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1

Association of programmatic factors with low contraceptive prevalence rates in a rural area of Bangladesh  

PubMed Central

Objective The study was conducted to identify selected programmatic factors relating to low contraceptive-use in a low-performing rural sub-district in Sylhet division of Bangladesh. Methods A cross-sectional survey was carried out among 6983 currently-married women of reproductive age (MWRA) (15–49 years). To estimate the association between current contraceptive-use and other selected factors, multivariate analyse were performed, estimating the crude and adjusted odds ratios (OR), including 95% confidence intervals (CI). Results The use of health facility by the MWRA in the last three months, distance from the residence to the nearest health facility, and contact with field workers in the last six months was significantly associated with contraceptive prevalence rate (CPR). There were potential differences regarding CPR, sources of contraceptive supply and Family Welfare Assistant (FWA) visit between hard to reach and non-hard to reach unions of Nabiganj sub-district. Conclusion Strategies should be devised to increase the accessibility of MWRA to contraceptive methods by increased partnership with non-public sector and increased contacts with outreach workers through introducing community volunteers, and mobile phones help lines, by organizing frequent satellite clinics (SCs) and making community clinics (CCs) functional. Innovative strategies should be piloted for improving use of contraception in such hard to reach and low performing locality. PMID:23782912

2013-01-01

2

Failure rates of contraceptive methods.  

PubMed

A discussion of the measures used to determine the failure rates of contraceptive methods precedes the presentation of a table that presents the theoretical and use failure rates for the following contraceptive methods: condom; coitus interruptus; diaphragm; IUD; oral contraceptive combined; oral contraceptive, progestogen only; vasectomy; tubal ligation; spermicidal foam; depo-provera; chance; lactation for 12 months; and the symptothermal method of natural family planning. A commonly used measure of contraceptive effectiveness is the Pearl Index. It measures the percentage of sexually active women who become pregnant while using a method for 1 year and can be expressed as either the minimum failure rate (theoretical failure rate) or as a maximum failure rate (use failure rate). Whether an individual or a couple operates at the minimum or maximum failure rate or somewhere in-between is dependent on: the basic contraceptive priorities of the method; the information provided by the practitioner for its use; and the extent of the user's compliance with the instructions. Theoretical failure rate is defined as the method's failure rate when the user receives correct instructions and follows these instructions conscientiously. The use failure rate is defined as the method's failure rate in actual use which includes: the user receiving incorrect instructions as to method use; the user forgetting to use the method sometimes or not using the method correctly. Theoretical failure rates listed in the table are: condom, 0.4-1.6; diaphragm, 2; IUD, 1-3; combined OC, 0.1; progestogen only OC, 1-2; vasectomy 0.1; tubal ligation 0.04; spermicidal foam, 3; depo-provera, 1; lactation for 12 months, 25; coitus interruptus, 9; and the symptothermal method -- variant A, 1.5; variant B, 3.39; and variant C, 11.2. PMID:12263458

Mclure, Z

1981-04-01

3

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.

2014-01-01

4

Contraceptives.  

PubMed

This chart sets forth brief descriptions of 14 contraceptive methods: male condom, female condom, vaginal diaphragm and cap, spermicides, oral contraceptives, hormonal implants, injectables, IUD, natural family planning, fertility awareness, breast feeding, withdrawal, sterilization, and emergency contraception. After presenting a short description of each method, the chart rates its degree of protection from pregnancy, the protection provided against HIV and other sexually transmitted diseases, its availability, and the method's advantages and disadvantages. PMID:12348240

1997-01-01

5

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. PMID:25404960

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

2014-01-01

6

Hormonal contraception, sexual behaviour and HIV prevalence among women in Cameroon  

Microsoft Academic Search

BACKGROUND: Data on the effect of contraceptive methods, other than the condom, on HIV acquisition is not clear. The aim of this study was to describe hormonal contraceptive use, sexual behaviour and HIV prevalence among women in Cameroon in order to provide baseline information for future analytical studies. METHODS: This is a cross-sectional descriptive study based a nationally representative sample

Eugene J Kongnyuy; Varda Soskolne; Bella Adler

2008-01-01

7

A Longitudinal Analysis of Aggregate Fertility Decline as a Product of Increasing Contraceptive Prevalence  

E-print Network

. This dissertation addresses the fertility decline reported in 178 countries between 1960 and 2011. I draw on data from the World Bank Data Bank; my research focuses on the role of contraceptive prevalence in facilitating the vast fertility decline observed over...

Field, Layton Marshall

2014-06-06

8

The link between oral contraceptive use and prevalence in autism spectrum disorder.  

PubMed

Autism spectrum disorder (ASD) is a group of developmental disabilities that include full syndrome autism, Asperger's syndrome, and other pervasive developmental disorders. The identified prevalence of ASD has increased in a short time period across multiple studies causing some to conclude that it has reached epidemic proportions in the U.S. Many possible explanations for the rise in numbers of individuals diagnosed with ASD have been offered and yet, causes and contributing factors for ASD are inadequately understood. Current evidence suggests that both genetics and environment play a part in causing ASD. One possible risk factor for the increase in prevalence has been profoundly overlooked in the existing biomedical and epidemiologic literature. As the prevalence of ASD has risen in the last sixty years, so has the prevalence of the usage of the oral contraceptives and other modern hormonal delivery methods. In 1960 about one million American women were using oral contraceptives, today close to 11million women in the U.S. use oral contraceptives. Eighty-two percent of sexually active women in the U.S. have used oral contraceptives at some point during their reproductive years. Thus, the growth in use of progesterone/estrogen-based contraceptives in the United State has reached near-ubiquitous levels among women in the child-bearing age range. The suppression of ovulation produced by estrogen-progesterone is an indisputable abnormality. It is logical to consider the outcome of the ovum that would have been normally released from the ovary during ovulation. To date there is no comprehensive research into the potential neurodevelopmental effects of oral contraceptive use on progeny. The issue has been only sparsely considered in the biomedical literature. This article hypothesizes that the compounds, estrogen and progesterone, used in oral contraceptives modify the condition of the oocyte and give rise to a potent risk factor that helps explain the recent increase in the prevalence of ASD's. This hypothesis does not propose to delineate the cause of autism. Rather, it attempts to explain the recent dramatic increase in prevalence and point the way for further study that will lead to causal examination. PMID:25459142

Strifert, Kim

2014-10-12

9

High prevalence of insulin resistance assessed by the glucose clamp technique in hormonal and non-hormonal contraceptive users.  

PubMed

Objective To assess the prevalence of insulin resistance (IR) and associated factors in contraceptive users. Methods A total of 47 women 18 to 40 years of age with a body mass index (kg/m(2)) < 30, fasting glucose levels < 100 mg/dl and 2-hour glucose level < 140 mg/dl after a 75-g oral glucose load were submitted to a hyperinsulinemic-euglycemic clamp. The women were distributed in tertiles regarding M-values. The analysed variables were use of combined hormonal/non-hormonal contraception, duration of use, body composition, lipid profile, glucose levels and blood pressure. Results IR was detected in 19% of the participants. The women with low M-values presented significantly higher body fat mass, waist-to-hip ratio, fasting insulin, HOMA-IR and were nulligravida, showed > 1 year of contraceptive use and higher triglyceride levels. IR was more frequent among combined oral contraceptive users, however no association was observed after regression analysis. Conclusions The prevalence of IR was high among healthy women attending a family planning clinic independent of the contraceptive method used with possible long-term negative consequences regarding their metabolic and cardiovascular health. Although an association between hormonal contraception and IR could not be found this needs further research. Family planning professionals should be proactive counselling healthy women about the importance of healthy habits. PMID:25328007

Melhado-Kimura, Vaneska; Alegre, Sarah Monte; Pavin, Elizabeth João; Dos Santos, Priscilla de Nazaré Silva; Bahamondes, Luis; Fernandes, Arlete

2014-10-20

10

The prevalence rates of domestic abuse in women attending a family planning clinic  

Microsoft Academic Search

ContextDomestic abuse has a detrimental impact on the mental and physical health of a woman. The abusive partner may use physical and sexual violence and ‘control’ the choice of contraception.ObjectiveTo examine the prevalence rates of domestic abuse.DesignData collection using anonymous questionnaire.SettingA family planning clinic.ParticipantsTwo hundred and ninety-two women.Main outcome measuresThe prevalence rate of past and present history of domestic abuse

June Keeling; Linda Birch

2004-01-01

11

Contraceptive use and fertility in Paraguay, 1987.  

PubMed

In 1987, 38 percent of married Paraguayan women aged 15-44 were practicing contraception, with oral contraceptives being the most prevalent method. Fertility rates for the population were at corresponding levels, with an overall fertility rate of 5.4 births per woman. Fertility has not changed substantially for the nation as a whole since 1979, and contraceptive use has increased by only 6 percentage points. Findings from the present study are consistent with the lack of a public sector family planning program in the country. Pharmacies are the principal source of contraceptives in the country. Twenty-two percent of all women and one-third of married women are at risk of having an unplanned pregnancy. The greatest impact on contraceptive use can be made if new and continued program efforts focus n the interior of the Oriental region of the country. PMID:3188133

Monteith, R S; Carron, J M; Warren, C W; Melian, M M; Castagnino, D; Morris, L

1988-01-01

12

CONTRACEPTION GUIDELINES COMMITTEE  

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

2004-01-01

13

Association between long-acting reversible contraceptive use, teenage pregnancy, and abortion rates in England  

PubMed Central

Background Since the late 1990s, the British government has launched major strategies to address high teenage pregnancy and abortion rates in England. These have focused in part on improving access to contraception through national campaigns. This study assessed teenage pregnancy and abortion rate trends since 1998 and possible associations with usage of long-acting reversible contraceptives (LARCs). Methods Teenage conception rates and age-specific abortion rates were obtained from the Office for National Statistics and the Department of Health. LARC usage data was obtained for Depo-Provera, Implanon/Nexplanon, intrauterine devices, Mirena, and Noristerat from the IMS British Pharmaceutical Index, IMS Hospital Pharmacy Audit, IMS Disease Analyzer, and KT-31 reports. Through linear regression methods, changes in conception and abortion-related outcomes during 1998–2011 and the associations with LARC usage were assessed. Results Conception rates for girls younger than 18 years of age decreased significantly between 1998–2011, from 46.6 to 30.7 per 1,000 girls. A statistically significant association was observed between this decrease and increased LARC usage (P=0.0024) in this population. Abortion rates among females aged <18 years or aged 18–19 years decreased between 1998–2011, and their associations with increased LARC usage were statistically significant (P=0.0029 and P=0.0479, respectively). The pattern in older women was complex; abortion rates in women aged 20–24 years or 25–34 years increased slightly from 1998 to 2011, with stabilization during 2007–2011. Conclusion Increased LARC usage in England was significantly associated with decreased teenage pregnancy rates and abortion rates in females aged <20 years. Government strategies appears to have a positive impact on these outcomes; however, abortion rates among women over 20 years of age remain an issue. PMID:25473316

Connolly, Anne; Pietri, Guilhem; Yu, Jingbo; Humphreys, Samantha

2014-01-01

14

Prevalence rates of gallstone disease in Italy  

Microsoft Academic Search

The prevalence of gallstone disease and associated factors in the entire population of subjects aged 15–65 years born and resident in Chianciano Terme (Siena — Tuscany) was examined in the years 1985 and 1986. The investigation included gallbladder ultrasonography, administration of a questionnaire on personal and family history, physical examination and blood chemistry. A total of 1809 subjects (attendance rate

Michele A. Dilengite; Mara Bozzoli; Francesca Carubbi; Roberto Messora; Romano Sassatelli; Marco Bertolotti; Auro Tampieri; Pier Luigi Tartoni; Mariateresa Cassinadri; Mario Delia Ciana; Maurizio Contemori; Nicola Save; Bruno Sordi; ulio Alimenti; brizio Fabrizi; gelo Buciuni; Nicola Carulli

1994-01-01

15

[Orthorectic eating behaviour - nosology and prevalence rates].  

PubMed

Orthorectic eating behaviour is characterised by a fixation on a healthy diet and rigidity regarding self-imposed nutrition standards. Besides malnutrition, subjective distress and social isolation might be consequences of clinical relevance. So far there are few reliable data about nosology and prevalence rates, so that it is not yet possible to evaluate the clinical significance of orthorectic eating behaviour. This article discusses nosological classifications of orthorexia and presents prevalence rates of extremely healthy eating behaviour in general population as well as in several specific subgroups. To summarise, orthorectic eating behaviour seems to be most likely an eating disorder with healthy dieting as an overvalued idea. Data on prevelance of orthorectic eating behaviour, assessed with the recently developed Düsseldorfer Orthorexie Skala, suggest a rate of 1 to 2% in general population. PMID:22700108

Barthels, Friederike; Pietrowsky, Reinhard

2012-12-01

16

Improving access to emergency contraception under the Scottish Sexual Health Strategy: can rates of unintended pregnancy be reduced?  

PubMed

Unintended pregnancy is a global sexual health problem. Outcomes of unintended pregnancy include unwanted childbirth and abortion, which may be associated with negative physical and psychosocial health implications for women. In Scotland, the Scottish Sexual Health Strategy has the stated goal of improving the sexual health of the people of Scotland. One aim of the Strategy is to reduce rates of unintended pregnancy and one policy designed to achieve this is 'widening access to emergency contraception'. This paper examines the success of this policy with reference to the implicit link it makes between expanding access to emergency contraception and increasing its effective use, aiming thereby to reduce rates of unintended pregnancy. Since there is evidence that previous policies and strategies expanding access to emergency contraception have failed to reduce such rates, alternative approaches to achieve a reduction in unintended pregnancies are discussed. PMID:24007249

McGowan, James G

2013-09-01

17

Contraceptive procedures.  

PubMed

Although most women desire to control the size and spacing of their family, the rate of unintended pregnancy in the United States remains high, with approximately half of all pregnancies being unintended. Reducing unintended pregnancy is a national public health goal, and the increased use of long-acting reversible contraceptives (LARCs) (intrauterine devices and implants) can help meet this goal. LARCs are among the most effective forms of contraception available. There are few contraindications to their use, and insertion and removal are straightforward procedures that are well tolerated in the outpatient office setting. PMID:24286997

Beasley, Anitra; Schutt-Ainé, Ann

2013-12-01

18

Effect of pretreatment counseling on discontinuation rates in Chinese women given depo-medroxyprogesterone acetate for contraception  

Microsoft Academic Search

The study examined the effect of pretreatment counseling upon discontinuation of 150 mg depo-medroxyprogesterone acetate (Depo-Provera® (DMPA)), given for contraception. A total of 421 chinese women participated, 204 receiving detailed structured pretreatment and ongoing counseling on the hormonal effects and probable side effects of DMPA and 217 receiving only routine counseling. The primary study endpoint was termination rate; secondary endpoints

Zhen-Wu Lei; Shang Chun Wu; Roger J. Garceau; Sou Jiang; Qiao-Zhi Yang; Wei-Lun Wang; Timothy C. Vander Meulen

1996-01-01

19

Long-acting reversible contraception.  

PubMed

Although short-acting reversible hormonal contraceptives, such as oral contraceptives and the contraceptive patch and vaginal ring, remain the most commonly used contraceptive methods in the United States, they are also associated with the highest failure rates. Long-acting reversible contraception (LARC) methods, such as intrauterine devices and contraceptive implants, offer high continuation rates and very low failure rates, and are safe for use in most women. The provision of LARC methods to adolescent, young adult and nulliparous women is a relatively new concept that offers an innovative option for these populations. PMID:24138662

Peck, Susan A

2013-10-01

20

Comparison of contraceptive use between the Contraceptive CHOICE Project and state and national data  

PubMed Central

Background We compared contraceptive prevalence reported in the Contraceptive CHOICE Project (CHOICE) at time of enrollment, with estimates from representative surveys, the 2006–2008 National Survey of Family Growth (NSFG) and 2006 Missouri Behavioral Risk Factor Surveillance System (BRFSS). Study design We calculated survey weights for CHOICE participants and compared selected demographic characteristics and prevalence estimates of current contraceptive methods being used at the time of enrollment. Results Compared to the NSFG, CHOICE participants at time of enrollment were less likely to be pill users (16.1% vs. 24.0%) and more likely to use condoms (23.8% vs. 13.8%). Compared to the BRFSS, CHOICE participants were more likely to use condoms (20.4% vs. 12.9%) and withdrawal (6.6% vs. 0.4%). Conclusion Despite differences in sampling strategies between CHOICE and state and national surveys, the contraceptive prevalence estimates were largely similar. This information combined with the high rates of long-acting reversible contraception (LARC) use after enrollment by CHOICE particiants that have been previously reported by study participants, may imply that cost and restricted access to LARC could be essential factors in the low rates of LARC use in the US. PMID:21477693

Kittur, Nupur D.; Secura, Gina M.; Peipert, Jeffrey F.; Madden, Tessa; Finer, Lawrence B.; Allsworth, Jenifer E.

2010-01-01

21

Acceptability of contraception for men: a review.  

PubMed

Methods of contraception for use by men include condoms, withdrawal and vasectomy. Prevalence of use of a method and continuation rates are indirect measures of acceptability. Worldwide, none of these "male methods" accounts for more than 7% of contraceptive use although uptake varies considerably between countries. Acceptability can be assessed directly by asking about intended (hypothetical) use and assessing satisfaction during/after use. Since they have been around for a very long time, there are very few data of this nature on condoms (as contraceptives rather than for prevention of infection), withdrawal or vasectomy. There are direct data on the acceptability of hormonal methods for men but from relatively small clinical trials which undoubtedly do not represent the real world. Surveys undertaken among the male general public demonstrate that, whatever the setting, at least 25% of men - and in most countries substantially more - would consider using hormonal contraception. Although probably an overestimate of the number of potential users when such a method becomes available, it would appear that hormonal contraceptives for men may have an important place on the contraceptive menu. Despite commonly expressed views to the contrary, most women would trust their male partner to use a hormonal method. PMID:20933119

Glasier, Anna

2010-11-01

22

[Contraception and adolescence].  

