience is required. 1 of the program's many innovative features is the patient-profiling/decisionmaking section which can be used in the doctor's office to help decide what type of hormonal contraceptive is appropriate for a particular patient. The program permits the doctor to evaluate the significance of patient variables such as parity, smoking, menstrual difficulties and helps the doctor to identify the risks and benefits of the various methods and, ultimately, to make a balanced decision in the context of the most recent data. Contraceptive drugs and devices should include detailed information on the following: description of formula or device; indication, usage, and contraindications, clinical pharmacology and toxicology; dose-related risk; pregnancies per 100 women year; and detailed warning. The sequence of major pathophysiological reactions associated with copper IUDs is identified as are special problems of pelvic infections in users of copper IUDs. Those women who use oral contraceptives (OCs) or a barrier method of contraception or whose partners use a condom have a lower frequency of PID than women not employing any protection. It is well established that copper IUDs cause different types and different degrees of PID. Women using copper IUDs are more at risk for pelvic infection. There is a higher frequency of salpingitis and PID when copper IUDs are employed especially when the population is nulligravidas under the age of 25. The pamphlet lists criteria for the diagnosis of salpingo-oophoritis and actue salpingitis. PMID:12267728



Nomegestrol acetate-17b-estradiol for oral contraception  

PubMed Central

Oral contraceptives remain a popular method of contraception over 50 years after their introduction. While safe and effective for many women, the failure rate of oral contraception is about 8%. Concerns about the risk of venous thromboembolism continue to drive the search for the safest oral contraceptive formulations. The oral contraceptive NOMAC-E2 contains nomegestrol acetate (NOMAC) 2.5 mg + 17b-estradiol (E2) 1.5 mg. The approved dosing regimen is 24 days of active hormone, followed by a 4-day hormone-free interval. NOMAC is a progestin derived from testosterone, which has high bioavailability, rapid absorption, and a long half-life. Estradiol, though it has a lower bioavailability, has been successfully combined with NOMAC in a monophasic oral contraceptive. Two recently published randomized controlled trials demonstrate that NOMAC-E2 is an effective contraceptive, with a Pearl Index less than one pregnancy per 100 woman-years. The bleeding pattern on NOMAC-E2 is characterized by fewer bleeding/spotting days, shorter withdrawal bleeds, and a higher incidence of amenorrhea than the comparator oral contraceptive containing drospirenone and ethinyl estradiol. The adverse event profile appears to be acceptable. Few severe adverse events were reported in the randomized controlled trials. The most common adverse events were irregular bleeding, acne, and weight gain. Preliminary studies suggest that NOMAC-E2 does not seem to have negative effects on hemostatic and metabolic parameters. While no one oral contraceptive formulation is likely to be the optimum choice for all women, NOMAC-E2 is a formulation with effectiveness comparable with that of other oral contraceptives, and a reassuring safety profile. PMID:23836965

Burke, Anne



Hypertension and oral contraceptives.  


Large prospective epidemiologic studies have shown that long-term use of oral contraceptives containing estrogen induce an increase in blood pressure and sharply increase the risk of hypertension. Susceptibility to the hypertensive effects of oral contraceptives is heightened where risk factors such as age, family history of hypertension, preexisting or occult renal disease, parity and obesity exist. Hypertension among pill users usually develops within the first 6 months of usage and occasionally is delayed for as long as 6 years. Anitihypertensive therapy is seldom needed as the hypertension that developes is generally mild and uncomplicated, and rapidly reverses when the pills are discontinued. However, a small percentage of patients develop severe, even life-threatening hypertension and the hypertensive effects are felt long after the pills are discontinued. Cases of malignant hypertension and irreversible renal failure requiring maintenance hemodialysis, bilateral nephrectomy, and renal transplantation have occurred following administration of oral contraceptive pills. The mechanism by which oral pills induce hypertension in susceptible women is not known and needs further research. Before oral contraceptives are prescribed, physicians should take a careful history and perform a detailed physicial examination with special attention to the cardiovascular system. Multiple blood pressure measurements should be made and routine laboratory studies including urinalysis, blood urea and nitrogen and serum creatinine should be performed. It is preferable to start with a relatively low (50 mcg) estrogenic content preparation. Patients who develop hypertension (diastolic pressure, 90 mm Hg) on oral contraceptives should stop taking the pills immediately, and should be considered to have estrogen-induced hypertension. They should never again receive estrogen-containing oral pills, although they can try pills containing only progestogen. There is no contraindication to pregnancy in these patients, as most women who become hypertensive on oral pills go on to have normotensive pregnancies. Pregnancy in women who are susceptible to essential hypertension however should be treated as high risk. PMID:12263383

Oparil, S



Non-insulin-dependent diabetes in Kuwait: prevalence rates and associated risk factors.  


Non-insulin-dependent diabetes mellitus (NIDDM) is a major clinical and public health problem in Kuwait. The objective of the study was to determine prevalence rates of NIDDM among a representative sample of the Kuwaiti adult population aged 20 and older in two out of five governorates and identify the associated risk factors for the disease. A total of 3003 subjects (1105 men and 1898 women) were interviewed and examined by the research team during the period September 1995 to June 1996. A specially designed questionnaire was completed and the physical examination included height, weight and blood pressure measurements. Fasting blood samples were withdrawn, centrifuged immediately and refrigerated. Interpretation of oral glucose tolerance tests were based on the World Health Organisation diagnostic criteria for diabetes mellitus (1985). The denominator used for computing the prevalence was obtained from the 1995 Kuwait census. The overall prevalence of NIDDM in this study was found to be 14.8% (14.7% in men, 14.8% in women). Diabetic subjects presented at a relatively young age, prevalence rate in the age group 20-39 was 5.7% (95% confidence interval, 4.4-7.0) and in the age group 40-59 was 18.3% (95% confidence interval, 16.1-20.6). Obesity was found to be a significant risk factor, P < 0.001. The strong association of family history of NIDDM (adjusted odds ratio = 1.80, P < 0.001) suggests a genetic component. Hypertension was markedly associated with NIDDM and IGT (P < 0.001). With the demographic transition which already started among the Kuwaiti population and if the prevalence of NIDDM remains the same, aging of the population will contribute to even more upward trends in prevalence of abnormal glucose tolerance with its serious impact on morbidity and mortality among the Kuwaiti population. The strong association between hypertension and NIDDM may suggest a common approach to the prevention and control of these two conditions. PMID:9925350

Abdella, N; Al Arouj, M; Al Nakhi, A; Al Assoussi, A; Moussa, M



Crime and violence in Brazil: Systematic review of time trends, prevalence rates and risk factors?  

PubMed Central

Between 1980 and 2010 there were 1 million homicides in Brazil. Dramatic increases in homicide rates followed rises in inequality, more young men in the population, greater availability of firearms, and increased drug use. Nevertheless, disarmament legislation may have helped reduce homicide rates in recent years. Despite its very high rate of lethal violence, Brazil appears to have similar levels of general criminal victimization as several other Latin American and North American countries. Brazil has lower rates of drug use compared to other countries such as the United States, but the prevalence of youth drug use in Brazil has increased substantially in recent years. Since 1990, the growth of the Brazilian prison population has been enormous, resulting in the fourth largest prison population in the world. Through a systematic review of the literature, we identified 10 studies assessing the prevalence of self-reported offending in Brazil and 9 studies examining risk factors. Levels of self-reported offending seem quite high among school students in Brazil. Individual and family-level risk factors identified in Brazil are very similar to those found in high-income countries. PMID:24027422

Murray, Joseph; Cerqueira, Daniel Ricardo de Castro; Kahn, Tulio



Long acting methods of contraception.  


Long acting methods of contraception have been developed and refined over the last 10 years. From the classical long acting progestogen-only depot preparations we now have a range of delivery systems including both combined and progestogen only injection systems and vaginal rings also containing either progestogen only or oestrogen and progestogen in combination. Subcutaneous implants at present containing only a progestogen, offer a range of durations from 2-5 years. The efficacy of these methods is high, with failure rates as low as 0.1 per 100 woman years. However, with progestogen only systems a significant proportion of women develop unpredictable menstrual bleeding, which with counselling is acceptable. The commonest reason for discontinuation still remains menstrual disorders and recent WHO workshops have investigated the cause of this bleeding and refined the reference periods of analysis. The method of action of progestogen-only systems is primarily cervical mucus blockade and prevention of sperm penetration. However, they also tend to produce a thinned atrophic endometrium. Ovarian effects ranging from complete anovulation to disordered luteal phase, persistent follicles and disorganised hormone production add to the contraceptive effect in more than half of the treatment cycles, but cause some of the menstrual disturbance. All these long acting methods are essential to family planning programmes, offering highly acceptable, and in some cases novel methods with high efficacy. PMID:8324615

Newton, J



The Treated Prevalence of Mental Disorder Amongst Immigrants and the Australian-Born: Community and Primary-Care Rates  

Microsoft Academic Search

The objective of the study was to explore the relationship between birthplace and the treated prevalence of mental disorder in Australia. Treated prevalence rates were derived from two surveys. These were the 1989-1990 National Health Survey, carried out by the Australian Bureau of Statistics, and the general practice component of a one-day mental health census carried out in the state

G. W. Stuart; S. Klimidis; I. H. Minas



Changes in Yearly Birth Prevalence Rates of Children with Down Syndrome in the Period 1986-2007 in the Netherlands  

ERIC Educational Resources Information Center

Background: The Netherlands are lacking reliable national empirical data in relation to the development of birth prevalence of Down syndrome. Our study aims at assessing valid national live birth prevalence rates for the period 1986-2007. Method: On the basis of the annual child/adult ratio of Down syndrome diagnoses in five out of the eight Dutch…

de Graaf, G.; Haveman, M.; Hochstenbach, R.; Engelen, J.; Gerssen-Schoorl, K.; Poddighe, P.; Smeets, D.; van Hove, G.



Prevalence Rate and Risk Factors of Depression in Outpatients with Premature Ejaculation  

PubMed Central

The purpose of this study is to investigate the prevalence rate and risk factors of depression in outpatients who were diagnosed with PE. Therefore, between September 2009 and September 2011, 1801 outpatients at andrology clinics were enrolled and consented to participate in our survey by completed a verbal questionnaire. It included the following: (1) demographic data (e.g., age, body mass index), (2) PE duration, medical history, and sexual history, (3) self-estimated intravaginal ejaculatory latency times, (4) the Zung Self-rating Depression Scale (SDS), and (5) the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and (6) the International Index of Erectile Function (IIEF-5). The results showed that a total of 1,206 patients were diagnosed with PE. The prevalence rate of depression in these PE patients was 26.78%. Depression was associated with PE duration, NIH-CPSI score, and IIEF-5 score. Risk factors for depression specifically included PE durations for 13–24, 25–60, or ?61 months, CPSI scores of 15–30 or ?31, and IIEF-5 scores <22. These findings suggested that several associated factors (PE duration, CPSI scores, and IIEF-5 scores) were the risk factors of depression in men with PE. PMID:23844361

Zhang, Xiansheng; Liu, Jishuang; Xia, Lei; Yang, Jiajia; Hao, Zongyao; Zhou, Jun; Liang, Chaozhao



Explaining Recent Declines in Adolescent Pregnancy in the United States: The Contribution of Abstinence and Improved Contraceptive Use  

Microsoft Academic Search

Objectives. We explored the relative contributions of declining sexual activity and improved contraceptive use to the recent decline in adolescent pregnancy rates in the United States. Methods. We used data from 1995 and 2002 for women 15 to 19 years of age to develop 2 indexes: the contraceptive risk index, summarizing the overall effec- tiveness of contraceptive use among sexually

John S. Santelli; Laura Duberstein Lindberg; Lawrence B. Finer; Susheela Singh



Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) normative elevation rates: comparisons with epidemiological prevalence rates.  


Odland, Berthelson, Sharma, Martin, and Mittenberg ( 2013 ) caution that clinically elevated scale scores produced by members of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008 /2011) normative sample raise concerns about the potential for false positive findings of psychopathology. However, the MMPI-2-RF normative sample is intended to represent the general population of the United States, 26.2% of which met criteria for a Diagnostic and Statistical Manual-IV (APA, 1994 ) disorder in a 12-month period (Kessler, Chiu, Demler, & Walters, 2005 ). In the current study we compare scale elevation rates in the MMPI-2-RF normative sample to prevalence rates of mental disorders primarily drawn from the National Comorbidity Study Replication (Kessler et al., 2005 ). Our objective was to evaluate MMPI-2-RF elevation rates in an epidemiological context. Results indicate that MMPI-2-RF scale elevation rates were generally consistent with epidemiological data when examined in the context of standard interpretation guidelines for the inventory. We also reiterate Ben-Porath and Tellegen's (2008/2011) caution that MMPI-2-RF scale elevations alone are not sufficient to indicate the presence of psychiatric disorder. Rather they are best viewed as indications of the need to evaluate the individual for possible disorder(s). Implications of these results, limitations of this study, and future directions in research are discussed. PMID:23957313

Tarescavage, Anthony M; Marek, Ryan J; Finn, Jacob A; Hicks, Adam; Rapier, Jessica L; Ben-Porath, Yossef S



Postabortal and postpartum contraception.  


Healthcare providers often underestimate a woman' need for immediate effective contraception after an abortion or childbirth. Yet, these are times when women may be highly motivated to avoid or delay another pregnancy. In addition, starting the most effective long-acting reversible methods (i.e. the intrauterine device, intrauterine system or implants) at these times, is safe, with low risk of complications. Good evidence shows that women choosing long-acting reversible contraceptives at the time of an abortion are at significantly lower risk of another abortion, compared with counterparts choosing other methods. Uptake of long-acting reversible methods postpartum can also prevent short inter-pregnancy intervals, which have negative consequences for maternal and child health. It is important, therefore, that providers of abortion and maternity care are trained and funded to be able to provide these methods for women immediately after an abortion or childbirth. PMID:24951405

Cameron, Sharon



Contraceptive practices in women with repeat termination of pregnancies.  


The incidence of repeat termination of pregnancies (TOP) has been increasing in the past decade in-spite-of widespread availability of free and effective contraceptive methods. A retrospective analysis of case notes of women referred for TOP in the Family Planning clinic at Luton, between January and October 2005 was carried out. A total of 159 women were referred for TOP. Of these, 42 (26.4%) were repeat procedures. In this subgroup, 78.5% had used one or more contraceptive methods after the first termination. However, only 61.9% of them continued to use contraception at the time of presentation for a repeat TOP, the most common method being the male condom. Half of the total women seen for a repeat TOP were under 6-weeks' gestation and 14.2% had been treated for sexually transmitted infections in the past. The incidence of repeat TOPs is increasing in the UK. Many studies have shown that the periabortion contraceptive practices are generally poor. In our study, women undergoing repeat termination of pregnancies were either not using contraception or using a method with a high failure rate. We also found the highest number of repeat TOPs occurring in the 20 - 25 age group. Effective contraceptive counselling is vital to combat this worrying trend. Routine 2-week follow-up appointments after TOP and regular auditing of the periabortion contraceptive practices are needed. PMID:18097906

Palanivelu, L M; Oswal, A



Contraceptive practice before female sterilization.  


The reproductive profile and contraceptive practice of 402 women undergoing female sterilization at the Central Women's Hospital are presented. Most (89%) of the interviewees were urban-dwellers and housewives with primary school education. Fifty-two percent were between 30 and 34 years with a mean of 4.2 living children. Sixty-nine percent were past contraceptive users, of them; 29.9% had used more than one method. A considerable gap between knowledge and practice of different methods was found. Education level and employment had a significant effect on contraceptive practice (p < 0.01 and p < 0.5). The majority knew and used combined oral contraceptive pills and injectable progestogens, whereas rhythm, withdrawal and barrier contraception were lesser known methods. Contraceptive use was primarily for child-spacing whereas the main reasons for female sterilization were socioeconomic and achievement of desired family size. PMID:8250756

Thike, K B; Wai, K T; Oo, N; Yi, K H



New methods for estimating the tuberculosis case detection rate in high-HIV prevalence countries: the example of Kenya  

Microsoft Academic Search

Objective To develop new methods for estimating the sputum smear-positive tuberculosis case detection rate (CDR) in a country where infection with HIV is prevalent. Methods We estimated the smear-positive tuberculosis CDR in HIV-negative and HIV-positive adults, and in all adults in Kenya. Data on time trends in tuberculosis case notification rates and on HIV infection prevalence in adults and in

Brian Williams; Suzanne Scheele; Katherine Floyd; Christopher Dye; Joseph Sitienei



Cervical carcinogenesis and contraception.  


Cytologic evaluation of cervical smears has been carried out in 3,374 women who used different modes of contraception (Lippes loop, copper T200, copper T220, copper devices containing higher copper content than the copper T200, CuT380 Ag, levonorgestrel IUD, injections of noresthisterone oenanthate, and subdermal implants of levonorgestrel) under the Contraceptive Testing Programme of Indian Council of Medical Research for periods ranging from 6 months to 15 yr. While no case of severe dysplasia or malignancy was noticed with any type of contraceptive, 113 dysplastic smears (99 mild and 14 moderate) were encountered on follow-up, giving an incidence of 3.3%, which was statistically insignificant compared with the pretreatment incidence of 1.4% (47 of 3,374). The highest incidence of dysplasia was seen with devices containing a high copper content (9.2%), followed by CuT200 (6.1%) and levonorgestrel implants (4.2%), and was lowest with Lippes loop (1.8%), injection of noresthisterone oenanthate (1.7%), and CuT380 Ag (1.5%), but statistics higher than the pretreatment incidence of 1.4% were seen only with CuT200 and devices containing high copper content. Retrogression of dysplasia was seen in 85 of the 94 posttreatment dysplasia cases and in all 47 pretreatment dysplasia cases, whereas in the remaining nine posttreatment cases of dysplasia the lesion persisted for 6-12 mo, necessitating discontinuation of contraception. The accumulated follow-up data indicate that the CuT380 Ag device is a promising IUD for the future in view of its low incidence of dysplasia determined during its use up to 5 yr. However, more prolonged follow-up in larger numbers of subjects is required to confirm its innocuousness on long-term retention. PMID:1935511

Misra, J S; Engineer, A D; Das, K; Tandon, P



Marketing contraceptives by mail.  


7 ads (3" x 2") for information on nonprescription mail-order contraceptives were run in 51 college newspapters. Ads with specific product offerings, apparently directed to males and including offers of birth control literature, drew the most inquiries. Inquiries were also higher from ads placed in papers with larger circulations, and in rural areas. There were no discernible objections from the audience, and no difficulties were encountered in placing copy. About 207 of the inquiries resulted in orders. PMID:12276312

Farley, J U; Harvey, P D



Contraceptive practices, sexual and reproductive health needs of HIV-positive and negative female sex workers in Goa, India  

Microsoft Academic Search

ObjectivesIn India, female sex workers (FSWs), suffer from high HIV prevalence and abortions. Contraceptive use among general population women is well understood. However, FSWs contraceptives practices and reproductive health needs are under-researched. We investigated contraceptive practices among HIV-positive and negative FSWs in Goa, India and explored its association with socio-demographic and sex work related factors.MethodsCross-sectional study using respondent driven sampling

Sonali Wayal; Frances Cowan; Pamela Warner; Andrew Copas; David Mabey; Maryam Shahmanesh



The effect of joint contraceptive decisions on the use of Injectables, Long-Acting and Permanent Methods (ILAPMs) among married female (15-49) contraceptive users in Zambia: a cross-sectional study  

PubMed Central

Background Zambia’s fertility rate and unmet need for family planning are still high. This is in spite of the progress reported from 1992 to 2007 of the increase in contraceptive prevalence rate from 15% to 41% and use of modern methods of family planning from 9% to 33%. However, partner disapproval of family planning has been cited by many women in many countries including Zambia. Given the effectiveness of long-acting and permanent methods of family planning (ILAPMs) in fertility regulation, this paper sought to examine the relationship between contraceptive decision-making and use of ILAPMs among married women in Zambia. Methods This paper uses data from the 2007 Zambia Demographic and Health Survey. The analysis is based on married women (15–49) who reported using a method of family planning at the time of the survey. Out of the 7,146 women interviewed, only 1,630 women were valid for this analysis. Cross-tabulations and binary logistic regressions with Chi-square were used to analyse associations and the predictors of use of ILAPMs of contraception, respectively. A confidence interval of .95 was used in determining relationships between independent and dependent variables. Results Two thirds of women made joint decisions regarding contraception and 29% of the women were using ILAPMs. Women who made joint contraceptive decisions are significantly more likely to use ILAPMs than women who did not involve their husband in contraceptive decisions. However, the most significant predictor is the wealth index. Women from rich households are more likely to use ILAPMs than women from medium rich and poor households. Results also show that women of North Western ethnicities and those from Region 3 had higher odds of using ILAPMs than Tonga women and women from Region 2, respectively. Conclusion Joint contraceptive decision-making between spouses is key to use of ILAPMs in Zambia. Our findings have also shown that the wealth index is actually the strongest factor determining use of these methods. As such, family planning programmes directed at increasing use of LAPMs ought to not only encourage spousal communication but should also consider rolling out interventions that incorporate economic empowerment. PMID:24993034



History (of oral contraceptives).  


This article summarizes the interest and research in oral contraceptives, with particular attention given to recent discoveries in the field. Development of the present day pill was impossible until scientific discoveries of female ovarian hormones during pregnancy. Scientific work in the 1920s identified the 2 hormones, estrogen and progesterone, and scientists showed that use of the 2 together influenced ovulation and eased dysmenorrhea. It was not until 1944 that a scientist produced progesterone from a plant steroid; today synthetic steroids are available. Margaret Sanger, a pioneer in the American Family Planning Movement, financed and encouraged early human volunteer trials and later clinical trials with contraceptive pills. By 1957, the pills were approved by the FDA for use in treating menstrual disorders. In January 1962, they were released on the market as contraceptives. By 1976-77, the pill was used by 80-100 million women around the world. A dated table summarizes the information in the article in a timetable fashion. PMID:12308937



Factors influencing the contraceptive method choice: a university hospital experience  

PubMed Central

Objective To analyze the factors influencing behavior of women in choosing contraceptive methods. Material and Methods A total of 4022 women who were admitted to our clinic in a year, were the subjects in this current study for contraception choices. Relationship between the current contraceptive choice and the age, marital status, educational level, gravidity and induced abortions were evaluated. Results Current users of any contraceptive methods were found to make up thirty-three percent of the entire study population. The most preferred method of contraception was an intrauterine device (46.4%), followed by, condom (19.2%), coitus interruptus (16.4%), tubal sterilization (11%), oral contraceptives (5.7%) and lastly the “other methods” that consisted of depot injectables and implants (1.2%). Among other contraceptive methods, the condom was found to be used mostly by the younger age group (OR:0.956, 95% CI:0.936–0.976, p<0.001), while tubal sterilization was preferred mainly by the elderly population (p<0.001, OR:1.091, 95% CI:1.062–1.122). Women that have a higher educational level, were found to use OC (76.3%, OR:5.970, 95% CI:3.233–11.022), tubal sterilization (59.6%, OR:4.110, 95% CI:2.694–6.271) and other methods (62.5%, OR:3.279, 95% CI:1.033–10.402) more commonly than the low educational group (p<0.001). Conclusion These results demonstrated that the rates of both contraception utilization and the usage of more effective methods of contraception need to be increased by providing better family planning systems and counselling opportunities. PMID:24592017

Kahraman, Korhan; Göç, Göksu; Ta?k?n, Salih; Haznedar, P?nar; Karagözlü, Selen; Kale, Burak; Kurtipek, Zeynep; Özmen, Batuhan



Contraception: a social revolution.  


Modern contraceptive technology is more than a technical advance: it has brought about a true social revolution, the 'first reproductive revolution' in the history of mankind. This latter was followed in rapid succession by other major changes in human reproductive strategies. In the human species, sexual activity began to lose its exclusive reproductive meaning at an early stage of its evolution. Human beings must have practiced non-conceptive sex from the outset and therefore must have had a need to avoid, rather than to seek conception during intercourse from time immemorial. The search for methods to control fertility went on for millennia, but a valid solution was only found during the twentieth century, when the population explosion had forever changed the shape of humanity: in only one century the total population of the planet had grown from some 1.6 billion to more than 6 billion. That increase will remain unique in the history of Homo sapiens. At the global level, contraception provided a tool to deal with overpopulation and, in only 50 years, went a long way towards its resolution. However, to solve the problem, national and international family planning initiatives were required. For individuals, contraception also meant a revolution. It allowed sexual intercourse without reproduction. Only 25 years later, in vitro fertilisation permitted childbearing without sexual intercourse. Other advances followed and now cloning, that is, reproduction without the two gametes, looms on the horizon. Such a series of rapid, major changes in human reproductive strategies has confused many. For this reason, a constructive dialogue between sociology and biology is mandatory. Contraception is a powerful tool to promote equity between sexes; it improves women's status in the family and in the community. Avoiding pregnancy during the teens increases opportunities for a young woman's education, training and employment. By controlling their fertility, women get a chance to contribute economically to their household, which in turn may give them a greater share in decision-making. There are other specific areas in which contraception has produced beneficial social effects, first and foremost in reducing the need for induced abortion. It has also helped avoiding sexually-transmitted infections and is a very useful tool for educating youngsters to adopt more responsible sexual behaviors. Interventions in the field of family planning are among the most cost-effective health interventions. PMID:17455038

Benagiano, Giuseppe; Bastianelli, Carlo; Farris, Manuela



Poor contraceptive use in the teenage years: situational and developmental interpretations.  


Contraceptive methods have helped to reduce the incidence of unwanted pregnancies among married women over the past few decades. Rates for teenagers have not, however, declined commensurately. Instead, greater premarital sex has led to more conceptions and births among teens. Developmental hypotheses suggest that poor teenage contraceptive use stems from characteristics intrinsically related to young age. Situational hypotheses, however, posit that life conditions complicate and impede the adoption of an effective contraceptive program. Social proscriptions against teen sex, the sporadic, unplanned, nature of teen sexual encounters, limited knowledge at the onset of 1st sex, and limited mobility and access to contraception are such life conditions. This essay considers both developmental and situational interpretations of teen contraceptive practice. Factors discussed related to contraceptive use include race and socioeconomic status, marital status, educational aspirations, religion, knowledge of fertility and contraception, attitudes and beliefs about contraception, personality factors, influence of parents, peers, and partners, and age. Adults and teens are found to have similar determinants of contraceptive behavior. Contraceptive use behavior differences between adults and teens may therefore exist because sexually active teens are disproportionately represented in demographic groups most likely to take risks. Adolescents being generally single, of low personal income, and increasingly members of single parent homes, share demographic circumstances of adults who are also more prone to risk-taking behavior. Limited knowledge of contraceptives and comparatively high levels of sex guilt further predispose youths to taking risks. Teenagers are therefore more likely to experience as a group those factors predisposing them to early sexual initiation and poor contraceptive use, thereby suggesting a situational interpretation of age differentials in contraceptive use. Adults similar to teens in adult life are similarly likely to take contraceptive risks. PMID:12317632

Morrison, D M; Shaklee, H



Long-Acting Reversible Contraception (LARC) for Adolescent  

PubMed Central

Purpose of review Teen pregnancy continues to plague the United States. This review will discuss long-acting reversible contraceptive (LARC) method use in teens. It will specifically address the myths about appropriate candidates as well as continuation and satisfaction among teen users. Recent findings The American College of Obstetrics and Gynecology along with the American Academy of Pediatrics, the Centers for Disease Control, and the World health Organization have recognized the potential impact of LARC (comprising intrauterine contraception and subdermal implants) to reduce unintended pregnancies. They have affirmed the safety of such devices, and no effects on long-term fertility have been identified. Teen users of these methods have been shown to have high continuation and satisfaction rates. On the other hand, oral contraceptive pills, the patch, and the contraceptive vaginal ring have significantly higher contraceptive failure rates, and these rates are magnified in young women. Summary LARC methods should be considered first-line options for teens seeking contraception. PMID:22781078

McNicholas, Colleen; Peipert, Jeffrey F



Substances used and prevalence rates of pharmacological cognitive enhancement among healthy subjects.  


Pharmacological "cognitive enhancement" (CE) is defined as the use of any psychoactive drug with the purpose of enhancing cognition, e.g. regarding attention, concentration or memory by healthy subjects. Substances commonly used as CE drugs can be categorized into three groups of drugs: (1) over-the-counter (OTC) drugs such as coffee, caffeinated drinks/energy drinks, caffeine tablets or Ginkgo biloba; (2) drugs being approved for the treatment of certain disorders and being misused for CE: drugs to treat attention-deficit/hyperactivity disorder (ADHD) such as the stimulants methylphenidate (MPH, e.g. Ritalin(®)) or amphetamines (AMPH, e.g. Attentin(®) or Adderall(®)), to treat sleep disorders such as modafinil or to treat Alzheimer's disease such as acetylcholinesterase inhibitors; (3) illicit drugs such as illicit AMPH, e.g. "speed", ecstasy, methamphetamine (crystal meth) or others. Evidence from randomized placebo-controlled trials shows that the abovementioned substances have limited pro-cognitive effects as demonstrated, e.g. regarding increased attention, increased cognitive speed or shortening of reaction times, but on the same time poses considerable safety risks on the consumers. Prevalence rates for the use of CE drugs among healthy subjects show a broad range from less than 1 % up to more than 20 %. The range in prevalence rates estimates results from several factors which are chosen differently in the available survey studies: type of subjects (students, pupils, special professions, etc.), degree of anonymity in the survey (online, face-to-face, etc.), definition of CE and substances used/misused for CE, which are assessed (OTC drugs, prescription, illicit drugs) as well as time periods of use (e.g. ever, during the past year/month/week, etc.). A clear and comprehensive picture of the drugs used for CE by healthy subjects and their adverse events and safety risks as well as comprehensive and comparable international data on the prevalence rates of CE among healthy subjects are of paramount importance for informing policy makers and healthcare professionals about CE. PMID:25214391

Franke, Andreas G; Bagusat, Christiana; Rust, Sebastian; Engel, Alice; Lieb, Klaus



Phase of oral contraceptive cycle and endurance capacity of rowers.  


Eight female rowers (M age = 21.0 yr., SD = 2.8), using a monophasic oral-contraceptive pill, performed a 1-hr. rowing ergometer test (intensity: 70% VO2max) during the active-pill and non active-pill phases of the oral contraceptive cycle. No significant differences were found in mean energy expenditure, oxygen consumption, respiratory exchange ratio, and heart rate during the endurance test at the two phases of the oral contraceptive cycle. Mean energy expenditure rate, carbohydrate energy expenditure, lipid energy expenditure, and blood lactate during the test were not statistically significantly different among the cycle phases. In conclusion, there was no observed difference in substrate oxidation and blood lactate level during endurance rowing at different phases of the oral contraceptive cycle in these endurance-trained rowers. Endurance-trained female athletes on oral contraceptives should not worry about the possible differences in substrate oxidation during everyday training at different phases of the oral contraceptive cycle. PMID:22403922

Vaiksaar, Sille; Jürimäe, Jaak; Mäestu, Jarek; Purge, Priit; Kalytka, Svetlana; Shakhlina, Larissa; Jürimäe, Toivo



Estrogen and Progestin (Oral Contraceptives)  


... as scheduled and use a backup method of birth control until your questions are answered. ... about which oral contraceptive or other method of birth control may be the best choice for you.Oral contraceptives may cause other side effects. Call your doctor if you have any unusual ...


Emergency contraception hot line launched.  


Extensive scientific evidence demonstrates that some forms of contraception employed soon after an episode of unprotected sexual intercourse reduces the risk of pregnancy by at least 75%. Emergency contraception, however, is not well known among some physicians and the public mainly because none of the manufacturers of birth control products which may be used postcoitally has applied to the US Food and Drug Administration to label and market their products for emergency use. On February 14, a new nationwide, toll-free emergency contraception hotline was established to offer information about how to avoid an unintended pregnancy after unprotected sexual intercourse. The 24-hour confidential hotline, 800-584-9911, is available in English and Spanish. Callers to the hotline are provided with explanations of elevated doses of oral contraceptives, the minipill, and the copper-T IUD as possible emergency options, as well as the names, locations, and phone numbers of three providers in the caller's area who are willing to prescribe emergency contraceptives. The line is sponsored by the Reproductive Health Technologies Project and Bridging the Gap Communications and supplements the existing World Wide Web site on emergency contraception found at There are no long-term or serious side effects from the use of emergency contraception, although about half of all women who use elevated doses of oral contraceptives report experiencing temporary nausea and vomiting. Emergency IUD insertion carries an increased risk of pelvic infection. PMID:12290778



Contraceptives: choice for the millions?  


India adds each year the population of Sub-Saharan Africa to the earth. User based factors determining the type of contraceptive that is used most often in a country are sociocultural practices including religion, literacy, women's status and their role in decision making, men's status, misconceptions, and convenience of use. Service related factors include knowledge and skill of the provider, attitude of the provider, accessibility of family planning services, cost of the contraceptives, and quality of services. The government, nongovernmental organizations, and the pharmaceutical firms tend to be the contraceptive researchers and suppliers. The mass media are used to disseminate information on contraceptives. They often relay sensational reports about a contraceptive method that results in its reduced use. Temporary or spacing family planning methods include natural family planning methods, condoms, IUDs, oral contraceptives, implants, and injectables, spermicides and vaginal barriers. The natural family planning methods are sexual abstinence, especially in the postpartum period; rhythm or calendar method; and coitus interruptus. The most cost-effective method is also the most popular method--sexual sterilization. Even though female sterilization is more difficult to perform than vasectomy, it is more common than vasectomy. Contraception should become a people's movement rather than be forced upon the people. People should insist on good quality, affordable contraceptive services as their basic right. PMID:12345776

Dhall, A



Contraception and sexually transmitted infections  

Microsoft Academic Search

The link between different methods of contraception and the risk of acquiring sexually transmitted infections (STIs) raises several questions. Do the risks differ according to type of STI? Which methods reduce the risk of acquiring STIs and which, if any, increase the risk? How should people use such information when choosing a method of contraception? These questions have major public

Judith Stephenson



Progestin-Only Oral Contraceptives  


... If you have had a miscarriage or an abortion, you can start taking progestin-only oral contraceptives the next day.Progestin-only oral contraceptives are safe for use by breast-feeding mothers. If you are fully breastfeeding (not giving your ...


Contraception for adolescents with lupus  

Microsoft Academic Search

Sexually active adolescents, including young women with lupus, are at high risk for unplanned pregnancy. Unplanned pregnancy among teens with lupus is associated with an elevated risk of poor maternal and fetal outcomes. The provision of effective contraception is a crucial element of care for a sexually-active young woman with lupus. Unfortunately, providers may be hesitant to prescribe contraception to

Melissa S Tesher; Amy Whitaker; Melissa Gilliam; Linda Wagner-Weiner; Karen B Onel



Prevalence and incidence rates of autism in the UK: time trend from 2004-2010 in children aged 8 years  

PubMed Central

Objectives To update UK studies begun in the early 1990s on the annual prevalence and incidence rates of autism in children; undertaken in response to a March 2012 press release, widely covered by the media, from the US Centre for Disease Control (CDC) reporting that the autism prevalence rate in 2008 in 8-year-old US children was 1 in 88, a 78% increase from a CDC estimate in 2004. This finding suggested a continuation of the dramatic increase in children diagnosed as autistic, which occurred in the 1990s. Design Population study using the UK General Practice Research Database (GPRD). Methods Annual autism prevalence rates were estimated for children aged 8?years in 2004–2010 by dividing the number diagnosed as autistic in each or any previous year by the number of children active in the study population that year. We also calculated annual incidence rates for children aged 2–8?years, by dividing the number newly diagnosed in 2004–2010 by the same denominators. Results Annual prevalence rates for each year were steady at approximately 3.8/1000 boys and 0.8/1000 girls. Annual incidence rates each year were also steady at about 1.2/1000 boys and 0.2/1000 girls. Conclusions Following a fivefold increase in the annual incidence rates of autism during the 1990s in the UK, the incidence and prevalence rates in 8-year-old children reached a plateau in the early 2000s and remained steady through 2010. Whether prevalence rates have increased from the early 2000s in the USA remains uncertain. PMID:24131525

Taylor, Brent; Jick, Hershel; MacLaughlin, Dean



High rates of substance use in French youths 13/7/07 High prevalence rates of tobacco, alcohol and drug use in adolescents and  

E-print Network

High rates of substance use in French youths 13/7/07 1 High prevalence rates of tobacco, alcohol;33(1):122-33" DOI : 10.1016/j.addbeh.2007.09.009 #12;High rates of substance use in French youths 13/7/07 2 Abstract Background: Rates of substance use among adolescents have increased in the 1990s, however little is known

Paris-Sud XI, Université de


Adolescent pregnancy and contraception.  


7% of US teen women became pregnant in 2008, totaling 750,000 pregnancies nationwide. For women ages 15 to 19, 82% of pregnancies are unintended. Adolescents have a disproportionate risk of medical complications in pregnancy. Furthermore, adolescent parents and their infants both tend to suffer poor psychosocial outcomes. Preventing unintended and adolescent pregnancies are key public health objectives for Healthy People 2020. Screening for sexual activity and pregnancy risk should be a routine part of all adolescent visits. Proven reductions in unintended pregnancy in teens are attained by providing access to contraception at no cost and promoting the most-effective methods. PMID:25124209

Dalby, Jessica; Hayon, Ronni; Carlson, Jensena



[Young men's contraceptive habits].  


A total of 379 men from the greater Copenhagen area were invited to fill out a questionnaire about sexual habits and use of contraception in connection with conscription for military duty. A total of 334 (88%) answered the questionnaire. In the autumn of 1988, a total of 27 men answered the test questionnaire, while in the spring of 1989, when the real study was conducted, 307 men answered it. The median age of 334 participants was 18 years (range of 17-29 years). 33% of the group stated that they had used condoms during first intercourse, while 47% had not. 1 person reported to be exclusively attracted sexually to men, 5 persons were attracted both to men and women, but 97% were exclusively attracted to women. 82% had had intercourse or other sexual experience with women. 1.8% had had intercourse or other sexual experience with men. 8% had no sexual experience, and 8% did not answer the question. Oral contraceptives were used by 60% and the condom by 56%. 10% had used coitus interruptus at one time or another; 15% had used no contraception; 5% used the IUD; and 5% used the diaphragm. Some gave several answers. 1% used spermicidal lotion. 60% thought that it was the responsibility of both men and women to be concerned about contraception, 12% opined that it was exclusively men's duty, and 2% that it was exclusively women's, while 26% did not answer. 68% wanted to use the condom in the future for protection, 24% did not know, but 8% did not want to use it more extensively. 64% did not think that the fear of AIDS would affect their sexual life, but 36% thought it would. Several of the subjects indicated that they would be more careful about choosing a partner, and every 10th suggested that they would use the condom with a new partner. One person (0.3%) was a drug addict, 89% had never injected drugs, but about 11% did not answer about drugs. 97% and 95%, respectively, indicated that the condom provided good protection against pregnancy and venereal diseases. PMID:12288822

Kaiser, A H; Nielsen, B B; Hansen, K; Johansen, J B; Nielsen, M B



Adolescent contraception: nonhormonal methods.  


A comparison of the advantages, disadvantages, and costs of each method is presented in Table 1. Barrier methods of contraception offer adolescents protection against both pregnancy and STDs, but innovative approaches are needed to enhance availability and acceptability. Condom use in conjunction with a vaginal spermicide would provide optimal protection. The "female condom" may prove to be an effective alternative. Diaphragms and cervical caps can be prescribed for well-educated, highly motivated adolescents comfortable with insertion and removal. The vaginal contraceptive sponge provides many of the advantages of the diaphragm and cap without the need for an examination and fitting and also may be used as a backup method with the condom. Vaginal spermicides used alone are significantly less effective than in combination with a mechanical barrier. The IUD is not considered appropriate for most adolescents due to its association with an increased risk of pelvic infection. Periodic abstinence requires accurate identification of the fertile period, extensive education, and partner cooperation. Sterilization is rarely considered an option in adolescents. Alternate forms of sexual expression are available to adolescents who choose to abstain from intercourse. PMID:2660093

Kulig, J W



Contraceptive vaccines targeting sperm.  


Overpopulation is a global problem of significant magnitude, with grave implications for the future. Development of new contraceptives is necessary, as existing forms of birth control are unavailable, impractical and/or too expensive for many individuals due to sociological, financial or educational limitations. Immunocontraception and, in particular, the targeting of antibodies to sperm-specific antigens implicated in sperm-egg binding and fertilisation offers an attractive approach to control fertility. Sperm-specific antibodies may impair fertility by inhibiting sperm motility, by reducing penetration of the cervical mucus by sperm, or by interfering in sperm capacitation or the acrosome reaction; alternatively, antisperm antibodies may invoke the complement cascade, resulting in sperm lysis. The antibodies raised against sperm-specific antigens have proved to be extremely effective at reducing sperm-egg interactions in vitro; fertility trials in subhuman primates will eventually be needed to prove the effectiveness of the sperm antigens in terms of contraceptive efficacy before trials in humans can be justified. In addition, existing and emerging strategies (such as sperm proteomics, the determination of molecular and structural details of sperm proteins, and the modelling of protein-ligand interactions using X-ray and/or NMR structures to name a few) are expected to provide the experimental foundation for the design of small molecule inhibitors with antifertility effects. The technology underpinning vaccine development is constantly being developed and the introduction of DNA/RNA vaccines is certain to impact upon the field of immunocontraception. PMID:15833075

Suri, Anil



[Historical survey of modern reversible contraceptive methods].  