PubMed

The mean age of first sexual intercourse is still around 17 in France, but a lot of teenagers are concerned by contraception before, with approximately 25% of sexually active 15-year-old girls. The contraceptive method must take into consideration some typical features of this population, as sporadic and non-planned sexual activity, with several sexual partners in a short period of time. In 2004, the "Haute Autorité de santé" has recommended, as first-line method, combined oral contraceptive (COC) pills, in association with male condoms. Copper-containing intrauterine contraceptive devices (IUCD) and etonogestrel-containing subcutaneous implant have been suggested but not recommended. However, oral contraceptive pill, as a user-based method, carries an important typical-use failure rate, because remembering taking a daily pill, and dealing with stop periods, may be challenging. Some easier-to-use method should be kept in mind, as 28-day COC packs, transdermal contraceptive patches, and vaginal contraceptive rings. Moreover, American studies have shown that long-acting reversible contraceptives (LARC), i.e. IUCD and implant, have many advantages for teenagers: very effective, safe, invisible. They seem well-fitted for this population, with high satisfaction and continuation rates, as long as side effects are well explained. Thus, LARC methods should be proposed more widely to teenagers. Anyway, before prescribing a contraceptive method, it is important to determine the specific situation of every teenager, to let them choose the method that they consider as appropriate in their own case, and to think about the availability of the chosen method. It is necessary to explain how to handle mistakes or misses with user-based contraceptive methods, and emergency contraception can be anticipated and prescribed in advanced provision. The use of male condoms should be encouraged for adolescents, with another effective contraceptive method, in order to reduce the high risk of sexually transmitted infections (STI) in this population. PMID:23628120

Amate, P; Luton, D; Davitian, C

2013-06-01

23

[Contraceptive methods].  

PubMed

This brief article provides a review of the most common contraceptive methods. Contraceptive methods may be classified into primitive, traditional, and modern categories. Among primitive methods, coitus interruptus has a failure rate of 10-38%. It is not recommended by sexologists because of its possible physical and psychic secondary effects. Vaginal irrigation or washing immediately after intercourse are not effective because sperm arrive in the uterus seconds after ejaculation into the vagina. Prolonged lactation is not an effective method because of the impossibility of predicting the return of ovulation. Among traditional methods, the condom and diaphragm are relatively effective but not usually well accepted. Condoms are effective if the material is of high quality and they are properly positioned and removed before detumescence. The failure rate varies from 8-28%. Diaphragms are inserted into the vagina 2-4 hours or immediately before coitus and must remain in place for 6 hours after ejaculation. The correct size is determined by a physician. The proportion of failures is 20% for the diaphragm used alone and 10% when a spermicide is added. Local spermicides have the double objectives of mechanically blocking the cervix and chemically destroying sperm. They should be inserted deep into the vagina immediately before coitus and remain in place for 6 hours. They have a failure rate of 30% when used without other contraceptive methods. They are available in the form of creams, jellies, sprays, vaginal suppositories or tablets, and effervescent pills. Periodic continence methods require total sexual abstinence during the fertile periods of the menstrual cycle. The Ogino-Knaus method is based on a calendar estimation of the fertile days which normally occur between 19 and 12 days prior to the next menstrual period. The proportion of failures is over 14%. The method is without secondary effects but its acceptability is limited because of its interfrence with sexual expression and high failure rate. The basal temperature method requires sexual abstinence between the beginning of the cycle and the 3rd day after the periovulatory temperature rise. The method has a failure rate of 1-4% but is less widely used than the Ogino-Knaus calendar method because of its inconvenience, greater sexual restrictions, and difficulty of interpretation. Among modern methods, combined oral contraceptives (OCs) have the lowest failure rate, .1%. They function by interfering with the mechanism of ovulation. OC formulations vary by dose, hormones utilized, and form of administration. The physician must decide the appropriate formulation for each woman. IUDs have a failure rate of 3%. They are contraindicated for women with alterations of the genital organs, infections, abnormal uterine bleeding or pregnancy. Among permanent methods, vasectomy is a simple and quick operation which provides complete sterility for men about 8-10 weeks after operation. Tubal ligation by various surgical techniques is the most common form of contraceptive surgical sterilization for women. No currently used contraceptive method can be considered ideal. PMID:6914729

Creus, M E

1981-05-01

24

[Hormonal contraception].  

PubMed

The forms of administration, mechanisms of action, side effects and complications, and other aspects of female hormonal contraception are set forth in this "lesson" for medical students. Female hormonal contraception has been in use for over 30 years and is used by more than 150 million women worldwide. Oral contraceptives suppress the preovulatory peak of follicle stimulating hormone and luteinizing hormone, preventing ovulation and follicular maturation. Progestins render the cervical mucus impermeable to sperm and modify the endometrium so that it will no longer support implantation. The synthetic estrogen ethinyl estradiol is used in most combined oral contraceptives (OCs). Among the numerous progestins in use are the newer desogestrel, gestodene, and norgestimate, which have fewer androgenic and metabolic effects than did the 1st generation. the different forms of administration of hormonal methods include combined OCs, oral preparations containing low doses of progestin continuously administered or high doses continuously or discontinuously administered. Intramuscular injection of progestins and the so-called "morning after" postcoital pills are less often prescribed. The combined preparations may be monophasic, biphasic, triphasic, or sequential. Sequential preparations should be avoided because of the hyperestrogenic climate they induce. The low-dose progestin preparations are indicated for women with contraindications to synthetic estrogen. They must be taken at the same time each day and have a relatively high rate of side effects, especially ovarian and breast cysts and irregular bleeding. High-dose progestin preparations have significant metabolic effects and are indicated primarily for patients with gynecological problems such as fibromas and endometriosis. Intramuscular injection of medroxyprogesterone acetate every 3 months is effective but has the same side effects as high-dose progestins. It is indicated primarily for patients unable to control their own behavior. The hormonal methods are all highly effective in preventing pregnancy when correctly administered. Side effects may be minor problems, such as nervousness and nausea, that are usually of short duration. the more serious side effects, including modifications of lipid or carbohydrate metabolism, hemostasis, blood pressure, or hepatic functioning and cardiovascular effects, have been reduced with the new lower dosed formulations. Absolute contraindications to hormonal contraception include undiagnosed vaginal bleeding or amenorrhea, history of thromboembolic or cerebral vascular accidents, severe cardiopathy or hypertension, hyperlipidemia, hepatopathy, hormonodependent cancer, pituitary tumors, porphyria, and severe mental problems. Relative contraindications impose the need for careful monitoring and follow-up. The practitioner should be aware of the possibility of interactions between OCs and certain other drugs. PMID:1604074

Van Cauwenberge, J R

1992-05-01

25

A stochastic infection rate model for estimating and projecting national HIV prevalence rates  

E-print Network

A stochastic infection rate model for estimating and projecting national HIV prevalence rates Le/AIDS (UNAIDS) produces probabilistic estimates and projections of HIV prevalence rates for countries and projection package (EPP) model'. This has worked well for estimating and projecting prevalence in most

Raftery, Adrian

26

[Contraceptive methods].  

PubMed

The definitions, mode of action, use instructions, effectiveness, and advantages and disadvantages of the major contraceptive methods are described in general terms and in nontechnical language. Method failures and user failures are distinguished, and probabilities of pregnancy attributable to each are given. The longest section concerns the pill, with the mode of action and major and minor side effects discussed in slightly greater detail than for other methods. The section of the IUD mentions the newer devices and describes contraindications and possible complications of IUD use. The diaphragm, with a method failure rate estimated at 2-4/100 woman years and a user failure rate of 10-15/100 woman years, is discussed in the section with the pill and IUD. A section on "less effective methods" considers the condom, with 2-4 method failures and 6-13 user failures/100 woman years; contraceptive foam, with a slightly higher user failure rate, and periodic abstinence, including the calendar, temperature, and vaginal mucus methods, with method failure of 5-10 and user failure of 9-28/100 woman years. Finally, male and female sterilization techniques are briefly described. PMID:6907709

1980-05-01

27

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

28

Fertility and contraception in the Marshall Islands.  

PubMed

Data on fertility and contraception in Micronesian women in the Marshall Islands were collected during a women's health survey in 1985. High total fertility rates were found. The reproductive pattern of many Marshallese women is one that has been associated with adverse health consequences: pregnancies in teenagers and in women over 39 years, high parities of four or more births, and short birth intervals. The practice of breastfeeding is declining in younger women. The prevalence of contraceptive use is low, and the availability of reversible methods is limited. Most contraceptive nonusers would like to practice contraception, but are inhibited by the lack of information about family planning. It is suggested that more attention needs to be given to family planning services in the Marshall Islands, in particular to improving the availability of reversible methods of contraception and of information about family planning. Further research is also needed on how family planning services might best be organized to maximize participation by women and their partners who wish to use such services. PMID:3406966

Levy, S J; Taylor, R; Higgins, I L; Grafton-Wasserman, D A

1988-01-01

29

Unmet contraceptive needs among refugees  

PubMed Central

Abstract Objective To describe what women of reproductive age who received primary care at a refugee health clinic were using for contraception upon arrival to the clinic, and to quantify the unmet contraceptive needs within that population. Design Retrospective chart review. Setting Crossroads Clinic in downtown Toronto, Ont. Participants Women of reproductive age (15 to 49 years) who first presented for care between December 1, 2011, and December 1, 2012. To be included, a woman had to have had 2 or more clinic visits or an annual health examination. Exclusion criteria for the contraception prevalence calculation were female sexual partner, menopause, hysterectomy, pregnancy, or trying to conceive. Main outcome measures Contraception use prevalence was measured, as was unmet contraceptive need, which was calculated using a modified version of the World Health Organization’s definition: the number of women with an unmet need was expressed as a percentage of women of reproductive age who were married or in a union, or who were sexually active. Results Overall, 52 women met the criteria for inclusion in the contraceptive prevalence calculation. Of these, 16 women (30.8%) did not use any form of contraception. Twelve women were pregnant at some point in the year and stated the pregnancy was unwanted or mistimed. An additional 14 women were not using contraception but had no intention of becoming pregnant within the next 2 years. There were no women with postpartum amenorrhea not using contraception and who had wanted to delay or prevent their previous pregnancy. In total, 97 women were married or in a union, or were sexually active. Unmet need was calculated as follows: (12 + 14 + 0)/97 = 26.8%. Conclusion There was a high unmet contraceptive need in the refugee population in our study. All women of reproductive age should be screened for contraceptive need when first seeking medical care in Canada. PMID:25642489

Aptekman, Marina; Rashid, Meb; Wright, Vanessa; Dunn, Sheila

2014-01-01

30

Obesity and hormonal contraceptive efficacy.  

PubMed

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

2013-09-01

31

Emergency contraception.  

PubMed

The term 'emergency contraception', as employed in this paper, refers to methods that are used as emergency procedures to prevent pregnancy following unprotected intercourse. Alternative, less appropriate, terms are postcoital and 'morning-after' contraception. References to postcoital preparations can be found as far back as 1500 BC in Egyptian papyri, but it was not until fairly recently that contraceptive research has been able to at least partially fulfill that need. The development of hormonal methods of emergency contraception goes back to the 1960s when the first human trials of postcoitally administered high-dose oestrogens were undertaken. Combined oestrogen- progestogen combination therapy (the so-called Yuzpe regimen) was introduced in the early 1970s, while the postcoital insertion of an intrauterine contraceptive device (IUD) for emergency contraception was first reported in 1976. Other compounds that have been tested more recently include levonorgestrel, the antiprogestogen mifepristone, and danazol. Although there is some debate about the magnitude of the protective effect, few people question the important role that emergency contraception can play in preventing unwanted pregnancy and hence maternal mortality and morbidity resulting from unsafe abortion. Given that the most often used methods of emergency contraception, namely the Yuzpe regimen and postcoital insertion of an IUD, rely on technology that has been available for some 30 years, family planning programmes that claim to be concerned with improving women's reproductive health, cannot really be excused if they do not provide emergency contraception as part of their routine services. PMID:8324605

Van Look, P F; von Hertzen, H

1993-01-01

32

[Contraception in Austria].  

PubMed

952 sexual active women between 15 and 44 years were investigated for their contraceptive behaviour. In 42% the pill was the first choice followed by the condom in 16%. 18% of all sexual active women in this age group did not use any contraceptives. Therefore the rate of unplanned pregnancies was very high: 34% reported about such unplanned pregnancies in their history. The main sources for informations in contraception are the gynecologist and the partner, but not the parents or the newspapers. Nearly half of all women did not know how the pill really works and quite a lot has still the opinion that there are really harmful side effects of oral contraceptives. PMID:2396423

Vytiska-Binstorfer, E; Huber, J C; Riphagen, F E

1990-07-15

33

Women's knowledge of emergency contraception.  

PubMed Central

BACKGROUND. More widespread use of emergency contraception could help to reduce the number of unwanted pregnancies. AIM. The objective of this study was to assess women's knowledge of emergency contraception. METHOD. A questionnaire was distributed to 1290 women aged between 16 and 50 years attending 14 general practice surgeries in London over a two-week period in 1990. RESULTS. The response rate was 70%. Over three quarters of the women had heard of emergency contraception; these were mainly women who used contraception, who had higher educational qualifications or who were not Muslim. Women who were the most likely to need and to use emergency contraception--those using barrier methods--had no more accurate knowledge than women using any other method of contraception. Only 53% of barrier method users knew emergency contraception could be used as a backup when other methods failed. Only one fifth of women had heard about this method from their general practitioner or any other health professional, while half had obtained their information from the media. CONCLUSION. These results suggest that including information on emergency contraception in consultations with users of barrier methods of contraception is a small step which general practitioners and practice nurses could take to increase the use of emergency contraception. PMID:7748633

George, J; Turner, J; Cooke, E; Hennessy, E; Savage, W; Julian, P; Cochrane, R

1994-01-01

34

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

35

Intrauterine contraception.  

PubMed

Essential facts Intrauterine contraception (IUC) methods are long-acting reversible contraceptives with licensed durations of use lasting between three and ten years. They include copper intrauterine devices (Cu-IUD), which are non-hormonal, and levonorgestrel intrauterine systems (LNG-IUS), which release levonorgestrel. They are suitable for most women, including those who have not been pregnant. PMID:25315545

2014-10-21

36

Relationships between attitudes toward sexuality, sexual behaviors, and contraceptive practices among Chinese medical and nursing undergraduates.  

PubMed

In this study, we investigated attitudes toward sexuality, the prevalence of sexual behaviors and contraceptive use among Chinese medical and nursing undergraduates, and relationships between attitudes toward sexuality and sexual and contraceptive practices among these participants. This was a descriptive, cross-sectional study carried out by using a Personal Attitude toward Sexuality Scale and Sexual and Contraceptive Questionnaire. The participants were recruited in the researcher's lectures. A total of 158 participants joined this study. Overall, Chinese medical and nursing undergraduates in this study held relatively conservative attitudes toward sexuality. The prevalence of sexually-active students was relatively low, and the percentage of contraceptive use among those sexually-active students was also low. Participants' attitudes toward sexuality had statistically-significant effects on their sexual and contraceptive practices. Nearly half of the sexually-active participants reported never using any contraceptive method during sexual intercourse. This finding has important public health implications, as young people represent the group with the largest rate of new infections of HIV/AIDS in China. A more comprehensive sexual education program that extends to college undergraduates and promotes the social acceptability of using contraception, specifically condoms, is needed. PMID:25491444

Zeng, Yingchun; Luo, Taizhen; Zhou, Ying

2014-12-10

37

Emergency contraception  

MedlinePLUS

... in women. It can be used: After a sexual assault or rape When a condom breaks or a diaphragm slips ... your health care provider first). Emergency contraception may cause side effects. Most are mild. They may include: ...

38

Emergency Contraception  

MedlinePLUS

... taken within 72 hours after having unprotected sex Levonorgestrel: 2 pills; the first dose taken within 72 ... can decrease the effectiveness of emergency contraceptives with levonorgestrel, including Plan B One-Step. Women weighing more ...

39

Emergency contraception.  

PubMed

There have been numerous attempts to control fertility after unprotected sexual intercourse (UPSI). From very bizarre methods like the vaginal application of Coca Cola to the more serious attempts using calcium antagonists influencing fertility parameters in sperm to hormonal methods or intrauterine devices. So far, hormonal methods preventing or delaying ovulation have proved to be the most popular starting with the combination of ethinyl estradiol and levonorgestrel (LNG), known as the Yuzpe regimen. The first dose had to be taken within 72 hours of UPSI, a second one 12 hours later. Later on, LNG alone, at first in a regimen similar to the Yuzpe method (2?×?0.75?mg 12 hours apart) showed to be more successful, eventually resulting in the development of a 1.5?mg LNG pill that combined good efficacy with a high ease of use. Several efficacious and easy to use methods for emergency contraception (EC) are available on the market today with the most widely spread being LNG in a single dose of 1.5?mg (given as one tablet of 1.5?mg or 2 tablets of 0.75?mg each) for administration up to 3 days (according to WHO up to 5 days) after UPSI. Its limitations are the non-optimal efficacy which is decreasing the later the drug is taken and the fact that it is only approved for up to 72 hours after UPSI. This regimen has no effect on the endometrium, corpus luteum function and implantation, is not abortive and don't harm the fetus if accidentally taken in early pregnancy. It has no impact on the rate of ectopic pregnancies. It has become the standard method used up to this day in most countries. Since the mid 1970s copper IUDs have been used for EC, which show a high efficacy. Their disadvantages lie in the fact that EC is considered an off label use for most IUDs (not for the GynFix copper IUD in the European Union) and that they might not be acceptable for every patient. Furthermore IUD-insertion is an invasive procedure and it is required trained providers and sterilized facilities. Mifepristone in the dosages of 10 or 25?mg is used with good results as an emergency contraceptive in China for up to 120 hours after UPSI, but has never received any significant consideration in Western countries. While high doses of mifepristone has an effect on endometrial receptivity and will inhibit ovulation if given in the follicular phase and prevent implantation if given in the early luteal phase, low doses such as 10?mg has no impact on the endometrium. Mifepristone does not increase the rate of ectopic pregnancies. The most recent development is the approval of the selective progesterone receptor modulator ulipristal acetate (UPA) in the dosage of 30?mg for EC up to 5 days after UPSI, combining the safe and easy application of the single dose LNG pill with an even higher efficacy. It has shown to be more efficacious than LNG and can be used for up to 120 hours after UPSI; the difference in efficacy is highest for 0-24 hours, followed by 0-72 hours following UPSI. No VTE has been reported following UPA-administration or any progesterone receptor modulator. No effect on endometrium, corpus luteum function and implantation has been observed with doses used for EC. Independent of the substance it should be noted that, if there is a choice, the intake of an oral emergency contraceptive pill should happen as soon as possible after the risk situation. A pre-existing pregnancy must be excluded. Possible contraindications and drug interactions must be considered according to the individual special product informations. PMID:23437846

Gemzell-Danielsson, Kristina; Rabe, Thomas; Cheng, Linan

2013-03-01

40

Spousal discordance on fertility preference and its effect on contraceptive practice among married couples in Jimma zone, Ethiopia  

PubMed Central

Objectives To assess spousal agreement levels regarding fertility preference and spousal communication, and to look at how it affects contraceptive use by couples. Methods We conducted a cross-sectional study to collect quantitative data from March to May 2010 in Jimma zone, Ethiopia, using a multistage sampling design covering six districts. In each of the 811 couples included in the survey, both spouses were interviewed. Concordance between the husband and wife was assessed using different statistics and tests including concordance rates, ANOVA, Cohen’s ? and McNemar’s test for paired samples. Multivariate analysis was computed to ascertain factors associated with contraceptive use. Results Over half of the couples wanted more children and 27.8% of the spouses differed about the desire for more children. In terms of sex preference, there was a 48.7% discord in couples who wanted to have more children. At large, spousal concordance on the importance of family planning was positive. However, it was the husband’s favourable attitude towards family planning that determined a couple’s use of contraception. Overall, contraceptive prevalence was 42.9%. Among the groups with the highest level of contraceptive users, were couples where the husband does not want any more children. Spousal communication about the decision to use contraception showed a positive association with a couple’s contraceptive prevalence. Conclusions Family planning programs aiming to increase contraceptive uptake could benefit from findings on spousal agreement regarding fertility desire, because the characteristics of each spouse influences the couple’s fertility level. Disparities between husband and wife about the desire for more children sustain the need for male consideration while analysing the unmet need for contraception. Moreover, men play a significant role in the decision making concerning contraceptive use. Accordingly, involving men in family planning programs could increase a couple’s contraceptive practice in the future. PMID:24708827

2014-01-01

41

Effect of ?-dose rate and total dose interrelation on the polymeric hydrogel: A novel injectable male contraceptive  

NASA Astrophysics Data System (ADS)

Functional necessity to use a particular range of dose rate and total dose of ?-initiated polymerization to manufacture a novel polymeric hydrogel RISUG ® (reversible inhibition of sperm under guidance) made of styrene maleic anhydride (SMA) dissolved in dimethyl sulphoxide (DMSO), for its broad biomedical application explores new dimension of research. The present work involves 16 irradiated samples. They were tested by fourier transform infrared spectroscopy, matrix assisted laser desorption/ionization-TOF, field emission scanning electron microscopy, high resolution transmission electron microscopy, etc. to see the interrelation effect of gamma dose rates (8.25, 17.29, 20.01 and 25.00 Gy/min) and four sets of doses (1.8, 2.0, 2.2 and 2.4 kGy) on the molecular weight, molecular weight distribution and porosity analysis of the biopolymeric drug RISUG ®. The results of randomized experiment indicated that a range of 18-24 Gy/min ?-dose rate and 2.0-2.4 kGy ?-total doses is suitable for the desirable in vivo performance of the contraceptive copolymer.

Jha, Pradeep K.; Jha, Rakhi; Gupta, B. L.; Guha, Sujoy K.

2010-05-01

42

The Contraceptive Needs for STD Protection Among Women in Jail  

Microsoft Academic Search

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 metropolitan area. Results from 188 women indicated high rates of STDs,

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

2010-01-01

43

Prevalence Rates of Youth Gambling Problems: Are the Current Rates Inflated?  

Microsoft Academic Search

While there is a general consensus in the literature that it is common for youth to gamble, considerable variability in the reported prevalence rates of youth problem gambling has been found. More recently, issues concerning the possible overestimation of these rates have been raised. Arguments underlying the proposition that problem gambling rates for youth are inflated are examined. It is

Jeffrey L. Derevensky; Rina Gupta; Ken Winters

2003-01-01

44

Hormonal contraception in men.  

PubMed

All major advances in the development of hormonal methods of contraception over the past 40 years have been exclusively female orientated with male hormonal contraception forever "just around the corner". Despite this, the last few years have seen a significant increase in the pace of research and increased involvement from the pharmaceutical industry. This is essential if the progress derived from the public sector is to be translated into a real product for widespread use. Current male methods of contraception, condoms and vasectomy, are relied on by 30% of couples throughout the world but there have been no new male contraceptive methods introduced in the last century. There is currently an increasing emphasis on male involvement in family planning, and evidence both that some men would be keen to shoulder this responsibility and that their partners would trust them to do so. There are several potential novel approaches to male contraception, but the hormonal one is the only one at the stage of clinical research. This method is based on the normal regulation of spermatogenesis by the pituitary gonadotrophins: suppression of gonadotrophin secretion results in a reduction in the rate of spermatogenesis, and azoospermia, the absence of sperm from the ejaculate, can be achieved. Current approaches are now getting close to the ideal of inducing azoospermia in all men. This approach also results in suppression of testicular testosterone production, thus androgen 'add-back' is an essential component of a contraceptive regime. Many different steroids and delivery methods -oral, buccal, transdermal, subcutaneous implants- are under exploration at present, each with their own advantages and drawbacks. The use of synthetic androgens is also starting to be explored: these have the potential advantage of offering tissue-specific actions. PMID:16178786

Walton, Melanie; Anderson, Richard A

2005-09-01

45

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.

2008-01-01

46

A three-year comparative study of continuation rates, bleeding patterns and satisfaction in Australian women using a subdermal contraceptive implant or progestogen releasing-intrauterine system.  

PubMed

BACKGROUND Long-acting reversible contraceptive methods (LARCs) are safe, highly effective, readily reversible, and require no action on the part of the user following insertion. Early discontinuation may put women at increased risk of unintended pregnancy. METHODS Following insertion of a progestogen-only subdermal implant or intrauterine system (IUS) at Family Planning NSW, women 18 years and older completed a questionnaire about their choice. At 6 weeks, 6, 12, 24 and 36 months by telephone or online they completed a questionnaire about bleeding patterns, side effects, satisfaction, and reasons for discontinuation. RESULTS Two hundred IUS users and 149 implant users were enrolled. The former were generally older, married or in a de-facto relationship, and had children. Forty-seven percent of implant users discontinued within three years compared to 27% of IUS users (p = 0.002). In the first two years amenorrhoea was more frequent in implant users. Frequent bleeding/spotting was more prevalent in the first year of IUS use but over time was twice as prevalent in implant users. Infrequent bleeding/spotting was more common in IUS users. CONCLUSION Both devices are highly effective and acceptable cost-effective methods. While LARCs should be promoted to women of all ages seeking contraception, early discontinuation due to unacceptable bleeding highlights the need for pre-insertion counselling. PMID:24229367

Weisberg, Edith; Bateson, Deborah; McGeechan, Kevin; Mohapatra, Lita

2014-02-01

47

Emergency Contraception  

MedlinePLUS

... contraception. This is rarely prescribed for teens, though. How Does It Work? Levonorgestrel progesterone-like hormone that is given in ... girl has unprotected sex after taking the ECPs. How Well Does It Work? About 1 or 2 in every 100 women ...

48

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

2013-01-01

49

Childhood asthma hospitalization rates, childhood asthma prevalence, and their relationships in Erie County, New York.  

PubMed

We estimated asthma hospitalization rates, prevalence, and their relationships for children under age 15 in Erie County, New York. Information on hospitalizations was obtained from hospital discharge data, and prevalence was estimated through a mailed survey of 9271 children. The hospitalization rate was 2.3 per 1000, the lifetime prevalence was 14.1%, and the hospitalization-to-prevalence ratio was 16.3 per 1000 prevalent cases. Hospitalization rates and hospitalization-to-prevalence ratios were higher among young children relative to older children; and hospitalization rates, prevalence, and hospitalization-to-prevalence ratios were higher among males, blacks, and Buffalo residents, suggesting greater severity, poorer management, and/or less access to care among these groups. The hospitalization-to-prevalence ratio may be useful in estimating prevalence from more easily available hospitalization data. PMID:16266956

Lin, Shao; Kielb, Christine; Chen, Zhongliang; Hwang, Syni-An

2005-10-01

50

Modern contraceptive utilization among female ART attendees in health facilities of Gimbie town, West Ethiopia  

PubMed Central

Background In many areas of the world where HIV prevalence is high, rates of unintended pregnancy have also been shown to be high. Of all pregnancies worldwide in 2008, 41% were reported as unintended and approximately 50% of these ended in abortion. To address these problems family planning is the best solution. Therefore, the purpose of the study was to assess modern contraceptive use among females on ART in health facilities of Gimbie town, Western Ethiopia. Methods A facility based cross-sectional study was conducted in Gimbie town, western Ethiopia from December 2012 to January 2013. HIV infected women of reproductive age group (15-49 years) who came for ART care follow up during the data collection period were included in the study. Data was collected using an interviewer administered questionnaire. Binary logistic regression and multivariate analysis were employed using SPSS version 17. Results Three hundred ninety five women on ART have participated in the study. More than half, 224 (56.7%), of the respondents were using modern contraceptive, of whom 67 (30%) use dual contraceptive method. Having information on modern contraception is positively associated with modern contraceptive use with (AOR=6.3, 95% CI (1.67, 24.1)) and respondents who have family size ?4 were 50% less contraceptive users than those who have family size >4 (AOR=0.51, 95% CI (0.27, 0.96)). Conclusion In this study contraceptive use among HIV positive women is better than the general population. However, use of dual methods, long acting and permanent method of contraceptives were found to be low. Continuous and targeted information provision on modern contraceptive should be done. PMID:24731751

2014-01-01

51

Different approaches in contraception.  

PubMed

Female contraception methods -- inhibiting ovulation (suppression of ovulation), inhibiting fertilization (fusion of the oocyte and the spermatozoa), inhibiting implantation (prevention of the nidation of the fertilized oocyte), and abortion pregnancy wastage); and male contraception methods -- spermatogenesis inhibition (disruption of spermatocyte formation) and methods acting on fertilization (fusion of sperm and oocyte) are reviewed. Ovulation can be inhibited by steroid hormones including synthetic estrogens and progestins and by releasing hormone analogs. Steroidal contraception is now used by approximately 60 million women worldwide. The objective in developing new contraceptives is to reduce the side effect rate. This might be possible by the detection of risk groups, the lowering of the steroid dose per cycle, and the introduction of new application schemes, the development of new steroids, and the improvement of steroid release. Oral contraceptives (OCs) should be applicable during lactation. This is possible by the development of substances which will not be transferred to the maternal milk or completely metabolized by the fetus. Due to the cardiovascular risks associated with both estrogens and progestins, the estrogen and progestin content of OCs has been reduced. Drugs with ovulatory inhibitory potency can be injected in the form of microcapsules or subcutaneously implanted or possibly applied as local plaster contraceptives. For implantables new technologies allow a slow release of substances from deposits by biodegradation of thecarriers. LHRH analogs (luteinizing hormone-releasing hormone) administered as nasal sprays, implantables, or injectables could not fulfill the hopes they had raised. The high rate of menstural cycle disturbances can only be prevented by progestins given in the 2nd part of the menstrual cycle. For the inhibition of fertilization of oocyte various different behavioral methods can prevent contact between oocyte and spermatozoa due to the time-dependent course of the menstrual cycle, e.g., symptothermal methods (e.g., Billings method, ovulation method) are gaining more acceptance. For immunological contraception both active and passive immunization can be applied. Implantation can be prevented by IUDs steroid hormones synthetic compounds, and immunological methods. For abortion, surgical methods, hormonal methods, plant extracts, and enzyme inhibitors can be used. In the male, spermatogenesis can be successfully inhibited by a large number of steroid hormones which lead to a fall of peripheral testicular levels. The solution of this problem would be to discover a substance which inhibits locally the testicular testosterone synthesis and would not influence peripheral androgen levels which are necessary for secondary sexual characteristics and the maintenance of libido. On the post testicular level, the ripening of the spermatozoa in the epididymis and sperm transport can be disturbed. PMID:12266639

Runnebaum, B; Rabe, T; Kiesel, L

1984-07-01

52

Latest developments in contraception.  

PubMed

The 10th Annual Symposium on Latest Developments in Contraception, organized by the Biological Science Committee of the Australian Federation of Family Planning Associations, was held in February 1983 and provided an update on the current status of contraceptive technology. In a review of steroidal contraception, it was proposed that the Silastic vaginal ring is the most promising of the fertility control devices not requiring continual involvement of the couple. Product development costs, the length of time required for safety trials have hindered development of the perfect contraceptive device. In a discussion of IUD use, it was reported that there are fewer expulsions and a lower incidence of infection when the device is inserted between the 11th and 17th days of the menstrual cycle. Although it is current practice to reinsert copper IUDs every 2 years, no increase in failure rates has been observed after 5 years of continual use. It is recommended that IUD insertion be delayed until 8 weeks postpartum. Another participant asserted that there is no empirical evidence to justify the use of spermicides with diaphragms. Unknown factors of vaginal physiology and its interaction with sperm must be elucidated before a good barrier method can be introduced. Concern was expressed with the numbers of women seeking reanastomosis of the Fallopian tubes after tubal ligation. Success of reanastomosis depends on the type of initial procedure and the time elapsed. 7% of Australian men have had vasectomies, and the request rate for reversal is 2-3/1000/year. In a review of immunological contraception, it was noted that long-lasting, non-pharmacologically active agents are the most promising substances for future research, but their potential hazards are great. Dr. Evelyn Billings reported that the ovulation method of natural family planning is superior to the basal-body-temperature or rhythm methods since it takes stress-induced fluctuations in ovulation into account. The Symposium concluded that the effectiveness of the Billings method must be proven in follow-up research before it is offered as an alternative to other methods. A report that 40% of Australian teenagers surveyed did not use contraception at last intercourse underscores the need for medical personnel to educate younger patients about contraceptive techniques. PMID:6843444

Gold, J

1983-05-28

53

Contraception and Birth Control  

MedlinePLUS

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

54

Emergency contraception  

PubMed Central

Abstract Objective To determine the extent to which Nova Scotian FPs prescribe and provide emergency contraceptive pills (ECPs) and to explore their knowledge of and attitudes toward ECPs. Design Survey of Nova Scotian FPs using a modified Dillman method. Setting All regions of Nova Scotia. Participants Family physicians registered with Dalhousie University’s Division of Continuing Medical Education. Main outcome measures Sex differences in the provision of ECPs and knowledge and attitudes about the ECP Plan B. Results Of 913 eligible FPs, 155 (17.0%) participated in the survey. Respondents resembled the sampling frame closely. Most physicians (64.0%) had prescribed ECPs in the previous year (mean number of prescriptions, 4.92); only 12.9% provided ECPs in advance of need. Knowledge about Plan B was quite good, except for knowledge of the time frame for potential effectiveness; only 29.2% of respondents answered that question correctly. Respondents generally supported nonprescription availability of ECPs, but 25.0% of FPs were concerned that this could lead to less use of more effective methods of contraception, and 39.2% believed that it would encourage repeat use. Younger FPs provided ECPs more often than their older colleagues, while female respondents had better knowledge about Plan B. In multivariate analysis being younger than 40 years was marginally associated with prescribing Plan B and with prescribing any form of ECP. Conclusion Most Nova Scotian FPs provided ECPs and had generally good knowledge about and attitudes toward providing such contraception without prescription. However, FPs were poorly informed about the length of time that Plan B can be effective, which could potentially affect use when patients consult several days after unprotected sex. There were some concerns about nonprescription availability of ECPs, which could have implications for recommending it to patients. Rarely were ECPs prescribed for advance use, which might represent a lost prevention opportunity, especially for adolescents who often do not use effective contraception. PMID:22586200

Langille, Donald B.; Allen, Michael; Whelan, Anne Marie

2012-01-01

55

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

2013-01-01

56

Gambling disorder: Estimated prevalence rates and risk factors in Macao.  

PubMed

An excessive, problematic gambling pattern has been regarded as a mental disorder in the Diagnostic and Statistical Manual for Mental Disorders (DSM) for more than 3 decades (American Psychiatric Association [APA], 1980). In this study, its latest prevalence in Macao (one of very few cities with legalized gambling in China and the Far East) was estimated with 2 major changes in the diagnostic criteria, suggested by the 5th edition of DSM (APA, 2013): (a) removing the "Illegal Act" criterion, and (b) lowering the threshold for diagnosis. A random, representative sample of 1,018 Macao residents was surveyed with a phone poll design in January 2013. After the 2 changes were adopted, the present study showed that the estimated prevalence rate of gambling disorder was 2.1% of the Macao adult population. Moreover, the present findings also provided empirical support to the application of these 2 recommended changes when assessing symptoms of gambling disorder among Chinese community adults. Personal risk factors of gambling disorder, namely being male, having low education, a preference for casino gambling, as well as high materialism, were identified. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:25134026

Wu, Anise M S; Lai, Mark H C; Tong, Kwok-Kit

2014-12-01

57

The contraceptive needs for STD protection among women in jail.  

PubMed

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 metropolitan area. Results from 188 women indicated high rates of STDs, inconsistent contraceptive use, and use of unreliable and user-dependent contraception methods. Intended contraceptive use following release varied depending on women's ability to bear children. Women planning to use condoms after release were more likely to have had an STD and more sexual partners than were women not planning to use condoms. Racial differences were found for participants' sexual health and contraception histories. These women were at high risk for STDs and appeared to need education about contraception methods. Therefore, they might benefit from education on safe sex practices provided prior to release. PMID:20705810

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

2010-08-01

58

A systematic review of effectiveness and safety of different regimens of levonorgestrel oral tablets for emergency contraception  

PubMed Central

Background Unintended pregnancy is a complex phenomenon which raise to take an emergency decision. Low contraceptive prevalence and high user failure rates are the leading causes of this unexpected situation. High user failure rates suggest the vital role of emergency contraception to prevent unplanned pregnancy. Levonorgestrel - a commonly used progestin for emergency contraception. However, little is known about its pharmacokinetics and optimal dose for use. Hence, there is a need to conduct a systematic review of the available evidences. Methods Randomized, double-blind trials were sought, evaluating healthy women with regular menstrual cycles, who requested emergency contraception within 72 h of unprotected coitus, to one of three regimens: 1.5 mg single dose levonorgestrel, two doses of 0.75 mg levonorgestrel given 12 h apart or two doses of 0.75 mg levonorgestrel given 24 h apart. The primary outcome was unintended pregnancy; other outcomes were side-effects and timing of next menstruation. Results Every trial under consideration successfully established the contraceptive effectiveness of levonorgestrel for preventing unintended pregnancy. Moreover, a single dose of levonorgestrel 1.5 mg for emergency contraception supports its safety and efficacy profile. If two doses of levonorgestrel 0.75 mg are intended for administration, the second dose can positively be taken 12–24 h after the first dose without compromising its contraceptive efficacy. The main side effect was frequent menstrual irregularities. No serious adverse events were reported. Conclusions The review shows that, emergency contraceptive regimen of single-dose levonorgestrel is not inferior in efficacy to the two-dose regimen. All the regimens studied were very efficacious for emergency contraception and prevented a high proportion of pregnancies if taken within 72 h of unprotected coitus. Single levonorgestrel dose (1.5 mg) can substitute two 0.75 mg doses 12 or 24 h apart. With either regimen, the earlier the treatment is given, the more effective it seems to be. PMID:24708837

2014-01-01

59

Advance Provision of Emergency Contraception for Adolescents  

ERIC Educational Resources Information Center

Emergency contraception is most effective at preventing unintended pregnancy when taken as early as possible following unprotected sexual intercourse. Advance provision of this medication supports more timely and effective use. In the midst of rising teen pregnancy rates, current policies often limit access to emergency contraception for…

Adamji, Jehan-Marie; Swartwout, Kathryn

2010-01-01

60

Liability concerns in contraceptive research and development  

Microsoft Academic Search

The history of liability claims in the US against contraceptive products is among the issues that discourage manufacturers from investing in discovery and development in this field. Other factors are the high cost of new drug development, elevated insurance rates for contraceptives, and the desire to avoid controversy that can disturb corporate tranquility. General features of the American legal system

S. J Segal

1999-01-01

61

Underage contraception.  