Because of contraception, pregnancy need not be viewed by women as punishment for sexual activity but as a planned and desired event. Most of the contraceptive methods used in developing countries at present were introduced during the 1960s, but use of contraception has a long history and some methods date back to antiquity. Contraceptive pills were already used around 2000 BC in the form of mercury and arsenic tablets. Their effectiveness was questionable. The role of hormones in human reproduction began to be understood only in the early 1900s. The discovery of progesterone in a Mexican iguana in the 1940s permitted production of progesterone on a large scale. Estrogens had been identified around 1930. Human trials of a contraceptive pill beginning in 1956 in Puerto Rico demonstrated that progestins could prevent pregnancy by suppressing ovulation. Later on, estrogen was added to reduce menstrual irregularities. The 1st generation of combined oral contraceptives contained very high levels of hormones associated with high rates of side effects. Numerous formulations with lower hormonal contents became available beginning around 1970 and constitute the principal formulations in use today. A number of long acting hormonal methods based on progestins have been developed, including injectables, some IUDs and vaginal rings, and implants. The 1st commercially available injectable, norethisterone enanthate, did not acquire the wide distribution of medroxyprogesterone acetate, sold as Depo Provera and used to treat various pathological conditions as well as for contraception. The 1st true IUDs were small stones placed within the uteri of camels by nomads to prevent pregnancy during long caravans. An IUD was developed in 1909 by Richter, and the 2 most widely used models before 1960 were the Grafenberg and Ota silver rings. Use of the 2 rings became rare for medical reasons after 1935 despite their efficacy. Safe plastic IUDs which appeared beginning in the early 1960s were flexible and capable of returning to their original shape after insertion. The Lippes loop was the 1st highly successful IUD. Bioactive IUDs containing copper were developed in the 1970s. Research is underway to develop IUDs which will resist expulsion, reduce bleeding, be more appropriate for multiparas, and last longer. IUDs are used to treat intrauterine adhesions as well as for contraception. A gummy substance used to block the cervix was described in Egypt in 1850 BC. Japanese and Chinese prostitutes of antiquity placed oiled bamboo paper at the cervical opening for contraception. Diaphragms and cervical caps were developed in the 19th century in Germany. Large scale production became possible after 1880 with the development of better, more durable, and cheaper rubber. An Egyptian writing in 3500 BC began the study of spermicides. Numerous substances such as lemon juice and honey have been placed in the vagina to avoid pregnancy. Such substances are available to all women and some were reasonably effective. Current research is directed toward development of spermicides which will also prevent sexually transmitted diseases. The 1st condoms were made of animal skins by an English physician to prevent transmission of venereal diseases. Rubber condoms appeared in the early 20th century and are widely utilized in some family planning programs. Pregnancy vaccines and a reversible hormonal method for men are among methods under development. PMID:12268230

Mbabajende, V



Depo-Provera: an injectable contraceptive.  


The contraceptive effect of Depo-Provera or medroxyprogesterone acetate, a long-acting injectable progestogen, has been mainly attributed to its ability to prevent ovulation through its action on the hypothalamic pituitary axis, reducing the levels of plasma gonadotropin, progesterone, and estradiol, and suppressing the midcycle surge of luteinizing hormone. Its other contraceptive effects are thickening of the cervical mucus, causing a barrier to spermatozoa, alteration in tubal ovum transport, and atrophy of the endometrium. A standard dose of 150 mg injected every 3 months is as effective as the combined oral pill and more effective than the progestogen-only pill or IUD. Contraindications to use are thrombophlebitis, liver dysfunctions, suspected breast or genital malignancy, and abnormal uterine bleeding. Reported discontinuation rates range from 7-80%. The World Health Organization (1977) reported a gross cumulative discontinuation rate of 23.4/100 women years in 8 centers. Depo-Provera has a long list of short-term (menstrual disorders, fluid retention, nausea, hair loss, and others) and long-term (delayed fertility return, congenital abnormalities, cancer others) disorders. Its advantages include: 1) convenience, 2) effectiveness, 3) no risk of infection or other side effects of the coil, 4) none of proven side effects or long-term hazards of estrogen, and 5) no inhibition of lactation. The safety of Depo-Provera has been a controversial issue which led to its banning in the U.S. Its carcinogenic potential has been reported in clinical trials with animals. Its greatest disadvantage is that it takes control of a woman's fertility firmly out of her hands into those of the doctor. Depo-Provera should not be used except as an absolute last resort. It should not be used as a long-term contraceptive in this country, and research monies should instead be channeled into the development of a safe, reliable contraceptive with no systemic side effects. PMID:6458020

Wigington, S


Users of traditional methods of contraception in Bangladesh: 1981-91.  


This paper examines the changing patterns of knowledge, attitude and use of traditional methods of contraception, compared to modern methods, over the last five contraceptive prevalence surveys in Bangladesh (1981-91). The results show that knowledge of at least one method of family planning is universal in Bangladesh and usage is higher at all ages for women who are using modern methods than for those who are using traditional methods. Educated women and those in employment are more likely to use modern contraceptive methods. PMID:8698706

Rahman, M M; Islam, M N; Islam, M M



The menstrual cycle from a bio-behavioral approach: a comparison of oral contraceptive and non-contraceptive users.  


The purpose of the present study was to clarify the effects of the menstrual cycle on: (1) accuracy and simple reaction time in a problem-solving situation; (2) academic performance; (3) identify corresponding cyclic changes in a set of psychophysiological measures during rest/test conditions; and (4) to compare oral contraceptive with non-oral contraceptive users. Eight volunteer females, 4 normally cyclic and 4 oral contraceptive users, reported once weekly throughout two menstrual cycles during which changes in blood pressure, heart rate, skin temperature, finger pulse amplitude, and verbal reaction time were monitored. Differences in verbal reaction time were found between oral contraceptive users and non-users over phases of the cycle, the users being significantly slower during menstrual and premenstrual phases. It was also observed that all subjects reacted slower in the menstrual and ovulatory phases during cycle one, although no differences were found during cycle two. Skin temperature changes between groups occurred during the postovulatory phase of cycle two, the control group having shown a much greater increase than oral contraceptive users. These results indicated a suppressive influence of oral contraceptives which appeared to affect cognitive rather than motor responses, and that these effects were residual when no pills were taken menstrually and premenstrually. Also indicated was the finding that although a 28-day cycle of menstrual events exists, periodicity of these events may be reflected in a much larger cycle non-currently defined. PMID:6542080

Garrett, K F; Elder, S T



Oral contraceptive use among young women in southern Sweden.  

PubMed Central

STUDY OBJECTIVE--The aim was to survey oral contraceptive usage among women under 25 years of age. DESIGN--This was a cross sectional population study based on information collected by questionnaire mailed to randomly selected individuals. SETTING--The study population consisted of Swedish women born between 1960 and 1964 and living in the southern Swedish health care region which has about one and a half million inhabitants. PARTICIPANTS--The sample consisted of 3477 women, of whom 2573 or 74% agreed to participate in the study and were interviewed between November 1990 and April 1991. MAIN RESULTS--Of the 2573 women participating, 2254 (88%) reported having used oral contraceptives at some time, 77% of them having started during their teens. Teenage start of oral contraceptive use was found to be related to a lower age at menarche, a higher marriage/cohabitation rate, a lower rate of teenage full term pregnancy, a higher rate of spontaneous abortion, a lower frequency of teetotalism, and a higher frequency of smoking. Longterm use of antipsychotic drugs appeared to be less common among women who started oral contraceptive use early, but no relationship with other pharmaceutical drug usage was found. No relationship was found between oral contraceptive use and the presence of a first degree relative with cancer. CONCLUSIONS--A large proportion of Swedish women start using oral contraceptives during their teens, and report long duration of usage both before their first full term pregnancy and before the age of 25 years. The few women who have never used oral contraceptives do not appear to be representative of the general population. PMID:8436889

Ranstam, J; Olsson, H



Association between the Delta Estimated Glomerular Filtration Rate and the Prevalence of Monoclonal Gammopathy of Undetermined Significance in Korean Males  

PubMed Central

Background. We investigated the association between the reduction in the estimated glomerular filtration rate (eGFR) and the prevalence of monoclonal gammopathy of undetermined significance (MGUS) in Korean males. Methods. We enrolled 723 healthy Korean males. Serum creatinine concentration, serum electrophoresis, serum immunofixation, and the serum free light chain assay were performed. We calculated delta eGFR per year (?eGFR/yr). The prevalence of MGUS was compared based on the ?eGFR/yr and age group. Results. Thirteen (1.8%) of 723 participants exhibited the monoclonal band on serum immunofixation. Prevalence of MGUS by age group was 0.00% (0/172 for 40 years), 1.63% (6/367 for 60 years), and 3.80% (7/184 for >60 years). The median decrease in ?eGFR/yr was 5.3%. The prevalence of MGUS in participants in their 50s with >5.3% decline in ?eGFR/yr was significantly higher than those with <5.3% decrease in ?eGFR/yr (3.16% versus 0.00%; P = 0.049). The prevalence of MGUS in participants in their 50s with >5.3% decrease in ?eGFR/yr was similar to that of healthy males in their 60s. Conclusion. Using the rate of reduction in ?eGFR/yr in healthy Korean males who had their serum creatinine level checked regularly may increase the MGUS detection rate in clinical practice. PMID:24895568

Chun, Sail; Min, Won-Ki



The social marketing of contraceptives in Mexico.  


The success in social marketing of the PROFAM brand of subsidized contraceptives, by a nonprofit private institution that supports the Mexican government program, is related here. PROFAM began in 1978, when half of contraceptives were purchased commercially from drugstores: they were neither economical, consistently distributed, nor advertised. Comprehensive market research revealed that a great demand existed. It generated information for choice of items to market, package design, and instructions. In 1979, pills, condoms, foam, cream and vaginal suppositories, all locally produced were distributed. A serious problem initially was the impropriety of using the word "contraceptive" in the media. The first phase of advertising targeted newspapers. After 3 months, 40% of Mexico's drugstores carried PROFAM. The second phase of advertising, in radio, magazines and newspapers, approached consumers with information tailored to the specific socioeconomic group involved. The third phase, geared to rural areas and general stores, concentrates on advantages of each method. Other aggressive aspects of the campaign include house to house sampling and a mail-in question and answer service. Evidence of success in broadcasting the PROFAM message is the frequent reference to PROFAM in jokes in the media and even in graffiti. The government's goal is to reduce the growth rate form 2.9 percent annually to 1 percent by 2000. PMID:12315136

De La Macorra, L



[Disease and contraception. Recent aspects].  


This article reviews several different articles which have contributed to an understanding of the harmful or beneficial effects of oral contraceptives (OCs) on various diseases. The Royal College of General Practitioners study found that current OC users compared to women who had never used OCs had relative risks of .52 for menorrhagia, .37 for dysmenorrhea, .65 for irregular cycles, .72 for intermenstrual bleeding, and .71 for premenstrual syndrome. Several studies found combined OCs to offer protection against ovarian cysts. Microdose progestin only pills did not ameliorate most menstrual problems and aggravated ovarian cysts. Despite some theoretical grounds for suspecting an association between pituitary prolactinomas and OC use, recent studies have failed to find an increased relative risk for prolactinomas in women using OCs for contraceptive purposes, although 1 study found an increased risk in women using OCs for cycle control. 1 study reported 11 pregnancies in 30 diabetic women in 15 months of IUD use; the high rate was attributed to abnormal patterns of mineral deposit on the IUD surface. The 11 pregnancies occurred with 5 Gravigardes, 5 Saf-T-Coils, and 1 Dalkon Shield. Other studies on the contrary have noted no difference in pregnancy rates among 103 diabetic women using Copper Ts or 118 diabetic women using Lippes loops. Combined OCs appear to reduce the incidence of rheumatoid arthritis by 1/2 among current OC users and to protect former users as well. Combined OCs aggravate lupus erythmatous but synthetic progestins alone are effective without aggravating the condition. It has recently been argued that low dose OCs are not contraindicated in cases of sickle cell disease and may even offer protection against thromboembolic vascular accidents for women with sickle cell anemia. Estimates of relative risk of pelvic infection among IUD users vary from 1.5 to 6.5, with the risk apparently greatest for women under 25. Recent studies have indicated that copper IUDs do not have the bactericidal power formerly attributed to them. Numerous in vitro studies and statistical comparisons of the effect of spermicides in vivo have demonstrated that local methods provide protection against sexually transmitted diseases. OCs may favor vaginal infection, but some recent studies have indicated that they offer protection against pelvic infections. The protective effect of the condom against sexually transmitted diseases is well known. It has been estimated that, relative to non-users of OCs, each 100,000 users will have 235 fewer cases of benign breast disease, 35 fewer of ovarian cysts, 320 fewer of iron deficiency anemia, 600 fewer of pelivc infection, 117 fewer of extrauterine pregnancy, 32 fewer of rheumatoid arthritis, 1 fewer of endometrial cancer, and 3 fewer of ovarian cancer. PMID:12280211

Rozenbaum, H



Using Pharmacies in Washington State To Expand Access to Emergency Contraception  

Microsoft Academic Search

women's awareness and use of emergency contraception by utilizing pharmacists to increase its availability. We also discuss the impact that their expanded role is having on access to emergency contraception, and thereby the potential impact of the pro- gram on rates of unintended pregnancy.

Elisa S. Wells; Jane Hutchings; Jacqueline S. Gardner; Jennifer L. Winkler; Timothy S. Fuller; Don Downing; Rod Shafer


Contraceptive Use Patterns across Teens' Sexual Relationships. Fact Sheet. Publication #2008-07  

ERIC Educational Resources Information Center

Teens typically fail to use contraceptives consistently, which contributes to high rates of unintended pregnancy and sexually transmitted infections (STIs) among this age group. Existing research has focused primarily on how teens' own characteristics are related to contraceptive use, but has paid less attention to how the characteristics of…

Holcombe, Emily; Carrier, David; Manlove, Jennifer; Ryan, Suzanne



Conscientious objection and emergency contraception.  


This article argues that practitioners have a professional ethical obligation to dispense emergency contraception, even given conscientious objection to this treatment. This recent controversy affects all medical professionals, including physicians as well as pharmacists. This article begins by analyzing the option of referring the patient to another willing provider. Objecting professionals may conscientiously refuse because they consider emergency contraception to be equivalent to abortion or because they believe contraception itself is immoral. This article critically evaluates these reasons and concludes that they do not successfully support conscientious objection in this context. Contrary to the views of other thinkers, it is not possible to easily strike a respectful balance between the interests of objecting providers and patients in this case. As medical professionals, providers have an ethical duty to inform women of this option and provide emergency contraception when this treatment is requested. PMID:17558978

Card, Robert F



Oral contraceptives and hepatocellular carcinoma  

Microsoft Academic Search

A series of 26 white women aged under 50 who developed hepatocellular carcinoma in a non-cirrhotic liver were studied for the possible role of oral contraceptives. Eighteen of the women had used the \\

J Neuberger; D Forman; R Doll; R Williams



[Psychosomatic aspects of oral contraception].  


Oral contraceptive use is influenced by multiple emotional factors. Physiological and psychological effects are closely correlated. Contraception may assist women in pursuing important psychosocial goals, on the other hand, it may cause a number of problems. Many unconscious wishes or fears may interfere with the clear separation of sexuality from fertility. Ambivalence about pregnancy, neurotic personalities and problems in partner relationship may cause psychic conflicts with regard to contraception. Anxiety, side effects, misuse of contraceptives or problems in the relationship between doctor and patient may result. As a further development psychosomatic symptoms such as discomfort, nervousness, sleep disturbance, fatigue, nausea and sexual disorders may appear. The physician must take contradictory feelings of the patient into consideration, including her anxiety and her possible ambivalence with respect to pregnancy. PMID:1794682

Schanzer, K



Non-use of contraception: determinants among Ugandan university students  

PubMed Central

Background In Uganda, adolescent pregnancy often results in adverse maternal and neonatal health outcomes. In this context, low use of contraception and high rates of maternal mortality rate make preventing unwanted pregnancies critical. Objective The objective was to determine the relationship between non-use of contraception and socio-demographic factors, alcohol consumption, and types of partner(s) among Ugandan university students. Design In 2010, 1,954 students at Mbarara University of Science and Technology in southwestern Uganda participated in a cross-sectional study whereby a self-administered questionnaire was used to assess socio-demographic factors, alcohol consumption, and sexual behaviour including the use of contraceptives. Multivariable logistic regression was used for the analysis and data were stratified by sex. Results 1,179 students (60.3% of the study population) reported that they were sexually active. Of these, 199 (18.6%) did not use contraception in their last sexual encounter. Students currently not in a relationship had higher odds of non-use of contraception (odds ratio 1.8, 95% confidence interval 1.2–2.7). The association remained statistically significant for both males and females after controlling for age, sexual debut, area of growing up, and educational level of the household head. Socio-demographic determinants of age (22 or younger), early sexual debut (at age 16 years or earlier), and a rural background were significant for males but not for females. A synergistic effect between not currently being in a relationship and early sexual debut were also observed to have an effect on the non-use of contraception. Conclusion Non-use of contraception among Ugandan university students differs for males and females, possibly due to gendered power relations. Sexual and reproductive health policies and programmes should be designed to take these differences into account. PMID:23058273

Mehra, Devika; Agardh, Anette; Petterson, Karen Odberg; Ostergren, Per-Olof



NOVEMBER 2013 POLICY BRIEF | Integrating family planning into HIV services increases use of more effective contraception | 1 Integrating family planning into HIV services  

E-print Network

), subdermal implants, injectables and oral contraceptives--in sub-Saharan Africa in general and among HIV effective contraception | 1 Integrating family planning into HIV services increases use of more effective contraception Policy Brief KEY MESSAGES � There is a very high rate of unintended pregnancy among HIV

Mullins, Dyche


Progestin-only contraceptive rings  

Microsoft Academic Search

Several progestin-only long acting contraceptives are currently available in the form of implants or injectables. Vaginal rings are another contraceptive option in the final stages of development. These steroid-containing polymer rings are placed in the vagina, providing relatively constant drug release, thus allowing for lower effective doses. Vaginal rings have the advantage of being user-controlled and non-provider dependent, and their

Vivian Brache; Francisco Alvarez-Sanchez; Anibal Faundes; Theodore Jackanicz; Daniel R. Mishell; Pekka Lähteenmäki



Knowledge, attitude and practice of emergency contraceptive among women who seek abortion care at Jimma University specialized hospital, southwest Ethiopia  

PubMed Central

Background In Ethiopia maternal mortality rate is very high more than one in five women die from pregnancy or pregnancy related causes. The use of contraceptives to prevent unwanted pregnancies and unsafe abortion is an important strategy to minimize maternal mortality rate. Among various forms of contraception, emergency contraceptives are the only one that can be used after sexual intercourse offering chance to prevent unwanted pregnancy. The aim of this study was to assess the knowledge, attitude and practice of emergency contraceptive among women who seek abortion care at Jimma University specialized hospital (JUSH). Methods Institution base cross-sectional study on knowledge, attitude and practice of emergency contraceptive was conducted at JUSH from April to June, 2011Data was collected using structured questionnaire and analyzed using SPSS version 17.0. Results In this study 89 women were interviewed. More than half of them (48) were from urban area and 41 were from rural area.46 (51.7%) of them were single. Of all the respondents only nine women had awareness about emergency contraceptive. Seven of the women mentioned pills as emergency contraception and only two of them mentioned both pills and injectable as emergency contraception. All of them have positive attitude towards emergency contraception but none of them have ever used emergency contraceptives. Conclusion and recommendation The finding revealed pregnancy among women of 15-19 years was very common. The knowledge and practice of emergency contraception is very low. But there is high positive attitude towards emergency contraceptives. Since there is much deficit on knowledge of women on emergency contraceptives, in addition to making them accessible; programs targeted at promotion and education of emergency contraceptives is helpful to prevent unwanted pregnancy. PMID:22410271



Effect of agricultural activities on prevalence rates, and clinical and presumptive malaria episodes in central Côte d'Ivoire.  


Agricultural activities, among other factors, can influence the transmission of malaria. In two villages of central Côte d'Ivoire (Tiémélékro and Zatta) with distinctively different agro-ecological characteristics, we assessed Plasmodium prevalence rates, fever and clinically confirmed malaria episodes among children aged 15 years and below by means of repeated cross-sectional surveys. Additionally, presumptive malaria cases were monitored in dispensaries for a 4-year period. In Tiémélékro, we observed a decrease in malaria prevalence rates from 2002 to 2005, which might be partially explained by changes in agricultural activities from subsistence farming to cash crop production. In Zatta, where an irrigated rice perimeter is located in close proximity to human habitations, malaria prevalence rates in 2003 were significantly lower than in 2002 and 2005, which coincided with the interruption of irrigated rice farming in 2003/2004. Although malaria transmission differed by an order of magnitude in the two villages in 2003, there was no statistically significant difference between the proportions of severe malaria episodes (i.e. axillary temperature>37.5 degrees C plus parasitaemia>5000 parasites/microl blood). Our study underscores the complex relationship between malaria transmission, prevalence rate and the dynamics of malaria episodes. A better understanding of local contextual determinants, including the effect of agricultural activities, will help to improve the local epidemiology and control of malaria. PMID:19450537

Koudou, Benjamin G; Tano, Yao; Keiser, Jennifer; Vounatsou, Penelope; Girardin, Olivier; Klero, Kouassi; Koné, Mamadou; N'goran, Eliézer K; Cissé, Guéladio; Tanner, Marcel; Utzinger, Jürg



4:41 Prevalence rates of human immunodeficiency virus, hepatitis B virus and hepatitis C virus among musculoskeletal tissue donors  

Microsoft Academic Search

Purpose of study: The purpose of this study was to determine the prevalence rates of human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) among potential musculoskeletal tissue donors tested during the period July 1996 through June 2001. Limitations of the methods of acquiring, screening and testing tissue donors that contribute to higher risk for viral

Robert Kennedy; Jeffrey Wang; Randal Mills; Michael Roberts



Male and Female Recipients of Unwanted Sexual Contact in a College Student Sample: Prevalence Rates, Alcohol Use, and Depression Symptoms  

Microsoft Academic Search

It is typically assumed that acquaintance rapeand other forms of unwanted sexual contact involve malesas perpetrators and females as victims. The currentstudyinvestigated prevalence rates of experiencing as well as instigating sexual coercion, force,and other types of unwanted sexual contact for both menand women in a college Greek system. 165 men and 131women (82% Caucasian) completed 2 gender neutral measures of

Mary E. Larimer; Amy R. Lydum; Britt K. Anderson; Aaron P. Turner



Construction Industry Apprentices' Substance Use: A Survey of Prevalence Rates, Reasons for Use, and Regional and Age Differences  

ERIC Educational Resources Information Center

Prevalence rates and reasons for substance use were studied in a sample of 172 male construction industry apprentices who had a mean age of 20 years. Results were compared with those of men in similar age groups in Victoria, and regional and age differences were explored. Findings indicate that more metropolitan apprentices had experimented with…

du Plessis, Karin; Corney, Tim



Role of the levonorgestrel intrauterine system in effective contraception  

PubMed Central

Norgestrel, a synthetic progestin chemically derived from 19-nortestosterone, is six times more potent than progesterone, with variable binding affinity to various steroid receptors. The levonorgestrel-releasing intrauterine system (LNG IUS) provides a long-acting, highly effective, and reversible form of contraception, with a pearl index of 0.18 per 100 women-years. The locally released hormone leads to endometrial concentrations that are 200–800 times those found after daily oral use and a plasma level that is lower than that with other forms of levonorgestrel-containing contraception. The contraceptive effect of the LNG IUS is achieved mainly through its local suppressive effect on the endometrium, leading to endometrial thinning, glandular atrophy, and stromal decidualization without affecting ovulation. The LNG IUS is generally well tolerated. The main side effects are related to its androgenic activity, which is usually mild and transient, resolving after the first few months. Menstrual abnormalities are also common but well tolerated, and even become desirable (eg, amenorrhea, hypomenorrhea, and oligomenorrhea) with proper counseling of the patient during the choice of the method of contraception. The satisfaction rates after 3 years of insertion are high, reaching between 77% and 94%. The local effect of the LNG IUS on the endometrium and low rates of systemic adverse effects have led to its use in other conditions rather than contraception, as for the treatment of endometrial hyperplasia, benign menorrhagia, endometriosis, adenomyosis, and uterine fibroids. PMID:23990713

Attia, Abdelhamid M; Ibrahim, Magdy M; Abou-Setta, Ahmed M



Prevalence rates of Giardia and Cryptosporidium among diarrheic patients in the Philippines.  


The prevalence of Giardia and Cryptosporidium among 3,456 diarrheic patients corrected from May 2004 to May 2005 in the Philippines was determined. Of 133 (3.8%) positive samples, 69 (2.0%) were positive for Giardia and 67 (1.9%) for Cryptosporidium. Three samples had co-infection with Giardia and Cryptosporidium. Luzon had the highest positive samples (5.0%) followed by Mindanao (4.9%), then Visayas (2.2%). Giardia was most prevalent in Mindanao (3.6%) while Cryptosporidium was most prevalent in Luzon (3.1%). The prevalence of Giardia (2.0%) among pediatric patients (0-18 years) did not significantly differ from that (1.9%) among adults (> 18 years old). However, for Cryptosporidium, the prevalence (2.9%) among pediatric patients was significantly higher compared to that (0.2%) among adult patients. In the pediatric population, the highest percentage of patients with Giardia was the 5-9 year old age group, while that of Cryptosporidium was in the 0-4 year old group. The prevalence of Giardia, but not Cryptosporidium, was significantly higher in male than female adults. Seasonality had a distinct peak in September with Cryptosporidium more prevalent in the rainy (2.6%) than dry season (0.9%). PMID:19062686

Natividad, Filipinas F; Buerano, Corazon C; Lago, Catherine B; Mapua, Cynthia A; de Guzman, Blanquita B; Seraspe, Ebonia B; Samentar, Lorena P; Endo, Takuro



The Prevalence Rate of Helicobacter pylori Infection in, Chronic Otitis Media With Effusion Patients  

PubMed Central

Background: Otitis media with effusion (OME) is a common disease in children. Viral or bacterial infections, allergy, adenoids, functional abnormalities of the Eustachian tube, and gastroesophageal reflux might have a possible role in the pathogenesis of OME. However, the exact pathogenesis of OME is still unsettled. Objectives: The purpose of this study was to compare Helicobacter pylori prevalence rates in the nasopharynx of pediatric patients with and without OME. Patients and Methods: Eighty-four patients (50 males and 34 females) who were subjected to adenoidectomy and myringotomy were included in the study group. Ninety-one patients (48 males and 43 females) who had only adenoidectomy were selected as the control group. Detection of H. pylori was done by polymerase chain reaction (PCR). Results: Adenoid samples were positive for H. pylori in 21 (25%) patients in study group and 18 (19.8%) patients in control group. In the study group, 36 (42.8%) effusion samples (otitis media) of the patients were positive for H. pylori. In an analysis that compared H. pylori–negative and –positive children, the odds ratio (OR) for the occurrence of H. pylori was 1.35 (95% CI, 0.66 - 2.71). The association of age with H. pylori positivity decreased for 1-5 years age group, (1.09; 95% CI, 0.39 – 3.05) but increased for the 6-10 years group (OR, 1.48; 95% CI, 0.61–3.58). Furthermore, the association of sex with H. pylori positivity decreased for the male group (OR, 1.21; 95% CI, 0.50 – 2.91), but increased in the female group (OR, 1.44; 95% CI, 0.51–0.4.05). Conclusions: Heavy colonization of H. pylori in adenoid tissue and middle ear might have a role in pathogenesis of this infection. For OME cases resistant to medical treatment, it might be meaningful to evaluate the patient for H. pylori. PMID:25147680

Saki, Nader; Samarbaf Zadeh, Ali Reza; Sheikhpour Jonaky, Reza; Noori, Seyed Mahdi; Kayedani, Gholam Abbas; Nikakhlagh, Soheila



Insomnia in Older Veterans: Prevalence, Self-Rated Health, and Talking to a Doctor About Sleep Problems  

PubMed Central

Objectives To determine insomnia prevalence and variations in prevalence with age among older Veterans and examine the relationships among insomnia, self-rated health, and talking to a doctor about sleep problems. Design A cross-sectional postal survey. Setting: VA Greater Los Angeles Healthcare System - Sepulveda Ambulatory Care Center (SACC) Participants: Veterans over age 60, who received outpatient care at SACC in the prior 12 months and resided within 25 miles of SACC (n=9080) Interventions: None Measures Data were collected from a postal survey, which included items addressing the diagnostic criteria for insomnia (difficultly falling or staying asleep, early awakening, insufficient/non-restorative sleep, daytime symptoms, duration of sleep problems) plus demographics, self-rated health, and whether the Veteran had previously talked to a doctor about sleep problems. Results Of 9080 surveys 4758 were returned. Of responders 51.5% met International Classification of Sleep Disorders (ICSD) insomnia diagnostic criteria. An unadjusted logistic regression model showed that individuals in the 60–65 year age bin were at the highest risk for insomnia, with the odds of having insomnia decreasing with each successively older age group (all P<.05). Veterans with poor self-rated health had higher insomnia prevalence, more daytime symptoms of insomnia, and reported fewer hours of sleep compared to Veterans with good self-rated health. In a regression model, poorer self-rated health, meeting insomnia criteria, younger age, and more daytime symptoms were significant independent predictors of discussing sleep problems with a doctor. Conclusion Older Veterans had high rates of insomnia, but contrary to most prior work, insomnia became less prevalent as age increased. Greater efforts are needed to help older Veterans recognize and disclose sleep problems, and doctors should routinely screen for insomnia and account for comorbidities when treating insomnia patients.

Martin, Jennifer; Alessi, Cathy



Male contraception: another Holy Grail.  


The idea that men should participate in family planning by playing an active role in contraception has become more acceptable in recent years. Up to the present the condom and vasectomy have been the main methods of male contraception. There have been and continue to be efforts to develop an acceptable hormonal contraceptive involving testosterone (T) suppression. However the off target affects, delivery of the analogs and the need for T replacement have proven difficult obstacles to this technology. Research into the development of non-hormonal contraception for men is progressing in several laboratories and this will be the subject of the present review. A number of promising targets for the male pill are being investigated. These involve disruption of spermatogenesis by compromising the integrity of the germinal epithelium, interfering with sperm production at the level of meiosis, attacking specific sperm proteins to disrupt fertilizing ability, or interfering with the assembly of seminal fluid components required by ejaculated sperm for acquisition of motility. Blocking contractility of the vas deferens smooth muscle vasculature to prevent ejaculation is a unique approach that prevents sperm from reaching the egg. We shall note the lack of interest by big pharma with most of the support for male contraception provided by the NIH. PMID:24368213

Murdoch, Fern E; Goldberg, Erwin



Contraceptive coverage laws proliferate in 1999.  


In 1999, contraceptive coverage laws proliferated both in the government and private sectors in the US. On September 29, President Clinton signed a bill ensuring federal employees' access to contraceptives. While Congress has been creating initiatives of providing contraceptive coverage for its employees, individuals insured under private employers do not enjoy such coverage. In response to this, the Equity in Prescription Insurance Act was introduced to provide contraceptive coverage in private sector employment-based plans. Between April and September, 9 states enacted an almost similar contraceptive coverage law; these were California, Connecticut, Georgia, Hawaii, Maine, Nevada, New Hampshire, North Carolina, and Vermont. All require private insurance coverage of contraceptives and devices approved by the Food and Drug Administration. California, Connecticut, and Georgia require coverage of contraceptive services. In most states, however, addressing difficult questions concerning the scope of exemption for employers who object to contraceptive coverage was central to the ultimate success of the bill. PMID:12295561

Dailard, C



A survey of knowledge, attitudes and practice of emergency contraception among university students in Cameroon  

PubMed Central

Background Unsafe abortion is a major public health problem in low-and-middle income countries. Young and unmarried women constitute a high risk group for unsafe abortions. It has been estimated that widespread use of emergency contraception may significantly reduce the number of abortion-related morbidity and mortality. The purpose of this study was to evaluate the knowledge, attitudes and experiences on emergency contraceptive pills by the university students in Cameroon in order to develop and refine a national health programme for reducing unwanted pregnancies and their associated morbidity and mortality. Methods A convenient sample of 700 students of the University of Buea (Cameroon) was selected for the study. Data was collected by a self-administered, anonymous and pre-tested questionnaire. Results The response rate was 94.9% (664/700). General level of awareness of emergency contraceptive pills was 63.0% (418/664). However, knowledge of the general features of emergency contraceptive pills was low and misinformation was high among these students. Knowledge differed according to the source of information: informal source was associated with misinformation, while medical and informational sources were associated with better knowledge. Although the students generally had positive attitudes regarding emergency contraceptive pills, up to 65.0% (465/664) believed that emergency contraceptive pills were unsafe. Those with adequate knowledge generally showed favourable attitudes with regards to emergency contraceptive pills (Mann-Whitney U = 2592.5, p = 0.000). Forty-nine students (7.4%) had used emergency contraceptive pills themselves or had a partner who had used them. Conclusion Awareness of emergency contraception pills by Cameroonian students is low and the method is still underused. Strategies to promote use of emergency contraception should be focused on spreading accurate information through medical and informational sources, which have been found to be reliable and associated with good knowledge on emergency contraceptive pills. PMID:17634106

Kongnyuy, Eugene J; Ngassa, Pius; Fomulu, Nelson; Wiysonge, Charles Shey; Kouam, Luc; Doh, Anderson S



Sperm-based contraceptive vaccines: current status, merits and development.  


At the present growth rate, the world population is estimated to reach a phenomenal 8.9 billion people by the year 2050, posing a great risk of overpopulation. Therefore, new strategies of contraception are required. A novel contraceptive strategy that is receiving considerable attention is that of immunocontraception. Spermatozoa have proteins that are unique, cell specific, immunogenic and accessible to antibodies. The targeting of antibodies to gamete-specific antigens implicated in sperm function, sperm-egg binding and fertilisation could block sperm binding and thus fertilisation. The present review highlights the current status, relative merits and future directions for various sperm-based candidate antigens with regard to the development of a contraceptive vaccine. PMID:16153335

Suri, Anil



Fertility after stopping different methods of contraception  

Microsoft Academic Search

Data on the return of fertility after discontinuing various methods of contraception were collected from among the women taking part in the Oxford-Family Planning Association contraceptive study. Return of fertility was measured as the time taken to give birth to a child. The fertility of both nulligravid and parous women who stopped taking oral contraceptives was initially impaired in comparison

M P Vessey; N H Wright; K McPherson; P Wiggins




E-print Network

�TUDE DU RETENTISSEMENT DE LA CONTRACEPTION ORALE SUR DIVERS M�TABOLISMES G. LE LORIER, G'étude du retentissement de la contraception orale sur le métabolisme des lipides, le métabolisme des classiques de la contraception orale : fibrome, frottis suspects, adénome ou kyste du sein. Les explorations

Paris-Sud XI, Université de


Ectopic gestation following emergency contraceptive pill administration  

Microsoft Academic Search

Emergency contraceptive pill prescription following rape is common. We report a case of ectopic gestation after emergency contraceptive pill failure and review the literature on this rare complication. A 26-year-old woman with a normal menstrual period 2 weeks before was administered an emergency contraceptive pill 8 hours after a single sexual assault. The assault was her only sexual activity before

Carin L. Nielsen; Leslie Miller



Knowledge and use of hormonal emergency contraception in Finland  

Microsoft Academic Search

We studied the knowledge and use of hormonal emergency contraception (EC) in Finland by mailing a questionnaire to a national sample of 3000 women aged 18–44 years (response rate 74%). Ten percent of the women aged under 25 and 4% of all respondents had sometimes used EC. Unmarried women were more likely to report having used hormonal EC than were

Elise Kosunen; Sinikka Sihvo; Elina Hemminki



To what extent do oral contraceptives influence mood and affect?  

Microsoft Academic Search

Background: Studies examining the effects of oral contraceptives (OCs) on mood, affect, and affect variability are reviewed. Methods: MEDLINE and PsycLIT data bases were examined to identify studies that compared OC users with nonusers using daily ratings of mood, affect, or affect variability. Results: Compared to non-users, OC users experience less variability in affect across the entire menstrual cycle, and

Kirsten A Oinonen; Dwight Mazmanian



Determinants of oral contraceptive use in northern Italy.  


Socio-demographic characteristics, general lifestyle habits, reproductive and medical histories were compared of 328 women who had ever used oral contraceptives and 2306 never users from a case-control surveillance conducted in Northern Italy. Oral contraceptive use was positively and strongly related with the level of education and indicators of social class. The rate ratio of ever use (adjusted for age and diagnostic category) was 3.3 for women with 12 years of education or more compared with less than 7 years, and 3.0 for women of highest compared with lowest social class. The frequency of pill use was lower among never married women, and significantly elevated among smokers (rate ratio = 2.4 for heavy smokers). In contrast, no relation was evident between alcohol or coffee consumption and pill use. Likewise, ever users of oral contraceptives were not significantly different from women who had never used the pill with regard to major reproductive factors (parity and age at first pregnancy) or several medical variables of potential interest (e.g., diabetes, hypertension, hyperlipidemia), with the only possible exclusion of obesity which was less frequent among pill users. Thus, this study indicates that the major determinants of the persistently low frequency of oral contraceptive use in this Northern Italian population are social rather than reproductive or medical factors. These findings have important implications for epidemiological research on oral contraceptive and disease in this population, and underline the importance of selection and screening of oral contraceptive users on the basis of knowledge of medical factors and lifestyle habits. PMID:3780230

La Vecchia, C; Decarli, A; Parazzini, F; Gentile, A; Negri, E; Franceschi, S



Effect of agricultural activities on prevalence rates, and clinical and presumptive malaria episodes in central Côte d’Ivoire  

Microsoft Academic Search

Agricultural activities, among other factors, can influence the transmission of malaria. In two villages of central Côte d’Ivoire (Tiémélékro and Zatta) with distinctively different agro-ecological characteristics, we assessed Plasmodium prevalence rates, fever and clinically confirmed malaria episodes among children aged 15 years and below by means of repeated cross-sectional surveys. Additionally, presumptive malaria cases were monitored in dispensaries for a

Benjamin G. Koudou; Yao Tano; Jennifer Keiser; Penelope Vounatsou; Olivier Girardin; Kouassi Klero; Mamadou Koné; Eliézer K. N’Goran; Guéladio Cissé; Marcel Tanner; Jürg Utzinger



The Comorbidity of Alcoholism and Personality Disorders in a Clinical Population: Prevalence Rates and Relation to Alcohol Typology Variables  

Microsoft Academic Search

This study assessed prevalence rates and overlap among Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised; DSM–III–R;American Psychiatric Association, 1987) personality disorders in a multisite sample of 366 substance abusers in treatment. In addition, the relation of antisocial personality disorder (APD), borderline personality disorder (BPD), and paranoid personality disorder (PPD) to alcohol typology variables was examined. Structured diagnostic

Jon Morgenstern; James Langenbucher; Erich Labouvie; Kevin J Miller



Estimating unmet need for contraception by district within Ghana: an application of small-area estimation techniques.  


The importance of meeting the unmet need for contraception is nowhere more urgent than in the countries of sub-Saharan Africa, where the fertility decline is stalling and total unmet need exceeds 30 per cent among married women. In Ghana, where fertility levels vary considerably, demographic information at sub-national level is essential for building effective family planning programmes. We used small-area estimation techniques, linking data from the 2003 Ghana Demographic and Health Survey to the 2000 Ghana Population and Housing Census, to derive district-level estimates of contraceptive use and unmet need for contraception. The results show considerable variation between districts in contraceptive use and unmet need. The prevalence of contraceptive use varies from 4.1 to 41.7 per cent, while that of the use of modern methods varies from 4.0 to 34.8 per cent. The findings identify districts where family planning programmes need to be strengthened. PMID:22553978

Amoako Johnson, Fiifi; Padmadas, Sabu S; Chandra, Hukum; Matthews, Zoe; Madise, Nyovani J



The Impact of Emotional, Physical, and Sexual Abuse on Contraceptive Method Selection and Discontinuation  

PubMed Central

Objectives We evaluated the impact of exposure to emotional, physical, or sexual abuse on contraceptive method selection and discontinuation. Methods We performed a secondary analysis of 7170 women enrolled in the Contraceptive CHOICE Project in St. Louis, Missouri, a prospective cohort study in which 9256 women were provided their preferred method of contraception at no cost from 2007 to 2011. We defined contraceptive discontinuation as device removal or nonuse for at least 4 weeks within the first 12 months after initiation. Results One third of women experienced some abuse in their lifetimes. Women with an abuse history were as likely as those without to select a long-acting reversible contraceptive method. When we compared women who were abused to those who were not, rates of discontinuation at 12 months were higher among women who selected long-acting reversible contraception (18% vs 15%; P = .04) and significantly higher among women who selected non–long-acting methods (80% vs 62%; P < .001). Type of abuse did not alter the association between abuse and contraceptive continuation. Conclusions Previous experiences of abuse are associated with both contraceptive method selection and continuation. PMID:23948012

Allsworth, Jenifer E.; Secura, Gina M.; Zhao, Qiuhong; Madden, Tessa; Peipert, Jeffrey F.