PubMed

This article discusses the ethical and legal dilemmas confronting general practitioners in regard to contraceptive advice for adolescents. When a teenage girl comes to a physician for advice, she alone is the patient and the physician has an obligation to her. However, this obligation must be reconociled with the obligation to her parents. A UK parent, Victoria Gillick, sought declarations in the High Court against a National Health Service Notice concerning family planning services for adolescents. She argued: 1) that physicians who give family planning advice to girls under 16 years of age witout parental consent are guilty of causing or encouraging unlawful sexual intercourse; and 2) the doctor's actions interfere with the rights of the child's parents and undermine their ability to carry out their duties of supervising the physical and moral welfare of their children. If Gillick's position is adopted by society, no minor will be able to consult a physician without the parent being present. In practice, many physicians consulted by teenagers under 16 attempt to determine whether the girl has reached a stage in her development where she is capable of behaving as an autonomous agent, with the rights and responsibilities this entails. In the US, the concept of the mature minor doctrine has been developed. This approach recognizes that some teenagers mature more rapidly than others, and leaves it to the judgment of the physician to determine whether a given adolescent has reached a stage at which she can be considered competent to make decisions about her health care. Moreover, it is noted that when young teenagers ask for contraception, they are likely to be already sexually active and at risk for pregnancy. Given the difficult issues involved, physicians who want to respect an adolescent's autonomy yet consider her parents' feelings must be clear about the ethical basis on which they practice. PMID:4088960

Southgate, L

1985-12-01

62

Contraception and the dermatologist.  

PubMed

Contraceptives are pertinent to dermatologists in 3 major instances: (1) prescribing combined oral contraceptives for the treatment of acne; (2) ensuring that women being treated with potential teratogens are on adequate contraception; and (3) counseling female patients regarding contraceptives that can worsen acne. Most modern combined oral contraceptives will benefit acne; however, there are some agents that may be more effective than others, primarily because of the progestin used in the agent. Long-acting reversible contraceptives should be first line for women on teratogenic medications, but some of these agents can worsen acne because they release progestins. PMID:23332517

Tyler, Kelly H; Zirwas, Matthew J

2013-06-01

63

Determinants of modern contraceptive utilization among married women of reproductive age group in North Shoa Zone, Amhara Region, Ethiopia  

PubMed Central

Background Ethiopia is the second most populous country in Africa with high fertility and fast population growth rate. It is also one of the countries with high maternal and child mortality rate in sub-Saharan Africa Family planning is a crucial strategy to halt the fast population growth, to reduce child mortality and improve maternal health (Millennium Development Goal 4 and 5). Therefore, this study aimed to assess the prevalence and determinants of modern contraceptive utilization among married women of reproductive age group. Methods A community based cross-sectional study was conducted from August 15 to September 1, 2010 among married women aged 15–49 years in Debre Birhan District. Multistage sampling technique was used to select a total of 851 study participants. A pre-tested structured questionnaire was used for gathering data. Bivariate and multivariate logistic regression analyses were performed using SPSS version 16.0 statistical package. Results Modern contraceptive prevalence rate among currently married women was 46.9%. Injectable contraceptives were the most frequently used methods (62.9%), followed by intrauterine device (16.8%), pills (14%), norplant (4.3%), male condom (1.2%) and female sterilization (0.8%). Multiple logistic regression model revealed that the need for more children (AOR 9.27, 95% CI 5.43-15.84), husband approve (AOR 2.82, 95% CI 1.67-4.80), couple’s discussion about family planning issues (AOR 7.32, 95% CI 3.60-14.86). Similarly, monthly family income and number of living children were significantly associated with the use of modern contraceptives. Conclusion Modern contraceptive use was high in the district. Couple’s discussion and husband approval of contraceptives use were significantly associated with the use of modern contraceptives. Therefore, district health office and concerned stakeholders should focus on couples to encourage communication and male involvement for family planning. PMID:24490810

2014-01-01

64

Contraception and Hormonal Management in the Perimenopause.  

PubMed

Abstract This literature review focuses on contraception in perimenopausal women. As women age, their fecundity decreases but does not disappear until menopause. After age 40, 75% of pregnancies are unplanned and may result in profound physical and emotional impact. Clinical evaluation must be relied on to diagnose menopause, since hormonal levels fluctuate widely. Until menopause is confirmed, some potential for pregnancy remains; at age 45, women's sterility rate is 55%. Older gravidas experience higher rates of diabetes, hypertension, and death. Many safe and effective contraceptive options are available to perimenopausal women. In addition to preventing an unplanned and higher-risk pregnancy, perimenopausal contraception may improve abnormal uterine bleeding, hot flashes, and menstrual migraines. Long-acting reversible contraceptives, including the levonorgestrel intrauterine system (LNG-IUS), the etonogestrel subdermal implant (ESI), and the copper intrauterine device (Cu-IUD), provide high efficacy without estrogen. LNG-IUS markedly decreases menorrhagia commonly seen in perimenopause. Both ESI and LNG-IUS provide endometrial protection for women using estrogen for vasomotor symptoms. Women without cardiovascular risk factors can safely use combined hormonal contraception. The CDC's Medical Eligibility Criteria for Contraceptive Use informs choices for women with comorbidities. No medical contraindications exist for levonorgestrel emergency-contraceptive pills, though obesity does decrease efficacy. In contrast, the Cu-IUD provides reliable emergency and ongoing contraception regardless of body mass index (BMI). PMID:24773233

Long, Margaret E; Faubion, Stephanie S; Maclaughlin, Kathy L; Pruthi, Sandhya; Casey, Petra M

2014-04-28

65

Male contraception.  

PubMed

To share contraceptive measures between partners is a goal which should be reached in the future. The possibilities on the male side are still limited in comparison with the techniques available for women. During the last 20 years many efforts have been undertaken to study and evaluate possible methods for fertility control in the male, based on interaction with the hormonal axis, sperm maturation and sperm transport. The requirements for such a method in the male are the same as in female: high efficacy, little or almost no side-effects, high practicability and compliance and the possibility for easy reversibility in a high percentage of men. Despite their increasing acceptability worldwide, the existing male methods, condom and vasectomy, do not fully meet these requirements and therefore a search for alternative male methods is warranted. At present, the following medical approaches to male fertility control have been tested or are under consideration: (i) selective inhibition of FSH: antibodies, inhibin; (ii) inhibition of pituitary-gonadal axis: steroids such as testosterone, progestin-testosterone combinations, LHRH analogues with and without testosterone substitution; and (iii) selective inhibition of spermatogenesis by gossypol, a phenolic compound from cotton plant. Whether one of these methods will reach the desired goal for male fertility control has yet to be determined. PMID:3281961

Frick, J; Aulitzky, W

1988-02-01

66

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.

2012-01-01

67

Associations between national gambling policies and disordered gambling prevalence rates within Europe.  

PubMed

Policymakers and other interested stakeholders currently are seeking information about the comparative effectiveness of different regulatory approaches to minimising gambling-related harm. This study responds to this research gap by exploring associations between gambling policies and disordered gambling prevalence rates. We gathered information about gambling policies for thirty European jurisdictions and past-year prevalence rates for disordered gambling for twelve of these jurisdictions. We present policy trends and prevalence rates and then describe the level of association between policy and prevalence. We observe one statistically significant association between policy and prevalence: rates of sub-clinical (i.e., Level 2) disordered gambling were higher within environments that mandated less strict regulation of advertising for online gambling. Finally, we discuss the implications of our research in the context of the current process regarding the pan-European regulation of gambling. Our findings do not offer evidence for certain assumptions made in the past by the European judiciary. PMID:24370209

Planzer, Simon; Gray, Heather M; Shaffer, Howard J

2014-01-01

68

Attitude toward contraception and abortion among Curaçao 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

2011-01-01

69

Prevalence and rate of diagnosis of allergic rhinitis in Europe  

Microsoft Academic Search

To measure the prevalence of allergic rhinitis among European adults and the proportion of undiagnosed subjects, a two-step, cross-sectional, population- based survey in Belgium, France, Germany, Italy, Spain, and the UK was undertaken. Step one of the study involved screening for allergic rhinitis by telephone interview, based on history of symptoms and\\/or self-awareness of the condition. Step two undertook confirmation

V. Bauchau; S. R. Durham

2004-01-01

70

[The adolescent and contraception: psychological factors].  

PubMed

Psychological aspects of contraception in adolescence tend to be of interest primarily because of the belief that better understanding of psychological resistence to contraception would lead to more effective use and a lower rate of pregnancy. The failure of adolescents to use contraception appears to be due in part to irresponsibility but in part also to a variety of other factors. There is no ideal contraceptive for adolescents. The pill has potentially serious side effects whose significance may be exaggerated by adolescents, and the price of the contraceptive sponge may be prohibitive. Contraceptives themselves are perceived by adolescents as belonging more to parents, physicians, or the media than to themselves. Low-dose pills considered appropriate for adolescents are often abandoned because of their annoying minor side effects. Most adolescents do not seek contraception in an independent way, but out of fear that they are already pregnant or, if they have been sexually active for some time without using contraception, out of fear of infertility. Use of contraception may also be initiated by the partner, or the mother wishing to protect her daughter against pregnancy or to regularize the menstrual cycle. Contraceptive use by adolescents is complex because it signifies delaying rather than spacing or terminating pregnancy. The long duration of use that may be required until the time is right for pregnancy and the need to foresee future consequences are difficult given the cognitive level of adolescents. There are also difficult problems of access, prescription, and follow-up. Prescription of contraceptives for an adolescent is likely to invoke ambivalent feelings. Follow-up should be scheduled at fairly short intervals because of the fragility of motivation for contraceptive use at this age. The constraints of contraceptive use are not adapted to the sporadic and unplanned nature of much adolescent sexual activity. Society has an image of the adolescent as preoccupied with sexuality, but in fact adolescents are seeking to know and understand the new realities of their identity in a process in which the sexual quest plays only a secondary part. In order to improve the contraceptive performance of adolescents, a 3rd party other than a parent is needed to interact in a complementary way with the adolescent and to allow the adolescent to be heard. The objective of the interaction should not be to avoid abortion but to work to replace the rigid complementary interaction of adolescents with parents and other authority figures with a symmetrical model of communication open to the search for identity. PMID:12280865

Viala, M; Sperandeo, D; Duprez, D

1986-05-01

71

Bias From Using Occupational Smoking Prevalence to Adjust Occupational Incidence Cohort Lung Cancer Mortality Rates  

PubMed Central

Objective: To describe how smoking correction factors based on comparing worker smoking prevalence with population smoking prevalence are biased if applied to an occupational incidence cohort. Methods: Relative rates of smoking for shorter-tenure workers derived from occupational cohort lung cancer studies were applied to incidence and prevalence population tenure distributions to calculate relative smoking estimates. Results: High smoking rates in short-tenure workers have little effect on prevalent worker rates (relative smoking estimates, 1.04 and 1.02) and much larger effect in occupational incidence populations (relative smoking estimates, 1.58 and 1.21), which have a much higher proportion of short tenure-workers. Conclusions: Smoking correction estimates derived from surveys of smoking habits in prevalent workers may introduce bias when applied to incidence workers because of very different proportions of short-tenure workers (length-time biased sampling). PMID:25427172

Roth, H. Daniel

2015-01-01

72

Improving the uptake of long acting reversible contraception: a review.  

PubMed

Across the world rates of unintended pregnancy are high. Unintended pregnancy not only results in substantial costs to health services, it can lead to personal distress for women experiencing this. Whilst a large number of unintended pregnancies occur in those not using any method of contraception, a proportion occur in women using a contraceptive method incorrectly or inconsistently. Long acting reversible methods of contraception such as the IUD, IUS, contraceptive implant and contraceptive injectables are the most effective methods of contraception. In spite of this, they are under-utilized by women in developed countries. Educating women and health professionals, and dispelling myths about these methods may improve their acceptability. Furthermore, facilitating uptake by ensuring that a range of contraceptive providers are trained and able to provide to women without undue delay, particularly in the immediate post abortion and postpartum period, may also be effective strategies to improve uptake, and prevent more unintended pregnancies. PMID:23689167

Michie, L; Cameron, S T

2013-06-01

73

Obesity and contraception: metabolic changes, risk of thromboembolism, use of emergency contraceptives, and role of bariatric surgery.  

PubMed

Rates of obesity are increasing worldwide. Due to the medical consequences of obesity, routine health care like family planning becomes complicated. Conflicting data exists regarding efficacy of hormonal contraceptives in obese women, while little data on efficacy of emergency contraception in obese women exists. Much of what is available suggests lower serum hormonal levels in obese women with little effect on ovulation inhibition. Contraceptive steroids can cause a number of deteriorating metabolic changes, particularly in obese women; whether these changes are clinically significant is unknown. Venous thromboembolic risk is increased with both obesity and use of hormonal contraceptives; however the question remains if the risk is additive or multiplicative. Bariatric surgery can lead to digestive changes which may affect absorption of contraceptive hormones. While long acting reversible contraceptives may be the best option in the post operative obese patient, little data, beyond a simple recommendation to avoid pregnancy for at least one year, exists to help guide appropriate contraceptive choice. PMID:23689170

Gurney, E P; Murthy, A S

2013-06-01

74

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

2013-01-01

75

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.

2011-01-01

76

Oral Contraceptive Pill and PCOS  

MedlinePLUS

PCOS: The Oral Contraceptive Pill Posted under Health Guides . Updated 25 February 2014. +Related Content Key Facts ... of oral contraceptive pills for young women with PCOS? Regular and Lighter Periods: Oral contraceptive pills can ...

77

Unexpected sequelae of contraception.  

PubMed

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

1996-01-01

78

Determinants of contraceptive method choice in an industrial city of India.  

PubMed

This study examines the determinants of contraceptive method choice in Jamshedpur, an industrial city in Bihar State, one of the few areas in India that enjoys a "cafeteria approach" to family planning method selection. While contraceptive prevalence in India is about 35%, Jamshedpur has a prevalence rate close to 60%. One of Jamshedpur's special programs is the Tata Iron and Steel Company (TISCO) Family Welfare Programme, which provides an array of services to both employees and nonemployees. In 1983, TISCO commissioned the International Institute for Populations Studies (IIPS) to evaluate its programs. Based on the findings of an IIPS survey of 2376 currently married women between the ages of 15-44, this study attempts to identify determinants of contraceptive method choice. For its analysis, the study used a multinomial method choice. For its analysis, the study used a multinomial logit regression, a model appropriate for studying the relationships between a number of covariates and a dependent variable (the contraceptive method used) that has more than 2 possible outcomes (female sterilization, male sterilization, condom, female temporary method, natural methods, or no method). The survey examined the following covariates: religion/caste, mother tongue, husband's occupation, place of employment, age at consummation of marriage, husband's education, wife's education, marriage duration, survival status of last child, number and sex of living children, and attitude variables. The study found that religion, mother tongue, and educational levels are important determinants of acceptance and method choice. The number of children -- especially sons -- also affected contraceptive use, rising as family size increases. The study revealed that the Jamshedpur population did exercise choice in clear patterns when the choices were made available. PMID:12284858

Bhende, A A; Choe, M K; Rele, J R; Palmore, J A

1991-09-01

79

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

1996-01-01

80

Changes in Contraceptive Use in Bulgaria, 1995-2000  

PubMed Central

Comparison of results from national surveys conducted in Bulgaria in 1995 and 2000 reveal little overall change in use of modern contraceptives. Dramatic increases occurred, however, among women younger than 25 who entered their reproductive period after the end of the state socialist period. This finding suggests that contraceptive gains in the country will come largely as a cohort-replacement process. From these data, no separate program impact appears for special clinics established to provide direct, subsidized delivery of modern contraceptives to women in selected cities. The special clinics opened in cities where contraceptive use was already above the national average. During these five years, other cities lacking special clinics managed to gain in prevalence of modern contraceptive use, leaving a relatively homogenous urban-rural difference in levels of use throughout the country. PMID:11831051

Carlson, Elwood; Lamb, Vicki

2009-01-01

81

Knowledge of Contraceptive Effectiveness  

PubMed Central

Objectives To determine women's knowledge of contraceptive effectiveness. Study Design We performed a cross-sectional analysis of a contraceptive knowledge questionnaire completed by 4,144 women enrolled in the Contraceptive CHOICE Project prior to receiving comprehensive contraceptive counseling and choosing their method. For each contraceptive method, women were asked “what percentage would get pregnant in a year: <1%, 1-5%, 6-10%, >10%, don't know.” Results Overall, 86% of subjects knew the annual risk of pregnancy was >10% if no contraception is used. More than 45% of women overestimate the effectiveness of depo-medroxyprogesterone acetate, pills, patch, ring, and condoms. After adjusting for age, education and contraceptive history, women who chose the intrauterine device (IUD) [RRadj=6.9, 95% CI: 5.6-8.5] or implant [RRadj = 5.9, 95% CI 4.7-7.3] were significantly more likely to accurately identify the effectiveness of their method compared to women who chose either the pill, patch, or ring. Conclusions This cohort demonstrated significant knowledge gaps regarding contraceptive effectiveness and over-estimated the effectiveness of pills, patch, ring, DMPA, and condoms. PMID:22521458

EISENBERG, David L.; SECURA, Gina M.; MADDEN, Tessa E.; ALLSWORTH, Jenifer E.; ZHAO, Qiuhong; PEIPERT, Jeffrey F.