[Side effects of hormonal contraception].  


Female sex hormones have an influence not only on the reproductive process, but on nearly all organs and functional systems. This explains their broad spectre of side-effects, which by their degree of subjective annoyance may impair the acceptability of hormonal contraception or--through a suggested risk to the patient--even enforce discontinuation of medication. The significance of quite a number of alterations in biochemical and metabolic parameters cannot yet be fully elucidated. The author offers a summary of the principal side-effects of present-day hormonal contraceptives. PMID:7025479

Carol, W; Göretzlehner, G; Klinger, G



Prevalence Rates and Demographic Characteristics Associated with Depression in Pregnancy and the Postpartum.  

ERIC Educational Resources Information Center

Examined prevalence of depression in 360 women during pregnancy and after delivery. At both assessments, approximately 25 percent reported elevated levels of depressive symptomatology. Ten percent met diagnostic criteria for depression during pregnancy; 6.8 percent were depressed postpartum. One-half of postpartum depression cases were new onset.…

Gotlib, Ian H.; And Others



Household gun prevalence and rates of violent crime: a test of competing gun theories  

Microsoft Academic Search

This study analyzes the reciprocal relationship between a direct measure of gun availability and three types of violent crime across the 120 most populous counties in the USA. Survey data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System are used to construct a measure of household gun prevalence. Hypotheses derived from four competing perspectives concerning

Anthony Hoskin



Effect of progestin vs. combined oral contraceptive pills on lactation: A double-blind randomized controlled trial  

PubMed Central

Objective To estimate the effect of progestin-only vs. combined hormonal contraceptive pills on rates of breastfeeding continuation in postpartum women. Secondary outcomes include infant growth parameters, contraceptive method continuation and patient satisfaction with breastfeeding and contraceptive method. Methods In this randomized controlled trial, postpartum breastfeeding women who desired oral contraceptives were assigned to progestin-only vs. combined hormonal contraceptive pills. At two and eight weeks postpartum, participants completed in-person questionnaires that assessed breastfeeding continuation and contraceptive use. Infant growth parameters including weight, length and head circumference were assessed at eight weeks postpartum. Telephone questionnaires assessing breastfeeding, contraceptive continuation and satisfaction were completed at 3-7 weeks and 4 and 6 months. Breastfeeding continuation was compared between groups using Cox proportional hazards regression. Differences in baseline demographic characteristics and in variables between the two intervention groups were compared using chi-square tests, Fisher’s Exact test, or two-sample t-tests as appropriate. Results Breastfeeding continuation rates, contraceptive continuation, and infant growth parameters did not differ between users of progestin-only and combined hormonal contraceptive pills. Infant formula supplementation and maternal perception of inadequate milk supply were associated with decreased rates of breastfeeding in both groups. Conclusions Choice of combined or progestin-only birth control pills administered two weeks postpartum did not adversely affect breastfeeding continuation. PMID:22143258

Espey, Eve; Ogburn, Tony; Leeman, Larry; Singh, Rameet; Schrader, Ronald



Current Opinion of Obstetricians on the Prescription of Emergency Contraception: A German-American Comparison  

PubMed Central

Background: There are no current studies on the opinions of obstetricians and gynaecologists in Germany about emergency contraception (or post-coital contraception, morning-after pill). The opinions of a large group of physicians were collected using of a questionnaire and compared with the results of an American survey (n?=?1154). Methods: A two-part questionnaire was used – part 1: sociodemographic data, part 2: 4 scenarios to illustrate the possible advantages and disadvantages of free access to emergency contraception as well as 4 indications and situations for which emergency contraception can be prescribed. Results: The response rate was 91.7?% (165/180 questionnaires). 63.9?% (103/161) of the German responding physicians were of the opinion that women with access to emergency contraception experienced unwanted pregnancies less frequently than those without access. Merely 26.2?% of the responding physicians supported the prescription-free availability of emergency contraception in apothecaries. The German-American comparison ultimately revealed only a few major differences, e.g., in answers to the question whether or not access to emergency contraception could reduce the number of unwanted pregnancies (89 vs. 64?%). Conclusions: The high rejection rate of free access to emergency contraception of almost 70?% in our surveyed group supports the current position published by the German Society for Gynaecology and Obstetrics (Deutsche Gesellschaft für Gynäkologie und Geburtshilfe) and the German Professional Union of Gynaecologists (deutscher Berufsverband der Frauenärzte). Since other medical organisations, e.g., WHO, supported the prescription-free access to levonorgestrel formulations as emergency contraception a few years ago, it would be interesting to ask a larger sample of German gynaecologists and obstetricians about their opinions on emergency contraception. PMID:25258456

David, M.; Berends, L.; Bartley, J.



Women's contraceptive attitudes and use in 1992.  


Women aged 15-44 rate the pill, the condom, vasectomy and female sterilization most highly, according to 1992 data from an annual survey by Ortho Pharmaceutical Corporation of contraceptive attitudes and method use. The 6,955 survey respondents underrepresent women who are black or who have household annual incomes greater than $50,000, but they are similar to all American women in age, marital status and region of the country. About 74-84% of women giving an opinion view these methods favorably and 64% rate the hormonal implant favorably. The proportion of unmarried women who had had intercourse increased from 76% in 1987 to 86% in 1992. As a result, proportions of women at risk of unintended pregnancy rose from 72% to 77%. Contraceptive use also rose, from 92% to 94%. The most commonly used method is the pill (39%), followed by the condom (25%), female sterilization (19%) and vasectomy (12%). Married women exposed to the risk of unintended pregnancy are more likely to use sterilization (48%), while unmarried women are more likely to use the pill (52%) and the condom (33%). Pill use has increased since 1987, especially among married women, and condom use has increased among all women. Among unmarried women at risk of unintended pregnancy, condom use rose from 18% in 1987 to 33% in 1992. Among condom users, 40% of unmarried users and 13% of married users also use another method. PMID:8405344

Forrest, J D; Fordyce, R R



Geographical variation and factors influencing modern contraceptive use among married women in Ethiopia: evidence from a national population based survey  

PubMed Central

Background Modern contraceptive use persists to be low in most African countries where fertility, population growth, and unmet need for family planning are high. Though there is an evidence of increased overall contraceptive prevalence, a substantial effort remains behind in Ethiopia. This study aimed to identify factors associated with modern contraceptive use and to examine its geographical variations among 15–49 married women in Ethiopia. Methods We conducted secondary analysis of 10,204 reproductive age women included in the 2011 Ethiopia Demographic and Health Survey (DHS). The survey sample was designed to provide national, urban/rural, and regional representative estimates for key health and demographic indicators. The sample was selected using a two-stage stratified sampling process. Bivariate and multivariate logistic regressions were applied to determine the prevalence of modern contraceptive use and associated factors in Ethiopia. Results Being wealthy, more educated, being employed, higher number of living children, being in a monogamous relationship, attending community conversation, being visited by health worker at home strongly predicted use of modern contraception. While living in rural areas, older age, being in polygamous relationship, and witnessing one’s own child’s death were found negatively influence modern contraceptive use. The spatial analysis of contraceptive use revealed that the central and southwestern parts of the country had higher prevalence of modern contraceptive use than that of the eastern and western parts. Conclusion The findings indicate significant socio-economic, urban–rural and regional variation in modern contraceptive use among reproductive age women in Ethiopia. Strengthening community conversation programs and female education should be given top priority. PMID:24067083



Oral contraception and breast pathology.  


After a rapid examination of the international literature concerning human, animal, histological and epidemiological experimental data, the Authors state that the use of oral contraceptives considerably reduces the risk of benign disease of the breast. This risk reduction seems to be connected to the presence of progestin in this type of contraception. The Authors then expound the data regarding a group of patients (3527), who came to the center for the diagosis and prevention of cancer of the breast at the S. Martino hospital of Genoa during the years 1977-1980. The results of the study are comparable to those found in international literature, in that they confirm the protective effect of hormonal contraception on benign pathology of the breast. Finally we have shown the data of the retrospective and prospective studies conducted up till now on the effects of hormonal contraception on malignant breast pathology. In conclusion we have shown which lines of study should be taken in order to clarify once and for all the links existing between estroprogestins and cancer of the breast. PMID:6794288

Ragni, N; Boccardo, E; Viglino, S; Larosa, E



What makes a contraceptive acceptable?  


The women's health movement is developing an increasing number of negative campaigns against various contraceptive methods based on three assumptions: 1) user-controlled methods are better for women than provider-controlled methods, 2) long-acting methods are undesirable because of their susceptibility to abuse, and 3) systemic methods carry unacceptable health risks to women. While these objections have sparked helpful debate, criticizing an overreliance on such methods is one thing and calling for bans on the provision of injectables and implants and on the development of vaccine contraceptives is another. Examination of the terms "provider-controlled," "user-controlled," and "long-acting" reveals that their definitions are not as clear-cut as opponents would have us believe. Some women's health advocates find the methods that are long-acting and provider-controlled to be the most problematic. They also criticize the near 100% contraceptive effectiveness of the long-acting methods despite the fact that the goal of contraception is to prevent pregnancy. It is wrong to condemn these methods because of their link to population control policies of the 1960s, and it is important to understand that long-acting, effective methods are often beneficial to women who require contraception for 20-22 years of their lives. Arguments against systemic methods (including RU-486 for early abortion and contraceptive vaccines) rebound around issues of safety. Feminists have gone so far as to create an intolerable situation by publishing books that criticize these methods based on erroneous conclusions and faulty scientific analysis. While women's health advocates have always rightly called for bans on abuse of various methods, they have not extended this ban to the methods themselves. In settings where other methods are not available, bans can lead to harm or maternal deaths. Another perspective can be used to consider methods in terms of their relationship with the user (repeated application). While feminists have called for more barrier and natural methods, most people in the world today refuse to use condoms even though they are the best protection from infection. Instead science should pursue promising new methods as well as continue to improve existing methods and to fill important gaps. Feminists should be advocates for women and their diverse needs rather than advocates against specific contraceptive methods. PMID:12179713

Berer, M



[Sexually transmitted diseases (STD) and contraception].  


Sexually transmitted diseases (STDs) have shown a considerable resurgence in recent years both in number of cases and in spread of new infectious agents. The spread of STDs is favored by numerous factors including the liberalization of sexual behavior made possible by reliable contraception. Information on STDs has not been widely diffused. Changes in the status of women and the development of means of communication and transportation have encouraged less rigid control of sexual behavior. STDs themselves have often escaped diagnosis or not been cured despite treatment, increasing the risk of spread. Numerous organisms cause STDs, from external parasites to life-threatening viruses. 60% of upper genital tract infections that can lead to sterility, tubal alterations, ectopic pregnancy and pain result from STDs. Chlamydia infections are insidious and chronic, and cause greater damage with each recurrence. The risk of STDs should be considered in contraceptive choice along with other indications and contraindications. Combined oral contraceptives provide protection against acute upper genital tract infections. The protective role has been explained by scanty and highly viscous cervical mucus forming a barrier against germs and by reductions of menstrual flow, myometrial activity, and inflammation. It is actually uncertain whether combined oral contraceptives protect against latent chlamydia infections, since higher rates of cervicitis caused by chlamydia have been found in pill users. In situations carrying risk of STDs, pill users should be protected by a supplementary barrier method. IUDs have been implicated in numerous studies in acute pelvic infections. Possible explanations are the local trauma and inflammations due to the physical presence of the IUD, more abundant bleeding, absence of a cervical barrier to motile sperm that could be a vector for germs, and possible ascent of the infectious agent on the string. Other risk factors are involved. Epidemiologic studies indicate that the spermicides benzalkonium chloride and nonoxynol 9 have a protective effect against gonococcus, trichomonas, and chlamydia as well as cervical cancer. The protection is not absolute and is associated with the use of barrier methods. Condoms provide an excellent barrier against gonorrhea, chlamydia, cytomegalovirus, herpes, hepatitis B, and HIV infection. Use of spermicides may increase protection even more. PMID:12342583

Erny, R; Porte, H



Rethinking Mandatory HIV Testing During Pregnancy in Areas With High HIV Prevalence Rates: Ethical and Policy Issues  

PubMed Central

We analyzed the ethical and policy issues surrounding mandatory HIV testing of pregnant women in areas with high HIV prevalence rates. Through this analysis, we seek to demonstrate that a mandatory approach to testing and treatment has the potential to significantly reduce perinatal transmission of HIV and defend the view that mandatory testing is morally required if a number of conditions can be met. If such programs are to be introduced, continuing medical care, including highly active antiretroviral therapy, must be provided and pregnant women must have reasonable alternatives to compulsory testing and treatment. We propose that a liberal regime entailing abortion rights up to the point of fetal viability would satisfy these requirements. Pilot studies in the high-prevalence region of southern African countries should investigate the feasibility of this approach. PMID:17538051

Schuklenk, Udo; Kleinsmidt, Anita



Progress in male contraceptive research.  


80% of the world's contraceptive users are women. This gender-based usage has occurred due to the emphasis of family planning programs and contraception research on female methods. Even if men desired to take responsibility for contraception, only the condom and vasectomy are available and have a reasonable assurance of protection. The Population Council has been researching male contraception through its Center for Biomedical Research. An oral contraceptive derived from gossypol, a cottonseed plant pigment, is being tested after successful clinical trials were performed in China during the 1970s. Also being investigated are male hormonal methods that regulate sperm production while protecting against loss of potency, loss of libido, and changes in secondary sex characteristics. A hormonal implant, effective for one year, has been in Phase I clinical trials since 1993. A small Phase I clinical trial is in process for a vaccine/implant for men that is effective for one year. Testing with injectables for men has suggested that different hormonal mixes could increase cardiovascular risk for men and exacerbate prostate cancer. Research has focused on new materials for condoms. Kraton-type materials are made from block copolymers and polyurethanes, and these condoms have shown some promise. The advantages of these products are that they are allergen-free, less susceptible to oxidation, and can be of thinner construction, which would increase sensitivity and acceptability. The percutaneous chemical method of no-scalpel vasectomy has been studied as a means of blocking passage of sperm in the vas deferens. In China and India, injections with liquid silicone, polyurethane, neem-oil, and n-butyl-cyanoacrylate mixed with phenol are being studied. Zinc injections that cause the epididymis to atrophy are being tested on animals in the US. Lasers and fiber cautery are other methods under investigation. Increased funding is essential for these and other research efforts. PMID:12288916



Serological evidence for remarkably variable prevalence rates of Toxoplasma gondii in children of major residential areas in United Arab Emirates.  


The major objective of this study was to determine the seroprevalence rate of Toxoplasma gondii in children citizens of United Arab Emirates (UAE) main residential areas. Questionnaire information, clinical data and blood samples were obtained from 1006 primary school children residence of seven out of nine districts of UAE. ELISA was used for detection of antibodies against the immunodominant surface antigen (SAG1) of T. gondii. The sensitivity and specificity of the employed ELISA were 98.4 and 99.1%, respectively using 'Eiken' latex agglutination test as a reference test. The seroprevalence rates were remarkably variable in different residential areas and ranged between 3.5% for Dubai and 34.6% for Sharjah, with an overall prevalence of 12.5% for the seven districts. Rear of ruminants at home and consumption of raw milk associated significantly (P<0.05) with exposure to T. gondii. UAE children exposed to T. gondii infection had a significantly higher hepatomegaly rate (P<0.05) and complained more of various symptoms at the time of sampling (P<0.01) compared to unexposed children. This study urges for more population studies to further elucidate the prevalence rates of toxoplasmosis in UAE in relation to age, gender, place of residence and risk factors. PMID:12062794

Abu-Zeid, Y A



Contraceptive sterilization: A comparison of Mexican?Americans and Anglos living in U.S. counties bordering Mexico  

Microsoft Academic Search

Prior to the U.S.?Mexico Border Survey of Maternal and Child Health and Family Planning conducted by the Centers for Disease Control in 1979, little information was available about the extent to which Mexican?Americans in the U.S., relative to Anglos, were using male and female sterilization for contraceptive reasons. This paper compares Mexican?Americans and Anglos for (a) prevalence of contraceptive sterilization;

Charles W. Warren; Jack C. Smith; Roger W. Rochat; Susan E. Holck



Contraceptive knowledge, contraceptive use, and self-esteem among Navy personnel.  


This study evaluated the sexual knowledge (including contraceptive and reproductive knowledge), contraceptive use, and self-esteem among a sample of 158 male and female United States Navy sailors assigned to Navy ships. In spite of the fact that men and women viewed themselves as relatively knowledgeable with respect to contraception, results showed substantial knowledge deficits. Women demonstrated significantly greater sexual knowledge than men, and contraceptive/ reproductive knowledge was highly correlated with self-reported use of contraceptives. Finally, self-esteem was highly correlated with sexual knowledge and certain contraceptive use behaviors. PMID:9110557

Gallagher, C K; Lall, R; Johnson, W B



Deriving estimates of contralateral footedness from prevalence rates in samples of Brazilian and non-Brazilian right- and left-handers  

Microsoft Academic Search

Although footedness is closely associated with handedness, accurate prevalence rates of contralateral footedness in right- and left-handed populations were previously unavailable to researchers studying the relationship between phenotypic and hemispheric asymmetries. We collected preference data from 2081 Brazilian children and adolescents, and relate the prevalence of crossed hand\\/foot preferences to values reported elsewhere in the literature. In our samples, about

William Lee Berdel Martin; Angélica Homobono Machado



Contraception-related venous thromboembolism in adolescents.  


Venous thromboembolism (VTE) is a rare but serious complication of combined hormonal contraception. While the absolute risk of VTE is low in adolescents, thrombotic events in contraception users younger than the age of 20 years account for 5 to 10% of total contraception-related VTE events in population studies, because of the high frequency of contraception use in adolescents. An increased risk of VTE exists not only with oral contraceptives, but also the contraceptive patch and vaginal ring. Most adolescents who experience contraception-related VTE have additional transient or inherited thrombotic risk factors at the time of VTE. Although the presence of inherited thrombophilia impacts the risk of contraception-related VTE, thrombophilia screening before contraception prescribing should be targeted only to high-risk populations. Pediatric institutions, caregivers, and young women need to be aware of the risk of VTE with estrogen-containing contraception, and maintain a high index of suspicion for this complication in women using these agents. PMID:24356931

O'Brien, Sarah H



Perceived competence and contraceptive use during adolescence  

PubMed Central

Background Little is known about psychosocial correlates of different contraceptive methods in adolescence. Study Design Cross-sectional analyses of 209 post-menarcheal girls (mean=15.68 yrs ± 1.74), primarily Caucasian (62.8%) or African American (32.8%). Competence (activities and social) and rule-breaking behavior were assessed by the Youth Self Report (YSR; adolescent) and the Child Behavior Checklist (CBCL; parent). Three contraceptive use groups were created: no hormonal contraceptive (n=142), combined oral contraceptives or the transdermal patch (COCs/patch, n=41), and depot medroxyprogesterone acetate (DMPA, n=20). Results There was a significant effect of contraceptive use group on competence (p=.003). The DMPA group had lower competence (CBCL activities and social; YSR social) than the no hormonal contraceptive and COCs/patch groups. The COCs/patch group scored lower than the no hormonal contraceptive group on YSR activities competence, but was not different from the DMPA group. Lastly, there was an effect of contraceptive use group on CBCL (but not YSR) rule-breaking behavior (p=.029) with the DMPA group having higher rule-breaking behavior than the other groups. Conclusions Type of contraceptive method was associated with parent and adolescent’s perceived competence. For rule-breaking behavior, parental perception may be more relevant to contraceptive use. PMID:20159183

Hillman, Jennifer B.; Negriff, Sonya; Dorn, Lorah D.



Spatial Variation in Contraceptive Use in Bangladesh: Looking Beyond the Borders  

Microsoft Academic Search

Abstract In this paper, an analysis is made of spatial patterns of contraceptiveuse in Bangladesh and the contiguous state of West Bengal in India in order to promote a more,complete understanding of social change. Earlier analysis found strong evi- dence of higher ,contraceptive prevalence in districts of Bangladesh ,that border Bengali-speaking districts of India. Moreover, analysis of past fertility decline

Sajeda Amin; Alaka Malwade Basu; Rob Stephenson



High prevalence and resistance rates to antibiotics in anaerobic bacteria in specimens from patients with chronic balanitis.  


Aim of the study was to assess both prevalence and antibiotic resistance in anaerobic bacteria from glans penis skin of 70 adults. Strain susceptibility was determined by breakpoint susceptibility test or E test. In 9 asymptomatic, 48 untreated and 13 treated symptomatic patients, anaerobes were found in 22.2%, 70.8% and 53.3%, respectively. Gram-positive strains (GPAs) were 2.2-fold more common than Gram-negative ones. Prevalent Gram-negative (GNAs) and GPAs were Prevotella spp. and anaerobic cocci, respectively. Clostridium difficile strain was found in an untreated patient. In GNAs, resistance rates to amoxicillin, metronidazole, clindamycin, tetracycline, levofloxacin, and amoxicillin/clavulanate were 42.1, 0, 52.6, 53.3, 86.7 and 5.2%, respectively. In GPAs, the resistance rates to metronidazole, clindamycin, tetracycline, levofloxacin and amoxicillin/clavulanate were 18.2, 34.1, 52.6, 36.8 and 0%, respectively. In conclusion, anaerobes were 1.6-fold more frequent in untreated symptomatic patients compared with other patients, suggesting their participation in development of chronic balanitis. GPAs were more common than GNAs. The resistance rates to amoxicillin, clindamycin, tetracycline, and levofloxacin were high. Most active agents were metronidazole and amoxicillin/clavulanate. Resistance in anaerobes varies according to sites of specimens and years of study. PMID:22710106

Boyanova, Lyudmila; Mitev, Angel; Gergova, Galina; Mateev, Grisha; Mitov, Ivan



Contraceptive Options and Their Associated Estrogenic Environmental Loads: Relationships and Trade-Offs  

PubMed Central

This work explores the relationships between a user's choice of a given contraceptive option and the load of steroidal estrogens that can be associated with that choice. Family planning data for the USA served as a basis for the analysis. The results showed that collectively the use of contraception in the USA conservatively averts the release of approximately 4.8 tonnes of estradiol equivalents to the environment. 35% of the estrogenic load released over the course of all experienced pregnancies events and 34% the estrogenic load represented by all resultant legacies are a result of contraception failure and the non-use of contraception. A scenario analysis conducted to explore the impacts of discontinuing the use of ethinylestradiol-based oral contraceptives revealed that this would not only result in a 1.7-fold increase in the estrogenic loading of the users, but the users would also be expected to experience undesired family planning outcomes at a rate that is 3.3 times higher. Additional scenario analyses in which ethinylestradiol-based oral contraceptive users were modeled as having switched entirely to the use of male condoms, diaphragms or copper IUDs suggested that whether a higher or lower estrogenic load can be associated with the switching population depends on the typical failure rates of the options adopted following discontinuation. And, finally, it was estimated that, in the USA, at most 13% of the annual estrogenic load can be averted by fully meeting the contraceptive needs of the population. Therefore, while the issue of estrogen impacts on the environment cannot be addressed solely by meeting the population's contraceptive needs, a significant fraction of the estrogenic mass released to environment can be averted by improving the level with which their contraceptive needs are met. PMID:24670973

Khan, Usman; Nicell, Jim A.



Combined role of reduced estimated glomerular filtration rate and microalbuminuria on the prevalence of peripheral arterial disease.  


Chronic kidney disease (CKD), defined by either microalbuminuria (MA) or a reduced estimated glomerular filtration rate (eGFR), is associated with an increased risk of peripheral arterial disease (PAD). The presence of both abnormalities might identify a subgroup of adults at particularly high risk of PAD. Accordingly, we sought to evaluate the combined effect of a reduced eGFR and MA on the prevalence of PAD among United States adults. United States adults >or=40 years old (n = 6,951) participating in the 1999 to 2004 National Health and Nutrition Examination Survey were cross-classified into 4 groups according to the presence or absence of MA (urinary albumin/creatinine ratio >or=30 mg/g) and reduced eGFR (<60 mL/min/1.73 m(2)). PAD was defined as an ankle-brachial index of <0.9. The prevalence of PAD among adults without MA or a reduced eGFR was 3.6% compared to 9.7%, 14.8%, and 25.4% among adults with MA alone, reduced eGFR alone, and both reduced eGFR and MA, respectively. After multivariate adjustment, the odds ratio for prevalent PAD associated with MA alone, reduced eGFR alone, and both reduced eGFR and MA compared to those without MA or reduced eGFR was 1.72 (95% confidence interval 1.16 to 2.55), 1.58 (95% confidence interval 1.09 to 2.29), and 2.26 (95% confidence interval 1.30 to 3.94), respectively. In conclusion, the coexistence of MA and reduced eGFR was associated with a high prevalence of PAD and might be useful in identifying patients with vascular disease. PMID:19892066

Baber, Usman; Mann, Devin; Shimbo, Daichi; Woodward, Mark; Olin, Jeffrey W; Muntner, Paul



Behavioral Methods of Contraception  

Microsoft Academic Search

Total sexual abstinence is the most effective method of birth control, but incomplete commitment can result in high rates\\u000a of unintended pregnancies. Periodic abstinence and fertility awareness methods rely on menstrual calendars, CycleBeads, BBT,\\u000a the Billings method, or the symptothermal method to detect at-risk fertile days. Coitus interruptus has failure rates similar to the female barrier methods. LAM is very

Jennefer A. Russo; Anita L. Nelson


FPIA helps expand contraceptive services.  


Since the beginning in 1971 of the Planned Parenthood Federation of America's international program, Family Planning International Assistance (FPIA), US$54 million has been contributed in direct financial support for the operation of over 300 family planning programs in 51 countries; over 3000 institutions in 115 countries have been supplied with family planning commodities, including over 600 million condoms, 120 cycles of oral contraceptives, and 4 million IUD; and about 1 million contraceptive clients were served by FPIA funded projects in 1982 aone. Since 1971, however, the world's population has increased from 3.7 billion to around 4.7 billion people. About 85 million people are added to the world each year. There is consensus that without organized family planning programs, today's world population would be even higher. FPIA measures its progress in terms of expanding the availability of contraceptive services in devloping countries. FPIA supported projects have helped make services available in areas previously lacking them, and has helped involve a wide variety of organizations, such as women's groups, youth organizations, and Red Cross Societies, in family planning services. A prime concern of FPIA, which has limited resources, is what happens to projects once FPIA support is terminated. FPIA has been paying attention to local income generation to help projects become more self-supporting and to increas staff members' management skills. The more successful income-generating schemes appear to be directly related to family planning, selling contraceptives and locally produced educational materials, and charging fees for family planning and related medical services and tuition for training courses. FPIA funded to projects use management by objectives (MBO) to help improve management skills. MBO helps grantees improve their ability to set objectives, plan, monitor, report, and do day-to-day project management. PMID:12266275

Groot, H



Modern oral contraceptives and dysmenorrhoea.  


Women with primary dysmenorrhoea not sufficiently helped by triphasic oral contraceptives (OCs) were offered a modern, low-dose monophasic OC containing 30 micrograms of ethinylestradiol and 150 micrograms of desogestrel. The study shows that for these women, the monophasic pill was the better alternative. The fact that 19 of 23 women who continue treatment on the monophasic OC indicates that this type of pill may be chosen as the first alternative for women with primary dysmenorrhoea. PMID:2149696

Nabrink, M; Birgersson, L; Colling-Saltin, A S; Solum, T



Contraception and sexually transmitted infections  

Microsoft Academic Search

This contribution considers links between different methods of contraception and the risk of acquiring sexually transmitted infections (STIs). This is a major public health issue, because STIs cause a huge disease burden that affects women disproportionately. Worldwide each year, there are 340 million new cases of curable STIs in 15–49-year-olds. In developing countries, STIs, even excluding HIV, are second only

Judith Stephenson



Update on hormonal contraception and bone density  

Microsoft Academic Search

Combination hormonal contraception and progestin-only contraception (including depot medroxyprogesterone acetate [DMPA]) are\\u000a effective and convenient forms of reversible contraception that millions of women use worldwide. In recent years, observations\\u000a of reduced bone mineral density in current users of these methods have led to concerns that this hormone-induced bone loss\\u000a might translate into long-term increased fracture risk. Special focus has been

Michelle M. Isley; Andrew M. Kaunitz



Sex Education, Contraceptive and Reproductive Knowledge, and Contraceptive Use among Black Adolescent Females  

Microsoft Academic Search

This study examined sources of sex education for Black adolescent females and assessed relationships among sex education, knowledge about contraception and reproduction, and contraceptive use. The majority of adolescents reported having discussions with parents and having formal instruction regarding pregnancy, the menstrual cycle, and contraception. Neither parental discussion nor formal instruction on pregnancy and the menstrual cycle was related to

Diane Scott-Jones; Sherry L. Turner



Communication about Contraception and Knowledge of Oral Contraceptives amongst Norwegian High School Students.  

ERIC Educational Resources Information Center

Examines communication about contraception and specific knowledge of oral contraceptives (OCs) in a sample of Norwegian high school students. More females than males discussed contraception at least monthly. Discussions were predominantly held with peers and not adults. Females were far more knowledgeable about OCs than males. The most significant…

Hansen, Thomas; Skjeldestad, Finn Egil



Birth prevalence of cleft lip and palate in British Columbia between 1952 and 1986: stability of rates.  

PubMed Central

We examined the birth prevalence of cleft lip with or without cleft palate and of isolated cleft palate in British Columbia between 1952 and 1986 using the data of the BC Health Surveillance Registry. The rates fluctuated over the study period, but linear trend analysis showed no increase or decrease for cleft lip with or without cleft palate; however, there was a significant increase for isolated cleft palate, attributed to improved ascertainment around 1963-66. Given the possible effects of newer agents used in both silviculture and agriculture, as well as the general concern over drugs and other environmental agents, such a long-term monitoring program is important. Furthermore, if significant clustering occurs, good background data are essential for comparison. The general public's perception is that the rates of birth defects are increasing. Our findings should give some reassurance with respect to orofacial clefts. PMID:2713802

Lowry, R B; Thunem, N Y; Uh, S H



The acceptability of combined oral hormonal contraceptives in Shanghai, People’s Republic of China  

Microsoft Academic Search

Although combined oral hormonal contraceptives have been described as the most significant medical advance of the 20th century, the usage rate in the People’s Republic of China is considerably lower than in developed countries. This survey aimed to explore the acceptability of combined oral hormonal contraceptives (COC) amongst women aged 18–35 years who attended the family planning clinic in the

Junling Chen; Karen B Smith; Susan Morrow; Anna Glasier; Linan Cheng



Contraceptive behavior among sexually active Hispanic adolescents.  


The purpose of this study was to examine those factors associated with the contraceptive behavior of a national representative sample of Hispanic female adolescents. The subjects included all (n = 85) unmarried, sexually active Hispanic women, aged 15 to 19, from the 1982 National Survey of Family Growth. Contraceptive behavior was measured on a normalized scale, ranging from oral contraceptives to no contraception. Mexican/American and Central/South American background females were more likely (p less than 0.031) to use effective birth control than Puerto Rican, Cuban, and other Hispanic background subjects. Twenty additional social, behavioral, and demographic variables were found to be significantly associated (p less than 0.05) with contraceptive behavior. Based on multiple regression analysis, seven of these variables were found to explain 62% (p less than 0.0001) of the variation in the contraceptive behavior of this sample. Poorer contraceptive behavior was associated with noncompliance with the initial birth control method used (33.8%), lower coital frequency (8.3%), older postmenarchial age (5.7%), failure to use birth control at first coitus (4.6%), fewer years dating (4.0%), lower frequency of church attendance (3.3%), and never having experienced a pregnancy scare (2.0%). These findings suggest that the contraceptive behavior of Hispanic female adolescents is a dynamic process that can be understood in the context of previous sexual and contraceptive behavior. PMID:2262395

Durant, R H; Seymore, C; Pendergrast, R; Beckman, R



[Contraception and bone health in adolescence].  


Adolescents' access to contraception has improved and indication for their use have been extended beyond pregnancy prevention. For adolescents, this implies the use of hormonal contraception before the accrual of peak bone mass. Sexual hormones, notably estrogens, play a major role in skeletal development, growth and acquisition of maximal bone mass density (BMD). This article will review different contraceptive methods and their impact on BMD, with particular attention to low-dose pills and medroxyprogesterone acetate, both of which seem to alter peak bone mass acquisition. Nevertheless, benefits from appropriate contraception should be weighed against safety concerns, and recommended on an individual basis. PMID:23167074

Julen, Olivier; Larigaldie, Sophie; Yaron, Michal



The contraceptive vaginal ring compared with the combined oral contraceptive pill: a comprehensive review of randomized controlled trials  

Microsoft Academic Search

BackgroundThe purpose of this review was to compare pharmacology, contraceptive efficacy, cycle control, side effects and acceptability with the combined contraceptive vaginal ring (CCVR) and combined oral contraceptives (COCs).

Frans J. M. E. Roumen



Trends in the Prevalence Rates and Numbers of Blind and Visually Impaired Schoolchildren.  

ERIC Educational Resources Information Center

This paper draws on primary and secondary data sources to document an increasing number of visually handicapped children. The paper discusses socioeconomic trends, increased rates of handicapping conditions in general, increased number of legally blind schoolchildren, and evidence of an increase in retinopathy of prematurity. (JDD)

Kirchner, C.



The newly-weds' decisions on contraception.  


In China, the interval between first marriage and first childbearing has declined. This study examined the relationship between sociopsychological and demographic factors and contraceptive usage among newly married couples in Shanghai districts of Luwan and Hongku between August 15, 1987, and August 14, 1988. A random sample of 7872 newlyweds who intended to postpone childbearing were interviewed; 12.5% of the 15,938 registered marriages desired postponement of childbearing. Premarital courtship spanned an average of 35.1 months with a standard deviation of 23.2 months. 73% of couples did not desire two children. 13.8% desired two children. 77% of couples were dependent on parents after 3 months of marriage. 11% had sexual relations before registration and 20% before the wedding. 87% used contraception before marriage registration and 89% before the wedding. 6% failed to use any contraception. Those using contraception has sexual relations less frequently than those not using contraception. 70% did not use contraception after the wedding because of unavailability of pills, fear of side effects from pills, and lack of knowledge about nonpill contraception. In a univariate analysis, 17 independent variables were selected for the logistic models: education level of the couple and husband's parents, wife's age at marriage, monthly income of couple, premarital romance period, wife's and husband's occupation, husband's family position as the only son, work shifts, residence with their parents, desire for 2 children, channel for information about contraception, wife's contraceptive knowledge and communication, and expected pregnancy date. The results indicated that wives with high educational levels use contraception more frequently. A 1% increase in education yields a 28.1% increase in likelihood of contraceptive use. Official channels of information are more likely to result in contraceptive use. Wives who exchange contraceptive knowledge with many others are better contraceptors. Greater likelihood of use was also related to employment in state-owned enterprises. In models excluding couple's desire for children and wife's contraceptive knowledge, 10 variables were found to have a stabilizing effect as evidenced in assessment at 3 different points after marriage registration. These were wife's age at marriage, educational level of the couple, wife's occupation, premarital romance period, work shifts, desire for 2 children, channel of communication, wife's interaction with others about contraception, residence with parents, and husband's work unit. PMID:12317923

Guo, Y; Lin, D; Shi, Y; Lou, C; Fang, K; Li, H; Gao, E; Zhang, D



Awareness and practices of contraception among Pakistani women attending a tertiary care hospital.  


Pakistan is one of the most populous nations in the world, with an annual growth rate of 2.8 and high total fertility rate, even among developing nations. The Pakistan Reproductive Health and Family Planning Survey highlighted the wide gap between knowledge (97%) and use of contraceptives (28%) among currently married women. Our actual need is to enhance contraceptive practice in our country. This study was designed to investigate contraceptive knowledge and practice in Pakistani women attending a tertiary care hospital. This questionnaire-based study was conducted at the Gynaecology Unit II of Sir Ganga Ram Hospital, Fatima Jinnah Medical College, Lahore, Pakistan. A total of 204 married women of reproductive age were interviewed by a registrar to record their age, occupation, educational status, number of children, knowledge about contraceptive methods, source of the knowledge, attitudes and practices of contraception. About 57% of women were between 26 and 35 years of age, while 52% of men were between 31 and 40 years. Educational status of the majority of females was below matriculation (33%), while 34% males were above matriculation; 88% of females were housewives and less than 1% of men were out of work. Regarding the social status of couples, 64% were living on income less than 5000 rupees /month (about 60 pound sterling). Of the women, 67% were para 2-5; 68% had some sort of awareness regarding contraception. The main source of information was television (26%) and relatives (24%). The majority knew about the pill (68%) and IUCD (55%). Only 47% were using some sort of contraception. The most common method chosen was the barrier method (15%), followed by IUCD (10%) and the pill (10%). The least common methods were sterilisation (2%) and the rhythm method (2%); 85% of the women and 74% of the men in the study group had a positive attitude toward contraception. In order to improve contraceptive use in Pakistan we need to use multiple media sources to educate couples and their parents regarding contraceptive services, strengthen the perceptions that religion not only allows but also recommends family planning and to create awareness among women to have their rights and opinions about the size of family. The concept of differentiation between sons and daughters should be discouraged. In addition government and non-governmental organisations (NGOs) should organise groups to provide counselling and promotion of contraceptive services at the doorstep. We must act as a team to control our growth rate for economic stabilisation of the country and to raise the living standards of our people. PMID:15369942

Khawaja, N P; Tayyeb, R; Malik, N



Research gaps in defining the biological link between HIV risk and hormonal contraception.  


Epidemiologic data suggest an association between depot medroxyprogesterone acetate (DMPA), a progesterone-based hormonal contraceptive, and increased risk of HIV acquisition and transmission. DMPA is highly effective and is among the most commonly used form of hormonal contraception in areas of high HIV prevalence. Thus, defining the biological mechanisms that contribute to the potential negative synergy between DMPA and HIV is key and may facilitate the identification of alternative contraceptive strategies. Proposed mechanisms include thinning or disruption of the cervicovaginal epithelial barrier, induction of mucosal inflammation, interference with innate and adaptive soluble and cellular immune responses, and/or alterations in the vaginal microbiome. DMPA may also indirectly increase the risk of HIV by promoting genital herpes or other sexually transmitted infections. However, there is a paucity of rigorous in vitro, animal model and clinical data to support these potential mechanisms highlighting the need for future research. PMID:24548147

Murphy, Kerry; Irvin, Susan C; Herold, Betsy C



Oral contraception in Bangladesh: social marketing and the importance of husbands.  


This is a report on a study that examined the characteristics of three types of commercial providers of oral contraceptives, as well as users and users' husbands. The study also examined how and from whom users and/or their husbands obtain oral contraceptives and instructions for use. The socioeconomic level of providers and user-couples was, on average, higher than for the general population. Husbands were particularly important for obtaining supplies from the commercial sector and acting as instructors. The findings suggest that: a special effort will be required if social marketing techniques are to increase oral contraceptive prevalence among the rural poor in Bangladesh, and family planning researchers and managers should give more attention to husbands in countries where men dominate communication networks. PMID:3617122

Davies, J; Mitra, S N; Schellstede, W P



Causes and consequences of oral contraceptive noncompliance  

Microsoft Academic Search

Compliance difficulties are more common among oral contraceptive users than is generally appreciated. Inconsistent use and method discontinuation are estimated to account for approximately 20% of the annual 3.5 million annual unintended pregnancies in the United States. In the past research focused on adolescents, for whom predictors of poor oral contraceptive compliance include multiple sex partners, low evaluation of personal

Michael Rosenberg; Michael S. Waugh



Oral contraceptives and the risk of cancer  

Microsoft Academic Search

This study explores the risk of cancer associated with the use of oral contraceptives. It is based on the results of follow up of the Royal College of General Practitioners' (GPs') oral contraceptive study. The outcome of interest in this prospective cohort study was the incidence of some selected cancers. The study was started in mid-1968 and recruited about 46

Selvaraj S; Angus V; Iversen L



Model for Effective Contraceptive Counseling on Campus.  

ERIC Educational Resources Information Center

A study compared the effective v ineffective use of contraceptives at a major university by comparing college women who had experienced birth control failure with those who had not. Factors related to a woman's use of a contraceptive device include: satisfaction with its aesthetic properties; trust in its effectiveness; a feeling of comfort…

Bachmann, Gloria A.



Efficacy and Safety of Long-Acting Reversible Contraception  

PubMed Central

Long-acting reversible contraception (LARC) includes intrauterine devices (IUDs) and the subdermal implant. These methods are the most effective reversible methods of contraception, and have the additional advantages of being long-lasting, convenient, well liked by users and cost effective. Compared with other user-dependent methods that increase the risk of noncompliance-related method failure, LARC methods can bring ‘typical use’ failure rates more in line with ‘perfect use’ failure rates. LARC methods are ‘forgettable’; they are not dependent on compliance with a pill-taking regimen, remembering to change a patch or ring, or coming back to the clinician for an injection. LARC method failure rates rival that of tubal sterilization at <1% for IUDs and the subdermal implant. For these reasons, we believe that IUDs and implants should be offered as first-line contraception for most women. This article provides a review of the LARC methods that are currently available in the US, including their effectiveness, advantages, disadvantages and contraindications. Additionally, we dispel myths and misconceptions regarding IUDs, and address the barriers to LARC use. PMID:21668037

Stoddard, Amy; McNicholas, Colleen; Peipert, Jeffrey F.



Family planning and the controversial contraceptives.  


India was one of the first countries in the world to launch a national family planning program in an apparent effort to help women gain access to birth control measures and reduce population growth. Family planning acquired a different meaning and emphasis in the 1960s, however, when a clause in the US PL480 wheat import policy demanded that India speed its implementation of birth control measures if the country wanted food aid. Women in India were therefore expected to consume contraceptives with dangerous and unknown side effects in order to quality the country for food aid. Women rejected this stipulation. By the 1980s, it was acknowledged that family planning programs in India had failed to produce a decline in the birth rate and that no sign of change was on the horizon despite the investment of substantial funds to that end, the input of expert assistance, and the establishment of appropriate infrastructure in the country. Experts and policy makers blamed women for having misused the pill and sought alternative methods which would not require user compliance. Norplant and norethisterone enanthate (Net-en) were subsequently developed. Policymakers, experts, and the press have now been clamoring for the right to conduct Norplant trials despite reported side effects. The drug's ability to prevent pregnancy is more important for family planning experts. The author notes that the emphasis has been upon contraceptive methods for women instead of men because men were not expected to take responsibility for family planning. She also notes that feminists are opposed to Norplant and Net-en, and hopes that the government withdraws them from the market. PMID:12289896

Dias Saxena, F



HIV prevalence rates among men who have sex with men in the southern United States: population-based estimates by race/ethnicity.  


States across the U.S. lack effective ways to quantify HIV prevalence rates among men who have sex with men (MSM). We estimated population-based HIV prevalence rates among MSM in the 17 southern states by race/ethnicity. Through 2007, estimated HIV prevalence rates per 100,000 MSM ranged from 2,607.6 among white (non-Hispanic) MSM in Maryland to 41,512.9 among black (non-Hispanic) MSM in the District of Columbia. Black MSM rates significantly exceeded Hispanic and white MSM rates in each state. Significant racial/ethnic disparities in rates persisted in a sensitivity analysis examining the possibility that minority MSM populations had been underestimated in each state. Compared with black, Hispanic, and white non-MSM males, respectively, rates at the regional level were 25.2 times higher for black MSM, 43.0 times higher for Hispanic MSM, and 106.0 times higher for white MSM. State-level analysis of racial/ethnic-specific MSM HIV prevalence rates can help guide resource allocation and assist advocacy. PMID:20872062

Lieb, Spencer; Prejean, Joseph; Thompson, Daniel R; Fallon, Stephen J; Cooper, Hannah; Gates, Gary J; Liberti, Thomas M; Friedman, Samuel R; Malow, Robert M



Is anti-abortion movement undermining contraception?  


Opposition to abortion is often tied to opposition to contraception. This is because opinions on abortion do not occur in isolation, they are part of a world view that is against sex for pleasure, and therefore against contraception. Many anti-abortion groups are under the false impression that contraception increases the number of abortions. There is no scientific evidence for this claim. It is also common sense that contraception prevents abortion because it prevents so many unwanted pregnancies. If a woman uses contraceptives, she must not want to be pregnant. Therefore, every cycle she has without becoming pregnant is the prevention of an unwanted pregnancy. In the 1960s the early studies of the pill had 6000 cycles without a single pregnancy. The anti-abortion lobby has had an influence on the politics of the US concerning abortion and it is also having an effect on the politics of contraception. Many anti-abortion groups are against premarital sex and advocate abstinence as the preferable method but there is no evidence that abstinence is an effective method of preventing unwanted pregnancies, especially in teens. Contraceptive research is being hindered by political pressure from anti-abortion groups. Postovulatory contraceptive research is prohibited in many facilities. The National Academy of Science's Institute of Medicine in Washington, DC published an extensive report detailing the problems of getting new contraceptives researched and developed in the US. The report notes that federal funding for contraceptive development rose only $6 million between 1973-87, from $7.4 to $13.2 million. While there are a wide variety of problems, pressure from anti-abortion groups is considered to have had an adverse affect. Many groups advocate drug company boycotts. PMID:12317308



Safety, efficacy and patient acceptability of the contraceptive and non-contraceptive uses of the LNG-IUS  

PubMed Central

Intrauterine devices (IUDs) provide highly effective, long-term, safe, reversible contraception, and are the most widely used reversible contraceptive method worldwide. The levonorgestrel-releasing intrauterine system (LNG-IUS) is a T-shaped IUD with a steroid reservoir containing 52 mg of levonorgestrel that is released at an initial rate of 20 ?g daily. It is highly effective, with a typical-use first year pregnancy rate of 0.1% – similar to surgical tubal occlusion. It is approved for 5 years of contraceptive use, and there is evidence that it can be effective for up to 7 years of continuous use. After removal, there is rapid return to fertility, with 1-year life-table pregnancy rates of 89 per 100 for women less than 30 years of age. Most users experience a dramatic reduction in menstrual bleeding, and about 15% to 20% of women become amenorrheic 1 year after insertion. The device’s strong local effects on the endometrium benefit women with various benign gynecological conditions such as menorrhagia, dysmenorrhea, leiomyomata, adenomyosis, and endometriosis. There is also evidence to support its role in endometrial protection during postmenopausal estrogen replacement therapy, and in the treatment of endometrial hyperplasia. PMID:21072274

Bednarek, Paula H; Jensen, Jeffrey T



Australian scientists develop male contraceptive.  


The Australian Information Service in Canberra reports that Australian scientists have formulated a contraceptive pill to temporarily stop spermatogenesis in man, thus producing infertility. The research was done by a team consisting of Dr. Henry Burger, director of the Medical Reserach Center at Prince Henry's Hospital in Melbourne, Dr. Bryan Hudson, Principal Research Fellow at the Howard Florey Institute of Experimental Medicine at the Univeristy of Melbourne, and Dr. David de Kretser, senior lecturer in Monash University's Department of Medicine at Prince Henry's Hospital. The contraceptive pill consists of progestagen (d-norgestrel) with androgen (methyltestosterone), a combination that suppresses the production of the sperm but conserves libido and potency. The testing program has yet to be undertaken in human volunteers. There will be three phases to the drug trial: pretreatment, during which the health of the volunteers and the safety of the drug will be established; the treatment phase, lasting six months, during which the volunteers will be given daily oral dose of the drugs; and the recovery phase, lasting at least three months, during which the restoration of normal spermatogenesis will be observed. PMID:12333267



Oral contraceptive discontinuation: A prospective evaluation of frequency and reasons  

Microsoft Academic Search

OBJECTIVES: Our purpose was to define the frequency and reasons for oral contraceptive discontinuation and subsequent contraceptive behavior.STUDY DESIGN: A nationwide prospective study of 1657 women initiating or switching to the use of a new contraceptive from private practices, clinics, and a health maintenance organization was performed.RESULTS: Six months after a new oral contraceptive prescription, 68% of new starts and

Michael J. Rosenberg; Michael S. Waugh



The Contraceptive Needs for STD Protection among Women in Jail  

ERIC Educational Resources Information Center

We assessed the contraceptive needs of women in jails and their sexually transmitted disease (STD) history and risk to determine effective contraceptive methods for this population. A survey of demographics, sexual health, contraceptive use, and preferred method of contraception was completed by participants recruited at jails in a medium-sized…

Oswalt, Krista; Hale, Galen J.; Cropsey, Karen L.; Villalobos, Gabriella C.; Ivey, Sara E.; Matthews, Catherine A.



Women's autonomy, education and employment in Oman and their influence on contraceptive use.  


Since 1970 political and economic changes have brought about great improvements in health and education in Oman, and since 1994 the government has provided free contraceptives to all married couples in primary health care centres. Despite rapid socio-economic development, the fertility rate was 4.2 in 2001. The aim of this study was to define baseline data on ever-married women's empowerment in Oman from a national study in 2000, analyse the correlates of women's empowerment and the effect of empowerment on unmet need for contraception. Two indicators of empowerment were used: women's involvement in decision-making and freedom of movement. Bivariate analysis was used to link these measures and their proxies, education and employment status, with use of a family planning method. Education was a key indicator of women's status. Unmet contraceptive need for women exposed to pregnancy was nearly 25%, but decreased significantly with educational level and paid employment. While empowered women were more likely to use contraception, women's education was a better predictor of "met need" than autonomy, as traditional factors and community influence remain strong. For nearly half the 1,830 women in the study, the husband decided whether contraception was used. Fewer than 1% were using contraception before their first child as women are expected to have a child within the first year of marriage. PMID:15242223

Al Riyami, Asya; Afifi, Mustafa; Mabry, Ruth M



Oral contraception in the former Czech and Slovak Federal Republic: attitudes and use.  


This paper presents and discusses data on oral contraception from a national representative survey (n = 1072) on knowledge, attitudes and practice with regard to contraceptive use in the Czech and Slovak Federal Republic (CSFR). Only 7% of the women at risk of unplanned pregnancy used the pill. The low rate of use seems to be due to the general negative image of oral contraception, reinforced by the experiences of past users and opinions expressed by relative, friends, doctors, and the media. In particular, perceived psychological disadvantages have an important bearing on the decision not to use the method, whereas perceived advantages have hardly any impact. It is likely that this negative image is closely linked with the types of oral contraceptives that have been available in the country and also with the limited choice. Second- and third-generation oral contraceptives have only very recently become available. It is recommended that balanced information on the advantages and disadvantages of oral contraception be made available to doctors and to the general public on a large scale and through a variety of channels. PMID:8237567

Ketting, E; Visser, A P; Uzel, R; Lehert, P



The role of health literacy and numeracy in contraceptive decision-making for urban Chicago women.  


Low functional health literacy and numeracy have known associations with poor health outcomes, yet little work has investigated these markers of health disparity in a family planning population. We used an in-depth qualitative process and 2 literacy and numeracy assessment tools, the REALM-7 and the Schwartz numeracy scale, to assess the role of literacy and numeracy in contraceptive decision-making in an urban Chicago population. Brief surveys and semi-structured interviews were conducted with 30 postpartum women who had received Medicaid-funded care at an obstetrics clinic in an academic medical center. In-person one-on-one interviews were then reviewed for themes using an iterative process. Qualitative analysis techniques identifying emergent themes were applied to interview data. Literacy and numeracy were assessed using REALM-7 and a validated 3-question numeracy scale. In this cohort of African American (63 %) and Hispanic (37 %) women (median age 26), 73 % had unplanned pregnancies. Although health literacy rates on the REALM-7 were adequate, numeracy scores were low. Low literacy and numeracy scores were associated with interview reports of poor contraceptive knowledge and difficulty with contraceptive use. Low health literacy and numeracy may play an important role in contraception decision-making in this low-income, minority population of women. We recommend further study of literacy and numeracy in a family planning population. Comprehensive contraception education and communication around the contraceptive decision-making process should take place at literacy and numeracy levels appropriate to each individual. PMID:24105614

Yee, Lynn M; Simon, Melissa A



Socio-economic and demographic factors affecting contraceptive use in Egypt.  


High fertility levels prevail in Egypt. Such high fertility leading to rapid and ongoing population growth are not in the best interest of the country's social and economic development. The author notes that Egypt's still high rate of total fertility nonetheless dropped from 6.2 in 1960 to 3.9 in 1992. That decline in fertility is attributed to the rising level of contraceptive use fostered by national family planning program and private sector efforts. The level of ever-married women who never used modern contraceptives decreased from 61.1% in 1980 to 37.1% in 1992. The major determinants of contraceptive use are examined and the characteristics of ever-married women who never used a modern contraceptive method highlighted. These factors affecting contraceptive use include urbanization, region, age group, education status, work status, duration of marriage in years, total number of children alive and dead, number of boys dead, and number of girls dead. The Chi square and T-test were used in the bivariate analysis, while logistic regression is used in the multivariate analysis. Rural Upper Egypt was isolated for further analysis because 45.1% of ever married women who never used a contraceptive method are in the region. Policy implications are suggested. PMID:12291976

Mahgoub, Y M



Sexual victimization of youth with a physical disability: an examination of prevalence rates, and risk and protective factors.  


Children with disabilities have been shown to be at greater risk of victimization than those without. Although much of the research combines disability of any type into a single disability category, recent evidence suggests that not all types of disabilities are equally associated with victimization. To date, little knowledge exists about the victimization of youth with physical disabilities. This study used data from a national school-based survey of adolescents (n = 6,749, mean age = 15.41, SD = .66) in Switzerland to investigate sexual victimization (SV) among physically disabled youth. Two subtypes of SV were differentiated: contact SV, including penetration or touching/kissing, and non-contact SV, such as exhibitionism, verbal harassment, exposure to sexual acts, or cyber SV. A total of 360 (5.1%) youth self-identified as having a physical disability. Lifetime prevalence rates for contact SV were 25.95% for girls with a physical disability (odds ratio [OR] = 1.29 compared with able-bodied girls), 18.50% for boys with physical disability (OR = 2.78 compared with able-bodied boys), and 22.35% for the total sample with physical disability (OR = 1.74 compared with able-bodied youth). For non-contact SV, the lifetime prevalence was 48.11% for girls with a physical disability (OR = 1.44 compared with able-bodied girls), 31.76% for boys with physical disability (OR = 1.95 compared with able-bodied boys), and 40.28% for the total sample with physical disability (OR = 1.67 compared with able-bodied youth). After controlling for other risk factors, physical disability was a significant predictor of contact and non-contact SV for boys, but not for girls. PMID:24870960

Mueller-Johnson, Katrin; Eisner, Manuel P; Obsuth, Ingrid



Prevalence rates of respiratory symptoms in Italian general population samples exposed to different levels of air pollution  

SciTech Connect

The authors surveyed two general population samples aged 8 to 64 living in the unpolluted, rural area of the Po Delta (northern Italy) and in the urban area of Pisa (central Italy). Each subject filled out a standardized interviewer-administered questionnaire. The Pisa sample was divided into three groups according to their residence in the urban-suburban areas and to outdoor air pollution exposure (automobile exhaust only or industrial fumes as well). Significantly higher prevalence rates of all the respiratory symptoms and diseases were found in Pisa compared with the Po Delta. Current smoking was more frequent in the rural area, but the urban smokers had a higher lifetime cigarette consumption. Childhood respiratory trouble and recurrent respiratory illnesses were evenly distributed. Exposure to parental smoking in childhood and lower educational level were more frequent in Po Delta, whereas familial history of respiratory/allergic disorders and work and indoor exposures were more often reported in the city. Multiple logistic regression models estimating independently the role of the various risk factors showed significant odds ratios associated with residence in Pisa for all the symptoms but chronic phlegm. The conclusion, these preliminary analyses indicate an urban factor related to the rates of respiratory symptoms and diseases in Italy in the 1980s.

Viegi, G. (Univ. of Pisa (Italy) Univ. of Arizona, Tucson (United States)); Paoletti, P.; Carrozzi, L.; Vellutini, M.; Diviggiano, E.; Pistelli, G.; Giutini, G. (Univ. of Pisa (Italy)); Di Pede, C. (Univ. of Arizona, Tucson (United States) Occupational Medicine Service, Toscana (Italy)); Lebowitz, M.D. (Univ. of Arizona, Tucson (United States))



Progestin-only contraception: injectables and implants.  


Progestin-only contraceptive injectables and implants are highly effective, longer-acting contraceptive methods that can be used by most women in most circumstances. Globally, 6% of women using modern contraception use injectables and 1% use implants. Injectables are the predominant contraceptive method used in sub-Saharan Africa, and account for 43% of modern contraceptive methods used. A lower-dose, subcutaneous formulation of the most widely used injectable, depot-medroxyprogesterone acetate, has been developed. Implants have the highest effectiveness of any contraceptive method. Commodity cost, which historically limited implant availability in low-resource countries, was markedly lowered between 2012 and 2013. Changes in menstrual bleeding patterns are extremely common with both methods, and a main cause of discontinuation. Advice from normative bodies differs on progestin-only contraceptive use by breastfeeding women 0-6 weeks postpartum. Whether these methods are associated with HIV acquisition is a controversial issue, with important implications for sub-Saharan Africa, which has a disproportionate burden of both human immunodeficiency virus (HIV) and maternal mortality. PMID:24996766

Jacobstein, Roy; Polis, Chelsea B



Contraceptive failure in the United States  

PubMed Central

This review provides an update of previous estimates of first-year probabilities of contraceptive failure for all methods of contraception available in the United States. Estimates are provided of probabilities of failure during typical use (which includes both incorrect and inconsistent use) and during perfect use (correct and consistent use). The difference between these two probabilities reveals the consequences of imperfect use; it depends both on how unforgiving of imperfect use a method is and on how hard it is to use that method perfectly. These revisions reflect new research on contraceptive failure both during perfect use and during typical use. PMID:21477680

Trussell, James




PubMed Central

Steady progress in contraception research has been achieved over the past 50 years. Hormonal and non-hormonal modern contraceptives have improved women’s lives by reducing different health conditions that contributed to considerable morbidity. However the contraceptives available today are not suitable to all users and the need to expand contraceptive choices still exists. Novel products such as new implants, contraceptive vaginal rings, transdermal patches and newer combinations of oral contraceptives have recently been introduced in family planning programs and hormonal contraception is widely used for spacing and limiting births. Concerns over the adverse effects of hormonal contraceptives have led to research and development of new combinations with improved metabolic profile. Recent developments include use of natural compounds such as estradiol (E2) and estradiol valerate (E2V) with the hope to decrease thrombotic risk, in combination with newer progestins derived from the progesterone structure or from spirolactone, in order to avoid the androgenic effects. Progesterone antagonists and progesterone receptor modulators are highly effective in blocking ovulation and preventing follicular rupture and are undergoing investigations in the form of oral pills and in semi long-acting delivery systems. Future developments also include the combination of a contraceptive with an antiretroviral agent for dual contraception and protection against sexually transmitted diseases, to be used before intercourse or on demand, as well as for continuous use in dual-protection rings. Alhough clinical trials of male contraception have reflected promising results, limited involvement of industry in that area of research has decreased the likelihood of having a male method available in the current decade. Development of non-hormonal methods are still at an early stage of research, with the identification of specific targets within the reproductive system in ovaries and testes, as well as interactions between spermatozoa and ova. It is hoped that the introduction of new methods with additional health benefits would help women and couples with unmet needs to obtain access to a wider range of contraceptives with improved acceptability. PMID:22995540

Sitruk-Ware, Regine; Nath, Anita; Mishell, Daniel R.



Political and economic factors influencing contraceptive uptake.  


International, national and local level politics influence the uptake of contraception through consensuses, laws, financial and moral support or the creation of an enabling atmosphere. Opposition to contraception generally comes from some churches and groups opposed to particular technologies. Socio-economic factors, particularly education, the health care system and the perceived or actual cost of fertility regulation as compared to benefits expected from children also powerfully influence contraceptive use. For many poor women in developing countries their powerlessness in relation to their male partners is an important obstacle. PMID:8324609

Sai, F T



Contraception for women with heart disease.  


There is a lack of studies dealing specifically with contraceptive use in women with heart disease. This may generate doubts in professionals counseling on the patient's risk of pregnancy as a function of her cardiomyopathy. Moreover, uncertainties may arise with respect to the optimal contraceptive choice for each individual case. In view of the increasing number of women of reproductive age with cardiac disease, this review aims at providing practical guidance for clinicians, including cardiologists, obstetricians, general practitioners and family planning specialists, with regards to safe contraceptive choices and counseling on the risk of pregnancy in women with heart disease. PMID:25283185

Bonassi Machado, R; Santana, N; Gonzaga, M; Antonacio, F



Testing Mechanisms of the Dilution Effect: Deer Mice Encounter Rates, Sin Nombre Virus Prevalence and Species Diversity  

Microsoft Academic Search

Species diversity has been shown to decrease prevalence of disease in a variety of host–pathogen systems, in a phenomenon\\u000a termed the Dilution Effect. Several mechanisms have been proposed by which diversity may decrease prevalence, though few have\\u000a been tested in natural host-pathogen systems. We investigated the mechanisms by which diversity influenced the prevalence\\u000a of Sin Nombre virus (SNV), a directly

Christine A. Clay; Erin M. Lehmer; Stephen St. Jeor; M. Denise Dearing



MIS promotes contraception and reproductive health: Yandu, Jiangsu.  


Yandu county, Jiangsu Province has made much progress in improving its family planning services through an effective management information system (MIS). Birth rate has decreased from 23.65/1000 in 1990 to 8/1000 in 1999. The MIS software was developed by the State Family Planning Commission and was applied in 1995 when the quality of care program was launched. The application of microcomputers in the family planning program makes it possible to integrate management with service provision at the county, township and village levels. Subsequently, it creates an information transmission system centering on townships and strengthens basic data management on a regular basis. In addition, the MIS also delivers services, which include information dissemination on contraception, informed choice, regular follow-up visits, and prevention and treatment of complications and side effects of contraception. In the context of reproductive health, services include health care for the periods of puberty, premarital, marital, contraceptive and menopausal; genetic counseling, sex education and prenatal care; and gynecological check-ups, infertility treatment, and counseling on sexually transmitted disease prevention. PMID:12349373

Liu, G



Resistance to activated protein C as a basis for venous thromboembolism associated with pregnancy and oral contraceptives  

Microsoft Academic Search

OBJECTIVE: Inherited resistance to activated protein C, which is caused by a single factor V gene mutation, is a frequent risk factor for thrombosis. The purpose of this study was to determine the prevalence of activated protein C resistance in women with thromboembolic complications that had occured in connection with pregnancy or use of oral contraceptives.STUDY DESIGN: Activated protein C

Margareta Hellgren; Peter J. Svensson; Björn Dahlbäch



An all time low utilization of intrauterine contraceptive device as a birth spacing method- a qualitative descriptive study in district Rawalpindi, Pakistan  

PubMed Central

Background Pakistan was among the leading countries in south Asia which started the family planning program in late 50s, forecasting the need to control the population. Despite this early intervention, fertility rate has declined but slower in Pakistan as compared to most other Asian countries. Pakistan has almost a stagnant contraceptive prevalence rate for more than a decade now, perhaps owing to the inadequate performance of the family planning programs. The provision and use of long term contraceptives such as IUCD has always been low (around 2%) and associated with numerous issues. Married women who want to wait before having another child, or end childbearing altogether, are not using any long term method of contraception. Methodology A descriptive qualitative study was conducted from May to July 2012, to explore and understand the perceptions of women regarding the use of IUCDs and to understand the challenges/issues at the service provider’s end. Six FGDs with community women and 12 in-depth interviews were conducted with family planning providers. The data was analyzed using the Qualitative Content Analysis approach. Results The study revealed that the family planning clients are reluctant to use IUCDs because of a number of myths and misconceptions associated with the method. They have reservations about the provider’s capability and quality of care at the facility. Private health providers are not motivated and are reluctant to provide the IUCDs because of inadequate counseling skills, lack of competence and improper supporting infrastructure. Government programs either do not have enough supplies or trained staff to promote the IUCD utilization. Conclusion Besides a well-designed community awareness campaign, providers’ communication and counseling skills have to be enhanced, as these are major contributing factors in IUCD acceptance. Ongoing training of all family planning service providers in IUCD insertion is very important, along with strengthening of their services. PMID:23394188



The position of Islamic tradition on contraception.  


The first source of Islamic law, the Koran, does not mention contraception. On the contrary, most of the 'sayings' (hadith) of the Prophet Mohammed (the second source of Islamic law) on the subject, tolerate coitus interruptus (azl). The position commonly and historically shared by Islamic jurists coincides with Al-Ghazali's interpretation according to which, under many circumstances, coitus interruptus is a blameworthy but tolerated (makruh) act. However, there has always been a minority of jurists opposed to contraception. Analogical reasoning (qiyas, the fourth source of Islamic law) makes it possible to legitimize most modern contraceptive techniques. Nowadays, because of the risks of overpopulation, the majority of Islamic governments have passed family planning laws; however among the masses the wrong belief that Islamic law prohibits contraception is spreading. PMID:7731352

Atighetchi, D



Truth about Oral Contraceptives and Acne  


... gynecologist for regular examinations. Clearing Takes Time The truth is clearing takes time. Patients can expect to ... acne — excess sebum. Now that you know the truth about oral contraceptives and acne, you may wonder ...


Documentation of Contraception and Pregnancy When Prescribing Potentially Teratogenic Medications for Reproductive-Age Women  

PubMed Central

Background Certain medications are identified by the U.S. Food and Drug Administration (FDA) as class D or X because they increase the risk for birth defects if used during pregnancy. Objective To assess pregnancy rates and the frequency of contraceptive counseling documented with prescriptions for class D or X drugs filled by women of reproductive age. Design Description of prescriptions filled in 2001. Setting A large health maintenance organization in northern California in 2001. Patients 488 175 women age 15 to 44 years who filled a total of 1 011 658 class A, B, D, or X prescriptions. Measurements Medications dispensed, contraceptive counseling, and pregnancy testing. Results A class D or X prescription was filled by 1 of every 6 women studied. Women who filled a prescription for class D or X medications were no more likely than women who filled prescriptions for safer, class A or B medications to have received contraceptive counseling, filled a contraceptive prescription, or been sterilized (48% vs. 51% of prescriptions). There was little variation by clinical indication in rates of contraceptive counseling with class D or X prescriptions, except for isotretinoin. Women who filled a class D or X prescription were only slightly less likely to have a pregnancy documented within 3 months than women filling a class A or B prescription (1.0% vs. 1.4% of prescriptions). Limitations International Classification of Diseases, Ninth Revision, codes underestimate contraceptive counseling. Documentation of a positive pregnancy test after filling a prescription may overestimate medication use in early pregnancy. Women who filled several prescriptions are overrepresented in prescription analyses. Conclusion Prescriptions for potentially teratogenic medications are frequently filled by women of childbearing age without documentation of contraceptive counseling. PMID:17876020

Schwarz, Eleanor Bimla; Postlethwaite, Debbie A.; Hung, Yun-Yi; Armstrong, Mary Anne



Epilepsy in a population of 6000 re-examined: secular trends in first attendance rates, prevalence, and prognosis  

Microsoft Academic Search

It is important to document changes in the vital statistics of epilepsy in the general population so that the success or failure of prevention and treatment can be assessed and health provisions planned. A population of 6000 persons was studied 10 years apart to determine secular trends in the prevalence and prognosis of epilepsy. The lifetime prevalence of all patients

O C Cockerell; I Eckle; D M Goodridge; J W Sander; S D Shorvon



Nurse-led management of contraceptive services.  


This article discusses the role of the practice nurse (PN) in the provision of health assessment for contraceptive choices. PNs who have an extended role as an independent nurse prescriber must demonstrate the principles of safe prescribing practice, with appropriate and informed assessment of the patient's needs and risk within the limited time of a general practice appointment. With continued professional development, PNs are well placed to provide comprehensive, independent nurse-led contraceptive services. PMID:25159787

Wilson, Emma



The quest for a herbal contraceptive.  


An oral herbal contraceptive would allow couples control their fertility without consulting a health worker, which in turn would likely markedly increase the number of couples practicing family planning. Other advantages of such a contraceptive would include the familiarity rural people have with herbal medicines, the fewer side effects associated with herbal preparations, their ready availability from local sources, and protection of privacy. There are many references to plants in India with antifertility properties. Since 1966, the Indian Council of Medical Research (ICMR) has been conducting research to identify a herbal contraceptive, as have other organizations. Plants that have exhibited antifertility activity in clinical trials include Hibiscus rosasinensis (benzene extract of the flower petals suppresses implantation); Rudrapushpaka (extract of the flower petals prevents pregnancy); Embelia ribes (pregnancy prevention); Davcus carota, Butea monosperma, and Sapindus trifoliatis (seeds have an anti-implantation effect); and Mentha arvensis (leaves have anti-implantation effect). The Central Drug Research Institute in Lucknow, India, in collaboration with the US National Institutes of Health, the World Health Organization, and the ICMR confirm anti-implantation activity in Ferula jaeschkeana, Bupleurum marginatum, Lepidium capitatum, Caesalpinia sepiaria, Lonicera japonica, Juniperus communis, Lotus corniculatus, Lamium allum, and Acacia farnesiana. In China, scientists have evaluated the cotton-seed extract gossypol as a male contraceptive. They are now studying the possible antifertility effect on men of the plant Tripterygium wilfordii. From all the aforementioned plants as well as others under investigation, three possible types of contraceptives could be developed: an anti-ovulatory contraceptive; a postcoital contraceptive; and a male contraceptive. Some obstacles to their development include difficulties in obtaining adequate quantities of the herbs, a shortage of clinical pharmacologists and clinicians interested in conducting clinical trials, and lack of long-term financial support. PMID:8241931

Chaudhury, R R



Flow Rate and Composition of Whole Saliva in Children from Rural and Urban Thailand with Different Caries Prevalence and Dietary Intake  

Microsoft Academic Search

The aim of this study was to compare the prevalence of dental caries, dietary composition and whole salivary flow rates together with some of the components of saliva between two groups of children aged 12-16 years, one group from an urban area and the other from a rural area of Thailand. A stratified random samples were taken by class from

U. Kedjarune; P. Migasen; S. Changbumrung; P. Pongpaew; R. Tungtrongchitr



Secular trends in heart rate, blood presure components and hypertension prevalence in young adults, 1949 to 2004: analyses of cross-sectional studies  

Microsoft Academic Search

As few studies have comprehensively examined hemodynamic cardiovascular risk factors in youth, this study was designed to investigate the trends in blood pressure, pulse pressure, heart rate levels and hypertension prevalence in young adults between 1949 and 2004.We studied 5 240 (55% male and 45% female) students who entered Queen's University Belfast (QUB) as first year undergraduates between 1975 and

Amanda Black; Liam Murray; GeorgeDavey Smith; Chris Cardwell; Peter McCarron



Barriers to use of modern contraceptives among women in an inner city area of Osogbo metropolis, Osun state, Nigeria  

PubMed Central

Objectives To determine the knowledge and attitudes on modern contraceptive use of women living in an inner city area of Osogbo. Materials and methods Three hundred and fifty nine women of childbearing age were studied utilizing a community-based, descriptive, cross-sectional study design. A multistage random sampling technique was used in recruiting respondents to the study. A four-part questionnaire was applied dually, by interviewers and by respondents’ self administration, and the data was analyzed using the SPSS software version 17.0. Results The mean age of respondents was 28.6 ± 6.65 years. The majority (90.3%) of respondents were aware of modern methods of family planning (FP), 76.0% claimed awareness of where to obtain FP services, and 74.9% knew of at least five methods. However, only 30.6% had ever used contraceptives, while only 13.1% were current users. The most frequently used method was the male condom. The commonly perceived barriers accounting for low use of FP methods were fear of perceived side effects (44.0%), ignorance (32.6%), misinformation (25.1%), superstition (22.0%), and culture (20.3%). Some reasons were proffered for respondents’ nonuse of modern contraception. Predictors of use of modern contraceptives include the awareness of a place of FP service provision, respondents’ approval of the use of contraceptives, higher education status, and being married. Conclusion Most of the barriers reported appeared preventable and removable and may be responsible for the reported low point prevalence of use of contraceptives. It is recommended that community-based behavioral-change communication programs be instituted, aimed at improving the perceptions of women with respect to bridging knowledge gaps about contraceptive methods and to changing deep-seated negative beliefs related to contraceptive use in Nigeria. PMID:24143124

Asekun-Olarinmoye, EO; Adebimpe, WO; Bamidele, JO; Odu, OO; Asekun-Olarinmoye, IO; Ojofeitimi, EO



Oral contraceptive use and mortality after 36 years of follow-up in the Nurses' Health Study: prospective cohort study  

PubMed Central

Objective To determine whether use of oral contraceptives is associated with all cause and cause specific mortality. Design Prospective cohort study. Setting Nurses’ Health Study, data collected between 1976 and 2012. Population 121?701 participants were prospectively followed for 36 years; lifetime oral contraceptive use was recorded biennially from 1976 to 1982. Main outcome measures Overall and cause specific mortality, assessed throughout follow-up until 2012. Cox proportional hazards models were used to calculate the relative risks of all cause and cause specific mortality associated with use of oral contraceptives. Results In our population of 121?577 women with information on oral contraceptive use, 63?626 were never users (52%) and 57?951 were ever users (48%). After 3.6 million person years, we recorded 31?286 deaths. No association was observed between ever use of oral contraceptives and all cause mortality. However, violent or accidental deaths were more common among ever users (hazard ratio 1.20, 95% confidence interval 1.04 to 1.37). Longer duration of use was more strongly associated with certain causes of death, including premature mortality due to breast cancer (test for trend P<0.0001) and decreased mortality rates of ovarian cancer (P=0.002). Longer time since last use was also associated with certain outcomes, including a positive association with violent or accidental deaths (P=0.005). Conclusions All cause mortality did not differ significantly between women who had ever used oral contraceptives and never users. Oral contraceptive use was associated with certain causes of death, including increased rates of violent or accidental death and deaths due to breast cancer, whereas deaths due to ovarian cancer were less common among women who used oral contraceptives. These results pertain to earlier oral contraceptive formulations with higher hormone doses rather than the now more commonly used third and fourth generation formulations with lower estrogen doses. PMID:25361731

Charlton, Brittany M; Rich-Edwards, Janet W; Colditz, Graham A; Missmer, Stacey A; Rosner, Bernard A; Hankinson, Susan E; Speizer, Frank E



[Hormonal contraception and breast cancer risk].  


The largest meta-analysis comprised a total of 54 epidemiologic studies (Collaborative Group on Hormonal Factors in Breast Cancer) and included 53,297 women with breast cancer and 100,239 controls. Women currently using hormonal contraceptives had a modestly elevated risk for breast cancer (RR 1.24). This risk continuously decreased over years and did not exist after discontinuation of the drugs after ten years. Women who had started on contraceptives before the age of 20, had an elevated risk for breast cancer over the subsequent years (relative risk = RR 1.95 until the 30th year of age, RR 1.54 between 30 and 34 years, and RR 1.27 between the age of 35 and 40 years, respectively) compared to those who started to use contraceptives after 20 years of age. There was no difference in the risk between the different dosages, combined or gestagen-based contraceptives. However, the proportion of women using gestagens only was small. Study data on the effect of oral contraceptives in women with BRCA1/2 mutation or women with a positive familial history are controversial. A recently published systematic overview of 10 studies including a pooled analysis of 54 studies did not reveal an elevated breast cancer risk for women carrying an elevated breast cancer risk taking contraceptives. PMID:20714815

Bjelic-Radisic, Vesna; Petru, Edgar



The DSM-IV Rates of Child and Adolescent Disorders in Puerto Rico: Prevalence, Correlates, Service Use, and the Effects of Impairment  

Microsoft Academic Search

to 6.9% when a measure of global impairment was added to that definition. The most prevalent disorders were at- tention-deficit\\/hyperactivity disorder (8.0%) and oppo- sitional defiant disorder (5.5%). Children in urban set- tings had higher rates than those in rural regions. Older age was related to higher rates of major depression and social phobia, and younger age was related to

Glorisa Canino; Patrick E. Shrout; Maritza Rubio-Stipec; Hector R. Bird; Milagros Bravo; Rafael Ramirez; Ligia Chavez; Margarita Alegria; Ann Hohmann; Julio Ribera; Pedro Garcia; Alfonso Martinez-Taboas



The role of the social network in contraceptive decision-making among young, African American and Latina women  

PubMed Central

Purpose Understanding reasons for contraception decisions is critical to improving our ability to reduce rates of unintended pregnancies. We used an in-depth qualitative approach to examine the contraceptive decision-making process, with special attention to the role of the social network, among a group of young, postpartum urban minority women. Methods Brief surveys and semi-structured interviews were conducted with 30 consenting postpartum women. In-person one-on-one interviews were then reviewed for themes using an iterative process. Qualitative analysis techniques identifying emergent themes were applied to interview data. Results In this cohort of African American (63%) and Hispanic (37%) women (median age 26), 73% had unplanned pregnancies. The social network, including friends, mothers, and partners, were key sources of contraception myths, misconceptions, and vicarious experiences. Women also utilized media, including the internet, as an additional source of information. Information relayed by the social network had a direct influence on contraceptive decisions for many women. Conclusions The experiences and opinions of the social network influence contraceptive decisions in this population of young, minority women. The social network, including friends, family members, and media sources, are a key source of contraceptive information for many women. Comprehensive contraception counseling should explore the experiences and opinions of the patient’s social network to the extent possible. PMID:20864007

Yee, Lynn M.; Simon, Melissa



Skewed contraceptive method mix: why it happens, why it matters.  


Contraceptive prevalence has been central to family planning research over the past few decades, but researchers have given surprisingly little consideration to method mix, a proxy for method availability or choice. There is no 'ideal' method mix recognized by the international community; however, there may be reason for concern when one or two methods predominate in a given country. In this article method skew is operationally defined as a single method constituting 50% or more of contraceptive use in a given country. Of 96 countries examined in this analysis, 34 have this type of skewed method mix. These 34 countries cluster in three groups: (1) sixteen countries in which traditional methods dominate, most of which are in sub-Saharan Africa; (2) four countries in which female sterilization predominates (India, Brazil, Dominican Republic and Panama); and (3) fourteen countries that rely on a single reversible method (the pill in Algeria, Kuwait, Liberia, Morocco, Sudan and Zimbabwe; the IUD in Cuba, Egypt, Kazakhstan, Kyrgyz Republic, Moldova, Turkmenistan and Uzbekistan; and the injectable in Malawi). A review of available literature on method choice in these countries provides substantial insight into the different patterns of method skew. Method skew in some countries reflects cultural preferences or social norms. Yet it becomes problematic if it stems from restrictive population policies, lack of access to a broad range of methods, or provider bias. PMID:16762087

Sullivan, Tara M; Bertrand, Jane T; Rice, Janet; Shelton, James D



Reimbursement of hormonal contraceptives and the frequency of induced abortion among teenagers in Sweden  

PubMed Central

Background Reduction in costs of hormonal contraceptives is often proposed to reduce rates of induced abortion among young women. This study investigates the relationship between rates of induced abortion and reimbursement of dispensed hormonal contraceptives among young women in Sweden. Comparisons are made with the Nordic countries Finland, Norway and Denmark. Methods Official statistics on induced abortion and numbers of prescribed and dispensed hormonal contraceptives presented as “Defined Daily Dose/thousand women” (DDD/T) aged 15-19 years were compiled and related to levels of reimbursement in all Swedish counties by using public official data. The Swedish numbers of induced abortion were compared to those of Finland, Norway and Denmark. The main outcome measure was rates of induced abortion and DDD/T. Results No correlation was observed between rates of abortion and reimbursement among Swedish counties. Nor was any correlation found between sales of hormonal contraceptives and the rates of abortion. In a Nordic perspective, Finland and Denmark, which have no reimbursement at all, and Norway all have lower rates of induced abortion than Sweden. Conclusions Reimbursement does not seem to be enough in order to reduce rates of induced abortion. Evidently, other factors such as attitudes, education, religion, tradition or cultural differences in each of Swedish counties as well as in the Nordic countries may be of importance. A more innovative approach is needed in order to facilitate safe sex and to protect young women from unwanted pregnancies. PMID:24884539



Substance Use and Other Mental Health Disorders Among Veterans Returning to the Inner City: Prevalence, Correlates, and Rates of Unmet Treatment Need  

PubMed Central

Estimates of substance use and other mental health disorders of veterans (N = 269) who returned to predominantly low-income minority New York City neighborhoods between 2009 and 2012 are presented. Although prevalences of posttraumatic stress disorder, traumatic brain injury, and depression clustered around 20%, the estimated prevalence rates of alcohol use disorder, drug use disorder, and substance use disorder were 28%, 18%, and 32%, respectively. Only about 40% of veterans with any diagnosed disorder received some form of treatment. For alcohol use disorder, the estimate of unmet treatment need was 84%, which is particularly worrisome given that excessive alcohol use was the greatest substance use problem. PMID:23869460

Vazan, Peter; Golub, Andrew; Bennett, Alex S.



Substance use and other mental health disorders among veterans returning to the inner city: prevalence, correlates, and rates of unmet treatment need.  


Estimates of substance use and other mental health disorders of veterans (N = 269) who returned to predominantly low-income minority New York City neighborhoods between 2009 and 2012 are presented. Although prevalences of posttraumatic stress disorder, traumatic brain injury, and depression clustered around 20%, the estimated prevalence rates of alcohol use disorder, drug use disorder, and substance use disorder were 28%, 18%, and 32%, respectively. Only about 40% of veterans with any diagnosed disorder received some form of treatment. For alcohol use disorder, the estimate of unmet treatment need was 84%, which is particularly worrisome given that excessive alcohol use was the greatest substance use problem. PMID:23869460

Vazan, Peter; Golub, Andrew; Bennett, Alex S



Acceptability and satisfaction using Quick Start with the contraceptive vaginal ring versus an oral contraceptive  

Microsoft Academic Search

BackgroundMany women discontinue their use of hormonal contraception, and even those who continue so may have difficulty using oral contraceptive pills consistently. New delivery systems, including the vaginal ring, may be easier to use, but user acceptability and satisfaction with these new methods may be affected by women's experience with their bodies.