2014-01-01

82

Rates and outcomes of planned pregnancy after use of Norplant capsules, Norplant II rods, or levonorgestrel-releasing or copper TCu 380Ag intrauterine contraceptive devices.  

PubMed

A Norplant capsule releasing 30 mcg/day of levonorgestrel (LNG), Norplant II rods releasing 30 mcg/day LNG, an IUD releasing 20 mcg/day LNG, and a model TCu 380Ag model copper T IUD were used in trials by 2748 women at 7 centers during 1882-90. 372 women requested removal by the end of 1990. 10-12% of implant subjects and 17-20% years and mean parity was 1.75. The 12-month life-table rate of pregnancy was 82/100 for those planning pregnancy. 2 years later the rate was 89/100 achieved for in the first years before age 30; and 93/100 of younger women got pregnant 2 years after removal. Duration of use for or= 3 years resulted in a pregnancy rate of 84/100, while use 3 years yielded 81/100. The rates were 85/100 at 1 year and 92/100 at 2 years for women desiring more children compared with the 70 and 81/100 rate of family limiters. Age was a major factor: under 30 years with or= 37 months of contraceptive use the pregnancy rate was 93/100, while age or= 30 years and use of 37 months produced a rate of 58/100 at 1 year. 58% of former users of Norplant II rods, 34% of LNG-releasing IUD users. 43% of copper T IUD, and 37% of Norplant capsules became pregnant within 3 months. Amenorrhea of 90 days occurred in LNG IUD users at removal with 1st month pregnancy of 5/100, but the conception rate reached 80- 92/100 at 1 year. 88% of pregnancies ended with live births: 2 newborns with weight of 2500 gm and tubal pregnancy in a former Norplant II rod user. Female neonates made up 50.5% of births. The recovery of fertility outcomes were not adversely affected by these methods. PMID:1566771

Sivin, I; Stern, J; Diaz, S; Pavéz, M; Alvarez, F; Brache, V; Mishell, D R; Lacarra, M; McCarthy, T; Holma, P

1992-04-01

83

[Contraception among adolescents].  

PubMed

Adolescence is a period of which the contraception is difficult, because of lower compliance of the teenagers to this methods. The authors were observed the contraceptive uses in 792 pregnant adolescent girls, 264 of which with abortions (group A) and 528 teen-age mothers (group B). Only 12.88% of all patients have used birth control methods, usually with low and middle effects. We founded only 15 patients (1.89%) practiced hormonal contraception and 1 case (0.13%) with Intrauterine devise. The condoms for men was the most popular and useful in teenagers (4.23%), and Natural family planning methods were practiced from 52 (6.57%) patients. There was the statistically differences between adolescent girls included in group A and B about their contraceptive behaviors and live standards (p < 0.01). By the kind of contraceptive methods, there was a high differences in the teenagers with a hormonal uses (p < 0.05). PMID:7793522

Porozhanova, V; Tanchev, S; Goranov, M

1994-01-01

84

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.

1999-01-01

85

An Unusual Presentation of Perforated Intrauterine Contraceptive Device  

PubMed Central

Contraception is an essential component of sexual and reproductive health issues, especially in Nigeria, which has a high fertility rate. The intrauterine contraceptive device (IUCD) is one of the most frequently used contraceptive methods. Countless researches have helped establish the fact that an intrauterine device IUCD is a safe and effective contraceptive method for most women regardless of their health status. However, many complications associated with the IUCD have also been described. In this report, we present an unusual complication of the IUCD in which the device perforated the uterus and migrated to the ileum, with the IUCD string still visible per vaginum. PMID:23919205

Mbamara, SU; Omojuwa, IO

2013-01-01

86

Contraceptive counselling and self-prescription of contraceptives of German gynaecologists: Results of a nationwide survey.  

PubMed

Abstract Objective To evaluate the attitude toward contraceptive methods of gynaecologists who, in Germany, are the sole prescribers of contraceptives. Methods An anonymous questionnaire was sent to 9545 gynaecologists inquiring about factors involved in their prescription of contraceptives, the contraceptives they preferred, and those they would recommend to their daughter, if they had one. Results The response rate of this survey was 21% (N = 2016). The combined oral contraceptive (COC) was the most commonly prescribed method followed by the levonorgestrel-releasing intrauterine system (LNG-IUS), the vaginal ring, the progestin-only pill (POP), the patch, and the progestin-only injectables. Of the respondents 51% would never prescribe the patch and 45% would never prescribe the hormonal implant at all; 61% would choose the LNG-IUS for themselves/for their partner; 18% would opt for a COC and 8% for the vaginal ring. Concerning their imaginary daughter, 71% would prefer a COC, 26% the ring, and 9% the LNG-IUS. The first counselling session lasted 13.8 ± 4.9 min, and the provision of information on the occasion of following visits 6.6 ± 3.2 min. Conclusion The contraceptives most prescribed by German gynaecologists were COCs, followed by the LNG-IUS, the vaginal ring, and POPs. The spectrum of contraceptives preferred for personal use differed in some ways from those prescribed to patients. Reasons for this discrepancy should be investigated. PMID:25112310

Buhling, Kai J; Klovekorn, Lisa; Daniels, Benita; Studnitz, Friederike S G; Eulenburg, Christine; Mueck, Alfred O

2014-12-01

87

Evidence based contraceptive choices.  

PubMed

People who attend for contraceptive advice have usually formulated an idea of the type of contraceptive that will suit them best. They may wish to use a method that is long, short or medium acting. These are defined as follows: Long-acting method requires renewal no more frequently than every 3 months (e.g. injectable or intrauterine). Short-acting method used daily or with every act of intercourse (e.g. pills, condoms) Medium-acting method requires renewal weekly or monthly (e.g. ring, patch). For men the choice is limited to condoms or vasectomy. Some women do not wish to use hormonal preparations or have an intrauterine device (IUD) or implant inserted. There may also be cultural influences making certain methods of contraception unacceptable. Each of these factors influences the final decision of which method of contraception is decided upon. In addition to taking a full medical and sexual history to identify any risks to the individual's health, which might be increased by a particular contraceptive, time must be spent discussing the options available. It is important to ensure that there is a full understanding of the advantages and disadvantages of each method. The most successful contraceptive method is likely to be the one that the woman (or man) chooses, rather than the one the clinician chooses for them. Access for women to contraception can be improved by having convenient clinic times and service developments such as nurse prescribing and Patient Group Directions. PMID:16707277

Scott, Alison; Glasier, Anna

2006-10-01

88

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.

2011-01-01

89

Choices on contraceptive methods in post-abortion family planning clinic in the northeast Brazil  

Microsoft Academic Search

BACKGROUND: In Brazil, a Ministry of Health report revealed women who underwent an abortion were predominantly in the use of contraceptive methods, but mentioned inconsistent or erroneously contraceptive use. Promoting the use of contraceptive methods to prevent unwanted pregnancies is one of the most effective strategies to reduce abortion rates and maternal morbidity and mortality. Therefore, providing post-abortion family planning

Ana Laura CG Ferreira; Ariani I Souza; Raitza A Lima; Cynthia Braga

2010-01-01

90

The economic value of contraception: a comparison of 15 methods.  

PubMed Central

OBJECTIVES. The purpose of the study was to determine the clinical and economic impact of alternative contraceptive methods. METHODS. Direct medical costs (method use, side effects, and unintended pregnancies) associated with 15 contraceptive methods were modeled from the perspectives of a private payer and a publicly funded program. Cost data were drawn from a national claims database and MediCal. The main outcome measures included 1-year and 5-year costs and number of pregnancies avoided compared with use of no contraceptive method. RESULTS. All 15 contraceptives were more effective and less costly than no method. Over 5 years, the copper-T IUD, vasectomy, the contraceptive implant, and the injectable contraceptive were the most cost-effective, saving $14,122, $13,899, $13,813, and $13,373, respectively, and preventing approximately the same number of pregnancies (4.2) per person. Because of their high failure rates, barrier methods, spermicides, withdrawal, and periodic abstinence were costly but still saved from $8933 to $12,239 over 5 years. Oral contraceptives fell between these groups, costing $1784 over 5 years, saving $12,879, and preventing 4.1 pregnancies. CONCLUSIONS. Contraceptives save health care resources by preventing unintended pregnancies. Up-front acquisition costs are inaccurate predictors of the total economic costs of competing contraceptive methods. Images FIGURE 1 FIGURE 2 PMID:7702112

Trussell, J; Leveque, J A; Koenig, J D; London, R; Borden, S; Henneberry, J; LaGuardia, K D; Stewart, F; Wilson, T G; Wysocki, S

1995-01-01

91

Prevalence rates and odds ratios of shoulder-neck diseases in different occupational groups  

Microsoft Academic Search

The aim of the present study was to evaluate the association and impact of occupational exposure and diseases of the shoulder and neck. Prevalence rates, odds ratios, aetiological fractions, and their confidence intervals were computed for pooled and non-pooled data of previous published reports. By comparison with office workers and farmers, dentists had an increased odds ratio for cervical spondylosis

M Hagberg; D H Wegman

1987-01-01

92

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.

93

Prevalence rate and antibiotic susceptibility of oral viridans group streptococci (VGS) in healthy children population  

Microsoft Academic Search

Purpose: The aim of this study was to evaluated the prevalence rate of oral viridans group streptococci (VGS) and their susceptibilities to some antibiotics in healthy children. Material and methods: Samples of pharyngeal swabs and supragingival dental plaques for microbiological studies were collected from 206 healthy children, aged 4-18 years. Additionally, 75 samples of carious lesions from children with dental

Daniluk T; Cylwik-Rokicka D; Milewska R; Marczuk-Kolada G; Stokowska W

2006-01-01

94

One-Year Prevalence Rates of Major Depressive Disorder in First-Year University Students  

ERIC Educational Resources Information Center

First-year university students may be more at risk for experiencing Major Depressive Disorder (MDD) than the general population given associated risk factors of this age range. A two-phase procedure was used to estimate the one-year prevalence rate of MDD and comorbid Major Anxiety Disorders among first-year university students at a small Canadian…

Price, E. Lisa; McLeod, Peter J.; Gleich, Stephen S.; Hand, Denise

2006-01-01

95

Back pain in the working population: prevalence rates in Dutch trades and professions  

Microsoft Academic Search

An analysis of three health surveys in the Dutch working population is described, aimed at the identification of Dutch trades and professions with relative high and low prevalence rates of back pain. The sample was representative of the working population in the Netherlands and consisted of 5840 men and 2908 women. The analysis included 33 trades and 34 professions, with

VINCENT H. HILDEBRANDT

1995-01-01

96

Unintended Pregnancy Prevention: Contraception  

MedlinePLUS

... of Contraceptive Methods [PDF - 670KB] . Effectiveness of Family Planning Methods (Poster Size, 2'x 3') Effectiveness of Family Planning Methods [PDF - 305KB] Reversible Methods of Birth Control ...

97

Contraceptive use in acne.  

PubMed

Acne vulgaris is an inflammatory disorder of the pilosebaceous follicle. It is well established that androgen hormones play a major role in sebum production and excretion, and are vital in the pathogenesis of acne. Isotretinoin notwithstanding, hormonal therapies such as combined oral contraceptives (COCs) and spironolactone are the only treatments that can affect sebum production and the androgen component of acne. Contraceptives are also used during isotretinoin therapy for pregnancy prevention. It is important for a dermatologist to be familiar with all the available methods of contraception to provide essential counseling to patients. The aim of this paper is to review the role of hormones in acne pathogenesis, discuss the use of hormonal therapies for acne, and detail various alternative contraceptive methods in relation to isotretinoin treatment and pregnancy prevention. PMID:25017461

Lam, Charlene; Zaenglein, Andrea L

2014-01-01

98

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

2014-01-01

99

Male contraception: history and development.  

PubMed

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

2014-02-01

100

Contraceptive needs of the adolescent.  

PubMed

The provision of contraception to adolescents requires specific attention. Adolescents require contraceptive methods which are safe, effective and simple to use. While long-acting reversible contraceptive methods are preferable, they should have a choice and not be forced or mandated especially in situations where this may compromise safety. After counselling they should have the ability to choose any method of contraception. Under the appropriate circumstances, each method of contraception may have a place. This chapter will be devoted to evaluating the most current scientific rationale for the indication for use of each method of contraception in adolescents. PMID:24947598

Steyn, Petrus S; Goldstuck, Norman D

2014-08-01

101

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

2010-01-01

102

Prevalence and Interpretation of Recent Trends in Rates of Pervasive Developmental Disorders  

PubMed Central

The aims of this article are to provide an up-to-date review of the methodological features and substantive results of published epidemiological surveys of the prevalence of pervasive developmental disorders (PDD). This article updates previous reviews (1, 2) with the inclusion of new studies made available since then. The specific questions addressed inthis article are: a) how are cases of PDD defined and identified in epidemiological surveys?; b) what are the best estimates for the prevalence of autism and related pervasive developmental disorders considering the methodological implications of the surveys, and c) what interpretation can be given to time trends observed in prevalence rates of PDDs given the hypothesized secular increase in PDDs? PMID:21152334

Fombonne, Eric; Quirke, Sara; Hagen, Arlene

2009-01-01

103

Twenty-Four–Month Continuation of Reversible Contraception  

PubMed Central

Objective To estimate 24-month continuation rates of all reversible contraceptive methods for women enrolled in the Contraceptive CHOICE Project. Methods We analyzed 24-month data from the 9,256 participants enrolled in the Contraceptive CHOICE Project, a prospective observational cohort study that provides no-cost contraception to women in the St. Louis region. The project promoted the use of long-acting reversible contraception (LARC; intrauterine devices (IUDs) and implants) in an effort to reduce the rates of unintended pregnancy. This analysis includes participants who received their baseline contraceptive method within 3 months of enrollment and who completed a 24-month follow-up survey (n=6,153). Results Twenty-four month continuation rates for LARC and non-LARC methods were 77% and 41%, respectively. Continuation rates for the levonorgestrel and the copper IUDs were similar (79% versus 77%), whereas the implant continuation rate was significantly lower (69%, p<0.001) compared to IUDs at 24 months. There was no statistically significant difference in 24-month continuation rates among the four non-LARC methods (oral contraceptive pill 43%, patch 40%, ring 41%, depot medroxyprogesterone acetate (DMPA) 38%, p=0.72). Participants who chose a LARC method at enrollment were at significantly lower risk of contraceptive method discontinuation (adjusted hazard ratio=0.29, 95% confidence interval 0.26, 0.32) compared with women who selected a non-LARC method. Conclusion IUDs and the implant have the highest rates of continuation at 24-months. Given their effectiveness and high continuation rates, IUDs and implants should be first-line contraceptive options and shorter-acting methods such as OCPs, patch, ring, and DMPA should be second tier. PMID:24104781

O’Neil, Micaela E.; Peipert, Jeffrey F.; Zhao, Qiuhong; Madden, Tessa; Secura, Gina

2014-01-01

104

Contraceptive Embarrassment and Contraceptive Behavior among Young Single Women.  

ERIC Educational Resources Information Center

This paper determined factors predictive of contraceptive embarrassment, and the relationship of contraceptive embarrassment to contraceptive use among young unmarried females. The most important predictors found were parental attitude to premarital intercourse and sexual guilt. The embarrassment scale had significant correlations with…

Herold, Edward S.

1981-01-01

105

Community-based research on the benign prostatic hyperplasia prevalence rate in Korean rural area  

PubMed Central

Purpose We investigated the prevalence rate of benign prostatic hyperplasia (BPH) among Korean males in a rural area through a cross-sectional, community-based epidemiologic survey and analyzed the correlation with epidemiologic factors. Materials and Methods A total of 779 males who lived in Yangpyeong County participated in a prostate examination campaign. Targeting these men, we collected the International Prostate Symptom Score (IPSS), medical history, demographic information, serum prostate-specific antigen, and prostate volume as measured by transrectal ultrasonography. The data for 599 participants were analyzed, excluding 180 men who had a possibility of prostate cancer. BPH was defined as an IPSS of 8 points or higher and a prostate volume of 25 mL or more. Results The prevalence rate of BPH was 20.0%. The prevalence rate increased with age. There were 2 subjects (4.4%) in the age group of 40-49 years, 18 subjects (10.9%) in the age group of 50-59 years, 44 subjects (22%) in the age group of 60-69 years, and 56 subjects (26.6%) in the age group of over 70 years; this increase with age was statistically significant (p<0.001). In the BPH group, the average IPSS was 14.67±5.95, the average prostate volume was 37.04±11.71 g, and the average prostate-specific antigen value was 1.56±0.88 ng/mL. In the analysis of correlations between the epidemiologic factors and the risk of BPH, smoking was the only statistically significant factor. Conclusions The total prevalence rate of BPH in this study was 20.0%, which was a little lower than the rate reported in other cities or rural areas.

Goh, Hyeok Jun; Kim, Shin Ah; Nam, Ji Won; Choi, Bo Youl

2015-01-01

106

Progestin-Only Oral Contraceptives  

MedlinePLUS

... Progestin-only oral contraceptives are a very effective method of birth control, but they do not prevent ... oral contraceptives on another day, use a backup method of birth control (such as a condom and/ ...

107

Recent advances in contraception  

PubMed Central

Focusing on intrauterine contraceptives (IUC), contraceptive implants, and emergency contraceptives, we review recent advances in contraceptive development and discuss progress in policies to improve access to the most effective methods. We report on the shift in practice towards routinely providing IUCs and implants to young and nulliparous women, prompted in part by the reduced diameter of the insertion tube for the Mirena IUC and the development of a smaller IUC called Skyla. Additionally, we describe the new SCu300A intrauterine ball and the development of an implant called Nexplanon, which comes with a preloaded inserter. We also discuss the efficacy of ulipristal acetate versus levonorgestrel for emergency contraception, especially for women who weigh more than 75 kg. Finally, in light of the increasing interest in providing IUCs and implants to women in the immediate postpartum and post-abortion periods, we consider the rationale for this change in practice and review the progress that has been made so far in the United States. PMID:25580267

Trussell, James

2014-01-01

108

Directive counseling on long-acting contraception.  