Julie E. Schafer; Lauren M. Osborne; Anne R. Davis; Carolyn Westhoff



Contraceptive vaginal ring use for women has less adverse metabolic effects than an oral contraceptive  

Microsoft Academic Search

BackgroundThis study compared metabolic, hormonal and lipid profiles before and during use of a contraceptive vaginal ring (RING) releasing 15 mcg ethinyl estradiol (EE) and 120 mcg etonogestrel per day (NuvaRing®, Organon USA Inc., Roseland, NJ) versus a low-dose oral contraceptive (PILL) containing 20 mcg EE and 100 mcg levonorgestrel daily (Aviane, Barr Pharmaceuticals Inc., Pomona, NY).

Karen E. Elkind-Hirsch; Carmen Darensbourg; Beverly Ogden; Lauren F. Ogden; Philip Hindelang



Emergency contraceptive pills over-the-counter: practices and attitudes of pharmacy and nurse-midwife providers  

Microsoft Academic Search

Deregulation of emergency contraceptive pills (ECP) has led to pharmacy staff becoming a new provider group of ECP, together with nurse-midwives, who are already experienced in prescribing contraceptives. This postal questionnaire survey aimed to assess practices and attitudes towards ECP and the over-the-counter (OTC)-availability among pharmacy staff (n=237) and nurse-midwives (n=163). The overall response rate was 89%. Both study groups

Gunilla Aneblom; Cecilia Stålsby Lundborg; Anders Carlsten; Karin Eurenius; Tanja Tydén



Reasons for contraceptive nonuse among women having unmet need for contraception in developing countries.  


The level of unmet need for contraception-an important motivator of international family planning programs and policies-has declined only slightly in recent decades. This study draws upon data from 51 surveys conducted between 2006 and 2013 in Africa, Asia, and Latin America and the Caribbean to provide an updated review of the reasons why many married women having unmet need are not practicing contraception. We examine the reasons for contraceptive nonuse and how these reasons vary across countries and according to national levels of unmet need and contraceptive use. We present specific findings regarding the most widespread reasons for nonuse, particularly infrequent sex and concerns regarding side effects or health risks. Our findings suggest that access to services that provide a range of methods from which to choose, and information and counseling to help women select and effectively use an appropriate method, can be critical in helping women having unmet need overcome obstacles to contraceptive use. PMID:24931073

Sedgh, Gilda; Hussain, Rubina



Designed Chemical Intervention with Thiols for Prophylactic Contraception  

PubMed Central

Unlike somatic cells, sperm have several-fold more available-thiols that are susceptible to redox-active agents. The present study explains the mechanism behind the instant sperm-immobilizing and trichomonacidal activities of pyrrolidinium pyrrolidine-1-carbodithioate (PPC), a novel thiol agent rationally created for prophylactic contraception by minor chemical modifications of some known thiol drugs. PPC, and its three derivatives (with potential active-site blocked by alkylation), were synthesized and evaluated against live human sperm and metronidazole-susceptible and resistant Trichomonas vaginalis, in vitro. Sperm hexokinase activity was evaluated by coupled enzyme assay. PPC irreversibly immobilized 100% human sperm in ?30 seconds and totally eliminated Trichomonas vaginalis more efficiently than nonoxynol-9 and metronidazole. It significantly inhibited (P<0.001) thiol-sensitive sperm hexokinase. However, the molecule completely lost all its biological activities once its thiol group was blocked by alkylation. PPC was subsequently formulated into a mucoadhesive vaginal film using GRaS excipients and evaluated for spermicidal and microbicidal activities (in vitro), and contraceptive efficacy in rabbits. PPC remained fully active in quick-dissolving, mucoadhesive vaginal-film formulation, and these PPC-films significantly reduced pregnancy and fertility rates in rabbits. The films released ?90% of PPC in simulated vaginal fluid (pH 4.2) at 37°C in 5 minutes, in vitro. We have thus discovered a common target (reactive thiols) on chiefly-anaerobic, redox-sensitive cells like sperm and Trichomonas, which is susceptible to designed chemical interference for prophylactic contraception. The active thiol in PPC inactivates sperm and Trichomonas via interference with crucial sulfhydryl-disulfide based reactions, e.g. hexokinase activation in human sperm. In comparison to non-specific surfactant action of OTC spermicide nonoxynol-9, the action of thiol-active PPC is apparently much more specific, potent and safe. PPC presents a proof-of-concept for prophylactic contraception via manipulation of thiols in vagina for selective targeting of sperm and Trichomonas, and qualifies as a promising lead for the development of dually protective vaginal-contraceptive. PMID:23826278

Jain, Ashish; Verma, Vikas; Sharma, Vikas; Kushwaha, Bhavana; Lal, Nand; Kumar, Lalit; Rawat, Tara; Dwivedi, Anil K.; Maikhuri, Jagdamba P.; Sharma, Vishnu L.; Gupta, Gopal



Biliary lipids, bile acids, and gallbladder function in the human female: effects of contraceptive steroids.  


Individuals who take contraceptive steroids or estrogens are at increased risk of developing cholesterol gallstones. The mechanisms of the increased stone formation are incompletely understood. In this study we report biliary lipid composition and secretion, bile acid composition and kinetics, and gallbladder function in a group of healthy, nonobese women taking a contraceptive steroid preparation. A comparable group of healthy women served as controls. Bile-rich duodenal fluid was obtained after stimulation of gallbladder contraction; bile acid, phospholipid, and cholesterol concentrations were determined. Biliary lipid secretion rate was measured by the marker perfusion technique. Bile acid distribution was determined by gas-liquid chromatography. The pool size, FTR, and synthesis rate of each bile acid were measured by using CA and CDCA labeled with the stable isotope of carbon, 13C. In some of the subjects gallbladder storage and emptying were measured during the kinetic study, by real-time ultrasonography. Contraceptive steroid use was associated with a significant increase in biliary cholesterol saturation and in the lithogenic index of bile. The rate of cholesterol secretion in the contraceptive steroid group was 50% greater than in the control (p much less than 0.001) and the rate of bile acid secretion was reduced (p less than 0.02). The total bile acid pool size was significantly increased by contraceptive steroids. The major increase occurred in the CA pool (p less than 0.04). The daily rate of enterohepatic cycles of the bile acid pool was decreased by contraceptive steroids from 6.6 to 4.3 (p less than 0.01). The only effect of contraceptive steroids on gallbladder function was a slower emptying rate in response to intraduodenal amino acid infusion. No index of gallbladder function correlated significantly with any parameter of bile acid kinetics in this small group of subjects. The findings confirm the lithogenic effect of contraceptive steroids and indicate that its causes are an increase in cholesterol secretion and a decrease in bile acid secretion. PMID:7077124

Kern, F; Everson, G T; DeMark, B; McKinley, C; Showalter, R; Braverman, D Z; Szczepanik-Van Leeuwen, P; Klein, P D



Prevalence rates of Escherichia coli O157:H7 and Salmonella at different sampling sites on cattle hides at a feedlot and processing plant.  


The prevalence rates of Escherichia coli O157:H7 and Salmonella at different sampling sites on cattle hides were determined at a feedlot and a processing plant. Sponge samples were collected from six hide surface sites at the feedlot (left and right shoulders, left and right ribs, back, and belly) and four sites at the processing plant (left and right shoulders, back, and belly). The prevalence of E. coli O157:H7 was approximately 80% for left and right shoulder and rib samples, 68% for back samples, and 92% for belly samples collected at the feedlot. At the processing plant, the prevalences of E. coli O157:H7 at all four sites were between 76 and 79%. Salmonella prevalence in feedlot samples was too low to allow for accurate analysis. The prevalence of Salmonella at processing was 49% for left shoulder samples, 48% for right shoulder samples, 40% for back samples, and 68% for belly samples. The results of this study indicate that the site most likely to be naturally contaminated with E. coli O157:H7 and Salmonella simultaneously was the belly. PMID:19610338

Kalchayanand, Norasak; Brichta-Harhay, Dayna M; Arthur, Terrance M; Bosilevac, Joseph M; Guerini, Michael N; Wheeler, Tommy L; Shackelford, Steven D; Koohmaraie, Mohammad



"El Sexo no es Malo": Maternal Values Accompanying Contraceptive Use Advice to Young Latina Adolescent Daughters.  


In this study, we utilized observational methods to identify maternal values and concerns accompanying contraceptive use advice in Latina mother-daughter sexuality conversations. The sample included non-sexually active early adolescents around 12 years of age and their mostly Spanish-speaking Latina mothers. Videotaped conversations were coded for the prevalence of messages related to four sexual values (abstinence, delay sex until older, sex is "normal", sex is "improper") and concerns about pregnancy and STD transmission. We examined whether the duration of time spent conversing about these messages was associated with participant characteristics, general communication openness, and the amount of time the dyads spent discussing contraceptive use. Results indicated that Latina mothers who had fewer years of education and lower family income talked longer to their daughters about the need to delay sex, avoid risky situations that would increase their chances of getting pregnant or acquiring an STD, and engage in self-protective practices. Less perceived openness in general communication as reported by both the mothers and the daughters was associated with increased time discussing that sex is improper. Although the duration of contraceptive use messages was brief, mothers and daughters who discussed the fact that sex is normal, and who communicated more about the importance of delaying sex, talked longer about contraceptive use practices compared to mothers and daughters who engaged in minimal discussion of these sexual values. PMID:20543876

Romo, Laura F; Bravo, Magali; Cruz, Maria Elena; Rios, Rebeca M; Kouyoumdjian, Claudia



“El Sexo no es Malo”: Maternal Values Accompanying Contraceptive Use Advice to Young Latina Adolescent Daughters  

PubMed Central

In this study, we utilized observational methods to identify maternal values and concerns accompanying contraceptive use advice in Latina mother–daughter sexuality conversations. The sample included non-sexually active early adolescents around 12 years of age and their mostly Spanish-speaking Latina mothers. Videotaped conversations were coded for the prevalence of messages related to four sexual values (abstinence, delay sex until older, sex is “normal”, sex is “improper”) and concerns about pregnancy and STD transmission. We examined whether the duration of time spent conversing about these messages was associated with participant characteristics, general communication openness, and the amount of time the dyads spent discussing contraceptive use. Results indicated that Latina mothers who had fewer years of education and lower family income talked longer to their daughters about the need to delay sex, avoid risky situations that would increase their chances of getting pregnant or acquiring an STD, and engage in self-protective practices. Less perceived openness in general communication as reported by both the mothers and the daughters was associated with increased time discussing that sex is improper. Although the duration of contraceptive use messages was brief, mothers and daughters who discussed the fact that sex is normal, and who communicated more about the importance of delaying sex, talked longer about contraceptive use practices compared to mothers and daughters who engaged in minimal discussion of these sexual values. PMID:20543876

Bravo, Magali; Cruz, Maria Elena; Rios, Rebeca M.; Kouyoumdjian, Claudia



The influence of oral contraceptives on athletic performance in female athletes.  


It is now estimated that the prevalence of oral contraceptive use in athletic women matches that of women in the general population. The oral contraceptive pill (OCP) reduces cycle-length variability and provides a consistent 28-day cycle by controlling concentrations of endogenous sex hormones. The OCP is administered in three different forms that differ widely in chemical constitution and concomitant effects on the human body. As fluctuation in sex steroids are believed to be a possible causal factor in performance and exercise capacity, it is imperative to understand the effect of administering the various types of OCP on women. However, the research into oral contraceptives and exercise performance is not consistent. The type of OCP administered (monophasic, biphasic or triphasic), as well as the type and dose of estrogen and progestogen within, will have varying effects on exercise. To date, research in the area of oral contraceptives and exercise capacity is sparse and much has been plagued by poor research design, methodology and small sample size. It is clear from the research to date that more randomised clinical trials are urgently required to assess the array of OCP formulations currently available to women and their concomitant effect on health and exercise capacity. Therefore, the purpose of this article is to critically appraise the literature to date and to provide a current review of the physiological scientific knowledge base in relation to the OCP and exercise performance. In addition, methodological control, design and conduct will be considered with future areas of research highlighted. PMID:17595152

Burrows, Melonie; Peters, Charlotte E



Factors predicting mood changes in oral contraceptive pill users  

PubMed Central

Background Over 100 million women worldwide are using oral contraceptives pills (OCP) and mood changes were being as the primary reason for OCP discontinuation. The purpose of this study was to determine the prevalence and predicting factors of mood changes in oral contraceptive pills users. Methods This was a cross-sectional study of 500 women aged 15–49 years old using low dose (LD) pills attending family planning centers in Ahwaz, Iran. Data were collected via face-to-face interviews using a structured questionnaire including items on demographic, self-efficacy and mood change. Both univarate and multiple logistic regression analyses were performed to assess the relationship between reported mood change and the independent variables. Results In all 406 women reported that they did experience OCP side effects. Of these, 37.7% of women (n =153) reported mood changes due to OCP use. The results of multiple logistic regression revealed that place of living (OR =2.57, 95% CI?=?1.06-6.20, p =0.03), not receiving information on OCP side effects (OR =1.80, 95% CI?=?1.15-2.80, p =0.009), and lower self-efficacy (OR?=?0.87, 95% CI?=?0.80-0.94, p =0.001) were significant predictors of mood changes. Conclusion The findings from this study indicated that the prevalence of reported mood changes due to OCP use among Iranian women appeared to be consistent with other studies. In addition the findings showed that receiving information on OCP side effects from health care workers and self-efficacy were important predicting factors for mood changes. Indeed implementing educational programs and improving self-efficacy among women are recommended. PMID:24015872



Knowledge and use of postcoital contraception: a survey among health professionals in Tower Hamlets.  

PubMed Central

The knowledge and estimated retrospective use of postcoital contraception was ascertained from health professionals in Tower Hamlets in the summer of 1988 using a postal questionnaire. Eighty five per cent of general practitioners responded and 91% of these had received requests for postcoital contraception within the previous six months. Only one third of general practitioners had information about postcoital contraception available in their surgeries. Family planning doctors and nurses had the most accurate knowledge of the method but many health professionals appeared to lack sufficient knowledge to ensure appropriate prescribing and to publicize this method to their women patients. It is concluded that if the high rate of abortion in the borough is to be reduced, health professionals as well as women need to be further educated as part of a postcoital contraception publicity campaign. Use of the term 'emergency contraception' rather than the non-medical term 'the morning after pill' may be more effective and reduce the present confusion among both groups. PMID:2121178

Burton, R; Savage, W



Dual use of long-acting reversible contraceptives and condoms among adolescents.  


Unintended pregnancy and sexually transmitted infections (STI) continue to be significant public health problems, and adolescents are disproportionately affected by both. With national attention and funding directed toward adolescent pregnancy prevention, promotion of long-acting reversible contraceptive (LARC) use among adolescents is both timely and relevant. However, LARCs provide no protection against STIs, requiring dual-method use of both LARC and barrier methods, most commonly the male latex condom, to address these issues simultaneously. Rates of both LARC and dual-method contraception are low in the United States, but have increased in recent years. Dual-method contraception is highest among younger women and adolescents with multiple or new sex partners. Consistent condom use remains a major barrier to dual-method use, as it necessitates admission of STI risk by both partners, and use is dependent upon two decision-makers rather than a single contraceptive user. Promoting the initiation and maintenance of LARC and condom use across multiple partnered sexual encounters requires understanding of individual, dyadic, and social influences. Successful maintenance of contraceptive and STI prevention behaviors requires individualized, longitudinal reinforcement, and social supports, but can ultimately reduce the burden of unintended pregnancy and STI among adolescents. PMID:23535054

Williams, Rebekah L; Fortenberry, J Dennis



Levonorgestrel subdermal implants. Contraception on trial.  


When they were introduced to the world market in the 1980s, levonorgestrel subdermal implants offered the promise of an exciting alternative to traditional hormonal contraception. They provide highly effective, long-acting protection from pregnancy, without the need for user compliance. Broad acceptability of the drug has been reported throughout the world. Recently, however, the implants have met with opposition. The drug is associated with a variety of adverse effects, and removal of implants can be problematic. Serious events have been reported in women using levonorgestrel subdermal implants, although causal relationships have not been demonstrated. Additionally, concerns have been raised over the potential for coercive use of the drug. Numerous law suits have been filed alleging serious problems with implants. As a result, the drug has received considerable negative media attention. Before the controversy over levonorgestrel subdermal implants erupted, contraceptive development had declined, resulting from limitations to profits and funding, legal threats, and changes in the insurance industry. The levonorgestrel subdermal implant experience may serve to accelerate this trend. While the introduction of levonorgestrel subdermal implants offered an alternative to the current array of medical contraception, its experience may serve to dampen future contraceptive development efforts. Costly litigation and much controversy involving the implants have acted to create disincentives to further research and development of new methods of medical contraception. PMID:9429835

Frank, M L; DiMaria, C



High prevalence rate of left superior vena cava determined by echocardiography in patients with congenital heart disease in Saudi Arabia  

PubMed Central

Background Persistent left superior vena cava (LSVC) is one of the common anomalies of the systemic veins. Its prevalence is 0.1–0.3% in the general population and is more common with congenital heart disease (CHD). The importance of detecting persistent LSVC prior to cardiac surgery is paramount for systemic veins cannulations. Aim The aim was to evaluate the prevalence of persistent LSVC in patients with CHD in Saudi Arabia. Methods All patients referred to our institution had echocardiography. All complete studies were reviewed for the presence of persistent LSVC. A computerized database was created including the demographic data, CHD diagnoses, and the presence of persistent LSVC. Results A total of 2,042 were examined with an age range of 1 day to 16 years. The complete echocardiographic studies were 1,832 (90%) of whom 738 (40%) patients had CHD. The prevalence of persistent LSVC in patients with CHD was 7.8% (OR 9.26, 95% CI 4.7–18.2, p<0.001). The most common cardiac defect associated with persistent LSVC was complete atrioventricular septal defect (AVSD); all patients with AVSD had Down syndrome. The total number of patients with AVSD was 41, and persistent LSVC was found in 11 (26%) of them (odds ratio 5.1, 95% CI 2.4–10.8, p<0.001). Conclusions The prevalence of persistent LSVC in the current population is almost double the reported prevalence obtained using the same echocardiographic screening tool. PMID:24107708

Eldin, Ghada Shiekh; El-Segaier, Milad; Galal, Mohammed Omer



Sexual initiation and contraceptive use among adolescent women in northeast Brazil.  


To estimate trends and determinants of sexual initiation and contraceptive use among adolescent women in Northeast Brazil, multivariate logistic hazard models are used that draw on data from three Demographic and Health Surveys conducted there between 1986 and 1996. Educational attainment is among the variables found to be associated most consistently with differential risk of engaging in first intercourse during adolescence, including premarital intercourse, and of contraceptive use during sexual initiation. Greater frequency of attending religious services and greater exposure to television are also associated with lower rates of sexual initiation and higher use of contraceptives. Seemingly diminishing returns of education on delayed sexual activity may help explain, in part, observed increases in the absolute level of adolescent sexual experience across survey periods, however. Multilevel modeling techniques pointing to the existence of cluster-level random variances underline the need for further research into community influences on individual sexual activity. PMID:11020934

Gupta, N



Supplying emergency contraception to adolescents: the nurse's role.  


This article explores issues surrounding the supply of emergency contraception to adolescents to reduce the risk of unintended pregnancy. It explains the female reproductive cycle, and describes the types of emergency contraception that may be supplied following unprotected sexual intercourse or contraception failure. The aftercare that should be offered to adolescents following the supply of emergency contraception is discussed, alongside issues surrounding the safeguarding of children and vulnerable adults. PMID:25424110

Hopkins, Craig



Thrombotic risk of contraceptive transdermal patches and the contraceptive vaginal ring.  


The annual risk of venous thrombosis has been estimated at 5 to 10 cases per 100 000 women aged 15 to 44 years who are not using hormonal contraception.The risk increases with age for all women. Combined oral oestrogen-progestin contraceptives increase the risk of venous and arterial thrombosis. The risk of venous thrombosis varies, depending on which oestrogen-progestin combination is used. It is about 20 cases per 100,000 woman-years with contraceptives combining norethisterone or levonorgestrel with ethinylestradiol at doses below 50 microgram.The risk is twice as high with third-generation oral contraceptives. In addition to the oral route, hormonal contraception is available as a a transdermal patch or a vaginal ring. What is the risk of thrombosis associated with these non-oral forms? A cohort study showed that the risk of venous thrombosis was approximately 8-fold higher among women using a transdermal patch and 7-fold higher in those using a vaginal ring compared to women not using contraception. Another study on arterial thrombosis demonstrated a statistically significant increase in the risk of stroke among vaginal ring users, but not in the risk of myocardial infarction. In practice, overall, these data show that the use of contraceptive transdermal patch or the contraceptive vaginal ring increases the risk of venous thrombosis.The excess risk of arterial thrombosis is unknown.When hormonal contraception is requested, it is better to recommend a combination containing levonorgestrel and less than 50 microgram of ethinylestradiol per tablet, which carries a lower risk of venous or arterial thrombosis. PMID:24427838



Induced abortion and contraception use  

PubMed Central

Abstract Objective To determine what proportion of women seeking induced abortion in the Calgary census metropolitan area were immigrants. Design For 2 months, eligible women were asked to complete a questionnaire. Women who refused were asked to provide their country of birth (COB) to assess for selection bias. Setting Two abortion clinics in Calgary, Alta. Participants Women presenting at or less than 15 weeks’ gestational age for induced abortion for maternal indications. Main outcome measures The primary outcome was the proportion of women seeking induced abortion services who were immigrants. Secondary outcomes compared socioeconomic characteristics and contraception use between immigrant and Canadian-born women. Results A total of 752 women either completed a questionnaire (78.6%) or provided their COB (21.4%). Overall, 28.9% of women living in the Calgary census metropolitan area who completed the questionnaire were immigrants, less than the 31.2% background proportion of immigrant women of childbearing age. However, 46.0% of women who provided only COB were immigrants. When these data were combined, 34.2% of women presenting for induced abortion identified as immigrant, a proportion not significantly different from the background proportion (P = .127). Immigrant women presenting for induced abortion tended to be older, more educated, married with children, and have increased parity. They were similar to Canadian-born women in number of previous abortions, income status, and employment status. Conclusion This study suggests that immigrant women in Calgary are not presenting for induced abortion in disproportionately higher numbers, which differs from existing European literature. This is likely owing to differing socioeconomic characteristics among the immigrant women in our study from what have been previously described in the literature (typically lower socioeconomic status). Much still needs to be explored with regard to factors influencing the use of abortion services by immigrant women. PMID:25217694

du Prey, Beatrice; Talavlikar, Rachel; Mangat, Rupinder; Freiheit, Elizabeth A.; Drummond, Neil



[Copper - a major contraceptive agent?].  


The effect of copper ions on the motility of human sperm was studied in vitro to determine whether copper is toxic to sperm. Sperm samples from 30 men of proven fertility who had high quality sperm were collected, separated from the seminal fluid, and resuspended in Menezzo, a chemical medium designed to resemble the secretions of the Fallopian tubes. Menezzo contains all the known constituents which aid sperm capacitation, including mineral salts, organic compounds, free amino acids, and enzymes. Its pH is between 7.4 and 7.6. After 1 hour of incubation the dead and weak sperm were separated out and only mobile sperm were tested. Crystallized copper sulfate was added to 4 of the 5 sperm-Menezzo mixtures. The final concentrations were of 1 millimolar, .1 millimolar, .01 millimolar, and .001 millimolar. Sperm motility showed a statistically significant decrease in the concentration of 1 millimolar but only after a latency period of at least 5 hours. At lesser concentrations and in shorter time periods no significant difference was observed compared to the control. The copper released from a copper IUD into the uterine fluid does not exceed a concentration of .1 millimolar. The lower concentration and the long latency period before the toxic effect manifests itself, seem to indicate that copper has no direct contraceptive effect. Copper is however known to promote inflammatory reactions, and it may work in vivo through the intermediacy of the leukocytes in the uterine cavity, either by directly stimulating phagocytosis or by release of substances toxic to sperm. PMID:12280892

Leroy-martin, B; Saint-pol, P; Hermand, E



Effect of oral contraceptives on plasma clearance.  


The effects of chronic steroid contraceptive therapy on drug clearance from plasma were studied by using plasma antipyrine, phenylbutazone, and cholecalciferol half-lives in women. After 3 mo of oral steroid therapy (Norinyl, 2 mg; norethindrone + mestranol), the antipyrine half-life was increased in 3 of 6 subjects, phenylbutazone half-life was not consistently altered, and vitamin D3 half-life was increased in 3 of 4 patients. After 1 to 7 yr of oral steroid theraphy, the antipyrine half-life was longer while taking the contraceptive than when the contraceptive treatment was discontinued in 4 of 6 subjects, whereas that of phenylbutazone was not consistently altered. PMID:173489

Carter, D E; Bressler, R; Hughes, M R; Haussler, M R; Christian, D; Heine, M W



Combined hormonal contraception and bone health: a systematic review  

Microsoft Academic Search

This systematic review examined whether women who use combined hormonal contraception experience changes in risk of fracture or bone mineral density (BMD) that differ from nonusers. We identified 86 articles from PubMed and EMBASE (published 1966 to August 2005) that reported on fracture or BMD outcomes by use of combined hormonal contraceptives. The evidence relating to combined oral contraceptives (COCs)

Summer L. Martins; Kathryn M. Curtis; Anna F. Glasier



Contraceptive vaginal rings releasing Nestorone® and ethinylestradiol: a 1-year dose-finding trial  

Microsoft Academic Search

In a multicenter 1-year trial of contraceptive vaginal rings (rings) involving 150 women, three dose combinations of the progestin Nestorone® (NES) and ethinylestradiol (EE) were compared with respect to effectiveness, safety and acceptability. Mean in vitro drug release rates for the three doses were 150 and 15, 150 and 20 and 200 and 15 ?g\\/day of NES and EE, respectively.

Irving Sivin; Daniel R. Mishell; Francisco Alvarez; Vivian Brache; Kaisa Elomaa; Pekka Lähteenmäki; Rebeca Massai; Patricia Miranda; Horacio Croxatto; Catherine Dean; Margaret Small; Harold Nash; Theodore M. Jackanicz



Relationship between Glomerular Filtration Rate and the Prevalence of Metabolic Abnormalities: Results from the Third National Health and Nutrition Examination Survey (NHANES III)  

Microsoft Academic Search

Background and Aims: National Kidney Foundation Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines recommend that all people with a glomerular filtration rate (GFR) <60 ml\\/min\\/1.73 m2 undergo evaluation for anaemia and metabolic bone disease. We aim to report the prevalence of metabolic complications in adults with low GFR. Methods: Analysis of 15,802 non-institutionalised adult participants in the Third National Health

Catherine M. Clase; Bryce A. Kiberd; Amit X. Garg



Factors affecting contraceptive use in Pakistan.  


This study postulates that contraceptive use in Pakistan is affected by the usual demographic factors as well as husband-wife communication, female autonomy, son preference, religious beliefs, and family planning service supply. Analysis is based on data obtained from the Pakistan Demographic and Health Survey of 1990-91. Findings indicate that 74% of women never talked in the past year with their husbands about family planning. Almost 60% believed that family size was "up to God." About 47% knew where to obtain contraception; only 20.4% had easy access to a source of supplies. Current use was 14% and ever use was 22.4%. Analysis is based on three basic models. Model 1 includes the control variables and son preference. Model 2 includes husband-wife communication, religious attitudes, and female autonomy. Model 3 includes the addition of family planning to model 2 variables. Urban residence increases the odds of contraceptive use considerably only in Model 1. The influence of urban residence in the other models is reduced. Husband's education is significant only in Models 1 and 2 and insignificant in Model 3 when the family planning variable is included. Increased women's age is also insignificant in Model 3. Of the supply factors in Model 3, knowledge of a source and easy access to a source were highly significant, while mass media exposure was not important. Knowledge of a source was the most important predictor. Model 3 explained 90% of use. Among urban women, lack of husband-wife communication and fatalistic beliefs reduce the log-odds of contraceptive use. For rural women, age and women's secondary education were key predictors. Findings confirm that demographic and socio-cultural factors affect contraceptive use in Pakistan. All the theorized variables exerted a strong influence on contraceptive use, which can be counteracted by improved supply and service strategies. PMID:12292564

Mahmood, N; Ringheim, K



Contraception, punishment and women who use drugs  

PubMed Central

Background In light of the recent debate on the use of financial incentives to promote long-acting contraception and sterilisation among women who use illicit drugs we discuss attitudes to contraception, pregnancy and parenting among Australian women who inject drugs. Methods Qualitative interviews were conducted with 90 women of reproductive age about contraceptive use, preferences, reproductive histories, attitudes to and experiences of parenting. All women were either currently, or had previously injected drugs. The in-depth, semi-structured interviews were compared and contrasted for themes relating to drug use, contraception, pregnancy and parenting. Results Participants aspired to control their fertility, expressed individual contraceptive preferences and concerns for their children (both born and unborn). Most had tried a number of contraceptive methods interspersed by periods of non-use related to experiences of side-effects, being single or abstinent, believing that they were infertile and trying to conceive. Attitudes varied from woman to woman and in the same individual over their life course. Some believed that they were not likely to be capable, but most aspired to be successful mothers. Conclusions Women’s drug use should not automatically be associated with an inability to make informed health care choices or to care for children. Evidence suggests that women who use drugs do not need to be paid to limit or end their fertility. Rather, programs that aim to reduce barriers to obtaining free, non-discriminating reproductive advice and parenting assistance would better utilise women’s agency to improve their own reproductive health. PMID:24405890



Communicating Contraceptive Effectiveness: A Randomized Controlled Trial  

PubMed Central

Introduction: Increasing the knowledge of women on effectiveness of contraceptive methods can lead to the use of more effective methods and reduce unwanted pregnancies and adverse outcomes. We aimed to compare three different approaches for increasing women’s understanding of effectiveness of contraceptive methods. Methods:We ran-domly assigned 630 eligible women of reproductive age to one of the three groups. Each woman received one of three charts presenting pregnancy risk with each contraceptive method. Participants before and while reviewing the chart, answered to three key ques-tions about the effectiveness of the methods. The data were analyzed using chi-square, ANOVA and McNemar's tests in SPSS version 13. Results: The most important reasons for choosing contraceptive methods were their effectiveness (45%), ease of use (18%) and few side effects (14%). At baseline, the participants' knowledge about the effective-ness of the methods was poor. Correct answers were 44% about comparing the effec-tiveness of the combined pills vs. that of condoms, 50% about intrauterine devices vs. injectables, and 52% about condoms vs. withdrawal. While reviewing the charts, the percentages significantly (p < 0.001) increased to 80%, 84% and 85%, respectively. All the three charts almost equally increased the correct responds to the questions. Conclusion: The three approaches had considerable and nearly identical effects on the promotion of women's knowledge about effectiveness of the contraceptive methods. Therefore, appropriate use of the charts is required during counseling sessions for contraceptive choice because it is impossible to have informed choice of the method without understanding their effectiveness.

Mohammad-Alizadeh-Charandabi, Sakineh; Shahnazi, Mahnaz; Jahanbakhsh, Roghaieh



Over-the-counter access to emergency contraception without age restriction: an opinion of the Women's Health Practice and Research Network of the American College of Clinical Pharmacy.  


Family planning remains a high priority area for the United States, with goals to increase the proportion of pregnancies that are intended, reduce pregnancy rates among adolescents, and increase contraceptive use prioritized in the Healthy People 2020 objectives. Contraception intended for use after unprotected intercourse, known as emergency contraception, remains underutilized. Levonorgestrel is one method of oral emergency contraception, which prevents fertilization and does not disrupt an already established pregnancy; thus, timing of administration is critical. Despite data demonstrating safety and efficacy, evidence-based decision making has been overshadowed by politically charged actions involving levonorgestrel emergency contraception for over a decade. The Women's Health Practice and Research Network of the American College of Clinical Pharmacy supports expanded access to levonorgestrel emergency contraception and removal of barriers such as age restrictions on the nonprescription drug product. Pharmacists remain a key provider of emergency contraceptive services and can help ensure timely access. In states where direct pharmacy access to emergency contraception is available, pharmacists are encouraged to participate. Education, research, and advocacy are other important responsibilities for pharmacists in this arena. PMID:23450827

Rafie, Sally; McIntosh, Jennifer; Gardner, Debra K; Gawronski, Kristen M; Karaoui, Lamis R; Koepf, Erin R; Lehman, Katherine Joy; McBane, Sarah; Patel-Shori, Nima M



Prevalence of antibodies to herpes simplex virus types 1 and 2 in pregnant women, and estimated rates of infection  

Microsoft Academic Search

There has been a recent increase in notifications of genital herpes but it is not known whether this has been reflected in the pregnant population. We have therefore carried out a study to determine the prevalence of herpes simplex antibodies in pregnant women and to estimate the incidence of primary infection. Sera were collected from 3533 women at antenatal clinics

A E Ades; C S Peckham; G E Dale; J M Best; S Jeansson



A Higher Prevalence Rate of Campylobacter in Retail Beef Livers Compared to Other Beef and Pork Meat Cuts  

PubMed Central

The objectives of this study were to determine the prevalence of Campylobacter jejuni and Campylobacter coli in retail beef, beef livers, and pork meats purchased from the Tulsa (OK, USA) area and to further characterize the isolates obtained through antimicrobial susceptibility testing. A total of 97 chilled retail beef (50 beef livers and 47 other cuts), and 100 pork samples were collected. The prevalence of Campylobacter in beef livers was 39/50 (78%), while no Campylobacter was isolated from the other beef cuts. The prevalence in pork samples was 2/100 (2%). A total of 108 Campylobacter isolates (102 beef livers isolates and six pork isolates) were subjected to antimicrobial resistance profiling against sixteen different antimicrobials that belong to eight different antibiotic classes. Of the six pork Campylobacter coli isolates, four showed resistance to all antimicrobials tested. Among the beef liver isolates, the highest antibiotic resistances were to tetracyclines and ?-lactams, while the lowest resistances were to macrolides, aminoglycosides, lincosamides, and phenicols. Resistances to the fluoroquinolone, macrolide, aminoglycoside, tetracycline, ?-lactam, lincosamide, and phenicol antibiotic classes were significantly higher in Campylobacter coli than Campylobacter jejuni isolates. Multidrug Resistance (MDR) among the 102 Campylobacter (33 Campylobacter jejuni and 69 Campylobacter coli) beef liver isolates was significantly higher in Campylobacter coli (62%) than Campylobacter jejuni (39%). The high prevalence of Campylobacter in retail beef livers and their antimicrobial resistance raise concern about the safety of these retail products. PMID:23698698

Noormohamed, Aneesa; Fakhr, Mohamed K.



The current and future contraceptive needs of Japanese women.  


Between 1945-1948, the population of Japan increased by 5 million people. Further, between 1947-1950, 2.7 million recorded births occurred each year resulting in the population growing from 72-83.2 million. The crude birth rate fell from a high of 34.3 in 1947 to a low of 11.1 in 1986. The population is expected to increase from 117-130 million (1090-2010) and then fall to and stabilize at 118 over 70 years. 80% of married women in Japan want to have 2-3 children. In 1984, 59% of married women used a family planning method and 83.1% ever used such a method. In 1979, the condom was the leading contraceptive among married couples (82%) followed by the rhythm method (23%). Since 1948 japanese women have been able to obtain a legal abortion. 600,000 induced abortions occur annually in Japan today. Even though the number of abortion have fallen steadily from 1955, the percentage of abortions among teenagers has increased from 1.6-4.7% between 1975-1985. Japanese would like to reverse this trend and the expected approval of oral contraceptives (OCs) could help do so. In 1979, only 3% of married couples depended on OCs. A concern of OCs many people worldwide held for many years was the cardiovascular risk of the high dose OCs. In Japan, however, the rate of thrombosis is lower than it is among Europeans and Americans. Thus Japanese women appear to be suitable candidates for Ocs, but, in 1986, 52% of married women had not formed an opinion on the pending approval of OCs. Further 43% said they would not use an OC. These results indicated a great need for OC education as well as for education on all contraception. Since 99% of all births occur under the guidance of skilled health workers, the health workers could inform women about contraceptives, but often are too busy to do so. PMID:2576250

Kobayashi, T



[Family planning, fertility, and family health in Zaire. A report on the results of a regional survey on the prevalence of co].  


The results of the 1982 Zaire Contraceptive Prevalence Survey are presented. The methodology and scope of the survey are first described. Information is included on the characteristics of those surveyed; nuptiality, fertility, and desired family size; contraceptive knowledge, use, and services; and the health status of the population. The need for further information on methods of contraception acceptable to a traditional, predominantly Catholic population is noted. PMID:12340816

Kikassa, M



Measured and reported weight change for women using a vaginal contraceptive ring vs. a low-dose oral contraceptive  

Microsoft Academic Search

BackgroundWomen often stop hormonal contraception because of perceived weight change. We conducted a randomized trial comparing the contraceptive vaginal ring to a low-dose oral contraceptive (OC). We examined the difference between women's reported and measured baseline weights and looked at factors affecting perceived weight change.

Katharine J. O'Connell; Lauren M. Osborne; Carolyn Westhoff



Variations in use of cardiology services in a health authority: comparison of coronary artery revascularisation rates with prevalence of angina and coronary mortality.  

PubMed Central

OBJECTIVE: To explore the relation between rates of coronary artery revascularisation and prevalence of angina to assess whether use of health services reflects need. DESIGN: Prevalence of angina symptoms determined by postal questionnaire on 16750 subjects (18 to 94 years). Comparison of data on use of coronary artery revascularisation with prevalence of symptoms and mortality from coronary heart disease. SETTING: Health authority with population of 530000. SUBJECTS: Patients admitted to hospital for coronary heart disease; patients who died; and patients undergoing angiography, angioplasty, or coronary artery bypass graft. Cohort of 491 people with symptoms from survey. MAIN OUTCOME MEASURES: Pearson's product moment correlation coefficients for relation between variables. RESULTS: Overall, 4.0% (95% confidence interval 3.7% to 4.4%) of subjects had symptoms. Prevalences varied widely between electoral wards and were positively associated with Townsend score (r = 0.79; P < 0.001), as was mortality, but the correlation between admission rates and Townsend score was less clear (r = 0.47; P < 0.01). Revascularisation rate and Townsend score were not associated. The ratio of revascularisation to number experiencing symptoms was inversely related to Townsend score (r = 0.67; P < 0.001). The most deprived wards had only about half the number of revascularisations per head of population with angina than did the more affluent wards. In affluent wards 11% (13/116) of those with symptoms had coronary angiograms compared with only 4% (9/216) in poorer wards (chi 2 = 4.96; P = 0.026). Townsend score also inversely correlated with revascularisations per premature death from coronary heart disease (r = 0.55; P < 0.01) and revascularisations per admission for myocardial infarction (r = 0.47; P < 0.01). CONCLUSION: The use of interventional cardiology services is not commensurate with need, thus exhibiting the inverse care law. PMID:9022488

Payne, N.; Saul, C.



[Attempt to elaborate an explanating model of adolescents' contraceptive behavior].  


Of the 3 main currents of literature seeking to explain adolescent pregnancy, the medical and demographic currents have essentially produced descriptions of behaviors, attitudes, and opinions, while the psychological current has produced primarily hypotheses interpreting sexual and contraceptive behavior in terms of predispositions. This work seeks to develop an explanatory framework for adolescent sexual and contraceptive behavior in which situational variables would be included. The explanatory variables utilized in the framework were informative and sociological variables, beliefs associated with side effects of contraceptive methods, social support for contraceptive use, norms associated with heterosexual behavior, ability to foresee future consequences, future prospects, perceptions of pregnancy and its consequences, and evaluation of the risk of pregnancy. A semiclosed questionnaire exploring the different model variables was orally administered to 186 female secondary school students in Liege, France. The data were subjected to a discriminant function analysis which permitted assessment of the role of each explanatory variable in determining contraceptive behavior. 53% of the respondents did not use contraception. 91% of those using contraception used pills. 5 types of contraceptive behavior were noted: 1) 20% of the sample were sexually active and had always used contraception 2) 20% were sexually active and used contraception but had not always done so 3) 13% were sexually active but had never used contraception 4) 40% were not sexually active and did not use contraception, and 5) 7% were not sexually active but used a contraceptive. The variables explained 75% of the difference between adolescents who used and did not use contraception, and 39% of the difference between adolescents ever exposed to risk of pregnancy or never exposed. The principle variables explaining use or nonuse of contraception were stated in declining order of importance. Girls having sexual relations under 17 years of age were much less likely to use a contraceptive method. 3 dimensions of norms associated with sexual behavior were relevant: adolescents using contraception had a more positive attitude toward sex, were less affected by aversion to programming or planning sexual activity, and had a more flexible sexual morality. Adolescents using contraception had parents and other associates who were more likely to approve of pill use, and they had less fear of the side effects of pills. Adolescents not using contraception tended to be under 17, with rigid norms associated with sexual behavior, weak social support for pill use, and beliefs in the negative effects of pills. Sexually active adolescents not using contraception tended to come from larger families, to have more unfavorable views of condoms than other adolescents, to have less social support for use of condoms than other adolescents, to want to have a child within the next 2 years, and to come from the lower social classes. PMID:12269088

Bodson, B; Bogaerts, S; Mondeville, D; Sciama, S; Vandekeere, M



Characteristics of contraceptive acceptors in an urban Nigerian setting.  


Intensive efforts in promoting family planning concepts and contraceptive delivery in the Third World over the past two- and one-half decades have yielded only token dividends . This has occurred in Nigeria, despite the favorable government attitude. A study of the characteristics of current contraceptive acceptors showed an overwhelming percentage of acceptors are uneducated , married and from the lower socioeconomic class, a striking departure from usual expectations. Most acceptors prefer oral contraceptives. The status of acceptance of modern contraception by the educated population is still undetermined. Contraceptives appeared to be used primarily by women aged 30 and older in our population. PMID:6144594

Ayangade, O



Impact of Pay for Performance on Prescribing of Long-Acting Reversible Contraception in Primary Care: An Interrupted Time Series Study  

PubMed Central

Background The aim of this study was to evaluate the impact of Quality and Outcomes Framework (QOF), a major pay-for-performance programme in the United Kingdom, on prescribing of long-acting reversible contraceptives (LARC) in primary care. Methods Negative binomial interrupted time series analysis using practice level prescribing data from April 2007 to March 2012. The main outcome measure was the prescribing rate of long-acting reversible contraceptives (LARC), including hormonal and non hormonal intrauterine devices and systems (IUDs and IUSs), injectable contraceptives and hormonal implants. Results Prescribing rates of Long-Acting Reversible Contraception (LARC) were stable before the introduction of contraceptive targets to the QOF and increased afterwards by 4% annually (rate ratios ?=?1.04, 95% CI?=?1.03, 1.06). The increase in LARC prescribing was mainly driven by increases in injectables (increased by 6% annually), which was the most commonly prescribed LARC method. Of other types of LARC, the QOF indicator was associated with a step increase of 20% in implant prescribing (RR?=? 1.20, 95% CI?=? 1.09, 1.32). This change is equivalent to an additional 110 thousand women being prescribed with LARC had QOF points not been introduced. Conclusions Pay for performance incentives for contraceptive counselling in primary care with women seeking contraceptive advice has increased uptake of LARC methods. PMID:24694949

Arrowsmith, Myat E.; Majeed, Azeem; Lee, John Tayu; Saxena, Sonia



Pretreatment with an Oral Contraceptive Is Effective in Reducing the Incidence of Functional Ovarian Cyst Formation During Pituitary Suppression by Gonadotropin-Releasing Hormone Analogues  

Microsoft Academic Search

Purpose:Our purpose was to assess the effect of pretreatment with oral contraceptives (OCs) on the formation of functional ovarian cysts during pituitary supression with gonadotropin-releasing hormone (GnRH) agonists, subsequent follicular development, and pregnancy rates.

Marinko M. Biljan; Neal G. Mahutte; Nicola Dean; Robert Hemmings; Francois Bissonnette; Seang Lin Tan



Knowledge, Attitude, Practice, and Determinants Emergency Contraceptive Use among Women Seeking Abortion Services in Dire Dawa, Ethiopia  

PubMed Central

Background Unplanned pregnancy from casual sex, unplanned sexual activity, and sexual violence are increasing. Emergency Contraceptives (EC) are used to prevent unplanned pregnancies thereby preventing the occurrence and consequences of unplanned pregnancy. Emergency contraception is widely available in Ethiopia particularly in major cities. Yet the use of EC is very low and abortion rate in cities is high compared to the national average. Objectives To assess knowledge, attitude and practice and determinants on the use of emergency contraception among women obtaining abortion service at selected health institutions in Dire Dawa, Eastern Ethiopia. Methods A facility based cross-sectional study was conducted on 390 women selected by multi-stage random sampling technique. The samples were generated from government and private for non profit health facilities. Participant’s knowledge and attitude towards emergency contraception were measured using composite index based on 7 and 9 questions, respectively and analyzed using mean score to classify them as knowledgeable or not, and have positive attitude or not. Practice was assessed if the women reported ever use of emergency contraception. Determinants of use of emergency contraception were analyzed using logistic regression. Result Out of 390 women interviewed, 162 women (41.5%) heard about EC, only 133 (34.1%) had good knowledge, and 200 (51.3%) of the respondents had positive attitudes towards to EC. Ever use of EC was reported by 38 (9.7%). Age, living arrangement, education, marital status, religion were found to be significantly associated with the use of emergency contraceptives. Women with poor knowledge were less likely to use EC compared to the knowledgeable ones [AOR?=?0.027, 95% CI (0.007, 0.105)]. Conclusion The study identified that most respondents lack adequate knowledge on the method of EC. In addition ever use of EC is very low. Recommendations Health professions should give attention in increasing knowledge and uptake of Emergency Contraception. PMID:25330229

Abate, Meskerem; Assefa, Nega; Alemayehu, Tadesse



New approaches to male non-hormonal contraception  

PubMed Central

A non-hormonal male contraceptive is a contraceptive that does not involve the administration of hormones or hormone blockers. This review will focus on the use of lonidamine derivatives and inhibitors of retinoic acid biosynthesis and function as approaches to male non-hormonal contraception. Two current lonidamine derivatives, Adjudin and H2-gamendazole, are in development as male contraceptives. These potent anti-spermatogenic compounds impair the integrity of the apical ectoplasmic specialization, resulting in premature spermiation and infertility. Another approach to male contraceptive development is the inhibition of retinoic acid in the testes, as retinoic acid signaling is necessary for spermatogenesis. The administration of the retinoic acid receptor antagonist BMS-189453 reversibly inhibits spermatogenesis in mice. Similarly, oral dosing of WIN 18,446, which inhibits testicular retinoic acid biosynthesis, effectively contracepts rabbits. Hopefully, one of these approaches to non-hormonal male contraception will prove to be safe and effective in future clinical trials. PMID:22995542

Nya-Ngatchou, Jean-Jacques; Amory, John K.



Contraception and Abortion: American Catholic Responses  

Microsoft Academic Search

The struggle within Roman Catholicism over contraception, and the struggle which is likely to arise over abortion, reflect a mixture of theological and social change. The challenge to papal authority inherent in the dissent from Pope Paul's encyclical on birth control is bound to have pro found ramifications in the church. At the same time, however, the fact of Catholic

Daniel Callahan



Contraceptives and teens: what are the options?  


This article focuses on the contraceptive options of adolescents to prevent unintended pregnancy. Based on the Contraceptive Technology Update 2000 Contraceptive Survey involving health care providers, 90% of the respondents will provide injectable depot medroxyprogesterone acetate (Depo-Provera or DMPA) to young teens. Meanwhile, in surveying providers¿ practices with regard to the possible link between DMPA use and diminishing bone mass, about half of the providers inform patients of such an effect and about 30% use other methods, such as counseling on calcium supplementation and weight-bearing exercise. However, just-released research revealed that DMPA's impact on bone density might be a short-term or current-user effect, apparently without long-term implications. On the other hand, when providers were asked for the treatment of severe dysmenorrhea in women who are not sexually active and have no plans to engage in such activity, 45% of respondents said they would prescribe an oral contraceptive and a prostaglandin inhibitor. PMID:12296243



Oral contraceptive health benefits: perception versus reality  

Microsoft Academic Search

Many women remain unaware of classic oral contraceptive (OC) noncontraceptive health benefits even as new health advantages emerge from experience and research. An extensive body of evidence has established that OC protect women against dysmenorrhea and menorrhagia, menstrual cycle irregularities, iron deficiency anemia, ectopic pregnancy, pelvic inflammatory disease, ovarian cysts, benign breast disease, endometrial cancer, and ovarian cancer. In addition,

Andrew M Kaunitz



Lamotrigine plasma levels reduced by oral contraceptives  

Microsoft Academic Search

Although it is known that the use of oral contraceptives (OC's) can induce glucuronide conjugating enzymes, currently no data exists as to the potential that the elimination of the glucuronidated drug lamotrigine (LTG) is increased by OC's. We present seven cases in whom the plasma levels of LTG were significantly decreased by OC's (mean 49%, range 41–64%). The interaction was

Anne Sabers; Jette M Buchholt; Peter Uldall; Ejvind L Hansen



An Oral Contraceptive Drug Interaction Study  

ERIC Educational Resources Information Center

This article focuses on a two treatment, two period, two treatment sequence crossover drug interaction study of a new drug and a standard oral contraceptive therapy. Both normal theory and distribution-free statistical analyses are provided along with a notable amount of graphical insight into the dataset. For one of the variables, the decision on…

Bradstreet, Thomas E.; Panebianco, Deborah L.



Oral contraceptives and death from myocardial infarction  

Microsoft Academic Search

We investigated 219 deaths from myocardial infarction in women under the age of 50. Their histories were compared with those of living age-matched controls selected from the same general practices. The frequency of use of oral contraceptives during the month before death was significantly greater in the group with infarction than during the corresponding month in the control group and

J I Mann; W H Inman



Compliance and oral contraceptives: A review  

Microsoft Academic Search

Compliance difficulties are more common among oral contraceptive (OC) users than generally appreciated by clinicians, in part because unintended pregnancy is a relatively infrequent consequence and in part because more common manifestations such as spotting and bleeding may not be recognized as resulting from poor compliance.While improving compliance is a shared responsibility of patients, clinicians, and manufacturers, the clinician is

Michael J. Rosenberg; Michael S. Burnhill; Michael S. Waugh; David A. Grimes; Paula J. A. Hillard



Vaginal rings for contraception in lactating women  

Microsoft Academic Search

Contraceptive methods for breastfeeding women should be safe for the mother and infant and should not interfere with lactation. Progestin-only methods meet these conditions and can be used from the sixth week postpartum. Because all progestins are excreted in milk, those that are insufficiently active by the oral route are preferable to avoid any possible effect on the baby. These

Rebeca Massai; Soledad D??az; Ted Jackanicz; Horacio B Croxatto



New delivery systems in contraception: vaginal rings  

Microsoft Academic Search

Vaginal rings, made of soft flexible silicone rubber, for delivery of contraceptive hormones are currently gaining clinical acceptance. This method provides extended release of hormones, which are implanted in the core of the ring and slowly disseminate into vaginal tissue. Although formulations and sizes vary, most rings are approximately 58 mm in diameter with a cross-section of 8.4 mm. Depending

Elof D. B. Johansson; Regine Sitruk-Ware



Contraception and Women with Intellectual Disabilities  

ERIC Educational Resources Information Center

Background: Contraception is widely prescribed to women with intellectual disabilities, yet little is known about what the women think and feel about this. One of the aims of the study was to explore what women understood and to what extent they were able to exercise choice and control. Method: Twenty-three women with mild and moderate…

McCarthy, Michelle



Sexual behaviour, contraceptive knowledge and use among female undergraduates' students of Muhimbili and Dar es Salaam Universities, Tanzania: a cross-sectional study  

PubMed Central

Background The rate of premarital sexual activity, unwanted pregnancies and illegal abortions remain higher among university students. This calls for understanding the knowledge on contraceptive use and sexual behaviours among this high risk group if the incidence of unintended pregnancy, illegal abortions and high sexual risky behaviour are to be minimized. This study aimed to assess ssexual behaviour, contraceptive knowledge and use among female undergraduates’ students of Muhimbili and Dar es Salaam Universities in Tanzania. Methods A cross-sectional analytic study was conducted among undergraduate female students in the two Universities located in Dar es Salaam region, Tanzania. The study period was from June 2013 to October 2013. A self-administered questionnaire was given to 281 students. Of these, 253 were retrieved, giving a response rate of 90%. Data was analyzed using Statistical Package for Social Science (SPSS) for Windows version 17.0. Descriptive statistics were summarized. The chi square test was used to examine relationship between various sociodemographic and sexual behaviours variables with contraceptive use. A P-value of less than 0.05 was considered statistically significant. Results Results showed that majority (70.4%) of the students have had sexual intercourse. All participants had knowledge of contraception. More than half, 148 (58.5%) of sexually active women reported ever used contraception before while 105 (41.5%) were current contraceptive users. Majority (74.7%) of the sexually active group started sexual activity at young age (19–24 years). Condom, 221(24.3%) and pills, 153 (16.8%) were the known contraceptive methods. The most popular method of contraception used were condoms, withdrawal and periodic abstinence. The main sources of information about contraception were from friends, radio and school (39.5%, 36% and 24%) respectively. Forty (15.8%) women had pregnancies. Of these, 11 (27%) have had unwanted pregnancies among which 54.6% have had induced abortion. Marital status, age at first sex, ever had sex, ever been pregnant and unwanted pregnancies were associated with use of contraception. Conclusions Most of the student’s had knowledge of contraception. However, rate of contraception use is still low. Majority of the respondent were sexually active, with the majority started sexual activity at young age. This needs advocacy for adolescence reproductive health education to promote the use of the available contraceptive services amongst university students. PMID:25099502



[Sex and contraceptive information for adolescents].  


A midwife with 6 years of experience in a family planning center serving many adolescent patients describes contraceptive information and education programs for adolescents. A meeting of school nurses and social assistants in 1978 to discuss the problems of adolescent contraceptive usage led to development of the current program of information visits to schools and provision of services in the center. A very active team of physicians, nurses, and social assistants has organized expositions and health debates to encourage student participation. The type of training needed for providers of contraceptive information to adolescents is difficult to specify. The author reports benefitting most from books, articles, and conferences, especially a training course on the French family planning movement with family counsellors and secondary school teachers, and a 1-year course on the theme of adolescence and maternity led by a multidisciplinary team. Provision of information on sex and contraception should be tailored to the needs of adolescents. It should be delivered in a way that respects their feelings, educational level, and right to speak. Attempts should be made to correct erroneous ideas, such as the common belief that pregnancy cannot occur at the 1st intercourse. Adolescents are often hesitant to discuss sexual topics with their parents. Parental fears of pregnancy, sexually transmitted diseases, and hypersexuality hinder free conversation. Parents may be embarrassed to use descriptive words in discussions about sex with their children. Adolescents able to communicate freely with their parents probably have no need of the family planning center, but a place should be provided for others to obtain information. The counselor should maintain the adult role and not try to act like a contemporary of the adolescent. In individual sessions, rapport should be established with the adolescent and efforts made to understand what he is seeking. It is better to avoid a complete anatomy course in favor of a personalized dialogue. The discussion of contraception should come after the adolescent's confidence has been gained. More personal questions about sexuality are often difficult for adolescents to ask. Answers to questions should be clear and reassuring. At the end of the interview an appointment can be made for a contraceptive consultation. Group discussions of sex and contraception are held monthly for adolescents. Information provided in schools varies depending on the age and grade level of the students. Descriptions of the genital organs and their functioning can lead to a discussion of the transformations of puberty for young groups. The discussion is easier for older students. Audiovisual aids of different kinds may be helpful but are not indispensable. PMID:3853924

Lacoste, C



Effectiveness of emergency contraception in women after sexual assault  

PubMed Central

Objective To assess the effectiveness of emergency single-dose levonorgestrel contraception in preventing unintended pregnancies among woman who visited the emergency department (ED) due to sexual assault (SA). Methods We conducted a retrospective chart review in a university hospital in South Korea. Cases from November 10, 2006 to November 9, 2009 were enrolled. Information from the initial visit to the ED and subsequent follow-up visits to the gynecology outpatient clinic was collected. Results In total, 1,179 women visited the ED due to SA. Among them, 416 patients had a gynecological examination and 302 patients who received emergency contraception (EC) (1.5 mg single-dose levonorgestrel) at the ED due to SA were enrolled. Ten patients did not return for follow-up examinations. In follow-up visits at the outpatient clinic, two pregnancies were confirmed, which showed the failure rate of the EC to be 0.68%. Conclusion Single-dose levonorgestrel EC is extremely effective at preventing pregnancy among victims of SA. PMID:24179870

Choi, Dong Seok; Hwang, Kyung Joo; Lee, Kyoung Mi; Kong, Tae Wook



Sexuality, sexual behaviour and contraception in East Germany.  


Social factors may influence sexual health and its related behaviour. The political changes in East Germany have revealed a positive attitude towards sexuality and the use of family planning methods. A study on sexual behaviour and the use of contraceptives was undertaken recently, at the end of the old regime and the beginning of the new one. The survey was performed among 3103 male and female respondents (pupils, students and workers) of between 16 and 48 years of age. The results show a decreased number of stable partner relationships among young people, however, love and sexuality are considered to be central values. Before the age of 19 years, the majority of girls (80%) and boys (68%) had had sexual intercourse for the first time, a rate which has not changed during the last decade. There is a tendency to postpone having a first child. Modern contraception is widely accepted and used. There is a growing number of condom users, however, the pill is still the most popular method. Family planning is much more advanced than in the other countries of Eastern Europe. Sex education and counselling should sustain this situation. PMID:7971550

Starke, K; Visser, A P



Women's reasons for discontinuing contraceptive use within 12 months: Jamaica.  


In Jamaica, contraceptive use is high at 66 per cent. However, only 34 per cent of pregnancies are planned. This study was carried out in 1998 to determine the factors which influenced continuation of use of family planning methods. Primary data were collected from 463 mostly post-natal women utilising eight large clinics in the public health sector in Kingston, Jamaica. They were interviewed using a closed-ended questionnaire three times over a year and a sub-sample participated in focus group discussions. The overall continuation rate was only 56 per cent. Cost of methods was an issue for some women. Long clinic waiting times discouraged women from attending clinics; the scheduling of clinic appointments would reduce this problem. Women need more information about side effects of methods and to be reassured of the quality of methods given out by clinics. Health personnel need to become more aware of the significance of rumors about methods and discuss these with women so that the negative influence of misinformation is minimised. Although the findings of this study are not 'new' information, 'old' problems in the provision of services still exist. Women, at least in poorer communities, continue to lack basic information about contraceptives and there is a need for ongoing attention to improving quality of care. PMID:11468842

Henry-Lee, A



Mortality among oral contraceptive users: 20 year follow up of women in a cohort study.  

PubMed Central

OBJECTIVE--To see whether the use of oral contraceptives influences mortality. DESIGN--Non-randomised cohort study of 17,032 women followed up on an annual basis for an average of nearly 16 years. SETTING--17 Family planning clinics in England and Scotland. SUBJECTS--Women recruited during 1968-74. At the time of recruitment each woman was aged 25-39, married, a white British subject, willing to participate, and either a current user of oral contraceptives or a current user of a diaphragm or intrauterine device (without previous exposure to the pill). MAIN OUTCOME MEASURES--Overall mortality and cause specific mortality. RESULTS--238 Deaths occurred during the follow up period. The main analyses concerned women entering the study while using either oral contraceptives or a diaphragm or intrauterine device. The overall relative risk of death in the oral contraceptive users was 0.9 (95% confidence interval 0.7 to 1.2). Though the numbers of deaths were small in most individual disease categories, the trends observed were generally consistent with findings in other reports. Thus the relative risk of death in the oral contraceptive users was 4.9 (95% confidence interval 0.7 to 230) for cancer of the cervix, 3.3 (95% confidence interval 0.9 to 17.9) for ischaemic heart disease, and 0.4 (95% confidence interval 0.1 to 1.2) for ovarian cancer. There was a linear trend in the death rates from cervical cancer and ovarian cancer (in opposite directions) with total duration of oral contraceptive use. Death rates from breast cancer (relative risk 0.9; 95% confidence interval 0.5 to 1.4) and suicide and probable suicide (relative risk 1.1; 95% confidence interval 0.3 to 3.6) were much the same in the two contraceptive groups. In 1981 the relative risk of death in oral contraceptive users from circulatory diseases as a group was reported to be 4.2 (95% confidence interval 2.3 to 7.7) in the Royal College of General Practitioners oral contraception study. The corresponding relative risk in this study was only 1.5 (95% confidence interval 0.7 to 3.0). CONCLUSIONS--These findings contain no significant evidence of any overall effect of oral contraceptive use on mortality. None the less, only small numbers of deaths occurred during the study period and a significant adverse (or beneficial) overall effect might emerge in the future. Interestingly, the mortality from circulatory disease associated with oral contraceptive use was substantially less than that found in the Royal College of General Practitioners study. PMID:2514858

Vessey, M. P.; Villard-Mackintosh, L.; McPherson, K.; Yeates, D.



Physical access to health facilities and contraceptive use in Kenya: evidence from the 2008-2009 Kenya Demographic and Health Survey.  


The objective of the study was to determine the spatial variation in modern contraceptive use and unmet need for family planning across the counties of Kenya and to examine whether the spatial patterns were associated with inequalities in physical access to health facilities. Data were obtained from the 2008-2009 Kenya Demographic and Health Survey and linked to the location of health facilities in the country. Multivariate logistic regression was used to examine the influence of distance to the nearest health facility and health facility density, in addition to other covariates, on modern contraceptive use and unmet need. Overall, the prevalence of modern contraceptive use and unmet need among women aged 15-49 in Kenya was 42.1% and 19.7% respectively. Among the respondents who lived more than 5 km from the nearest health facility modern contraceptive use was significantly less likely compared to women resident 5 km or less from the nearest health facility. Women from counties with higher health facility density were 53% more likely to use modern contraceptives compared to women in counties with low health facility density. Distance and health facility density in the county were not significantly associated with unmet need. Physical access to health facilities is an important determinant of modern contraceptive use and unmet need in Kenya. Strategies should be developed in underserved counties to mitigate the challenge of distance to health facilities, such as delivering services by outreach and mobile facilities. PMID:23437499

Ettarh, Remare R; Kyobutungi, Catherine



Correlates of Dual-Method Contraceptive Use: An Analysis of the National Survey of Family Growth (2006-2008)  

PubMed Central

Objective. To analyze a nationally representative sample of women for correlates of dual-contraceptive-method use. Materials and Methods. We conducted an analysis of the National Survey of Family Growth, 2006–2008, a cross-sectional survey of reproductive-aged women in the United States. Results. Dual method use was reported by 7.3% of the 5,178 women in the sample. Correlates of higher rates of dual-contraceptive-method use included age younger than 36 years and nonmarried marital status. Lower rates of dual method use were observed for women with less than a high-school education and women without consistent health insurance in the past year. Compared to women using oral contraceptives, use of the contraceptive injection or long-acting reversible contraception was associated with lower dual-method use. Conclusions. The overall rate of dual-method use in the USA is low. Future interventions to promote dual method use should target high-risk groups with modifiable risk factors. PMID:22505799

Eisenberg, David L.; Allsworth, Jenifer E.; Zhao, Qiuhong; Peipert, Jeffrey F.



Prevalence rates of sexual difficulties and associated distress in heterosexual men and women: results from an Internet survey in Flanders.  


As most epidemiological surveys on sexual problems have not included assessment of associated distress, the principal aim of this study was to provide prevalence estimates of both DSM-IV-TR-defined (American Psychiatric Association [APA], 2000 ) and less commonly assessed sexual difficulties and dysfunction (e.g., lack of responsive sexual desire, lack of subjective arousal). A secondary aim was to obtain information about comorbidity between sexual desire and sexual arousal difficulties/dysfunction. This study comprised an online survey completed by 35,132 heterosexual Flemish men and women (aged 16 to 74 years). Results indicated that sexual dysfunctions were far less common than sexual difficulties, and some uncommonly assessed sexual problems (e.g., "lack of responsive desire" in women; "hyperactive sexual desire" in men) were quite prevalent. In women, there was a high comorbidity between "lack of spontaneous sexual desire" and "lack of responsive sexual desire"; between "lack of genital arousal" and "lack of subjective sexual arousal"; and between sexual desire and sexual arousal difficulties/dysfunctions. The implications of these findings for epidemiological research on sexual dysfunction and for the newly defined DSM-5 Female Sexual Interest/Arousal Disorder (APA, 2013 ) are discussed. PMID:24164633

Hendrickx, Lies; Gijs, Luk; Enzlin, Paul



Partner Roles in Contraceptive Use: What Do Adolescent Mothers Say?  

PubMed Central

Study Objective To examine the role of sexual partners in adolescent mothers’ use of non-coital dependent contraceptive methods in the postpartum period. Design/Setting/Participants 40 African American adolescent mothers completed surveys and qualitative interviews during the first postpartum year as part of a larger longitudinal study in Chicago, Illinois. Themes related to contraception and sexual partners were analyzed. Main Outcome Measures Adolescent mothers’ reports of partners’ roles in the use of non-coital dependent contraceptive methods (i.e., oral contraceptives, intrauterine contraception, and depot medroxyprogesterone acetate). Results Partners largely supported the use of non-coital dependent contraceptive methods, yet mechanisms of support varied greatly, from advocating for specific methods to facilitating participants’ continuation of their chosen method. Unsupportive partners either expressed concerns about the safety and side effects of specific methods or desired another child in the near future. Participants valued these preferences to different degrees when making their contraceptive decisions. Conclusions Partners of adolescent mothers play varying roles in postpartum contraceptive decisions. They thus have the potential to both inhibit and facilitate the use of non-coital dependent contraception. Quantitative research is needed to further evaluate how partner attitudes and support behaviors, among other factors, affect contraceptive initiation and continuation among adolescent mothers. PMID:23089574

Lewis, Dinah A.; Martins, Summer L.; Gilliam, Melissa L.



Roles of the pharmacist in the use of safe and highly effective long-acting reversible contraception: an opinion of the women's health practice and research network of the American College of Clinical Pharmacy.  


The U.S. population continues to experience an alarmingly high rate of unintended pregnancies that have an impact on individual families and society alike. Lack of effective contraception accounts for most unintended pregnancies, along with incorrect use of contraceptives. The most common reversible contraceptive method used in the United States is the oral contraceptive pill, which has significant failure and discontinuation rates. Use of long-acting reversible contraceptive (LARC) methods has been increasing in recent years after efforts to educate providers and patients. Women are more likely to use LARC methods when barriers such as access and cost are removed. An uptake in the use of LARC methods would allow for markedly reduced contraception failure rates and higher user satisfaction and thus higher continuation rates than those seen with current contraception use. Promoting the use of LARC methods is an important strategy in improving both individual and public health outcomes by reducing unintended pregnancies. The pharmacist's role in family planning is expanding and can contribute to these efforts. Although knowledge regarding LARC has not been studied among pharmacists, a knowledge deficit exists among health care professionals in general. Thus pharmacist education and training should include LARC methods along with other contraceptives. The American College of Clinical Pharmacy Women's Health Practice and Research Network advocates for the pharmacist's role in the use of safe and highly effective LARC methods. These roles include educating patients, informing providers, facilitating access by providing referrals, and modifying institutional procedures to encourage provision of LARC methods. PMID:24989020

Rafie, Sally; McIntosh, Jennifer; Shealy, Kayce M; Borgelt, Laura M; Forinash, Alicia; Shrader, Sarah P; Koepf, Erin R; McClendon, Katie S; Griffin, Brooke L; Horlen, Cheryl; Karaoui, Lamis R; Rowe, Emily L; Lodise, Nicole M; Wigle, Patricia R



Popular Contraceptive Methods in Women Aged 35 Years and Older Attending Health Centers of 4 Cities in Khuzestan Province, Iran  

PubMed Central

Background The prevalence of unintended pregnancy and associated risks are higher in late reproductive years. Limited studies have focused on contraceptive choices in these women. The aim of the study was to identify contraceptive choices and their related factors in women 35 years or older attending health centers of Khuzestan province. Objectives Additionally, several line of evidence indicated relationship between increasing maternal age and poor pregnancy outcomes (1, 2). Pregnancies above the age of 35 are accompanied with more risks for complication related to pregnancy as compared to younger women (3-5). Risk of spontaneous abortion is 74.4% in mothers aged 45 years or more. Patients and Methods In a cross-sectional study 1584 women aged 35 years and older attending public health centers of four cities of Khuzestan were studied. We used an interviewer-administered questionnaire for data collection. Women investigators were recruited for interview and filling the questionnaire. Participants were assured of the confidentiality of their responses. Results The mean age of women was 39.8 ± 4.2 years. The most popular contraceptive methods used in this age group were oral contraceptive pills (31.4%), condom (28.1%), and tubal ligation (14.8%). Less effective contraceptive methods were used in 41.5% of women. Significant associations were found between the use of effective methods and literacy of husband (OR = 0.80, 95% CI: 0.75, 0.91), city of residence (OR = 0, 92, 95%CI: 0.87-0.97), women age (OR = 0.97, 95% CI; 0.94-0.99), and women education (OR = 0.87, 95%CI: 0.76-0.99) (P < 0.01). Conclusions In spite of risk of pregnancy and unintended pregnancy in this age group, about a half of them used less effective contraceptive methods, hence family planning education, and counseling to older women should be a priority in health centers. PMID:24693364

Nouhjah, Sedighe; Amiri, Elham; Khodai, Azim; Yazdanpanah, Azar; Nadi Baghu, Maryam



Contraception for the HIV-Positive Woman: A Review of Interactions between Hormonal Contraception and Antiretroviral Therapy  

PubMed Central

Background. Preventing unintended pregnancy in HIV-positive women can significantly reduce maternal-to-child HIV transmission as well as improve the woman's overall health. Hormonal contraceptives are safe and effective means to avoid unintended pregnancy, but there is concern that coadministration of antiretroviral drugs may alter contraceptive efficacy. Materials and Methods. We performed a literature search of PubMed and Ovid databases of articles published between January 1980 and February 2012 to identify English-language reports of drug-drug interactions between hormonal contraceptives (HCs) and antiretroviral drugs (ARVs). We also reviewed the FDA prescribing information of contraceptive hormone preparations and antiretrovirals for additional data and recommendations. Results. Twenty peer-reviewed publications and 42 pharmaceutical package labels were reviewed. Several studies of combined oral contraceptive pills (COCs) identified decreased serum estrogen and progestin levels when coadministered with certain ARVs. The contraceptive efficacy of injectable depot medroxyprogesterone acetate (DMPA) and the levonorgestrel intrauterine system (LNG-IUS) were largely unaffected by ARVs, while data on the contraceptive patch, ring, and implant were lacking. Conclusions. HIV-positive women should be offered a full range of hormonal contraceptive options, with conscientious counseling about possible reduced efficacy of COCs and the contraceptive implant when taken with ARVs. DMPA and the LNG-IUS maintain their contraceptive efficacy when taken with ARVs. PMID:22927715

Robinson, Jennifer A.; Jamshidi, Roxanne; Burke, Anne E.



[Evaluation of sex education and contraception instruction at the contraception clinic in Odense].  


The aim of the study was to evaluate 1 1/2 hours of lessons on contraception given to 9. and 10. grade students at the Contraception Clinic in Odense, Denmark. The lessons are a supplement to the traditional sexual education given at the school. The study included 148 pupils in the period from August 1991 to January 1992. The median age was 15 years for both girls and boys. The pupils answered two identical questionnaires; one just before the lessons were given and the other ten to 13 weeks after the visit to the clinic. The article presents the answers given about male and female sexual function, knowledge/own choice of contraception, pregnancy, abortion and HIV. The extra lessons improved the knowledge among the pupils, but there were still some boys with inadequate knowledge. The article gives suggestions for improving the teaching of contraception, such as having both male and female teachers. This would also emphasize that both sexes have a common responsibility. If the pupils answer a simple questionnaire before the lessons, it is possible to goal-direct the education to individual requirements. The pupils are introduced to the Contraception Clinic, where they easily can seek advice in the future. PMID:8644395

Mygind, L; Nielsen, R T; Wielandt, H B



The rate of TB-HIV co-infection depends on the prevalence of HIV infection in a community  

Microsoft Academic Search

BACKGROUND: A complex interaction exists between tuberculosis (TB) and human immunodeficiency virus (HIV) infection at an individual and community level. Limited knowledge about the rate of HIV infection in TB patients and the general population compromises the planning, resource allocation and prevention and control activities. The aim of this study was to determine the rate of HIV infection in TB

Daniel G Datiko; Mohammed A Yassin; Luelseged T Chekol; Lopisso E Kabeto; Bernt Lindtjørn



High and low contraceptive use amongst young male offenders: a qualitative interview study  

PubMed Central

Objectives There are high rates of fatherhood and sexually transmitted infections (STIs) among young incarcerated men. Here we focus on a sample of men incarcerated in a Scottish Young Offender Institution, analysing their accounts of their contraceptive use. Those who report low or no use of contraception are compared with those who report high use. Methods Semi-structured interviews with 40 young male offenders, aged 16–21?years. Participants were purposively sampled using answers from a questionnaire administered to 67 inmates. Data from those men (n=31) reporting either high (n=14) or low/no use (n=17) of contraception are analysed here. Results Low users emphasise their desire for pleasure and appear fatalistic about both pregnancy and disease prevention. High users report a strong desire to protect themselves and their ‘manliness’ by using condoms to avoid the risk of STIs and, to a lesser extent, pregnancy. Both sets of men present themselves in a traditionally masculine way, with high users emphasising power, authority and self-control to justify their non-risk-taking contraceptive behaviour. Conclusions The masculine narrative regarding self-protection, utilised by the high users, may be an effective method of intervention with potential and actual low users. Conventional masculinity valorises risk-taking but if particular forms of risk avoidance – condom use – can be legitimised as confirming one's masculinity it may be possible to persuade low users to adopt them. The opportunity to work with young men whilst incarcerated should be grasped. PMID:24736230

Buston, Katie; Parkes, Alison; Wight, Danny



[Adolescents and contraception. What should the pediatrician know? (Part 2)].  


Many adolescents are sexually active and reproductive health is an important aspect of adolescent medicine. However, pediatricians are often uncomfortable with the issues of sexuality and contraception, for which they have not been particularly trained. The general purpose of this article is to increase pediatricians' sense of competence with adolescents, particularly when having to deal with or counsel on such a sensitive issue as contraception. This second of two parts addresses confidentiality and prescription of oral contraceptives to minors, how to ask questions about sexual and reproductive life, best initial choice and eventual subsequent switch of contraceptive pill, acne and oral contraception, problems with mental handicap, and finally, what about boys. Pediatricians interested in the care of adolescents are strongly invited to keep developing their expertise in the field of sexuality, contraception and reproductive health. PMID:11915502

Alvin, P; Neu-Janicki, A M; Jacquin, P; Salinier, C



Demographic and sociocultural factors influencing contraceptive use in Uganda.  


Bivariate and multivariate analyses of the influence of demographic and sociocultural factors on contraceptive knowledge, attitudes and practice among currently married respondents in Uganda show that: (1) contraceptive knowledge is widespread, even among women with no education; (ii) the majority of the respondents have favourable attitudes towards contraceptive use; (iii) the level of contraceptive use is low in comparison with knowledge and attitudes. Post-primary education, ethnicity, residence, the presence of the spouse in the household and discussion of family planning with spouse were strong predictors of knowledge and favourable attitudes towards contraception. Secondary or higher education, discussion of family planning with spouse and urban residence strongly influenced contraceptive use, but child mortality did not. The use of condoms as a behavioural change to avoid contracting HIV/AIDS was low. The results suggest that, particularly in rural areas, family planning services are not meeting the needs of potential clients. PMID:7876295

Agyei, W K; Migadde, M



Hormone withdrawal symptoms in oral contraceptive users  

Microsoft Academic Search

Objective: To measure the timing, frequency, and severity of hormone-related symptoms in oral contraceptive (OC) users, specifically to compare active-pill with hormone-free intervals.Methods: Using daily diaries, women recorded pelvic pain, bleeding, headaches, analgesic use, nausea or vomiting, bloating or swelling, and breast tenderness during active-pill intervals and hormone-free intervals. Participants either had no prior OC use, had taken OCs and

Patricia J Sulak; Roger D Scow; Cheryl Preece; Mark W Riggs; Thomas J Kuehl



Frequency of intercourse and contraceptive choice.  


The effects of frequency of intercourse on perceptions of two of the most widely used contraceptive methods, the pill and condom, were assessed in 128 female college students currently involved in a sexual relationship. Intercourse frequency was found to be strongly associated with knowledge of both methods. People experiencing more frequent sexual intercourse were more favourably disposed towards the pill and less towards the condom than people experiencing intercourse less frequently. Implications of these results are discussed. PMID:2335544

Glor, J E; Severy, L J




Microsoft Academic Search

Due to increasing human-wildlife conflicts with birds and growing opposition to lethal techniques, nonlethal methods need to be developed to help manage bird populations. DiazaCon™ is a promising oral contraceptive that acts by directly inhibiting the conversion of desmosterol to cholesterol. Because cholesterol is essential for the production of the steroid reproductive hormones testosterone, progesterone, and estradiol, DiazaCon™ also indirectly



Progestin-only contraceptive pill use among women in the United States  

PubMed Central

Background Progestin-only contraceptive pills (POPs) offer a safe and effective contraceptive option, particularly for women at increased risk of venous thromboembolism. However, the prevalence of POP use among women in the United States is unknown. Study design We analyzed population-based data from 12,279 women ages 15-44 years in the National Survey of Family Growth. Data were collected continuously from 2006 to 2010 by in-person, computerized household interviews. Analyses describe POP use across sociodemographic and reproductive characteristics and thromboembolic risk profiles. Results Overall, 0.4% of all reproductive aged women in the U.S. currently use POPs. POP use was higher among parous, postpartum and breastfeeding women than their counterparts (all p-values<0.001). Women at higher risk of thromboembolism (older, obese, diabetic, or smoking women) had similar proportions of POP use as women without those risks. Conclusion POPs are rarely used by U.S. women. While data on chronic disease were limited, our results suggest relatively few women with increased risk of thromboembolism are considering POPs when choosing an oral contraceptive. PMID:22682722

Hall, Kelli Stidham; Trussell, James; Schwarz, Eleanor Bimla



Oral contraceptives in the immediate postpartum period.  


Although there is a critical need for effective contraception in the immediate postpartum period for women who are not breastfeeding, this need must be balanced against the inherent risks. The most effective form of contraceptive protection--oral contraceptives (OCs)--can present an increased risk of thromboembolism in the period after delivery. The thrombotic changes associated with pregnancy, and the statistics and vascular damage following a delivery, can combine to create greater potential for thromboembolism after delivery than during pregnancy. Reported here is the case of a 21-year-old woman who, 4 weeks postpartum, developed pain and swelling in the right lower calf and mottled discoloration extending from the proximal thigh to the toes. A diagnosis of deep venous thrombosis was made and heparin was administered. In the hospital, the patient experienced pleuritic chest pain and diaphoresis. A ventilation-perfusion scan indicated a pulmonary embolism. 1 week after delivery, the patient had initiated use of Triphasil. Although this woman had other risk factors (obesity, light cigarette smoking, and a sedentary life-style), OC use in the immediate postpartum period may have been the final factor precipitating the thromboembolic event. It is recommended that OC use should be delayed until at least 2 weeks postpartum in women without other risk factors for thromboembolism and until 4-6 weeks postpartum in those with such factors. PMID:2010744

Hume, A L; Hijab, J C



Unmet need for contraception: issues and challenges.  


Unmet need for contraception has been a central indicator for monitoring the progress of family planning programs for 25 years. The purpose of this article is to provide a broad context for the more focused contributions that follow in this special issue. The validity and measurement of the concept of unmet need are discussed. We then present regional trends among married women since 1970. Major reductions in unmet need have been achieved, with the clear exception of sub-Saharan Africa. Less success can be claimed in addressing the needs of sexually active unmarried women, who contribute nearly 20 percent to overall unmet need in developing countries. Prominent reasons for unmet need in settings where contraceptive uptake is low include social resistance and insufficient information concerning methods. As contraceptive use increases, the importance of these reasons wanes, but concerns regarding side effects and health impact remain a barrier, and discontinued users now constitute a large proportion of those with unmet need. Drawing on these reasons, we outline measures to further reduce unmet need. PMID:24931071

Cleland, John; Harbison, Sarah; Shah, Iqbal H



Impact of hormonal contraception on prothrombotic activity in vessels.  


One of the most common, efficient and convenient methods of contraception is hormonal contraception. Due to its popularity among young women, the safety of this method should be taken into consideration. Alternative ways of hormonal application are used and additional prothrombotic factors are being researched in order to minimize prothrombotic activity. The paper presents current data on the relationship between hormonal contraception and vascular complications based on peer-reviewed medical journals that were published between the years 2001 and 2013. PMID:24769552

Gacka, M; Adamiec, R



Use of Modern Contraception by the Poor Is Falling Behind  

Microsoft Academic Search

BackgroundThe widespread increase in the use of contraception, due to multiple factors including improved access to modern contraception, is one of the most dramatic social transformations of the past fifty years. This study explores whether the global progress in the use of modern contraceptives has also benefited the poorest.Methods and FindingsDemographic and Health Surveys from 55 developing countries were analyzed

Emmanuela Gakidou; Effy Vayena



The emerging use of the 20-?g oral contraceptive  

Microsoft Academic Search

Objective: To highlight studies that investigated the efficacy, safety, and tolerability of low-dose oral contraceptives (OCs) containing 20 ?g of ethinyl estradiol (EE) and to discuss the use of these low-dose contraceptives in women from adolescence to menopause and the noncontraceptive health benefits likely to be afforded by low-dose contraceptives.Design: Relevant literature was identified by searching MEDLINE and EMBASE. Other

Alfred Poindexter



21 CFR 310.501 - Patient package inserts for oral contraceptives.  

Code of Federal Regulations, 2012 CFR

...Patient package inserts for oral contraceptives. 310.501 Section 310...Patient package inserts for oral contraceptives. (a) Requirement and effective use of oral contraceptive drug products requires...