PubMed Central

National rates of unintended births are a major public health concern. The availability of highly effective long-acting contraceptives has prompted some public officials to promote the coercive use of these methods to reduce such problems as intergenerational poverty and child abuse. Broad-brush public policies that require long-term contraceptive use are unethical. However, persuasion to use these methods can be appropriate. One place for exerting ethically justified influence is in family planning counseling. The dominant nondirective counseling model, which excludes the possibility of vigorous persuasion, is overly rigid. Family planning professionals should develop practice protocols that permit and guide the exercise of directive counseling to use long-acting contraception. PMID:8659650

Moskowitz, E; Jennings, B

1996-01-01

109

Delivering non-hormonal contraceptives to men: advances and obstacles  

PubMed Central

There have been major advances in male contraceptive research during the past two decades. However, for a contraceptive to be used by men, its safety requires more stringent scrutiny than therapeutic compounds for treatment of illnesses because the contraceptives will be used by healthy individuals for an extended period of time, perhaps decades. A wide margin is therefore required between the effective dose range and doses that cause toxicity. It might be preferable that a male contraceptive, in particular a non-hormone-based compound, is delivered specifically and/or directly to the testis and has a rapid metabolic clearance rate, reducing the length of exposure in the liver and kidney. In this article, we highlight the latest developments regarding contraceptive delivery to men and with the aim of providing useful information for investigators in future studies. PMID:18191256

Mruk, Dolores D.; Cheng, C. Yan

2014-01-01

110

Prevalence Rate of Urinary Incontinence in Community-Dwelling Elderly Individuals: The Veneto Study  

Microsoft Academic Search

Results. The prevalence rate of UI was of 11.2% among men and of 21.6% among women. Among those reporting the condition, approximately 53% of women and 59% of men reported experiencing incontinence daily or weekly. As- sociation of UI was found for participants older than 70 years in both men (odds ratio (OR) 2.49, 95% confidence inter- val (CI) 1.45-4.28)

Stefania Maggi; Nadia Minicuci; Jean Langlois; Mara Pavan; Giuliano Enzi; Gaetano Crepaldi

2001-01-01

111

Contraceptive use by obese women one year postpartum  

PubMed Central

Background Obese women have higher rates of pregnancy complications, making the prevention of unintended pregnancies in this group of particular importance. Study Design We performed a secondary analysis of data from Active Mothers Postpartum (AMP), a randomized controlled trial aimed at postpartum weight reduction. We assessed contraceptive use among 361 overweight/obese women 12 months postpartum. Logistic regression was used to model the effect of BMI categories on effective contraceptive use (intrauterine, hormonal, or sterilization methods) while adjusting for potential confounders including age, race, parity, breastfeeding, education, and chronic illness. Results Effective contraceptive use was reported by 45% of women. In the multivariable model, women with a BMI ? 35 kg/m2 were less likely to use effective contraception than women with a BMI <30 kg/m2 (OR 0.5, 95% CI 0.3–0.8). There was a trend towards less use of effective contraception among women with a BMI 30–34.9 kg/m2 as compared to women with a BMI <30 kg/m2. Conclusion At 12 months postpartum, obese women were less likely to use effective contraceptive methods than overweight women. Although certain contraceptive methods may be preferred over others in this population, providers should reinforce the importance of effective contraception to avoid unintended pregnancies in obese women. PMID:19835721

Chin, Jeanette R.; Swamy, Geeta K.; Østbye, Truls; Bastian, Lori A.

2009-01-01

112

Screening for alcohol use disorders in a genitourinary medicine and contraception clinic: a service evaluation.  

PubMed

Summary National Institute for Health and Clinical Excellence guidance advises that all patients routinely undergo alcohol screening. Our service evaluation in a sexual health clinic assessed the acceptability of alcohol screening, the prevalence of hazardous drinking and the uptake of referral to a specialist alcohol service. Three services were evaluated: a genitourinary medicine service, a contraception service and an integrated sexual health service. AUDIT was used to screen 276 patients; those scoring ?8 were classified as hazardous drinkers. Screening uptake was 58% overall, 58% for the contraception service, 71% for the genitourinary medicine service and 100% for the integrated sexual health service. Overall, 28% had AUDIT scores ?8. Hazardous drinking rates were higher in the genitourinary medicine (32%) and integrated sexual health services (52%) compared to the contraception service (21%); 7% of hazardous drinkers accepted referral. High rates of hazardous drinking were identified within all three groups, but uptake of referral was low. Alternative strategies to specialist alcohol service referral are discussed. PMID:24501232

Thorley, Nicola L; Kumar, Vinod; Nightingale, Peter; Radcliffe, Keith

2014-10-01

113

Factors Associated with the Differences in Migraine Prevalence Rates between Spanish Regions  

PubMed Central

We have analyzed the relation of prevalence rates in Spanish regions with a series of human, environmental, and ecological factors. We find that the variability in migraine rates found between Spanish regions may be explained by interregional differences in the percentage of daily smokers, percentage of alcohol consumers, percentage of population presenting physical and/or psychological life-limiting conditions, percentage of population engaging in physical exercise, minimum absolute temperatures per year, number of days under 0°C per year, and altitude. PMID:24616622

Matias-Guiu, Jorge; Fernandez, Cristina; Porta-Etessam, Jesús; Mateos, Valentin; Diaz-Insa, Samuel

2014-01-01

114

Reproductive and Contraceptive Knowledge, Contraceptive Self-Efficacy, and Contraceptive Behavior among Teenage Women.  

ERIC Educational Resources Information Center

Investigates the relationships among teenage women's Contraceptive Self-Efficacy (CSE), reproductive and contraceptive knowledge (RCK), and contraceptive behavior. No significant relationships existed between RCK and behavior. However, CSE explained variance in RCK, while other measures uncovered common areas of misinformation that influence…

Levinson, Ruth Andrea

1995-01-01

115

Current status of contraceptive vaginal rings.  

PubMed

Contraceptive vaginal rings (CVR) offer a new, effective contraceptive option, expanding the available choices of hormonal contraception. Various ring prototypes have been evaluated: progestin-only rings and combined progestin-estrogen rings, as well as different combination of progestins and estrogens. The progestin-only ring is intended for continuous use, whereas the combined ring has been designed for cyclic 3-week in/1-week out use, although several studies have explored alternative schemes of extended use. However, only two ring designs have reached the market: NuvaRing, a 1-month combined ring that releases etonogestrel and ethinylestradiol, and Progering, a 3-month progesterone-releasing ring for use in lactating women. A one year Nestorone/ethinyl estradiol CVR is approaching the final stages of development, as the Population Council is preparing to submit a new drug application to the Food and Drug Administration. The main advantages of CVRs are their effectiveness (similar or slightly better than the pill), ease of use without the need of remembering a daily routine, user ability to control initiation and discontinuation, nearly constant release rate allowing for lower doses, greater bioavailability and good cycle control with the combined ring, in comparison with oral contraceptives. Current prototypes in development include rings releasing progesterone receptor modulators, which would provide estrogen-free contraception, as well as combined rings releasing estradiol, instead of ethinyl-estradiol, providing a safer profile. Furthermore, intensive efforts towards developing dual protection rings, providing both contraception and protection against reproductive tract infections, offer hope that this greatly needed technology will soon undergo clinical testing and will be in the hands of women worldwide in the near future. PMID:23040125

Brache, Vivian; Payán, Luis José; Faundes, Aníbal

2013-03-01

116

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

2013-01-01

117

Contraception and lactation.  

PubMed

Lactation's contraceptive effect cannot be relied upon for more than 6 weeks postpartum, and ovulation often occurs in advance of the 1st postpartum menstrual period. Although breastfeeding mothers should adopt a contraceptive method, care must be taken to select a method that will not adversely affect the production and composition of breast milk. Of greatest concern is the effect of synthetic hormones transmitted via breast milk on the developing infant. Possible alternatives are the Billings ovulation detection natural family planning method, diaphragms and caps, IUDs, and sexual sterilization. While combined oral contraceptives (OCs) are contraindicated because of their harmful effects on the fat and protein composition of breast milk and on milk production, the progestogen-only OC does not appear to interfere with the quality of breast milk and less than 0.1% of the progestogen passes on to the infant. Depo-Provera, and other injectable progestogens, appear to be appropriate for breastfeeding women, although the 1st injection should be postponed until 6 weeks postpartum to reduce the likelihood of heavy bleeding. Under investigation is a nasal spray containing buserelin, a luteinizing hormone-releasing hormone agonist, that shows promise as a reliable, acceptable, and easily administered nonsteroidal contraceptive that does not interfere with lactation. A biodegradable buserelin implant, which would last as least 3 months, also is being developed and would be especially useful in developing countries where storage of a nasal spray might be problematic. PMID:3650668

Dewart, P J; Loudon, N B

1987-08-01

118

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

2013-01-01

119

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.

2011-01-01

120

International variation in reported livebirth prevalence rates of Down syndrome, adjusted for maternal age  

PubMed Central

Reported livebirth prevalence of Down syndrome (DS) may be affected by the maternal age distribution of the population, completeness of ascertainment, accuracy of diagnosis, extent of selective prenatal termination of affected pregnancies, and as yet unidentified genetic and environmental factors. To search for evidence of the latter, we reviewed all published reports in which it was possible to adjust both for effects of maternal age and for selective termination (where relevant).?We constructed indices that allowed direct comparisons of prevalence rates after standardising for maternal age. Reference rates were derived from studies previously identified as having near complete ascertainment. An index value significantly different from 1 may result from random fluctuations, as well as from variations in the factors listed above. We found 49 population groups for which an index could be calculated. Methodological descriptions suggested that low values could often be attributed to underascertainment. A possible exception concerned African-American groups, though even among these most acceptable studies were compatible with an index value of 1. As we have reported elsewhere, there was also a suggestive increase in rates among US residents of Mexican or Central American origin. Nevertheless, our results suggest that "real" variation between population groups reported to date probably amounts to no more than ±25%. However, reliable data in many human populations are lacking including, surprisingly, some jurisdictions with relatively advanced health care systems. We suggest that future reports of DS livebirth prevalence should routinely present data that allow calculation of an index standardised for maternal age and adjusted for elective prenatal terminations.???Keywords: Down syndrome; prenatal diagnosis; maternal age standardisation; epidemiology PMID:10353785

Carothers, A.; Hecht, C.; Hook, E.

1999-01-01

121

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

2014-01-01

122

[The relation between trichomoniasis and contraceptive methods].  

PubMed

Trichomoniasis is a sexually transmitted disease caused by Trichomonas vaginalis (T. vaginalis) infecting the urogenital system. In this study, the relation between different contraceptive methods used and T. vaginalis infection was investigated. A total of 253 women (aged from 20-48 years) with abnormal vaginal discharges who applied to the Obstetrics and Gynecology outpatient clinic were enrolled in the study. T. vaginalis was diagnosed by microscopic examination of direct and Giemsa stained preparations. In addition, contraceptive methods, such as an intrauterine device (IUD), coitus interruptus (CI), oral contraceptive (OC), condoms, and injection that had been used, were recorded in the patients' questionnaire forms. Of the 253 women, 207 were using one of the contraceptive methods and a total of 22 (8.69%) trichomoniasis cases were observed. T. vaginalis was detected in 13 of 114 IUD users (14.70%), 5 of 34 CI (11.40%) cases, 3 of 31 (9.67%) condom users, 1 of 46 (2.17%) nonusers. There was no relation between women using the method of OC and T. vaginalis infection. T. vaginalis is the cause of vulvovaginitis and women with abnormal vaginal discharges should be investigated for possible trichomoniasis. In this study, detection of a higher rate of T. vaginalis infection in IUD users means that IUD usage might increase the risk of Trichomonas infection. PMID:20101574

Sönmez Tamer, Gülden; Keçeli Ozcan, Sema; Yücesoy, Gülseren; Gacar, Gülçin

2009-01-01

123

[Emergency oral contraception policy: the Peruvian experience].  

PubMed

Emergency oral contraception is part of the sexual and reproductive rights of women. In 2001, this health policy was incorporated into the Rules of the National Family Planning Program of the Ministry of Health, primarily to prevent unwanted pregnancy and its serious consequences, induced abortion and the high associated maternal mortality rate, which are major public health problems. Scientific research has confirmed that the main mechanism of action of levonorgestrel, component of emergency oral contraception (EOC) is to inhibit or delay ovulation, preventing fertilization of the egg; additionally, it increases the thickening of the cervical mucus, making the sperm migration more difficult. No study has found endometrial abnormalities that may interfere with the implantation of the fertilized egg or embryo development of an implanted egg. However, despite the support of medical science and legal backing, the EOC is available only to users with economic resources, but its use has not been fully implemented in public sector services, due to obstacles created by groups opposed to contraception under claim of an alleged abortive effect that has already been ruled out scientifically. This article describes the administrative experience and legal confrontations between groups of power that prevent the proper implementation of an emergency contraception policy in Peru. PMID:24100827

Pretell-Zárate, Eduardo A

2013-07-01

124

Cost Effectiveness of Contraceptives in the United States  

PubMed Central

Background The study was conducted to estimate the relative cost effectiveness of contraceptives in the United States from a payer’s perspective. Methods A Markov model was constructed to simulate costs for 16 contraceptive methods and no method over a 5-year period. Failure rates, adverse event rates, and resource utilization were derived from the literature. Sensitivity analyses were performed on costs and failure rates. Results Any contraceptive method is superior to “no method”. The three least expensive methods were the copper-T IUD ($647), vasectomy ($713) and LNG-20 IUS ($930). Results were sensitive to the cost of contraceptive methods, the cost of an unintended pregnancy, and plan disenrollment rates. Conclusion The copper-T IUD, vasectomy, and the LNG-20 IUS are the most cost-effective contraceptive methods available in the United States. Differences in method costs, the cost of an unintended pregnancy, and time horizon are influential factors that determine the overall value of a contraceptive method. PMID:19041435

Trussell, James; Lalla, Anjana M.; Doan, Quan V.; Reyes, Eileen; Pinto, Lionel; Gricar, Joseph

2013-01-01

125

Food allergies in developing and emerging economies: need for comprehensive data on prevalence rates.  

PubMed

Although much is known today about the prevalence of food allergy in the developed world, there are serious knowledge gaps about the prevalence rates of food allergy in developing countries. Food allergy affects up to 6% of children and 4% of adults. Symptoms include urticaria, gastrointestinal distress, failure to thrive, anaphylaxis and even death. There are over 170 foods known to provoke allergic reactions. Of these, the most common foods responsible for inducing 90% of reported allergic reactions are peanuts, milk, eggs, wheat, nuts (e.g., hazelnuts, walnuts, almonds, cashews, pecans, etc.), soybeans, fish, crustaceans and shellfish. Current assumptions are that prevalence rates are lower in developing countries and emerging economies such as China, Brazil and India which raises questions about potential health impacts should the assumptions not be supported by evidence. As the health and social burden of food allergy can be significant, national and international efforts focusing on food security, food safety, food quality and dietary diversity need to pay special attention to the role of food allergy in order to avoid marginalization of sub-populations in the community. More importantly, as the major food sources used in international food aid programs are frequently priority allergens (e.g., peanut, milk, eggs, soybean, fish, wheat), and due to the similarities between food allergy and some malnutrition symptoms, it will be increasingly important to understand and assess the interplay between food allergy and nutrition in order to protect and identify appropriate sources of foods for sensitized sub-populations especially in economically disadvantaged countries and communities. PMID:23256652

Boye, Joyce Irene

2012-01-01

126

Food allergies in developing and emerging economies: need for comprehensive data on prevalence rates  

PubMed Central

Although much is known today about the prevalence of food allergy in the developed world, there are serious knowledge gaps about the prevalence rates of food allergy in developing countries. Food allergy affects up to 6% of children and 4% of adults. Symptoms include urticaria, gastrointestinal distress, failure to thrive, anaphylaxis and even death. There are over 170 foods known to provoke allergic reactions. Of these, the most common foods responsible for inducing 90% of reported allergic reactions are peanuts, milk, eggs, wheat, nuts (e.g., hazelnuts, walnuts, almonds, cashews, pecans, etc.), soybeans, fish, crustaceans and shellfish. Current assumptions are that prevalence rates are lower in developing countries and emerging economies such as China, Brazil and India which raises questions about potential health impacts should the assumptions not be supported by evidence. As the health and social burden of food allergy can be significant, national and international efforts focusing on food security, food safety, food quality and dietary diversity need to pay special attention to the role of food allergy in order to avoid marginalization of sub-populations in the community. More importantly, as the major food sources used in international food aid programs are frequently priority allergens (e.g., peanut, milk, eggs, soybean, fish, wheat), and due to the similarities between food allergy and some malnutrition symptoms, it will be increasingly important to understand and assess the interplay between food allergy and nutrition in order to protect and identify appropriate sources of foods for sensitized sub-populations especially in economically disadvantaged countries and communities. PMID:23256652

2012-01-01

127

Postabortal and postpartum contraception.  

PubMed

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

2014-08-01

128

Oral contraceptive use and psychiatric disorders in a nationally representative sample of women.  

PubMed

The purpose of this study is to examine the association between oral contraceptive use (any current use, duration, and type) and major depressive disorder (MDD), generalized anxiety disorder (GAD), and panic disorder (PD) in a nationally representative sample of women in the USA. Data were drawn from 1,105 women aged 20-39 in the National Health and Nutrition Examination Surveys from 1999 to 2004. The associations between self-reported use of oral contraceptives in the past year and DSM-IV diagnosed and subthreshold MDD, GAD, and PD in the past year were assessed comparing oral contraceptive users to all non-users, former users, and former long-term users. Women using oral contraceptives had a lower past-year prevalence of all disorders assessed, other than subthreshold MDD. When adjusted for confounders, women using oral contraceptives in the past year had significantly lower odds of subthreshold PD, compared to former users (odds ratio (OR)?=?0.34, 95 % CI 0.14-0.84). Effects estimates were strongest for monophasic (versus multiphasic) oral contraceptive users. Hormonal contraceptive use was associated with reduced risk of subthreshold PD. A potential mental health benefit of hormonal contraceptives has substantial public health implications; prospective longitudinal studies are needed to confirm whether hormonal contraceptive use improves mental health. PMID:25113319

Cheslack-Postava, Keely; Keyes, Katherine M; Lowe, Sarah R; Koenen, Karestan C

2015-02-01

129

Contraception after heart surgery.  

PubMed

This study represents the different methods of contraception used by women having cardiac surgery at Ain Shams University Hospital. The study comprised of 250 women having had mitral commissurotomy, 77 women having had valve replacement including one case of triple valve repair and 3 women having had cardiac surgery for congenital heart disease. An IUCD was used by 170 women (51.5%), vaginal tablets by 4 women (1.2%), oral contraceptive pills by 7 women (2.1%), "safe period" by 7 women (2.1%), tubal ligation was performed in 10 women (3%). The husbands of 33 women (10%) used condoms, and 99 women (30%) did not use contraceptive methods. The IUCD was tolerable and was associated with bleeding in 60 women (35.2%) and leucorrhoea in 55 (32.3%). The IUCD was removed from only one woman due to severe bleeding. Three pregnancies occurred with condom users in two women who had had mitral commissurotomy and one having had valve replacement. There was no case of bacterial endocarditis in the study group. PMID:1591924

Abdalla, M Y; el Din Mostafa, E

1992-01-01

130

Contraceptive advertising in the United States.  