21 CFR 310.501 - Patient package inserts for oral contraceptives.  

Code of Federal Regulations, 2011 CFR

...Patient package inserts for oral contraceptives. 310.501 Section 310...Patient package inserts for oral contraceptives. (a) Requirement and effective use of oral contraceptive drug products requires...



Effects of Administration of Fostamatinib on Blood Concentrations of an Oral Contraceptive in Healthy Female Subjects

Scientific Terminology Rheumatoid Arthritis, Healthy Female Volunteers, Pharmacokinetics, Oral Contraceptive, Drug-drug Interaction; Laymen Terminology Level of Oral Contraceptive in Blood, Oral Contraceptive, Rheumatoid Arthritis, Drug -Drug Interaction



Original research article Risk of venous thromboembolism from oral contraceptives containing  

E-print Network

Original research article Risk of venous thromboembolism from oral contraceptives containing, USA Abstract Controversy exists regarding whether oral contraceptives (OCs) containing desogestrel for a given woman. © 2001 Elsevier Science Inc. All rights reserved. Keywords: Oral contraceptives; Venous

Hennessy, Sean


21 CFR 310.501 - Patient package inserts for oral contraceptives.  

Code of Federal Regulations, 2010 CFR

...Patient package inserts for oral contraceptives. 310.501 Section 310...Patient package inserts for oral contraceptives. (a) Requirement and effective use of oral contraceptive drug products requires...



21 CFR 310.501 - Patient package inserts for oral contraceptives.  

Code of Federal Regulations, 2013 CFR

...Patient package inserts for oral contraceptives. 310.501 Section 310...Patient package inserts for oral contraceptives. (a) Requirement and effective use of oral contraceptive drug products requires...



21 CFR 310.501 - Patient package inserts for oral contraceptives.  

...Patient package inserts for oral contraceptives. 310.501 Section 310...Patient package inserts for oral contraceptives. (a) Requirement and effective use of oral contraceptive drug products requires...



Very high childhood obesity prevalence and low adherence rates to the Mediterranean diet in Greek children: The GRECO study  

Microsoft Academic Search

ObjectiveIn order to provide estimates of overweight and obesity among Greek schoolchildren, and the adherence rates to the Mediterranean diet (MD), a nationwide survey was performed among fifth and sixth grade students aged 10–12 years old.

Paul Farajian; Grigoris Risvas; Konstantina Karasouli; Georgios D. Pounis; Christina M. Kastorini; Demosthenes B. Panagiotakos; Antonis Zampelas



Factors related to choosing oral contraception at age 15.  


This report aims to identify factors which are related to use of oral contraceptives at an early age. A self-administered questionnaire was completed at schools in 1988 and 1992 in southern and western Finland (N = 1339). Sexually experienced girls (mean age 15.8 years) who had answered the question concerning their oral contraceptive use were included (N = 389). Logistic regression analysis was used to compare oral contraceptive users (N = 121) with the group of non-users. Total number of coital experiences was associated with oral contraceptive use: the odds ratio for those having at least 10 coital experiences was 6.30 compared with those with only one intercourse. The proportion was 73% among oral contraceptive users and 30% among non-users. Girls using oral contraceptives perceived more often (67%) that parents accept their sexual relationship (30% among non-users). Oral contraceptive users were less afraid of getting pregnant (9% compared with 31% among non-users) and felt more often that sex was very important in their life (31 and 13%, respectively). Other factors that entered the model were age at menarche, having a steady partner and frequency of disco visits. When a young girl asks for oral contraceptives, she is probably at true risk of pregnancy, and regular contraception should be considered both in view of effective prevention of pregnancies and sexually transmitted diseases. PMID:10163954

Kosunen, E; Laippala, P



Reliance on condoms for contraceptive protection among HIV care and treatment clients: a mixed methods study on contraceptive choice and motivation within a generalised epidemic  

PubMed Central

Objectives To (i) describe the contraceptive practices of HIV care and treatment (HCTx) clients in Manzini, Swaziland, including their unmet needs for family planning (FP), and compare these with population-level estimates; and (ii) qualitatively explore the causal factors influencing contraceptive choice and use. Methods Mixed quantitative and qualitative methods were used. A cross-sectional survey conducted among HCTx clients (N=611) investigated FP and condom use patterns. Using descriptive statistics, findings were compared with population-level estimates derived from Swaziland Demographic and Health Survey data, weighted for clustering. In-depth interviews were conducted with HCTx providers (n=16) and clients (n=22) and analysed thematically. Results 64% of HCTx clients reported current contraceptive use; most relied on condoms alone, few practiced dual method use. Rates of condom use for FP among female HCTx clients (77%, 95% CI 71% to 82%) were higher than population-level estimates in the study region (50% HIV-positive, 95% CI 43% to 57%; 37% HIV-negative, 95% CI 31% to 43%); rates of unmet FP needs were similar when condom use consistency was accounted for (32% HCTx, 95% CI 26% to 37%; vs 35% HIV-positive, 95% CI 28% to 43%; 29% HIV-negative, 95% CI 24% to 35%). Qualitative analysis identified motivational factors influencing FP choice: fears of reinfection; a programmatic focus on condoms for people living with HIV; changing sexual behaviours before and after antiretroviral therapy (ART) initiation; failure to disclose to partners; and contraceptive side effect fears. Conclusions Fears of reinfection prevailed over consideration of pregnancy risk. Given current evidence on reinfection, HCTx services must move beyond a narrow focus on condom promotion, particularly for those in seroconcordant relationships, and consider diverse strategies to meet reproductive needs. PMID:24695990

Church, Kathryn; Wringe, Alison; Fakudze, Phelele; Kikuvi, Joshua; Nhlabatsi, Zelda; Masuku, Rachel; Initiative, Integra; Mayhew, Susannah H



[Sex education, sex behavior, contraception].  


Sexual behavior has changed during the last decades. Teenage fertility rate, and the number of gonococcal infections are both extremely high; the incidence of HIV-infections is increasing. Preventive measures include sex education. Sex education may help the adolescents to identify their own goals for sexual behavior, to avoid unintended and unwanted pregnancy, and to avoid sexually transmitted diseases. PMID:1945474

Borkenstein, M; Schwingshandl, J; Kuttnig, M; Limbert, C



Oral contraceptives and non-contraceptive oestrogens in the risk of gallstone disease requiring surgery.  

PubMed Central

STUDY OBJECTIVE--The aim was to investigate the relationship between oral contraceptives, non-contraceptive oestrogens, and the risk of gallstone disease requiring surgery. DESIGN--This was a hospital based case-control study carried out between 1987 and 1990. Main outcome measures were frequency of consumption of oral contraceptives and non-contraceptive oestrogens, and the corresponding multivariate relative risk estimates and 95% confidence intervals (CI) in relation to various measures of use of the preparations. SETTING--A network including major teaching and general hospitals in the greater Milan area, northern Italy. SUBJECTS--Subjects were 235 women with gallstones requiring surgery and 538 controls admitted for acute diseases, other than digestive or hormonal diseases or those potentially influencing the use of female hormone preparations. MAIN RESULTS--For oral contraceptives, the relative risk for ever use was 0.8 with 95% CI 0.4 to 1.5. With reference to duration of use, the multivariate relative risk was 1.0 for less than two and 0.5 for two or more years of use. The relative risk was 1.7 (95% CI 0.6 to 4.7) in women who had last used the pill less than five years before diagnosis, but declined to 0.4 (95% CI 0.2 to 1.0) in those who had stopped more than five years before. With reference to oestrogen replacement treatment, the relative risk for ever use was 1.9 (95% CI 1.0 to 3.1). The relative risk, however, was not related to duration of use, since it was 1.8 for less than two and 1.5 for two or more years of use. Relative risk was higher for women who had last used non-contraceptive oestrogens 10 or more years before diagnosis (2.4) than for shorter periods since last use (1.3). CONCLUSIONS--On a clinical and public health scale, oral contraceptives and non-contraceptive oestrogens are unlikely to have an important influence in the aetiology of gallbladder disease. PMID:1645077

La Vecchia, C; Negri, E; D'Avanzo, B; Parazzini, F; Gentile, A; Franceschi, S



Jordanian men's attitudes and views of birth-spacing and contraceptive use (a qualitative approach).  


This qualitative study was carried out to understand the meaning that Jordanian men attach to birth-spacing/family planning and to identify their attitudes and practices regarding contraceptives. Six focus group discussions were conducted over a 3-month period starting April 1996, with each group containing 6-10 men. The sample consisted of Jordanian men residing in Amman. Education, social class, and marital status stratified men's selection. The discussions were moderated by a social psychologist of the same sex. With respondents' consent, data gathered in the discussion groups were tape-recorded, transcribed, and critically analyzed using the content analysis method. The researchers found that there was a consensus among all men about the link between the concept of birth-spacing/family planning and the concept of better health for the mother and the child. Yet, the practice of contraception was influenced by some religious and cultural beliefs including that of "RIZK" (or fortune) which comes when the child is born. Moreover, some knowledge deficits concerning modern methods of contraception, and their side effects in particular, were noted. Some unfavorable attitudes of men for themselves using male contraceptives were also noted. Most men in the study indicated that spousal communication takes place on issues related to family planning, but the final decision is, in most cases, left to the husband alone (the head of the house). The demand for an increasing number of male children and the resistance of males to use condoms were among the most prevalent unexpected phenomena noticed in this study. The study concludes by recommending that special attention be directed to males when delivering family planning services. PMID:12418974

Petro-Nustas, Wasileh; Al-Qutob, Rae'da



Health Behaviors, Chronic Disease Prevalence and Self-Rated Health of Older Asian Indian Immigrants in the U.S  

Microsoft Academic Search

The purpose of this study was to examine the correlates of healthy behaviors and self-rated health in middle-aged and older Asian Indian immigrants in the U.S. Asian Indian men (n = 162) and women (n = 64), 50 years of age or older completed a telephone survey which collected information regarding demographics, behavioral risk factors, acculturation, perceived control, quality of

Satya S. Jonnalagadda; Sadhna Diwan



Diagnostic Prevalence Rates from Early to Mid-Adolescence among Indigenous Adolescents: First Results from a Longitudinal Study  

ERIC Educational Resources Information Center

The study investigates change in occurrences for mental and substance abuse children between early and mid-adolescence among a group of indigenous adolescents. Findings show a dramatic increase in occurrence rates for substance abuse disorder and conduct disorder, and a mental health crisis on indigenous reservations and reserves indicating a need…

Whitbeck, Les B.; Yu, Mansoo; Johnson, Kurt D.; Hoyt, Dan R.; Walls, Melissa L.



NFP offers user-control, but requires discipline. Contraceptive update.  


Natural family planning (NFP) is a low-cost, user-controlled contraceptive method void of side effects. Couples who choose to rely on NFP must recognize normal physiological changes (e.g., a rise in the woman's temperature and changes in the consistency of the cervical mucus) indicating ovulation so as to avoid sexual intercourse during the fertile period. Couples must be motivated to use NFP if they wish to prevent pregnancy. Physical or emotional factors can alter the signs used to predict fertility, however. They and other factors can reduce NFP's effectiveness. The pregnancy rate is 3% for perfect use of NFP and 20% for typical use. Training in identifying fertility signs and counseling concerning the need for sexual abstinence during the fertile period improve NFP's contraceptive effectiveness. Many physicians do not recommend NFP. About 14% of women worldwide use some form of periodic abstinence. Concerns about NFP include its efficacy under typical-use conditions, particularly when compared with other contraceptive methods; the need for participation and cooperation of both partners; difficulty in using NFP if women have factors that affect fertility symptoms (irregular menses, infections, lack of sleep, alcohol use, emotional stress, and use of some drugs); and no protection against sexually transmitted diseases. There has been the question of whether NFP increases the risk of spontaneous abortion, since some studies have found an association between spontaneous abortion and sperm or eggs that have been in the reproductive tract for a prolonged period and are at the end of their life span. Recent studies do not indicate an association between NFP and spontaneous abortion, however. Effective NFP training takes about 3 months. Non-medical personnel can effectively teach NFP. In a European study, many women using NFP use a barrier method during the fertile period. New technologies and ways of identifying fertility signs are being developed. Ovulation detection kits tend to revolve around measuring the body temperature or the levels of luteinizing hormone or other hormones in urine. PMID:12320444

Barnett, B



Fifty Years of Family Planning: New Evidence on the Long-Run Effects of Increasing Access to Contraception  

PubMed Central

This paper assembles new evidence on some of the longer-term consequences of U.S. family planning policies, defined in this paper as those increasing legal or financial access to modern contraceptives. The analysis leverages two large policy changes that occurred during the 1960s and 1970s: first, the interaction of the birth control pill’s introduction with Comstock-era restrictions on the sale of contraceptives and the repeal of these laws after Griswold v. Connecticut in 1965; and second, the expansion of federal funding for local family planning programs from 1964 to 1973. Building on previous research that demonstrates both policies’ effects on fertility rates, I find suggestive evidence that individuals’ access to contraceptives increased their children’s college completion, labor force participation, wages, and family incomes decades later. PMID:25339778

Bailey, Martha J.



Benefits of meeting the contraceptive needs of Ethiopian women.  


The ability to practice contraception is essential to protecting Ethiopian women's health and enables them to plan the size and timing of their families. Yet low levels of contraceptive use have led to high levels of unintended pregnancy in Ethiopia, a problem for which women and society pay dearly-in women's lives, family well-being and public funds. PMID:20653093

Sundaram, Aparna; Vlassoff, Michael; Bankole, Akinrinola; Remez, Lisa; Gebrehiwot, Yirgu



HEALTH MATTERS Frequently Asked Questions About the Contraceptive Patch  

E-print Network

. It works primarily by preventing the ovary from releasing an egg to be fertilized. The patch also causes? Women who use the contraceptive patch are likely to have lighter and less painful periods patch? Some women should not use the contraceptive patch, including women who have blood clots, certain

Yener, Aylin


Contraceptive behavior in adolescence: A decision-making perspective  

Microsoft Academic Search

The contraceptive behavior of adolescent girls was viewed from a decision-making perspective. A semistructured interview protocol was used in interviewing 120 girls aged 12–19 in three clinics (Teen Family Planning, Prenatal, Pediatric Acute Care) at Michael Reese Hospital and Medical Center on (1) demographic in formation; (2) sexual and obstetric history; (3) contraceptive and sexual knowledge, attitudes, and practices; (4)

Mary J. Rogel; Martha E. Zuehlke; Anne C. Petersen; Maryse Tobin-Richards; Michelle Shelton



Evaluation of a Computerized Contraceptive Decision Aid for Adolescent Patients.  

ERIC Educational Resources Information Center

Discusses a computer-based contraceptive decision aid used with adolescent female family planning clinic patients (N=949). Results show improved short-term knowledge of and confidence in oral contraceptive (OC) efficacy. Higher OC knowledge after one year and fewer pregnancies were seen in one group. Findings suggest the usefulness of informatics…

Chewning, Betty; Mosena, Pat; Wilson, Dale; Erdman, Harold; Potthoff, Sandra; Murphy, Anita; Kuhnen, Kathleen Kennedy



Affective and Physical Changes Associated with Oral Contraceptive Use.  

ERIC Educational Resources Information Center

Although investigations of the physiological effects of oral contraceptives suggest that affective changes may accompany their use, empirical documentation of these effects has not been consistent. This study examined physiological and affective changes accompanying use of a low-dosage oral contraceptive while controlling for possible expectancy…

Wiener, Alane L.; And Others


Effect of contraceptive steroids on monoamine oxidase activity  

PubMed Central

Cyclical variations in monoamine oxidase activity during the human menstrual cycle, specific to the endometrium and modified in women undergoing contraceptive steroid treatment, may reflect changes in hormonal environment. Treatment of rats with individual constituents of the contraceptive pill causes analogous changes: oestrogens inhibit and progestogens potentiate uterine monoamine oxidase activity. ImagesFig. 2Fig. 3

Southgate, Jennifer; Collins, G. G. S.; Pryse-Davies, J.; Sandler, M.



College Students' Knowledge, Attitudes, and Behaviors regarding Sex and Contraceptives  

ERIC Educational Resources Information Center

This study examined gender differences in college students' knowledge, attitudes, and sexual behaviors of 1,004 predominantly heterosexual students. Results indicated that students had limited knowledge about contraceptives and sexually transmitted infections (STIs). Females had a more positive view about contraceptives and males had more…

Toews, Michelle L.; Yazedjian, Ani



American Public Opinion Toward Sex Education and Contraception for Teenagers.  

ERIC Educational Resources Information Center

A study was undertaken to determine American attitudes toward sex education and contraceptive services to adolescents and toward the related topics of teenage pregnancy and related welfare and medical costs. The study was based on the premise that policy decisions regarding whether to offer sex education and contraceptive services to adolescents…

Reichelt, Paul A.


Premarital Contraceptives Usage among Male and Female Adolescents.  

ERIC Educational Resources Information Center

Variables important in predicting female contraception usage were found to be those which involved dyadic commitment, conditions of love, self-esteem, and father's occupation (social class). The best predictors of male contraception usage involved experience in dating and internalization of role models via mother's and father's permissiveness.…

Hornick, Joesph P.; And Others



Social Work Student Attitudes Toward Contraception and the HPV Vaccine  

Microsoft Academic Search

The purpose of the current study was to examine social work student attitudes toward the social work profession's perspective on certain aspects of reproductive health in the United States: contraception, emergency contraception, and the Human Papillomavirus (HPV) vaccine. Students at a large, public, land grant university were surveyed to determine whether their personal attitudes were in line with the National

Chris Flaherty; Gretchen E. Ely; L. Shevawn Akers; Mark Dignan; Tara Bonistall Noland



[Contraception. Recommendations from a group of experts].  


A set of new guidelines were formulated by an expert group meeting in Sweden organized by the pharmaceutical office during March 31-April 1, 1993. It contains various methods to avoid an undesired pregnancy and also advice about postcoital contraception. Among barrier methods, the condom is the only reversible method for men with a method failure of 2 and user failure of 10. It protects against gonorrhea, chlamydia, condyloma, herpes simplex, HIV, and hepatitis B. The diaphragm can be used with a spermicide and protects to a lesser degree against chlamydia, gonorrhea, and cervical cancer. The female condom is as effective as the condom. Among spermicides, nonoxynol-9 is not only effective against sperms but also against bacteria, viruses, and certain vaginal and cervical cells. The vaginal sponge is impregnated with nonoxynol-9 and is effective up to 24 hours. The copper IUD, with a method failure of less than 1, can cause profuse menstrual bleeding, dysmenorrhea, and endometritis-salpingitis. Hormonal methods include combination pills (2-phase and 3-phase pills) and gestagen methods (high dose with 150 mg of medroxyprogesterone acetate injection every 3 months and low-dose minipills with levonorgestrel, norethisterone, or lynestrol). Mechanisms of action concern combination pills, gestagen methods, minipills, Norplant, and Levonova. Drug cross reaction can reduce effectiveness. Side effects include bleeding and amenorrhea. Risk-benefit determination is based on health effects. Possible risks are associated with breast cancer, cervical cancer, blood pressure increase, venous thromboembolism, and heart infarction. Various phases of the reproductive age include young women, lactating women, and women in the later part of the reproductive age. Special groups include those who have experienced ectopic pregnancy, infections (candida, sexually transmitted diseases: chlamydia trachomatis, HIV infections), obesity, cardiovascular diseases, diabetes mellitus, tumors of the reproductive organs, liver diseases, migraine, epilepsy, surgery, and handicapped women. Postcoital contraception is used only in need, and methods for postcoital contraception include hormonal method and the copper IUD. PMID:7901465



Combined hormonal contraceptives: prescribing patterns, compliance, and benefits versus risks  

PubMed Central

Combined hormonal contraceptives [combined oral contraceptives (COCs)] have been available for over 50 years and the impact of this invention may not be overestimated. Today over 100 million women are current users and in Western Europe and the United States approximately 80% of women of fertile ages can be considered as ever-users. Over the years several drawbacks have been identified and media alarms on risks are frequently presented, resulting in suboptimal compliance and low compliance and continuation rates. Poor compliance and discontinuation is a big problem and is not generally identified by prescribers. During ideal use COCs offer very good protection against unwanted pregnancies, however there is a big problem with compliance and continuation and thus the ‘real-life’ efficacy is much lower. Reasons for poor compliance include side effects and fear of side effects and it is crucial that the prescriber gives the individual woman thorough and balanced information on the benefits and risks. Most well known is the increased risk of venous thromboembolism, but also an elevated risk of arterial thrombosis and several types of cancer has been reported. The risk estimates are low but according to the large number of users a substantial number of extra cases will occur. However, use of COCs also offers several additional health benefits with significant impact on morbidity and quality of life. COC use is associated with a substantial decrease in the risk of ovarian cancer, endometrial cancer and colorectal cancer. Moreover, COCs are a major option of treatment for women suffering from heavy menstrual bleeding and dysmenorrhea as well as hirsutism and acne vulgaris. The net effect of the additional health effects of COC- use may very well be positive, i.e. a slight increase in life expectancy. PMID:25360241



Eating disorder pathology and menstrual cycle fluctuations in eating variables in oral contraceptive users and non-users  

Microsoft Academic Search

Food intake and food cravings fluctuate across the menstrual cycle in women who are not using oral contraceptives (OCs), however less is known about cyclical variations in eating variables in women using OCs. Furthermore, few studies have examined the relationship between eating disorder pathology and menstrual cycle fluctuations in eating behaviors. In the present study, we examined self-report, retrospective ratings

Megan A. McVay; Amy L. Copeland; Paula J. Geiselman



An Examination of Emergency Contraception Use by Undergraduate College Students in the Midwest Using the Integrated Behavioural Model  

ERIC Educational Resources Information Center

The purpose of this study was to identify the factors that influence undergraduate college student use of emergency contraception (EC) and their level of knowledge about the product, in order to assist in the development of intervention programmes to increase its use, which could lead to lower rates of unintended pregnancies in this population. A…

Wohlwend, Jennifer; Glassman, Tavis; Dake, Joseph; Jordan, Timothy; Khuder, Sadik; Kimmel, Sanford



Progestin-only contraceptives: effects on weight  

PubMed Central

Background Progestin-only contraceptives (POCs) are appropriate for many women who cannot or should not take estrogen. Many POCs are long-acting, cost-effective methods of preventing pregnancy. However, concern about weight gain can deter the initiation of contraceptives and cause early discontinuation among users. Objectives The primary objective was to evaluate the association between progestin-only contraceptive use and changes in body weight. Search methods Through May 2013, we searched MEDLINE, CENTRAL, POPLINE, LILACS,, and ICTRP. The 2010 search also included EMBASE. For the initial review, we contacted investigators to identify other trials. Selection criteria All comparative studies were eligible that examined a POC versus another contraceptive method or no contraceptive. The primary outcome was mean change in body weight or mean change in body composition. We also considered the dichotomous outcome of loss or gain of a specified amount of weight. Data collection and analysis Two authors extracted the data. We computed the mean difference (MD) with 95% confidence interval (CI) for continuous variables. For dichotomous outcomes, the Mantel-Haenszel odds ratio (OR) with 95% CI was calculated. Main results We found 16 studies; one examined progestin-only pills, one studied the levonorgestrel-releasing intrauterine system (LNG-IUS), four examined an implant, and 10 focused on depot medroxyprogesterone acetate (DMPA). Outcomes examined were changes in body weight only (14 studies), changes in both body weight and body composition (1 study), and changes in body composition only (1 study). We did not conduct meta-analysis due to the various contraceptive methods and weight change measures. Comparison groups did not differ significantly for weight change in 12 studies. However, three studies showed weight change differences for POC users compared to women not using a hormonal method. In one study, weight gain (kg) was greater for the DMPA group than the group using a non-hormonal IUD in years one through three [(MD 2.28; 95% CI 1.79 to 2.77), (MD 2.71, 95% CI 2.12 to 3.30), and (MD 3.17; 95% CI 2.51 to 3.83), respectively]. The differences were notable within the normal weight and overweight subgroups. Two implant studies also showed differences in weight change. The implant group (six-capsule) had greater weight gain (kg) compared to the group using a non-hormonal IUD in both studies [(MD 0.47 (95% CI 0.29 to 0.65); (MD 1.10; 95% CI 0.36 to 1.84)]. In one of those studies, the implant group also had greater weight gain than a group using a barrier method or no contraceptive (MD 0.74; 95% CI 0.52 to 0.96). The two studies that assessed body composition change showed differences between POC users and women not using a hormonal method. Adolescents using DMPA had a greater increase in body fat (%) compared to a group not using a hormonal method (MD 11.00; 95% CI 2.64 to 19.36). The DMPA group also had a greater decrease in lean body mass (%) (MD ?4.00; 95% CI ?6.93 to ?1.07). The other study reported differences between an LNG-IUS group and a non-hormonal IUD group in percent change in body fat mass (2.5% versus ?1.3%, respectively; reported P value = 0.029) and percent change in lean body mass (?1.4% versus 1.0%, respectively; reported P value = 0.027). Authors’ conclusions The overall quality of evidence was moderate to low, given that the studies were evenly divided across the evidence quality groups (high, moderate, low, or very low quality). We found limited evidence of weight gain when using POCs. Mean gain was less than 2 kg for most studies up to 12 months. Weight change for the POC group generally did not differ significantly from that of the comparison group using another contraceptive. Two studies that assessed body composition showed that POC users had greater increases in body fat and decreases in lean body mass compared to users of non-hormonal methods. Appropriate counseling about typical weight gain may help reduce discontinuation of contraceptive

Lopez, Laureen M; Edelman, Alison; Chen, Mario; Otterness, Conrad; Trussell, James; Helmerhorst, Frans M



Nutrition during pregnancy, lactation, and oral contraception.  


The current state of knowledge in regard to nutritional requirements for pregnant and lactating women and for women who are taking oral contraceptives is reviewed. During pregnancy caloric intake should be moderately increased, and the consumption of 30-60 mg of iron and 800-1200 mg of calcium is recommended. Phosphorus intake should also be increased, but this increase should be balanced by a corresponding increase in calcium intake. Consumption of vitamins A and D should be increased but excessive increases should be avoided. Vitamin E should be slightly increased. The desirability of increasing vitamin K is till a matter of dispute. Pregnant women have a slightly increased need for most water soluble vitamins. Research has adequately demonstrated the need to increase folic acid and B6 consumption. There is some evidence that iodine, chromium, and zinc deficiencies may be teratogenic. Some care should be taken not to overconsume sodium, but the need for stringest restriction is unwarranted. Heavy consumption of alcohol and caffeine should definitely be discouraged during pregnancy. Certain problems experienced by pregnant women, such as nausea, may be managed through nutritional modification. The increased nutritional needs for lactating women can, in most cases, be met by increasing milk consumption by 3-3 1/2 cup/day and by consuming a well balanced diet. The content of maternal milk may to some extent be altered by the consumption patterns of the mothers. Ingestion of certain drugs and chemicals may also alter maternal milk. The use of oral contraceptives apparently affects metabolism, but the consequences of these effects are largely unknown. Oral contraceptive usage generally increases the serum levels of triglycerides, iron, copper, and vitamin A and reduces levels of some B vitamins of vitamin C and of zinc and albumin. These effects vary from woman to woman and at the present time there is no agreement on the need for dietary supplementation. The effects of a variety of drugs on lactating women and the effects of oral contraceptive usage on nutritional status are presented in tabular form. PMID:256028

Worthington, B S



An Oral Contraceptive Drug Interaction Study  

NSDL National Science Digital Library

This article, created by Thomas E. Bradstreet and Deborah L. Panebianco of Merck Research Laboratories, describes data from a drug interaction study of a new drug and a standard oral contraceptive therapy. Both normal theory and distribution-free statistical analyzes are provided along with a notable amount of graphical insight into the dataset. The article itself contains sections such as: an introduction, bioavailability, bioequivalence, interaction studies, motivation for the study, an initial exploration of the data, the model with ANOVA, software employed and references. This is an excellent look at the procedures behind medical testing.

Bradstreet, Thomas E.; Panebianco, Deborah L.



Sex discrimination and insurance for contraception.  


Unintended pregnancy is a serious problem in the United States. Most private insurance plans do not pay for contraception even though they pay for other prescription drugs and devices. This Article argues that this pattern constitutes sex discrimination and is prohibited by Title VII of the Civil Rights Act of 1964, as amended by the Pregnancy Discrimination Act. It discusses the reasons this issue has been neglected and suggests ways federal and state officials might remedy this common form of gender discrimination. PMID:12465638

Law, S A



When teens don't wait: encouraging contraception.  


Sexually active teenagers must be diligently encouraged to use contraceptives to reduce early unintended pregnancy. Public awareness of this problem has grown and the debate about how to stop has also grown. Delaying the initiation of sexual activity is seen as the only acceptable method by some, but abstinence will not help reduce early unintended pregnancy in already sexually active teenagers. Strategies must be developed to reach these teenagers with contraception, parenting, adoption, or abortion for when contraception fails. Wide spread sexual activity is the reality of the current era. Parents and teenagers must be provided a variety of strategies that reflect the diverse value system of the current era. Efforts to encourage contraception among adolescents that are successful presuppose that strong, effective family planning services are widely available. In order to create a positive climate for adolescents to fully adopt and use a regimen of contraceptive care automatically implies that such services are acceptable and accessible to the teenagers. PMID:12284486



Dispensation of emergency contraceptive pills in Michigan Title X clinics.  

PubMed Central

OBJECTIVES: Emergency contraceptive pill dispensation was estimated in Michigan Title X family planning programs. METHODS: Logistic regression and tobit estimation models were used to predict whether and to what extent emergency contraceptive pills are dispensed. RESULTS: Of the 53 programs studies, 32 dispensed emergency contraceptive pills, averaging fewer than one client per month. Total dispensation was skewed toward a few programs, and the contribution of health departments to this total was small. Emergency contraceptive pill services appeared to be randomly distributed across programs, although most dispenser reported having provided the pills for less than 12 months. CONCLUSIONS: Recent policy advances should lead to more consistent emergency contraceptive pill dispensation in Title X programs. PMID:9736882

Brown, J W; Boulton, M L



Prevalence of reproductive tract infections, genital prolapse, and obesity in a rural community in Lebanon.  

PubMed Central

OBJECTIVE: To determine the prevalence of reproduction-related illnesses in a rural community in Lebanon. METHODS: Data were collected through interviews with women in their homes, physical examinations and history taking by physicians in a clinic in the community, and laboratory tests. A total of 557 ever-married women aged 15-60 years were selected randomly. FINDINGS: Just over half of the sample (268, 50.6%) had five or more children, and (320, 78.9%) of women aged < 45 years were using contraception. The prevalence of reproductive tract infections was very low: six (1.2%) women had sexually transmitted diseases and 47 (9.3%) had endogenous reproductive tract infections. None had chlamydial infection or a positive serological finding of syphilis. None had invasive cervical cancer, and only one had cervical dysplasia. In contrast, genital prolapse and gynaecological morbidity were elevated. Half of the women studied (251, 49.6%) had genital prolapse, and 153 (30.2%) were obese. CONCLUSION: The prevalence of reproductive tract infections in this conservative rural community in east Lebanon was low. Possible explanations include the conservative nature of the community, the high rate of utilization of health care services, and the liberal use of antibiotics without a prescription. More importantly, the study showed an unexpectedly high prevalence of genital prolapse and obesity--a finding that has clear implications for primary health care priorities in such rural communities. PMID:14710505

Deeb, Mary E.; Awwad, Johnny; Yeretzian, Joumana S.; Kaspar, Hanna G.



Knowledge of Contraceptives and Sexually Transmitted Diseases and Contraceptive Practices Amongst Young People in Ho Chi Minh City, Vietnam  

Microsoft Academic Search

In this article, we examine knowledge of contraceptives and sexually transmitted diseases (STDs) and contraceptive practices amongst young Vietnamese people. We conducted a qualitative study on sexuality and abortion with young people in Ho Chi Minh City, Vietnam. Twelve female and 4 male young people were individually interviewed using an in-depth interview technique. We found that condoms and pills were

Hoa Ngan Nguyen; Pranee Liamputtong; Gregory Murphy



Prevalence rate of thyroid diseases among autopsy cases of the atomic bomb survivors in Hiroshima, 1951-1985  

SciTech Connect

To examine the radiogenic risk of latent thyroid cancer, thyroid adenoma, colloid/adenomatous goiter and chronic thyroiditis, the date for 3821 subjects collected in the course of autopsies of atomic bomb survivors in Hiroshima from 1951 to 1985 by the Radiation Effects Research Foundation (RERF) were analyzed using a logistic model. About 80% of the autopsies were performed at RERF and the remainder at local hospitals. The frequencies of the above diseases were not associated with whether the underlying cause of death was cancer. However, note that our results may be influenced by potentially biasing factors associated with autopsy selection. The relative frequency of latent thyroid cancer (greatest dimension {le}1.5 cm but detectable on a routine microscopic slide of the thyroid gland) increased as the radiation dose increased and was about 1.4-fold greater at 1 Gy than in the 0-Gy dose group. The relative occurrence of thyroid adenoma also increased as radiation dose increased, and was about 1.5-fold greater at 1 Gy than in the 0-Gy dose group. Sex, age at the time of the bombing or period of observation did not significantly modify the radiogenic risks for thyroid adenoma or latent thyroid cancer. No statistically significant association was found between radiation exposure and the rates of colloid/adenomatous goiter and chronic thyroiditis. The possible late effect of atomic bomb radiation on the frequency of benign thyroid diseases is discussed on the basis of these data. 38 refs., 2 figs., 5 tabs.

Yoshimoto, Yasuhiko; Ezaki, Haruo [Radiation Effects Research Foundation, Hiroshima (Japan); Etoh, Ryozo [Fukuyama Hospital, Kagoshima (Japan); Hiraoka, Toshio [Kawaishi Hospital, Hiroshima (Japan); Akiba, Suminori [Kagoshima Univ. (Japan)



[Changes in functional status of patients at initial admission to a psychogeriatric nursing home and at point-prevalence rate].  


During a period of 15 years (1973-1987) the dependency of 902 patients on first admission to a psychogeriatric nursing home has been registered by means of the Beoordelingsschaal voor Oudere Patiënten (BOP, i.e. Behavioural Rating Scale for Elderly Patients). Besides, age, sex, marital status and place of residence before admission were registered. During the research period the proportion of severely disabled patients decreased systematically. The proportion of patients directly admitted from their homes increased. Furthermore, we found an increase of the proportion of married patients. These results are compatible with a greater accessibility of the nursing home, since the availability of nursing home beds in the region has grown significantly. Though the proportion of patients who were severely disabled on first admission, decreased, the experienced burden of care for in-patients has strongly increased. Since 1973 not only the dependency of in-patients increased, but also the need for a higher quality of care. We assume that the burden of care giving has increased due to these factors, but not to changed characteristics of patients on first admission. PMID:2349622

van Loo, E H; Roelofs, C A; Diesfeldt, H F



Lower glomerular filtration rate is associated with higher systemic vascular resistance in patients without prevalent kidney disease.  


The authors examined the association between estimated glomerular filtration rate (eGFR), calculated using the Chronic Kidney Disease Epidemiology Collaboration creatinine-cystatin C equation, and hemodynamics in 556 normotensive or never-treated hypertensive patients without kidney disease (mean age, 46 years). Hemodynamic variables were recorded using pulse wave analysis and whole-body impedance cardiography. The mean eGFR was 98 mL/min/1.73 m(2) (range, 64-145 mL/min/1.73 m(2) and one third of the patients had values below 92, while none had proteinuria. In linear regression analyses adjusted for differences in age, weight:height ratio, low-density lipoprotein cholesterol, and sex, significant associations were found between lower eGFR and higher systolic (P=.001) and diastolic blood pressure (P<.001) and higher systemic vascular resistance (P=.001). There was no association between eGFR and cardiac output or extracellular volume. In the absence of clinical kidney disease, lower eGFR was associated with higher blood pressure and systemic vascular resistance. Therefore, early impairment in kidney function may be involved in the pathogenesis of essential hypertension. PMID:25228202

Vääräniemi, Kati; Koskela, Jenni; Tahvanainen, Anna; Tikkakoski, Antti; Wilenius, Matias; Kähönen, Mika; Kööbi, Tiit; Niemelä, Onni; Mustonen, Jukka; Pörsti, Ilkka



Postpartum Resumption of Sexual Activity, Sexual Morbidity and Use of Modern Contraceptives Among Nigerian Women in Jos  

PubMed Central

Background: Postpartum sexual abstinence until when the child is weaned from breast milk is deeply rooted in most cultures in Nigeria. Aim: The study aimed at describing the current sexual practices of postpartum women, sexual morbidity, contraceptive prevalence and predictive factors for early postpartum sexual intercourse and associated sexual problems in our setting. Subjects and Methods: This cross-sectional study was conducted among consecutive 340 women at a child welfare clinic 14 weeks after childbirth. Questionnaires were administered between January 2012 and June 2012 to ascertain their socio-demographic and obstetric features, sexual activity, time to coital resumption, reasons for resumption and non-resumption of intercourse, sexual problems encountered and contraceptive usage. Statistical analysis was performed using the SPSS version 16 for windows (SPSS Inc., Chicago, IL, USA). Results: Sexual intercourse was resumed by 67.6% (230/340) of women with a mean time to resuming intercourse of 8.2 (2.9) weeks postpartum and a median time of 8.0 weeks. About 3.5% (8/230) did so within the puerperium. Sexual intercourse was initiated mainly (77.4% [178/230]) by their husbands and only 19.1% (44/230) of them were using modern contraceptives. About 62.6% (144/230) of women experienced sexual morbidities including vaginal dryness/insufficient lubrication, dyspareunia and vaginal discharge. Socio-demographic and obstetric features, menstrual and breastfeeding status were not predictive of early resumption of coitus. Vaginal delivery (OR: 3.6, 95% CI: 1.3-10.0, P = 0.01,) and previous episiotomy (OR: 2.4, 95% CI: 2.0-6.1, P = 0.04,) were predictive of sexual morbidity. Conclusion: Women in our setting resume sexual intercourse early after childbirth without the use of contraception and often with associated sexual morbidity. Emphasis on sexual and contraceptive education during the immediate postpartum period is therefore imperative. PMID:24761240

Anzaku, AS; Mikah, S



Prevalence of genital Chlamydia trachomatis infection among young men and women in Spain  

PubMed Central

Background There are no accurate data regarding the real prevalence of Chlamydia trachomatis infection in Spain. Our aim was to determine the prevalence of C. trachomatis infections and the risk factors for acquiring them among 1,048 young (15–24 years old) inhabitants of Laviana. Methods The study was completed in the period between 1st November 2010 and 31st December 2011. We conducted a capture strategy in the whole population, instead of only in a sample group, with a capture conducted in schools, in the local health centre, by post and by phone as a last resort. The design was based on the model used by Shafer to increase screening rates. C. trachomatis was identified by RT-PCR in urine samples. Results A total of 487 sexually active people underwent the test, which implies a response rate of 59.8% of the sexually active people (target population). The prevalence was 4.1% (CI 95%: 3.1-5.8): women: 4% ( CI 95%; 2.8-6.4) and men: 4.3% (CI 95%: 2.9-7.2). The circulating genotype was the E genotype. There was an increase in the risk of C. trachomatis infection when barrier contraceptives were not routinely used OR: 4.76 (CI 95%:1.30-17.36) p<0.05. Conclusions In our study the prevalence in women resembles those found in other countries in Europe and the prevalence in men is similar to that in women. Screening for C. trachomatis infection in women would be cost-effective in Spain given the prevalence of C. trachomatis measured by this study. The use of a condom is the best preventative measure for avoiding STIs in sexually active people. PMID:23968487



Induction of Contraception by Intraepididymal Sclerotherapy  

PubMed Central

Purpose The objective of the present study was to evaluate the efficacy of a sclerosing solution for inducing epididymal occlusion in male rats. Materials and Methods Male Sprague-Dawley rats were divided into two groups: an injection group (n=20) and control group (n=20). Before injecting the sclerosing agent, seminal vesiculectomy and sperm identification using electrostimulation were performed in all of the rats. In the injection group, 0.2 mL of 0.1% sodium tetradecyl sulfate solution was injected into the epididymis. In the sham group, only the identification of the epididymis was performed. At 4 and 12 weeks after the injection, semen was collected by electrostimulation and evaluated to assess the contraceptive effect. Epididymis was evaluated by hematoxylin and eosin (H&E) staining. Results After 4 and 12 weeks, semen collection was performed in the two groups. Sperms were not observed in the injection group, while there was no change in the sperms in the sham group. H&E staining showed the obstruction of epididymal tubules and an accumulation of inflammatory cells in the injection group. Conclusions This study showed that the sclerosing agent induced sterilization in male rats. This result suggests that the injection method can replace vasectomy as a contraceptive method. However, a further study of large animals and a clinical study are needed. Further, the long-term effectiveness of this method needs to be studied.