PubMed

Despite the fact that most Americans support the advertising of family planning methods, the minority opposition has influenced the formulation of contraceptive advertising policies. This article attempts to clarify the current status of contraceptive advertising and to suggest a sensible public policy for the future. Opening with a review of opinion polls taken since 1985, the article points out that 70% of station managers reported their belief that contraceptive advertising would offend many people despite the fact that 87% of respondents in a public survey indicated no objection to such advertising. The policies that network television stations have adopted are traced from those instituted in the 1960s by the National Association of Broadcaster's Code Authority. These policies govern the airing of Public Service Announcements (PSAs) as well as advertisements. Magazines and newspapers also resist accepting contraceptive advertising, although they do not face the same regulations as the broadcast media. US Food and Drug Administration policies also act as a barrier to product-specific advertisements on network television despite the fact that the American Medical Association no longer opposes such advertising and the American College of Obstetricians and Gynecologists offered to provide valid information about advertising claims to the media. A review of attempts to advertise contraceptives shows that opposition has dropped significantly in the past 10 years for advertisements in newspapers, on cable television, in magazines, on some commercial television stations, and on many radio stations. However, the major television networks still fail to accept such advertisements. Part of the change that is occurring can be attributable to the emergence of AIDS and the need to promote methods to prevent the disease. However, much AIDS-related advertising has been in the form of PSAs, which are less and less available. The major obstacles to contraceptive advertising today are media reluctance, government regulation, lack of consistent effort on the part of advertisers, and a lack of consensus in society about the importance of this issue. These limits are the symptoms of a society which has an unrealistic view of sexual activity. Therefore, contraceptive advertising alone will not change the US's high unintended pregnancy and abortion rates. PMID:7849538

Lebow, M A

1994-01-01

131

Computers and Contraception: Strange Bedfellows? Contraception Education Survey.  

ERIC Educational Resources Information Center

The University Health Services (UHS) at the University of Massachusetts, Amherst, has been conducting contraception education sessions since 1970. The Contraception Education Session lasts about one and one-half hours and consists of three sections: a slide/tape production overview of all prescription and nonprescription methods available, a…

Gonyer, Pamela G.

132

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

PubMed

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

2014-11-01

133

The Impact of Height during Childhood on the National Prevalence Rates of Overweight  

PubMed Central

Background It is known that height and body mass index (BMI) are correlated in childhood. However, its impact on the (trend of) national prevalence rates of overweight and obesity has never been investigated. The aim of our study is to investigate the relation between height and national prevalence rates of overweight and obesity in childhood between 1980, 1997, and 2009, and to calculate which fixed value of p (2.0,2.1, …,3.0) in kg/mp during childhood is most accurate in predicting adult overweight. Methods and findings Cross-sectional growth data of children from three Dutch nationwide surveys in 1980, 1997, and 2009, and longitudinal data from the Terneuzen Birth Cohort and the Harpenden Growth Study were used. Relative risks (RR) and 95% confidence intervals (CI) were calculated. Our study showed that tall (>1 standard deviation (SD)) girls aged 5.0–13.9 y were more often overweight (RR?=?3.5,95%CI:2.8–4.4) and obese (RR?=?3.9,95%CI:2.1–7.4) than short girls (prevalence rates of overweight and obesity than their shorter peers. We suggest taking into account the impact of height when evaluating trends and variations of BMI distributions in childhood, and to use BMI to predict adult overweight. PMID:24465694

van Dommelen, Paula; de Kroon, Marlou L. A.; Cameron, Noël; Schönbeck, Yvonne; van Buuren, Stef

2014-01-01

134

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

2013-01-01

135

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

2010-01-01

136

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

-specific rates of substance (tobacco, alcohol, cannabis, other illicit drugs, inhalants and psychotropic: Prevalence rates of substance use were high and varied with age and sex. Tobacco, cannabis and polysubstance; regular cannabis use: respectively 23.9% and 10.9%; tobacco + alcohol + cannabis: respectively 9.9% and 4

Paris-Sud XI, Université de

137

Estimation of the prevalence and rate of acute transfusion reactions occurring in Windhoek, Namibia  

PubMed Central

Background Acute transfusion reactions are probably common in sub-Saharan Africa, but transfusion reaction surveillance systems have not been widely established. In 2008, the Blood Transfusion Service of Namibia implemented a national acute transfusion reaction surveillance system, but substantial under-reporting was suspected. We estimated the actual prevalence and rate of acute transfusion reactions occurring in Windhoek, Namibia. Methods The percentage of transfusion events resulting in a reported acute transfusion reaction was calculated. Actual percentage and rates of acute transfusion reactions per 1,000 transfused units were estimated by reviewing patients’ records from six hospitals, which transfuse >99% of all blood in Windhoek. Patients’ records for 1,162 transfusion events occurring between 1st January – 31st December 2011 were randomly selected. Clinical and demographic information were abstracted and Centers for Disease Control and Prevention National Healthcare Safety Network criteria were applied to categorize acute transfusion reactions1. Results From January 1 – December 31, 2011, there were 3,697 transfusion events (involving 10,338 blood units) in the selected hospitals. Eight (0.2%) acute transfusion reactions were reported to the surveillance system. Of the 1,162 transfusion events selected, medical records for 785 transfusion events were analysed, and 28 acute transfusion reactions were detected, of which only one had also been reported to the surveillance system. An estimated 3.4% (95% confidence interval [CI]: 2.3–4.4) of transfusion events in Windhoek resulted in an acute transfusion reaction, with an estimated rate of 11.5 (95% CI: 7.6–14.5) acute transfusion reactions per 1,000 transfused units. Conclusion The estimated actual rate of acute transfusion reactions is higher than the rate reported to the national haemovigilance system. Improved surveillance and interventions to reduce transfusion-related morbidity and mortality are required in Namibia. PMID:24333079

Meza, Benjamin P.L.; Lohrke, Britta; Wilkinson, Robert; Pitman, John P.; Shiraishi, Ray W.; Bock, Naomi; Lowrance, David W.; Kuehnert, Matthew J.; Mataranyika, Mary; Basavaraju, Sridhar V.

2014-01-01

138

Sexual and Reproductive Health Knowledge, Contraception Uptake, and Factors Associated with Unmet Need for Modern Contraception among Adolescent Female Sex Workers in China  

PubMed Central

Objective In China, policy and social taboo prevent unmarried adolescents from accessing sexual and reproductive health (SRH) services. Research is needed to determine the SRH needs of highly disadvantaged groups, such as adolescent female sex workers (FSWs). This study describes SRH knowledge, contraception use, pregnancy, and factors associated with unmet need for modern contraception among adolescent FSWs in Kunming, China. Methods A cross-sectional study using a one-stage cluster sampling method was employed to recruit adolescents aged 15 to 20 years, and who self-reported having received money or gifts in exchange for sex in the past 6 months. A semi-structured questionnaire was administered by trained peer educators or health workers. Multivariable logistic regression was conducted to determine correlates of low knowledge and unmet need for modern contraception. Results SRH knowledge was poor among the 310 adolescents surveyed; only 39% had heard of any long-acting reversible contraception (implant, injection or IUD). Despite 98% reporting not wanting to get pregnant, just 43% reported consistent condom use and 28% currently used another form of modern contraception. Unmet need for modern contraception was found in 35% of adolescents, and was associated with having a current non-paying partner, regular alcohol use, and having poorer SRH knowledge. Past abortion was common (136, 44%). In the past year, 76% had reported a contraception consultation but only 27% reported ever receiving SRH information from a health service. Conclusions This study demonstrated a low level of SRH knowledge, a high unmet need for modern contraception and a high prevalence of unintended pregnancy among adolescent FSWs in Kunming. Most girls relied on condoms, emergency contraception, or traditional methods, putting them at risk of unwanted pregnancy. This study identifies an urgent need for Chinese adolescent FSWs to be able to access quality SRH information and effective modern contraception. PMID:25625194

Lim, Megan S. C.; Zhang, Xu-Dong; Kennedy, Elissa; Li, Yan; Yang, Yin; Li, Lin; Li, Yun-Xia; Temmerman, Marleen; Luchters, Stanley

2015-01-01

139

Rare chromosome abnormalities, prevalence and prenatal diagnosis rates from population-based congenital anomaly registers in Europe.  

PubMed

The aim of this study is to quantify the prevalence and types of rare chromosome abnormalities (RCAs) in Europe for 2000-2006 inclusive, and to describe prenatal diagnosis rates and pregnancy outcome. Data held by the European Surveillance of Congenital Anomalies database were analysed on all the cases from 16 population-based registries in 11 European countries diagnosed prenatally or before 1 year of age, and delivered between 2000 and 2006. Cases were all unbalanced chromosome abnormalities and included live births, fetal deaths from 20 weeks gestation and terminations of pregnancy for fetal anomaly. There were 10,323 cases with a chromosome abnormality, giving a total birth prevalence rate of 43.8/10,000 births. Of these, 7335 cases had trisomy 21,18 or 13, giving individual prevalence rates of 23.0, 5.9 and 2.3/10,000 births, respectively (53, 13 and 5% of all reported chromosome errors, respectively). In all, 473 cases (5%) had a sex chromosome trisomy, and 778 (8%) had 45,X, giving prevalence rates of 2.0 and 3.3/10,000 births, respectively. There were 1,737 RCA cases (17%), giving a prevalence of 7.4/10,000 births. These included triploidy, other trisomies, marker chromosomes, unbalanced translocations, deletions and duplications. There was a wide variation between the registers in both the overall prenatal diagnosis rate of RCA, an average of 65% (range 5-92%) and the prevalence of RCA (range 2.4-12.9/10,000 births). In all, 49% were liveborn. The data provide the prevalence of families currently requiring specialised genetic counselling services in the perinatal period for these conditions and, for some, long-term care. PMID:22234154

Wellesley, Diana; Dolk, Helen; Boyd, Patricia A; Greenlees, Ruth; Haeusler, Martin; Nelen, Vera; Garne, Ester; Khoshnood, Babak; Doray, Berenice; Rissmann, Anke; Mullaney, Carmel; Calzolari, Elisa; Bakker, Marian; Salvador, Joaquin; Addor, Marie-Claude; Draper, Elizabeth; Rankin, Judith; Tucker, David

2012-05-01

140

Condom practices of urban teens using Norplant contraceptive implants, oral contraceptives, and condoms for contraception  

Microsoft Academic Search

Objectives: The availability of long-acting hormonal birth control methods has created new contraceptive options for adolescents. The purpose of this study was to determine whether teens initiating these methods use condoms less frequently than teens using oral contraceptive pills or condoms alone and may therefore be at an increased risk of acquiring sexually transmitted infections. Study Design: To investigate ongoing

Philip D. Darney; Lisa S. Callegari; Allison Swift; Elizabeth S. Atkinson; Anne M. Robert

1999-01-01

141

The effects of contraception on female poverty.  

PubMed

Poverty rates are particularly high among households headed by single women, and childbirth is often the event preceding these households' poverty spells. This paper examines the relationship between legal access to the birth control pill and female poverty. We rely on exogenous cross-state variation in the year in which oral contraception became legally available to young, single women. Using census data from 1960 to 1990, we find that having legal access to the birth control pill by age 20 significantly reduces the probability that a woman is subsequently in poverty. We estimate that early legal access to oral contraception reduces female poverty by 0.5 percentage points, even when controlling for completed education, employment status, and household composition. PMID:24988652

Browne, Stephanie P; LaLumia, Sara

2014-01-01

142

Pharmacokinetic and pharmacodynamic drug interactions between antiretrovirals and oral contraceptives.  

PubMed

More than 50 % of women living with HIV in low- and middle-income countries are of reproductive age, but there are limitations to the administration of oral contraception for HIV-infected women receiving antiretroviral therapy due to drug-drug interactions caused by metabolism via the cytochrome P450 isoenzymes and glucuronidation. However, with the development of newer antiretrovirals that use alternative metabolic pathways, options for contraception in HIV-positive women are increasing. This paper aims to review the literature on the pharmacokinetics and pharmacodynamics of oral hormonal contraceptives when given with antiretroviral agents, including those currently used in developed countries, older ones that might still be used in salvage regimens, or those used in resource-limited settings, as well as newer drugs. Nucleos(t)ide reverse transcriptase inhibitors (NRTIs), the usual backbone to most combined antiretroviral treatments (cARTs) are characterised by a low potential for drug-drug interactions with oral contraceptives. On the other hand non-NRTIs (NNRTIs) and protease inhibitors (PIs) may interact with oral contraceptives. Of the NNRTIs, efavirenz and nevirapine have been demonstrated to cause drug-drug interactions; however, etravirine and rilpivirine appear safe to use without dose adjustment. PIs boosted with ritonavir are not recommended to be used with oral contraceptives, with the exception of boosted atazanavir which should be used with doses of at least 35 µg of estrogen. Maraviroc, an entry inhibitor, is safe for co-administration with oral contraceptives, as are the integrase inhibitors (INIs) raltegravir and dolutegravir. However, the INI elvitegravir, which is given in combination with cobicistat, requires a dose of estrogen of at least 30 µg. Despite the growing evidence in this field, data are still lacking in terms of large cohort studies, randomised trials and correlations to real clinical outcomes, such as pregnancy rates, in women on antiretrovirals and hormonal contraception. PMID:25331712

Tittle, Victoria; Bull, Lauren; Boffito, Marta; Nwokolo, Nneka

2015-01-01

143

A Qualitative Analysis of Long-Acting Reversible Contraception.  

PubMed

Increasing access to long-acting reversible contraception (LARC), including the intrauterine device and the implant is a public health and clinical imperative to reduce rates of unintended pregnancy. In 2012, the American College of Obstetricians and Gynecologists recommended these methods for all women, including adolescents. Little research explores why young women reject these safe, effective contraceptive methods. A total of 53 women aged 18-24 years completed in-depth interviews. Analytical techniques from the grounded theory approach were used to identify patterns and themes across the data. Participants initiated hormonal contraception for "the pill's" beneficial side effects and believed a myth of perfect use, which constructed a false choice of LARC methods. Barriers to LARC options included access, medical resistance, and cost. Participants described a sense of unease about methods perceived as "alien." These women underestimated the risks of oral contraceptive pills and overestimated the risks of long-acting reversible contraception, including infertility. The myth of perfect use emerged as participants wanted to be in control by taking "the pill" every day; however, many described imperfect adherence. Findings include strategies for public health professionals and health care providers to distribute satisfactory and effective contraception for young women. Effective health communication campaigns will emphasize the desirable side effects, safety and increased effectiveness of LARC methods. PMID:25424456

Sundstrom, Beth; Baker-Whitcomb, Annalise; DeMaria, Andrea L

2014-11-26

144

Mapping the serological prevalence rate of west nile Fever in equids, Tunisia.  

PubMed

West Nile fever (WNF) is a viral disease of wild birds transmitted by mosquitoes. Humans and equids can also be affected and suffer from meningoencephalitis. In Tunisia, two outbreaks of WNF occurred in humans in 1997 and 2003; sporadic cases were reported on several other years. Small-scale serological surveys revealed the presence of antibodies against WN virus (WNV) in equid sera. However, clinical cases were never reported in equids, although their population is abundant in Tunisia. This study was achieved to characterize the nationwide serological status of WNV in Tunisian equids. In total, 1189 sera were collected in 2009 during a cross-sectional survey. Sera were tested for IgG antibodies, using ELISA and microneutralization tests. The estimated overall seroprevalence rate was 28%, 95% confidence interval [22; 34]. The highest rates were observed (i) in the north-eastern governorates (Jendouba, 74%), (ii) on the eastern coast (Monastir, 64%) and (iii) in the lowlands of Chott El Jerid and Chott el Gharsa (Kebili, 58%; Tozeur, 52%). Environmental risk factors were assessed, including various indicators of wetlands, wild avifauna, night temperature and chlorophyllous activity (normalized difference vegetation index: NDVI). Multimodel inference showed that lower distance to ornithological sites and wetlands, lower night-time temperature, and higher NDVI in late spring and late fall were associated with higher serological prevalence rate. The model-predicted nationwide map of WNF seroprevalence rate in Tunisian equids highlighted different areas with high seroprevalence probability. These findings are discussed in the perspective of implementing a better WNF surveillance system in Tunisia. This system might rely on (i) a longitudinal survey of sentinel birds in high-risk areas and time periods for WNV transmission, (ii) investigations of bird die-offs and (iii) syndromic surveillance of equine meningoencephalitis. PMID:23906318

Bargaoui, R; Lecollinet, S; Lancelot, R

2015-02-01

145

Medicinal plants: conception / contraception.  

PubMed

Researchers have conducted considerable experiments on the effectiveness and therapeutic values of Chinese herbs and parts of plants. We should not ignore the significance of natural medicine. The Chinese have been perfecting medicinal therapy based on the raw ingredients of plants/herbs and their derivatives for thousands of years. Chinese practitioners of traditional medicine prescribe medicines based on yin and yang. Traditional medicine is communicated in a verb or written form. Natural resources used in traditional medicine to treat diseases are not limited to just medicinal plants but also include animals, shell fish, and minerals. Parts of plants used in traditional medicine are leaves, stems, flowers, bark, and root. Chinese medicine is the world's oldest continuous surviving tradition. The Chinese experimented with local plants, often resulting in mild to violent reactions. This process allowed them to become familiar with poisonous plants and those that could relieve pain or successfully treat illness. Current allopathic medicines are composed of synthetic compounds copied from natural chemical derivatives, which tend to be more potent than the original compound. Some medicinal plants used to effect conception/contraception include Striga astiatica (contraceptive); Eurycoma longifolia (male virility); and a mixture of lengkuas, mengkudu masak, black pepper seeds, ginger, salt, and 2 eggs (increase libido). Women in Malaysia take jamu to preserve their body shape and to provide nutrition during pregnancy. Praneem causes local cell-mediated immunity in the uterus. Clinical trials of Praneem with or without the hCG vaccine are planned. PMID:12287843

Chaing, H S; Merino-chavez, G; Yang, L L; Wang, F N; Hafez, E S

1994-01-01

146

Contraception and unwanted pregnancy.  