Park, Hyoung Keun; Paick, Sung Hyun; Kim, Hyeong Gon; Lho, Yong Soo



Influence of oral contraceptives on breast diseases.  


Three sources of information are available pertaining to the effect of oral contraceptive hormones on the breast: 1) toxicity experiments in animals; 2) histologic examinations of breast tissue from women taking hormones; and 3) epidemiologic studies of women using hormones. Animals treated with hormones at doses equivalent to the human contraceptive level have not developed cancer of the breast at a greater than expected frequency. Monkeys, the one experimental animal with a reproductive cycle similar to humans, have not developed cancer during long-term hormone administration except for a single animal which likely represents a chance occurrence. In humans, histologic studies of breast tissue have failed to identify abnormalities which could be attributed to hormones with rare exceptions of secretory change indistinguishable from normal lactating breast. Epidemiologic studies have usually shown a decreased frequency of benign breast disease and neither an increase nor a decrease in carcinoma of the breast. The one exception to the latter statement is a possible increased risk of cancer in long-term users who have had previous surgery for benign breast disease. PMID:406035

Fechner, R E



Beyaz®: an oral contraceptive fortified with folate.  


Beyaz(®) (Bayer HealthCare Pharmaceuticals, Berlin, Germany) consists of 28 film-coated tablets: 24 tablets each containing 3 mg drospirenone plus 20 µg ethinylestradiol (EE) and 451 µg levomefolate calcium followed by four tablets, each containing 451 µg levomefolate calcium. It has the same indications of the parent compound 20 µg EE/3 mg drospirenone in a 24/4-day regimen (i.e., contraception, moderate acne, premenstrual dysforic disorder). In addition, the 24-day regimen with 20 µg EE/3 mg drospirenone/levomefolate calcium assure significant increases in red blood cell and plasma folate levels reaching values indicated to be protective in reducing the risk of neural tube defects. A progressive decrease in folate levels has been observed in women taking a 30 µg EE pill fortified with the same dose of levomefolate calcium upon discontinuation. At 4 and 8 weeks following cessation of the oral contraceptive, red blood cell folate levels >906 nmol/l were measured in 85 and 60% of women respectively. Because of this, the folate-containing pill may aid in reducing the risk of neural tube defects in a pregnancy conceived during use or shortly after the discontinuation of the product. PMID:22171769

Fruzzetti, Franca



Knowledge Translation in Africa for 21(st) Century Integrative Biology: The "Know-Do Gap" in Family Planning with Contraceptive Use among Somali Women.  


Abstract An emerging dimension of 21(st) century integrative biology is knowledge translation in global health. The maternal mortality rate in Somalia is amongst the highest in the world. We set out to study the "know-do" gap in family planning measures in Somalia, with a view to inform future interventions for knowledge integration between theory and practice. We interviewed 360 Somali females of reproductive age and compared university-educated females to women with less or no education, using structured interviews, with a validated questionnaire. The mean age of marriage was 18 years, with 4.5 pregnancies per marriage. The mean for the desired family size was 9.3 and 10.5 children for the university-educated group and the less-educated group, respectively. Importantly, nearly 90% of the university-educated group knew about family planning, compared to 45.6% of the less-educated group. All of the less-educated group indicated that they would never use contraceptives, as compared to 43.5% of the university-educated group. Prevalence of contraceptive use among ever-married women was 4.3%. In the less-educated group, 80.6% indicated that they would not recommend contraceptives to other women as compared to 66.0% of the university-educated group. There is a huge gap between knowledge and practice regarding family planning in Somalia. The attendant reasons for this gap, such as level of education, expressed personal religious beliefs and others, are examined here. For primary health care to gain traction in Africa, we need to address the existing "know-do" gaps that are endemic and adversely impacting on global health. This is the first independent research study examining the knowledge gaps for family planning in Somalia in the last 20 years, with a view to understanding knowledge integration in a global world. The results shall guide policy makers, donors, and implementers to develop a sound family planning policy and program to improve maternal and child health in 21(st) century primary healthcare. PMID:25333614

Ahmed, Ahmed A; Mohamed, Abdullahi A; Guled, Ibrahim A; Elamin, Hayfa M; Abou-Zeid, Alaa H



An ounce of prevention: policy prescriptions to reduce the prevalence of fragile families.  


Isabel Sawhill, Adam Thomas, and Emily Monea believe that given the well-documented costs of nonmarital births to the children and parents in fragile families, as well as to society as a whole, policy makers' primary goal should be to reduce births to unmarried parents. The authors say that the nation's swiftly rising nonmarital birth rate has many explanations--a cultural shift toward acceptance of unwed childbearing; a lack of positive alternatives to motherhood among the less advantaged; a sense of fatalism or ambivalence about pregnancy; a lack of marriageable men; limited access to effective contraception; a lack of knowledge about contraception; and the difficulty of using contraception consistently and correctly. Noting that these explanations fall generally into three categories--motivation, knowledge, and access--the authors discuss policies designed to motivate individuals to avoid unintended pregnancies, to improve their knowledge about contraception, and to remove barriers to contraceptive access. Some motivational programs, such as media campaigns, have been effective in changing behavior. Some, but not all, sex education programs designed to reduce teen pregnancy have also been effective at reducing sexual activity or increasing contraceptive use, or both. Programs providing access to subsidized contraception have also been effective and would be even more so if they could increase the use not just of contraceptives, but of long-acting, reversible contraceptive methods such as intrauterine devices (IUDs) and implants. Finally, the authors present simulations of the costs and effects of three policy initiatives--a mass media campaign that encourages men to use condoms, a teen pregnancy prevention program that discourages sexual activity and educates participants about proper contraceptive use, and an expansion in access to Medicaid-subsidized contraception. All three have benefit-cost ratios that are comfortably greater than one, making them excellent social investments that can actually save taxpayer dollars. PMID:20964135

Sawhill, Isabel; Thomas, Adam; Monea, Emily



Journal of Molecular Graphics and Modelling 20 (2002) 345358 Structureactivity relationships (SAR) of contraceptive  

E-print Network

) of the contraceptive progestogens for (I) oral contraceptive activity (OCA), (II) androgenic effect, and (III) binding Combined oral contraceptives (COCs) have been widely used all over the world for more than 3 decades) of contraceptive progestogens studied with four different methods using calculated physicochemical parameters

Ferreira, Márcia M. C.


Comparison of cycle control with a combined contraceptive vaginal ring and oral levonorgestrel\\/ethinyl estradiol  

Microsoft Academic Search

OBJECTIVE: The purpose of this study was to compare cycle control and tolerability of the NuvaRing (NV Organon, Oss, The Netherlands), a novel combined contraceptive vaginal ring, with a standard combined oral contraceptive pill. STUDY DESIGN: Healthy women aged 18 to 40 years who requested contraception received either NuvaRing or a combined oral contraceptive containing 30 ?g ethinyl estradiol and

Ragnheidur I. Bjarnadóttir; Marjo Tuppurainen; Stephen R. Killick



Sex-Specific Differences in Hemodialysis Prevalence and Practices and the Male-to-Female Mortality Rate: The Dialysis Outcomes and Practice Patterns Study (DOPPS)  

PubMed Central

Background A comprehensive analysis of sex-specific differences in the characteristics, treatment, and outcomes of individuals with end-stage renal disease undergoing dialysis might reveal treatment inequalities and targets to improve sex-specific patient care. Here we describe hemodialysis prevalence and patient characteristics by sex, compare the adult male-to-female mortality rate with data from the general population, and evaluate sex interactions with mortality. Methods and Findings We assessed the Human Mortality Database and 206,374 patients receiving hemodialysis from 12 countries (Australia, Belgium, Canada, France, Germany, Italy, Japan, New Zealand, Spain, Sweden, the UK, and the US) participating in the international, prospective Dialysis Outcomes and Practice Patterns Study (DOPPS) between June 1996 and March 2012. Among 35,964 sampled DOPPS patients with full data collection, we studied patient characteristics (descriptively) and mortality (via Cox regression) by sex. In all age groups, more men than women were on hemodialysis (59% versus 41% overall), with large differences observed between countries. The average estimated glomerular filtration rate at hemodialysis initiation was higher in men than women. The male-to-female mortality rate ratio in the general population varied from 1.5 to 2.6 for age groups <75 y, but in hemodialysis patients was close to one. Compared to women, men were younger (mean?=?61.9±standard deviation 14.6 versus 63.1±14.5 y), were less frequently obese, were more frequently married and recipients of a kidney transplant, more frequently had coronary artery disease, and were less frequently depressed. Interaction analyses showed that the mortality risk associated with several comorbidities and hemodialysis catheter use was lower for men (hazard ratio [HR]?=?1.11) than women (HR?=?1.33, interaction p<0.001). This study is limited by its inability to establish causality for the observed sex-specific differences and does not provide information about patients not treated with dialysis or dying prior to a planned start of dialysis. Conclusions Women's survival advantage was markedly diminished in hemodialysis patients. The finding that fewer women than men were being treated with dialysis for end-stage renal disease merits detailed further study, as the large discrepancies in sex-specific hemodialysis prevalence by country and age group are likely explained by factors beyond biology. Modifiable variables, such as catheter use, showing significant sex interactions suggest interventional targeting. Please see later in the article for the Editors' Summary PMID:25350533

Hecking, Manfred; Bieber, Brian A.; Ethier, Jean; Kautzky-Willer, Alexandra; Sunder-Plassmann, Gere; Saemann, Marcus D.; Ramirez, Sylvia P. B.; Gillespie, Brenda W.; Pisoni, Ronald L.; Robinson, Bruce M.; Port, Friedrich K.



Contraceptive Vaccines Targeting Factors Involved in Establishment of Pregnancy  

PubMed Central

Problem Current methods of contraception lack specificity and are accompanied with serious side effects. A more specific method of contraception is needed. Contraceptive vaccines can provide most, if not all, the desired characteristics of an ideal contraceptive. Approach This article reviews several factors involved in the establishment of pregnancy, focusing on those that are essential for successful implantation. Factors that are both essential and pregnancy-specific can provide potential targets for contraception. Conclusion Using database search, 76 factors (cytokines/chemokines/growth factors/others) were identified that are involved in various steps of the establishment of pregnancy. Among these factors, three, namely chorionic gonadotropin (CG), leukemia inhibitory factor (LIF), and preimplantation factor (PIF), are found to be unique and exciting molecules. Human CG is a well-known pregnancy-specific protein that has undergone phase I and phase II clinical trials, in women, as a contraceptive vaccine with encouraging results. LIF and PIF are pregnancy-specific and essential for successful implantation. These molecules are intriguing and may provide viable targets for immunocontraception. A multiepitope vaccine combining factors/antigens involved in various steps of the fertilization cascade and pregnancy establishment, may provide a highly immunogenic and efficacious modality for contraception in humans. PMID:21481058

Lemons, Angela R.; Naz, Rajesh K.



What women don't know about contraception.  


Women need accurate information about the various forms of contraception from which they may choose. Findings from four recent national telephone surveys conducted among reproductive-age women in the US since 1993, however, indicate that women in the US are not well informed or are misinformed about oral and other forms of contraception. Brief summaries are presented of the following surveys: the 1993 Gallup Organization follow-up survey conducted for the American College of Obstetricians and Gynecologists of 995 women's views on contraception, the 1995 Lou Harris and Associates telephone poll conducted for the American Medical Association of US women's attitudes and perceptions about reproductive health matters, the January 1996 Kaiser Family Foundation survey of 279 women's perceptions about contraception, and the Health Benefits of Contraception, ARHP survey of 280 women. The second part of this latter survey will be completed later in 1996. The common theme in the four surveys is that women do not have enough accurate information about contraception. Reproductive health professionals need to take advantage of every opportunity to provide such information, correct misperceptions, improve their counseling skills, and spread the word about the health benefits of contraception. PMID:12291630

Shields, W C



How often do children meet ICD10\\/DSM-IV criteria of attention deficit-\\/hyperactivity disorder and hyperkinetic disorder? Parent-based prevalence rates in a national sample – results of the BELLA study  

Microsoft Academic Search

Background  There is a lack of representative prevalence rates for attention deficit-\\/hyperactivity disorder (ADHD) according to DSM-IV\\u000a criteria and hyperkinetic disorder (HD) according to ICD-10 criteria for German subjects.\\u000a \\u000a \\u000a \\u000a Objective  To report the results of analyses of categorical data on the prevalence rates of the symptoms of ADHD\\/HD and additional diagnostic\\u000a criteria, as well as of the diagnoses of ADHD and HD

Manfred Döpfner; Dieter Breuer; Nora Wille; Michael Erhart; Ulrike Ravens-Sieberer



AIDing Contraception: HIV and Recent Trends in Abortion Rates  

Microsoft Academic Search

Since the onset of HIV\\/AIDS awareness in the early 1980s, much attention has centered around the substantial negative effects of the disease throughout the world. This paper provides evidence of a secondary effect the disease has had on sexual behavior in the United States. Using a difference-in-differences estimation framework and state level data, we show that the perceived threat of

Andrew Hussey; Alex Nikolsko-Rzhevskyy; Jay Walker



Effect of prospectively measured pregnancy intentions on the consistency of contraceptive use among young women in Michigan  

PubMed Central

STUDY QUESTION What is the predictive value of pregnancy intentions on contraceptive behaviours among women aged 18–19? SUMMARY ANSWER Women aged 18–19 have high levels of inconsistent use of contraception, which mostly occur at times when women strongly wish to avoid a pregnancy. WHAT IS KNOWN ALREADY Pregnancy intentions provide an indication of how well individuals achieve their reproductive goals. However, retrospective accounts of pregnancy intentions using dichotomous indicators suffer temporal instability and fail to capture the wide range of attitudes towards pregnancy. STUDY DESIGN, SIZE, DURATION In this study, data are drawn from a population-based survey of 992 women of ages 18–19 years in Michigan, who completed weekly journals assessing contraceptive use, pregnancy intentions and reproductive outcomes during 2.5 years of follow-up. The response rate was 86% for the baseline interview and 65% after 2.5 years of follow-up. PARTICIPANTS/MATERIALS, SETTING, METHODS We examined 15 446 pairs of journal entries. We used logistic regression with random effects to assess the predictive effect of women's desire to become pregnant and to avoid a pregnancy, measured each week, on consistency of use of contraception the following week. MAIN RESULTS AND THE ROLE OF CHANCE Women reported inconsistent use of contraception in more than a quarter of weekly journals (28.3%). Consistent use of contraception increased from 22 to 78% as women s intentions to become pregnant decreased and increased from 23 to 78% as motivations to avoid pregnancy increased. The combination of scores of the pregnancy desire and avoidance scales shows indifferent or ambivalent pregnancy attitudes in 8.6% of weekly records. These women were more likely to report inconsistent contraceptive use compared with women who expressed anti-conception attitudes [OR = 2.8 (2.2–3.5)]. However, 23% of women who had unequivocal anti-conception feelings did not use contraception consistently, contributing to 72% of the weeks of inconsistent use in our population. LIMITATIONS, REASONS FOR CAUTION In this study, consistency of contraceptive use, based on the use of contraception at every act of intercourse, does not fully capture a women's risk of becoming pregnant. The 35% attrition after 2.5 years may have affected the internal validity of our results, although a reanalysis based on the first year of observation produced very similar results. WIDER IMPLICATIONS OF THE FINDINGS Because most instances of inconsistent use of contraception occur among women who are keen to avoid a pregnancy, our results suggest there is room for improving contraceptive behaviours by promoting use of methods which do not require user adherence. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the National Institute of Child Health and Human Development for grant #R01-HDHD050329 (P.I. Barber, University of Michigan) and grant #R24HD047879 (Center infrastructure of the Office of Population Research at Princeton University, JT and KSH). None of the authors have a competing interest. PMID:23241838

Moreau, C.; Hall, K.; Trussell, J.; Barber, J.



[Contemporary possibilities of non-oral estrogen-progestin contraception].  


Besides the classic combined oral contraception (pill), there are alternative medical forms as transdermal contraception system, vaginal ring, intramuscular injections, and percutaneous gel, respectively. The mechanism of contraceptive effect is the same as well as they are the contraindications. The advantage of non-oral application is the elimination of the first-pass effect that enables reduction of doses, diminishing of undesirable side-effects and medical interactions, and only small effect on enzymatic systems associated with cytochrome P450. As the main advantage, comfort and better compliance of patients who have problems with daily use of tablets, is considered. PMID:24968292

Driák, Daniel



Return for follow-up care and contraceptive continuation among adolescents.  


Family planning clinic personnel have reported high rates of contraceptive discontinuation among adolescent clients and the majority of these teenagers fail to return for their 3-month and annual reproductive health examinations. To learn more about the characteristics of adolescents unlikely to return to family planning clinics for follow-up care, the medical history records of 218 adolescent oral contraceptive acceptors at 6 clinic sites in California's Bay Area were randomly selected from a sampling frame of all females 17 years of age and younger who received their initial OC prescription during the 22-month study period. The average age of study respondents was 15.4 years; 48% were black, 39% were white, 8% were Hispanic, and 4% were Asian. The average age at 1st intercourse was 14.3 years; only 9% of study subjects obtained contraception before becoming sexually active. Over half (110 adolescents) of the sample failed to return to the family planning clinic for follow-up care. Both bivariate and multivariate analyses were conducted to determine the correlates of nonreturn. There were no significant differences between adolescents were returned to the clinic and those who did not in terms of age, ethnicity, clinic where served, or other sources of medical care. In terms of reproductive history, adolescents who started having intercourse at younger ages and those who waited longest after the onset of intercourse to seek contraception were least likely to return to the clinic. 75% of the adolescents who had a sexually transmitted disease at the time of the initial visit did not return. Other factors significantly correlated with nonreturn for follow-up were irregular menstrual periods, referral for additional medical tests, failure to have obtained a pap smear in the year prior to the initial visit, and the presence of general health problems such as asthma. PMID:12283022

Balassone, M L



Convergence of Prevalence Rates of Diabetes and Cardiometabolic Risk Factors in Middle and Low Income Groups in Urban India: 10-Year Follow-Up of the Chennai Urban Population Study  

PubMed Central

Aim The aim of this study was to look for temporal changes in the prevalence of diabetes and cardiometabolic risk factors in two residential colonies in Chennai. Methods Chennai Urban Population Study (CUPS) was carried out between 1996–1998 in Chennai in two residential colonies representing the middle income group (MIG) and lower income group (LIG), respectively. The MIG had twice the prevalence rate of diabetes as the LIG and higher prevalence rates of hypertension, obesity, and dyslipidemia. They were motivated to increase their physical activity, which led to the building of a park. The LIG was given standard lifestyle advice. Follow-up surveys of both colonies were performed after a period of 10 years. Results In the MIG, the prevalence of diabetes increased from 12.4 to 15.4% (24% increase), while in the LIG, it increased from 6.5 to 15.3% (135% increase, p < .001). In the LIG, the prevalence rates of central obesity (baseline vs follow-up, male: 30.8 vs 50.9%, p < .001; female: 16.9 vs 49.8%, p < .001), hypertension (8.4 vs 20.1%, p < .001), hypercholesterolemia (14.2 vs. 20.4%, p < .05), and hypertriglyceridemia (8.0 vs 23.5%, p < .001) significantly increased and became similar to that seen in the MIG. Conclusion There is a rapid reversal of socioeconomic gradient for diabetes and cardiometabolic risk factors in urban India with a convergence of prevalence rates among people in the MIG and LIG. This could have a serious economic impact on poor people in developing countries such as India. PMID:21880235

Deepa, Mohan; Anjana, Ranjit Mohan; Manjula, Datta; Venkat Narayan, KM; Mohan, Viswanathan



Women & Cancer: Pregnancy, Contraceptives, and Menopausal Hormone Use

Information about breast cancer treatment options for pregnant women, risk of breast and other cancers in relation to reproductive history, and how oral contraceptives and hormone therapy affect cancer risk.


Contraception in patients with systemic lupus erythematosus and antiphospholipid syndrome.  


Contraceptive choice in patients with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) is challenging but important. Long-acting forms of contraception such as the progesterone intrauterine device (IUD) or subdermal implant are preferable for most patients. Estrogen-containing hormonal contraceptives may be used in stable, inactive SLE patients but are contraindicated in patients with positive antiphospholipid antibodies (aPL). The levonorgestrel IUD is a good alternative for many APS patients and often decreases menstrual blood loss. It is prudent to avoid depot medroxyprogesterone acetate (DMPA) in corticosteroid-treated or other patients at risk for osteoporosis because of the inhibition of ovulation. Effective and safe contraception in patients with SLE and APS permits planning for pregnancy during inactive disease and while on pregnancy-compatible medications, preventing a poorly timed pregnancy that may jeopardize maternal and/or fetal health. PMID:25228715

Sammaritano, L R



Determinants of contraceptive use and method choice in Turkey.  


In this study, the determinants of contraceptive use and method choice are examined based on various variables, classified as individual, cultural, fertility and contextual. The data used came from the 1993 Turkish Demographic and Health Survey. The main finding is that there exists a positive association between the educational level of both spouses and the use of contraceptive methods in Turkey. After all individual, cultural, fertility and contextual variables are controlled, a woman's education is a stronger predictor of method use and method choice than that of her husband. Increasing the educational level of women may be the most effective means of advancing family planning acceptance and increasing the demand for contraceptive services in Turkey. The study also shows that, to a great extent, contraceptive use and choice of modern method depend on the sex of a couple's living children, implying some preference for sons, although generally women prefer to have children of both sexes. PMID:10979227

Koc, I



As the world grows: contraception in the 21st century  

PubMed Central

Contraceptives that are readily available and acceptable are required in many poorer countries to reduce population growth and in all countries to prevent maternal morbidity and mortality arising from unintended pregnancies. Most available methods use hormonal steroids or are variations of barrier methods. Reports from several fora over the last 12 years have emphasized the number of unwanted pregnancies and resultant abortions, which indicate an unmet need for safe, acceptable, and inexpensive contraceptive methods. This unmet need can be assuaged, in part, by development of new nonhormonal contraceptive methods. This Review addresses the contribution that the “omic” revolution can make to the identification of novel contraceptive targets, as well as the progress that has been made for different target molecules under development. PMID:18382745

Aitken, R. John; Baker, Mark A.; Doncel, Gustavo F.; Matzuk, Martin M.; Mauck, Christine K.; Harper, Michael J.K.



Prevalence of low glomerular filtration rate, proteinuria and associated risk factors in North India using Cockcroft-Gault and Modification of Diet in Renal Disease equation: an observational, cross-sectional study  

Microsoft Academic Search

BACKGROUND: Chronic kidney disease (CKD) is increasingly being recognized as an emerging public health problem in India. However, community based estimates of low glomerular filtration rate (GFR) and proteinuria are few. Validity of traditional serum creatinine based GFR estimating equations in South Asian subjects is also debatable. We intended to estimate and compare the prevalence of low GFR, proteinuria and

Narinder P Singh; Gopal K Ingle; Vinay K Saini; Ajita Jami; Pankaj Beniwal; Madan Lal; Gajender S Meena



Decision-Making Patterns and Contraceptive Use: Evidence from Uganda  

Microsoft Academic Search

Literature on the effect of decision-making patterns on contraceptive use often does not (1) distinguish between women participating\\u000a in decisions and controlling them, and (2) account for effects of common decision-making patterns within the community. In\\u000a Uganda where high fertility persists, both of these factors may be relevant to adoption of contraception. We used data from\\u000a the 1995\\/96 Negotiating Reproductive

Laurie F. DeRose; Alex C. Ezeh



Knowledge and practice of contraception in United Arab Emirates women  

Microsoft Academic Search

ObjectiveTo determine the knowledge and practice of contraception among United Arab Emirates (UAE) women.MethodFour hundred and fifty UAE women at risk of pregnancy were randomly selected from the community and primary health care centres and interviewed about knowledge and practice of contraception using a structured questionnaire.ResultsFour hundred women (89%) gave consent to participate in the study. One hundred and sixty-six

Saad Ghazal-Aswad; Diaa EE Rizk; Samiha M. Al-Khoori; Huda Shaheen; Letha Thomas



Thirty years of hormonal contraception: an historical perspective.  


In 1919, a German scientist placed ovaries from pregnant rabbits under the skin of other female rabbits making them infertile. Later he injected extracts from pregnant cow corpora lutea into rabbits also making them infertile. In 1931, he states that hormonal sterilization is the ideal birth control. Yet, it was another 30 years before the first hormonal contraceptive was available. Estrogenic research led another German scientist to conclude that estrogen inhibits the pituitary gland. This resulted in more steroid research. Many obstacles existed, however; e.g. it took 4000 gallons of urine to extract a minute amount of androsterone and almost a ton of bull testicles and identify progesterone. Schering was able to synthesize it from ox bile, resulting in high-priced monopoly. Marker later synthesized it from a Mexican yam causing the price of progesterone to drop rapidly from dollars to cents per gram. Other scientists struggled to also develop estrogenic substances. By 1940, some physicians used estrogens to suppress ovulation. Despite this evidence, few physicians considered using them for contraceptive purposes because, like abortion, contraception was taboo. Instead political activists (e.g., Margaret Sanger) addressed synthetic hormones' potential for contraception. Their persistence encouraged some researchers to isolate compounds and to conduct clinical trials with oral contraceptives (OCs). The older OCs posed a deep vein thrombosis risk. The lower-dosed OCs no longer carry this risk. There has also been some evidence, albeit inconclusive, that OCs increase, the risk of breast cancer. 30 years later, physicians still are reluctant to address contraception. The Catholic Church and conservative economists are against contraceptives. The economists fear that smaller populations reduce markets. In many developing countries another obstacle to contraceptives is the cultural norm to produce many children. PMID:1687399

Goldzieher, J W



Cancer of the liver and the use of oral contraceptives  

Microsoft Academic Search

A case-control study of the use of oral contraceptives was conducted among women certified as having died from cancer of the liver in the period 1979-82 and in the age range 20-44 years. An age matched group of women who died from other causes, not related to use of oral contraceptives, in the same period were used as controls. Information

D Forman; T J Vincent; R Doll



The interaction between St John's wort and an oral contraceptive  

Microsoft Academic Search

Objectives: The popular herbal remedy St John's wort is an inducer of cytochrome P450 (CYP) 3A enzymes and may reduce the efficacy of oral contraceptives. Therefore we evaluated the effect of St John's wort on thedisposition and efficacy of Ortho-Novum 1\\/35 (Ortho-McNeil Pharmaceutical, Inc, Raritan, NJ), a popular combination oral contraceptive pill containing ethinyl estradiol (INN, ethinylestradiol) and norethindrone (INN,

Stephen D. Hall; Zaiqi Wang; Shiew-Mei Huang; Mitchell A. Hamman; Nina Vasavada; Adegboyega Q. Adigun; Janna K. Hilligoss; Margaret Miller; J. Christopher Gorski



Attitude of Nigerian women to contraceptive use by men.  


This study was aimed at finding the attitude of Nigerian women to contraceptive use by their male partners. A total of 417 women received the questionnaire; 71% of these were sexually active and 34.8% were not aware of any male contraceptive method. Only 1.7% reported regular use of condoms by their spouses, however this was significantly higher if the women were better educated. Most of the women had a positive attitude to contraceptive use by their spouses, as 54% (225/417) of them showed preference to male dependant contraceptives in their relationship. However, only 32.3% (135/417) of the women had ever-requested their spouse to use a condom and in just 18.5% (25/135) was such a request regularly complied with. Significantly more Muslim women prefer their partners to use a contraceptive rather than themselves (p = 0.001), but the condom usage by their spouses is significantly lower than their Christian counterparts (p = 0.000). There is a need to offer counselling on male contraceptives to both genders so that they can make an informed choice, especially with the dual protection offered by the use of condoms. PMID:19003659

Audu, B M; El-Nafaty, A U; Bako, B G; Melah, G S; Mairiga, A G; Kullima, A A



Comparison of ethinylestradiol pharmacokinetics in three hormonal contraceptive formulations: the vaginal ring, the transdermal patch and an oral contraceptive  

Microsoft Academic Search

This open-label, randomized study compared the pharmacokinetics of ethinylestradiol (EE) from the contraceptive vaginal ring NuvaRing (15 ?g EE\\/day), the transdermal patch (20 ?g EE\\/day) and a combined oral contraceptive (COC) containing 30 ?g EE. After 2–8 weeks of synchronization by COC treatment, subjects were randomized to 21 days of treatment with NuvaRing, patch or COC. Analysis of area under

Michiel Wilhelmus van den Heuvel; Antoinetta Jacoba Maria van Bragt; Ali Kafi Mohammed Alnabawy; Marc Carel John Kaptein



Thromboembolic disease developing during oral contraceptive therapy in young females with antiphospholipid antibodies.  


The role of oral contraceptives as a triggering factor for thrombosis in patients with lupus anticoagulant (LA) and/or anticardiolipin antibodies (ACA) has not yet been established. We describe the cases of three women aged 19, 29 and 48 years who developed venous thrombosis after 16 +/- 3.4 (mean +/- SD) cycles of oral contraceptives. They were all asymptomatic before taking the pill. Two patients subsequently developed venous and/or arterial recurrence of thrombosis. Laboratory studies performed after the diagnosis of thrombosis, showed the presence of LA and elevated levels of ACA (IgG and IgM) in all three patients. None of these patients had autoimmune diseases and therefore appeared to have a primary antiphospholipid antibody syndrome. The three patients belonged to a group of 45 young females who experienced their first thrombotic event while taking the pill. This group had a similar prevalence (8%) for antithrombin deficiency and antiphospholipid antibodies. We surmise that some of the women who developed venous thrombosis while taking the pill might have an undetected primary antiphospholipid syndrome. PMID:8840004

Girolami, A; Zanon, E; Zanardi, S; Saracino, M A; Simioni, P



Fusidic Acid Resistance Rates and Prevalence of Resistance Mechanisms among Staphylococcus spp. Isolated in North America and Australia, 2007-2008 ?  

PubMed Central

Among 4,167 Staphylococcus aureus and 790 coagulase-negative Staphylococcus (CoNS; not S. saprophyticus) isolates collected consecutively from North American and Australian hospitals, only 87 (1.7% overall) isolates displayed a fusidic acid (FA; also known as CEM-102) MIC of ?2 ?g/ml (FA resistance). These strains were further evaluated with a multiplex PCR to amplify the acquired resistance genes fusB, fusC, and fusD. Mutations in fusA and fusE were evaluated in all isolates showing an absence of acquired resistance genes and/or showing FA MIC values of ?64 ?g/ml. S. aureus resistance rates were very low in the United States (0.3%) and were higher in Canada and Australia (7.0% for both countries). Among CoNS isolates, FA resistance rates were significantly more elevated than that for S. aureus (7.2 to 20.0%; the highest rates were in Canada). All 52 (41 CoNS) FA-resistant isolates from the United States showed FA MIC results of ?64 ?g/ml, and 7 of 11 S. aureus isolates carried fusC. CoNS strains from the United States carried fusB or fusC. In Canada, fusB and fusC occurrences were similar among S. aureus and CoNS isolates, and modestly elevated FA MIC values were observed (all MIC results were ?32 ?g/ml). Isolates from Australia showed MIC values ranging from 2 to 32 ?g/ml, and S. aureus isolates were predominantly fusC positive. fusA mutations were detected in only three S. aureus isolates, conferring FA MIC values of 2 to 8 ?g/ml. Target mutations have been considered the primary FA resistance mechanism among Staphylococcus spp.; however, acquired resistance genes appear to have a dominant role in resistance against this older antimicrobial agent. In summary, this study shows that acquired genes are highly prevalent among FA-resistant strains (>90%) in three nations with distinct or absence (United States) of fusidic acid clinical use. PMID:20566766

Castanheira, Mariana; Watters, Amy A.; Bell, Jan M.; Turnidge, John D.; Jones, Ronald N.



Sexual experience and contraceptive use among female teens - United States, 1995, 2002, and 2006-2010.  


The 2010 U.S. teen birth rate of 34.3 births per 1,000 females reflected a 44% decline from 1990. Despite this trend, U.S. teen birth rates remain higher than rates in other developed countries; approximately 368,000 births occurred among teens aged 15-19 years in 2010, and marked racial/ethnic disparities persist. To describe trends in sexual experience and use of contraceptive methods among females aged 15-19 years, CDC analyzed data from the National Survey of Family Growth collected for 1995, 2002, and 2006-2010. During 2006-2010, 57% of females aged 15-19 years had never had sex (defined as vaginal intercourse), an increase from 49% in 1995. Younger teens (aged 15-17 years) were more likely not to have had sex (73%) than older teens (36%); the proportion of teens who had never had sex did not differ by race/ethnicity. Approximately 60% of sexually experienced teens reported current use of highly effective contraceptive methods (e.g., intrauterine device [IUD] or hormonal methods), an increase from 47% in 1995. However, use of highly effective methods varied by race/ethnicity, with higher rates observed for non-Hispanic whites (66%) than non-Hispanic black (46%) and Hispanic teens (54%). Addressing the complex issue of teen childbearing requires a comprehensive approach to sexual and reproductive health that includes continued promotion of delayed sexual debut and increased use of highly effective contraception among sexually experienced teens. PMID:22552205



Levonorgestrel-releasing IUD as a method of contraception with therapeutic properties.  


The levonorgestrel-releasing intrauterine device LNg IUD is a new contraceptive method that combines the advantages of both hormonal and intrauterine contraception. It gives users non-contraceptive health benefits and can also be used as an effective therapy for menorrhagia. The local release of LNg within the endometrial cavity results in strong suppression of endometrial growth as the endometrium becomes insensitive to ovarian estradiol. The endometrial suppression is the reason for a significant reduction of menstrual blood loss or amenorrhea, and for the disappearance of dysmenorrhea. The bleeding pattern during the use of the LNg IUD is characterized by reduction of the blood loss and in the number of bleeding days per cycle. During the first two to three months of use, however, irregular spotting is common. The removal of the device results in a quick return of menstrual bleeding and fertility. The failure rate of copper-releasing IUDs, as with other methods of fertility regulation, is higher in young women and decreases with age. The LNg IUD, on the other hand, has the same low pregnancy rate in every age group of the users. The LNg IUD also gives protection against ectopic pregnancy and pelvic inflammatory disease and, by reducing menstrual blood loss, increases the body iron stores. The LNg IUD can be used to effectively treat menorrhagia. This has been demonstrated in studies with quantitative determination of menstrual blood loss. During the first year of use, the LNg IUD reduced menstrual blood loss by 90% from pretreatment levels. Comparative clinical trials with the LNg IUD cover more than 10,000 women-years of follow-up during use over five to seven years. The Pearl pregnancy rate in studies has been 0.0-0.2 per 100 women-years. The overall ectopic Pearl pregnancy rate is 0.02 per 100 woman-years. The LNg IUD is marketed in Denmark, Finland, Norway, Sweden and in the United Kingdom. PMID:8585882

Luukkainen, T; Toivonen, J



New contraceptive eligibility checklists for provision of combined oral contraceptives and depot-medroxyprogesterone acetate in community-based programmes.  

PubMed Central

Community-based services (CBS) have long used checklists to determine eligibility for contraceptive method use, in particular for combined oral contraceptives (COCs) and the 3-month injectable contraceptive depot-medroxyprogesterone acetate (DMPA). As safety information changes, however, checklists can quickly become outdated. Inconsistent checklists and eligibility criteria often cause uneven access to contraceptives. In 1996, WHO produced updated eligibility criteria for the use of all contraceptive methods. Based on these criteria, new checklists for COCs and DMPA were developed. This article describes the new checklists and their development. Several rounds of expert review produced checklists that were correct, comprehensible and consistent with the eligibility requirements. Nevertheless, field-testing of the checklists revealed that approximately half (48%) of the respondents felt that one or more questions still needed greater comprehensibility. These findings indicated the need for a checklist guide. In March 2000, WHO convened a meeting of experts to review the medical eligibility criteria for contraceptive use. The article reflects also the resulting updated checklist. PMID:10994285

Stang, A.; Schwingl, P.; Rivera, R.



Marital Processes, Arranged Marriage, and Contraception to Limit Fertility  

PubMed Central

An international transition away from familially-arranged marriages toward participation in spouse choice has endured for decades and continues to spread through rural Asia today. Though we know this transformation has important consequences for childbearing early in marriage, we know much less about longer-term consequences of this marital revolution. This study draws upon theories of family and fertility change and a rural Asian panel study designed to investigate changes in both marital and childbearing behaviors to investigate these long-term consequences. Controlling for social changes that shape both marital practices and childbearing behaviors, and explicitly considering multiple dimensions of marital processes, we find evidence consistent with an independent, long-standing association of participation in spouse choice with higher rates of contraception to terminate childbearing. These results add a new dimension to the evidence linking revolutions in marital behavior to long-term declines in fertility, but also motivate new research to consider a broader range of long-term consequences of changing marital processes. PMID:23709184

Ghimire, Dirgha J.; Axinn, William G.



Birth control within reach: a national survey on women's attitudes toward and interest in pharmacy access to hormonal contraception  

Microsoft Academic Search

ObjectiveThis survey was conducted to better understand women's experiences with hormonal contraception and their interest in and attitudes toward gaining direct access to oral contraception (OC), patch, ring or emergency contraception (EC) in pharmacies.

Sharon Cohen Landau; Molly Parker Tapias; Belle Taylor McGhee



Medicaid spending on contraceptive coverage and pregnancy-related care  

PubMed Central

Objective Up to 50% of pregnancies are unintended in the United States, and the healthcare costs associated with pregnancy are the most expensive among hospitalized conditions. The current study aims to assess Medicaid spending on various methods of contraception and on pregnancy care including unintended pregnancies. Methods We analyzed Medicaid health claims data from 2004 to 2010. Women 14–49 years of age initiating contraceptive methods and pregnant women were included as separate cohorts. Medicaid spending was summarized using mean all-cause and contraceptive healthcare payments per patient per month (PPPM) over a follow-up period of up to 12 months. Medicaid payments were also estimated in 2008 per female member of childbearing age per month (PFCPM) and per member per month (PMPM). Medicaid payments on unintended pregnancies were also evaluated PFCPM and PMPM in 2008. Results For short-acting reversible contraception (SARC) users, all-cause payments and contraceptive payments PPPM were respectively $365 and $18.3 for oral contraceptive (OC) users, $308 and $19.9 for transdermal users, $215 and $21.6 for vaginal ring users, and $410 and $8.8 for injectable users. For long-acting reversible contraception (LARC) users (follow-up of 9–10 months), corresponding payments were $194 and $36.8 for IUD users, and $237 and $29.9 for implant users. Pregnancy cohort all-cause mean healthcare payments PPPM were $610. Payments PFCPM and PMPM for contraceptives were $1.44 and $0.54, while corresponding costs of pregnancies were estimated at $39.91 and $14.81, respectively. Payments PFCPM and PMPM for contraceptives represented a small fraction at 6.56% ($1.44/$21.95) and 6.63% ($0.54/$8.15), respectively of the estimated payments for unintended pregnancy. Conclusions This study of a large sample of Medicaid beneficiaries demonstrated that, over a follow-up period of 12 months, Medicaid payments for pregnancy were considerably higher than payments for either SARC or LARC users. Healthcare payments for contraceptives represented a small proportion of payments for unintended pregnancy when considering the overall Medicaid population perspective in 2008. PMID:24581033



Contraception and interaction among Dutch boys and girls.  


In 1986, 337 Dutch youths aged 15-19 were asked to complete a questionnaire on their sexual and contraceptive behavior, their behavior with respect to AIDS prevention, and the sex education they had received. Of those who completed the questionnaire, 42% of the men and 33% of the women had experienced sexual intercourse. 71% of the men and 65% of the women who had experienced sexual intercourse expected to do so on their first episode, while 50% of the women had explicitly discussed it with their boyfriends beforehand. More than 70% used effective contraception at first intercourse, with 40% using condoms, 20% using the pill, and almost 10% combining both methods. At most recent intercourse, 85% used the pill and/or condoms. While 50% of the sexually active teens reported having always used contraception, 10% had had sexual intercourse more than five times without contraceptive protection. Further, 43% of boys compared to 15% of girls reported either initiating condom use or using condoms more regularly to protect themselves against HIV infection. 75% of the teens received sex education from one or both parents, although boys tended to be comparatively more neglected in this regard by their parents than girls. The central element of the three-year study on the sexual and contraceptive behavior of adolescents was, however, a qualitative comparison between the sexual lifestyles and interaction skills of 39 girls who visited a family planning clinic to obtain contraception and 34 girls who visited a clinic for an abortion. The abortion clients were less effective contraceptors than the girls from the other group, while the effectiveness of contraceptive use was more permanent in the family planning clinic group. While family planning seekers view contraception as a functional tool to prevent unwanted pregnancies, abortion seekers were more preoccupied by the sexual aspect of contraception rather than by its original function such that sex seemed to be less self-evident for the abortion clients than for the girls from the family planning clinic. Furthermore, abortion clients were less active than contraception seekers during precoital negotiation with their sex partners, and had comparatively less control over what happened during sexual contacts. The author stresses that sex education programs must educate young audiences, but also explicitly focus upon the possibilities of changes in attitude and behavior, negotiation skills, and t