PubMed

An overview of research findings in the US on the psychological and social variables associated with unwanted pregnancy and on the consequences of unwanted pregnancy was provided. Studies which examined personality differences between women and adolescent females who practicaed effective contraception and thesse who experienced unwanted pregnancy consistently found that the latter group, compared to the former group, had lower self-esteem, were more passive, tended to engage in more risk taking behavior, and were less achievement and future oriented. Several studies found that those who experienced unwanted pregnancies were often poorly informed about sex and contraception. Sex education, however, did not always lead to an increase in the knowledge and use of contraception. Sex education was unable to overcome the effects of male and female sexual socialization processes in which adolescents were inculcated with a double sex standard and females with a sense of guilt concerning the use of contraception. Numerous studies showed that unperceived or denied motives played a role in the occurence of unwanted pregnancies. Unwanted pregnancies were associated with loss, and these pregnancies probably represented an attempt to replace the loss of a loved person. Women who were in conflict about their work and mothering roles, and women who did not want to work but felt pressured to do so, frequently had inappropriate pregnancies. Teenagers who were not interested in school or in future careers often had unwanted pregnancies. These pregnancies probably represented an attempt to establish a social identity. W.B. Miller identified 8 stages in the reproductive life span when unwanted pregnancies were most likely to occur. These stages were 1) the initial stage of adolescence when the individual may not be fully aware of her fertility, 2) the 1st 6 months following the initiation of sexual activity, 3) at the beginning of a new relationship, 4) during the initial stage of marriage, 5) immediately following geographical mobility, 6) immediately following a pregnancy, 7) toward the end of the reproductive period, and 8) during menopause. Several researchers investigated the factors which play a role in contraceptive decision making. All the options available to those who experienced unwanted pregnancies entailed some degree of pain. Women who chose abortion, compared to those who had term pregnancies tended to suffer less serious, longterm consequences. Most abortion patients suffered only mild or temporary stress. Abortion patients who had more serious reactions tended to be young, single, Catholid, and socially immature. Individuals who a history of psychological problems, had negative relationships with their mothers, felt ambivalent about the abortion, or felt pressured to have an abortion were also more likely to experience psychological disturbances at some point following abortion. Most studies of unwanted pregnancy were retrospective, correlational, and based on small samples. Many were based on self-selected samples. Several social factors hinder efforts to investigate this sensitive social problem. As a result, intervention strategies, designed to prevent unwanted pregnancy, are frequently based on inadequate research. Efforts must be made to increase research on unwanted pregnancy and to utilize this research to develop effective preventive strategies. PMID:12313429

Adler, N E

1984-01-01

147

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

148

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

2008-01-01

149

Contraceptive practices and attitudes among immigrant and nonimmigrant women in Canada  

PubMed Central

Abstract Objective To compare experiences, attitudes, and beliefs of immigrant and nonimmigrant women presenting for abortion with regard to contraception, and to identify difficulties involved in accessing contraception in Canada. Design A survey of immigrant and nonimmigrant women asking about women’s experiences with and attitudes toward contraceptives and any barriers to contraceptive access they have encountered. Demographic data including ethnicity, country of origin, and length of residence in Canada were collected. Setting Two urban abortion clinics. Participants Women presenting for first-trimester abortion. Main outcome measures Type of contraception used when the unwanted pregnancy was conceived, attitudes to contraceptives, and barriers to access of contraceptives. Results A total of 999 women completed questionnaires during the study period (75.9% response rate); 466 of them (46.6%) were born in Canada. Immigrant women presenting for abortion were less likely to be using hormonal contraception when they got pregnant (12.5% vs 23.5%, P < .001) and had more negative attitudes toward hormonal contraception (62.6% vs 51.6%, P < .003). They reported having more difficulties accessing contraception before the abortion (24.8% vs 15.3%, P < .001) than nonimmigrant women did. About half of all the women expressed fear about intrauterine device use. The longer immigrant women had lived in Canada, the more likely they were to have similar responses to those of Canadian-born women. Conclusion The information provided by this study might be valuable for family doctors and other clinicians to improve contraceptive information resources for immigrants to address existing knowledge gaps and other culturally relevant concerns. As about half of all women presenting for abortion expressed negative attitudes toward the more effective methods of contraception, it is important that family doctors educate all women at risk for unintended pregnancies. PMID:24130299

Wiebe, Ellen

2013-01-01

150

Prevalence rates and psychosocial characteristics associated with depression in pregnancy and postpartum in Maltese women  

Microsoft Academic Search

Background: Investigators have commented on the apparent high prevalence of psychiatric symptoms in pregnancy. In Malta there is lack of epidemiological data and therefore, the prevalence of depression during pregnancy and at 8 weeks postpartum among a community sample of Maltese women was carried out. Method: A random sample of 239 pregnant women were interviewed at booking using a detailed

Ethel Felice; Joseph Saliba; Victor Grech; John Cox

2004-01-01

151

Cholangiocarcinoma and oral contraceptives.  

PubMed

A 21-year-old woman presented with a 12-month history of epigastric pain, and for 3 months she had noticed a mass in the right hypochondrium. She had taken 'Norinyl-1' (norethisterone 1 mg and mestranol 50 mcg) for 5 years. She smoked 20 cigarettes a day but drank little alcohol. Physical examination revealed irregular hard hepatomegaly 10 cm below the right costal margin. Hepatitis B surface antigen was not detected in the serum and alpha fetoprotein levels were normal ( 10 M.R.C. units). A liver scan showed a large space-occupying lesion in the right lobe of the liver, and liver biopsy revealed a cholangicarcinoma with striking fibrous reaction. Multiple shadows consistent with metastases were present on chest X-ray, but no bony deposits were found on radiological skeletal survey or bone scan. The serum calcium was persistently high (2.74-2.92 mmol/l) but fell on prednisolone therapy. Serum parathyroid hormone levels were normal. A causal relation between oral contraceptives and hepatic adenoma is now generally accepted, and several patients with hepatocellular carcinoma have also been reported. We have been able to find only 1 previous report of cholangiocarcinoma in a young female taking oral contraceptives, and there is 1 report of this tumor in a man taking high doses of anabolic steroids for refractory anemia. This tumor has its peak incidence in the 6th decade and is very rare in the 3rd decade. The association with hypercalcemia due to pseudohyperparathyroidism is well recognized. In only some cases are parathyroid hormone levels raised, and the cause of the pseudohypercalcemia in our patient is unknown. PMID:6101761

Littlewood, E R; Barrison, I G; Murray-Lyon, I M; Paradinas, F J

1980-02-01

152

Seafood consumption, the DHA content of mothers’ milk and prevalence rates of postpartum depression: a cross-national, ecological analysis  

Microsoft Academic Search

Background: Mothers selectively transfer docosahexaenoic acid (DHA) to their fetuses to support optimal neurological development during pregnancy. Without sufficient dietary intake, mothers become depleted of DHA and may increase their risk of suffering major depressive symptoms in the postpartum period. We postulated that the DHA content of mothers’ milk and seafood consumption would both predict prevalence rates of postpartum depression

Joseph R. Hibbeln

2002-01-01

153

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

2011-01-01

154

How Effective Is Male Contraception?  

MedlinePLUS

... men, methods of contraception include male condoms and sterilization (vasectomy). Male condoms. This condom is a thin sheath ... are disposable after a single use. 1 , 2 Vasectomy ( va-SEK-tuh-mee ) is a surgical procedure ...

155

Emerging Options for Emergency Contraception  

PubMed Central

Emergency post-coital contraception (EC) is an effective method of preventing pregnancy when used appropriately. EC has been available since the 1970s, and its availability and use have become widespread. Options for EC are broad and include the copper intrauterine device (IUD) and emergency contraceptive pills such as levonorgestrel, ulipristal acetate, combined oral contraceptive pills (Yuzpe method), and less commonly, mifepristone. Some options are available over-the-counter, while others require provider prescription or placement. There are no absolute contraindications to the use of emergency contraceptive pills, with the exception of ulipristal acetate and mifepristone. This article reviews the mechanisms of action, efficacy, safety, side effects, clinical considerations, and patient preferences with respect to EC usage. The decision of which regimen to use is influenced by local availability, cost, and patient preference. PMID:24453516

Koyama, Atsuko; Hagopian, Laura; Linden, Judith

2013-01-01

156

Estrogen and Progestin (Oral Contraceptives)  

MedlinePLUS

... brain or leading to the brain); stroke or mini-stroke; an irregular heartbeat; heart disease; a heart ... were using hormonal contraceptives (birth control pills, patches, rings, implants, or injections); unexplained abnormal vaginal bleeding; adrenal ...

157

Interstitial Lung Abnormalities in a CT Lung Cancer Screening Population: Prevalence and Progression Rate  

PubMed Central

Purpose: To determine the prevalence of interstitial lung abnormalities (ILAs) at initial computed tomography (CT) examination and the rate of progression of ILAs on 2-year follow-up CT images in a National Lung Screening Trial population studied at a single site. Materials and Methods: The study was approved by the institutional review board and informed consent was obtained from all participants. Image review for this study was HIPAA compliant. We reviewed the CT images of 884 cigarette smokers who underwent low-dose CT at a single site in the National Lung Screening Trial. CT findings were categorized as having no evidence of ILA, equivocal for ILA, or ILA. We categorized the type of ILA as nonfibrotic (ground-glass opacity, consolidation, mosaic attenuation), or fibrotic (ground glass with reticular pattern, reticular pattern, honeycombing). We evaluated the temporal change of the CT findings (no change, improvement, or progression) of ILA at 2-year follow-up. A ?2 with Fisher exact test or unpaired t test was used to determine whether smoking parameters were associated with progression of ILA at 2-year follow-up CT. Results: The prevalence of ILA was 9.7% (86 of 884 participants; 95% confidence interval: 7.9%, 11.9%), with a further 11.5% (102 of 884 participants) who had findings equivocal for ILA. The pattern was fibrotic in 19 (2.1%), nonfibrotic in 52 (5.9%), and mixed fibrotic and nonfibrotic in 15 (1.7%) of the 86 participants with ILA. The percentage of current smokers (P = .001) and mean number of cigarette pack-years (P = .001) were significantly higher in those with ILA than those without. At 2-year follow-up of those with ILA (n = 79), findings of nonfibrotic ILA improved in 49% of cases and progressed in 11%. Fibrotic ILA improved in 0% and progressed in 37% of cases. Conclusion: ILA is common in cigarette smokers. Nonfibrotic ILA improved in about 50% of cases, and fibrotic ILA progressed in about 37%. © RSNA, 2013 PMID:23513242

Lynch, David; Chawla, Ashish; Garg, Kavita; Tammemagi, Martin C.; Sahin, Hakan; Misumi, Shigeki; Kwon, Keun Sang

2013-01-01

158

The contraception needs of the perimenopausal woman.  

PubMed

Perimenopausal women have low fertility but must still be advised to use contraception until natural sterility is reached if they are sexually active. Patterns of contraceptive use vary in different countries worldwide. Long-acting reversible contraceptive methods offer reliable contraception that may be an alternative to sterilisation. Hormonal methods confer significant non-contraceptive benefits, and each individual woman should weigh up the benefits and risks of a particular method. No method of contraception is contraindicated by age alone, although combined hormonal contraception and injectable progestogens are not recommended for women over the age of 50 years. The intrauterine system has particular advantages as a low-dose method of effective hormonal contraception, which also offers control of menstrual dysfunction and endometrial protection in women requiring oestrogen replacement. Condoms are recommended for personal protection against sexually transmitted infections in new relationships. Standard hormone replacement therapy is not a method of contraception. PMID:24990143

Hardman, Sarah M R; Gebbie, Ailsa E

2014-08-01

159

Variation in postpartum contraceptive method use: Results from the Pregnancy Risk Assessment Monitoring System (PRAMS)  

PubMed Central

Objective The National Survey of Family Growth has been a primary data source for trends in US women’s contraceptive use. However, national-level data may mask differences in contraceptive practice resulting from variation in local policies and norms. Study Design We used the Pregnancy Risk Assessment Monitoring System), a survey of women who are 2–4 months postpartum. Information on women’s current method was available for 18 reporting areas from 2000–2009. Using the two most recent years of data, we computed the weighted proportion of women using specific contraceptive methods according to payment for delivery (Medicaid or private insurance) and examined differences across states. We used log binomial regression to assess trends in method use in 8 areas with consecutive years of data. Results Across states, there was a wide range of use of female sterilization (7.0–22.6%) and long-acting reversible contraception (LARC; 1.9–25.5%). Other methods, like vasectomy and the patch/ring, had a narrower range of use. Women with Medicaid-paid deliveries were more likely to report female sterilization, LARC and injectables as their method compared to women with private insurance. LARC use increased ?18% per year, while use of injectables and oral contraceptives declined by 2.5%–10.6% annually. Conclusions The correlation in method-specific prevalence within states suggests shared social and medical norms, while the larger variation across states may reflect both differences in norms and access to contraception for low-income women. Surveys of postpartum women, who are beginning a new segment of contraceptive use, may better capture emerging trends in US contraceptive method mix. Implications There is considerable variation in contraceptive method use across states, which may result from differences in state policies and funding for family planning services, local medical norms surrounding contraceptive practice, and women’s and couples’ demand or preference for different methods. PMID:24237967

White, Kari; Potter, Joseph E.; Hopkins, Kristine; Grossman, Daniel

2013-01-01

160

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

PubMed

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

2008-11-01

161

Diagnosis and Prevalence of Uterine Leiomyomata in Female Chimpanzees (Pan troglodytes)  

PubMed Central

Uterine leiomyomata are common, affecting 70–80% of women between 30 and 50 years of age. Leiomyomata have been reported for a variety of primate species, although prevalence rates and treatments have not been widely reported. The prevalence, diagnosis, and treatment of uterine leiomyomata in the Alamogordo Primate Facility and the Keeling Center for Comparative Medicine and Research were examined. Uterine leiomyomata were diagnosed in 28.4% of chimpanzees with an average age at diagnosis of 30.4±8.0 years. Advanced age (>30 years) was related to an increase in leiomyomata and use of hormonal contraception was related to a decrease in leiomyomata. As the captive chimpanzee population ages, the incidence of leiomyomata among female chimpanzees will likely increase. The introduction of progesterone-based contraception for non-breeding research and zoological chimpanzees may reduce the development of leiomyomata. Finally, all chimpanzee facilities should institute aggressive screening programs and carefully consider treatment plans. PMID:21442632

Videan, EN; Satterfield, WC; Buchal, S; Lammey, ML

2011-01-01

162

Differences in prevalence rates of PTSD in various European countries explained by war exposure, other trauma and cultural value orientation  

PubMed Central

Background Guided by previous explorations of historical and cultural influences on the occurrence of PTSD, the aim of the present study was to investigate the contributions of war victimisation (in particular, World War II) and other civil trauma on the prevalence of PTSD, as mediated by cultural value orientation. Secondary data analysis was performed for 12 European countries using data, including PTSD prevalence and number of war victims, crime victims, and natural disaster victims, from different sources. Ten single value orientations, as well as value aggregates for traditional and modern factors, were investigated. Results Whilst differences in PTSD prevalence were strongly associated with war victim rates, associations, albeit weaker, were also found between crime victims and PTSD. When cultural value orientations, such as stimulation and conformity as representatives of modern and traditional values, were included in the multivariate predictions of PTSD prevalence, an average of approximately 80% of PTSD variance could be explained by the model, independent of the type of trauma exposure. Conclusion The results suggest that the aftermath of war contributes to current PTSD prevalence, which may be explained by the high proportion of the older population who directly or indirectly experienced traumatic war experiences. Additional findings for other types of civil trauma point towards an interaction between value orientation and country-specific trauma rates. Particularly, being personally oriented towards stimulation appears to interact with differences in trauma prevalence. Thus, cultural value orientation might be viewed not only as an individual intrinsic process but also as a compensatory strategy after trauma exposure. PMID:24972489

2014-01-01

163

Differences in the misreporting of chronic conditions, by level of education: the effect on inequalities in prevalence rates.  

PubMed Central

OBJECTIVES: Many studies of socio-economic inequalities in the prevalence of chronic conditions rely on self-reports. For chronic nonspecific lung disease, heart disease, and diabetes mellitus, we studied the effects of misreporting on variations in prevalence rates by respondents' level of education. METHODS: In 1991, a health interview survey was conducted in the southeastern Netherlands with 2867 respondents. Respondents' answers were compared with validated diagnostic questionnaires in the same survey and the diagnoses given by the respondents' general practitioners. RESULTS: Misreporting of chronic lung disease, heart disease, and diabetes may be extensive. Depending on the condition and the reference data used, the confirmation fractions ranged between .61 and .96 and the detection fractions between .13 and .93. Misreporting varied by level of education, and although various patterns were observed, the dominant pattern was that of more underreporting among less educated persons. The effects on prevalence rates were to underestimate differences by level of education to a sometimes considerable degree. CONCLUSIONS: Misreporting of chronic conditions differs by respondents' level of education. Health interview survey data underestimate socioeconomic inequalities in the prevalence of chronic conditions. PMID:8629723

Mackenbach, J P; Looman, C W; van der Meer, J B

1996-01-01

164

Contraceptive use by Iranian women with hypertension, diabetes or obesity.  

PubMed

Women with chronic medical conditions require careful contraceptive management. The aim of this cross-sectional study in Tehran was to determine the pattern of contraception use by women with diabetes, hypertension or obesity. A sample of 264 women aged 18-53 years old was recruited; 81 (30.7%) had diabetes type 2,100 (37.9%) were obese/overweight (BMI > 25 kg/m2) and 83 (31.5%) had hypertension. Across all 3 groups, the rate of use of contraceptive methods was significantly different before and after diagnosis. Before diagnosis of disease the most common method was hormonal contraception in all women (55.0%, 71.6% and 78.3% of diabetic, overweight and hypertensive women respectively), whereas after diagnosis coital withdrawal was the most common method in diabetic and obese/overweight women (41.2% and 28.0% respectively) and almost the most common method for hypertensive women (35.4%). Use of safe and modern methods of contraception in women with certain chronic medical conditions was low and needs more attention. PMID:24975309

Nojomi, M; Morrovatdar, N; Davoudi, F; Hosseini, S

2013-07-01

165

Male contraception: another Holy Grail.  

PubMed

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

2014-01-15

166

Contraception among bankers in an urban community in Lagos state, Nigeria  

PubMed Central

Introduction Contraception means procedures employed to interfere at one stage or the other with the normal sequence of events in the process of reproduction leading to a failure in conception. It means voluntary techniques adopted to achieve birth control. Its use remains sensitive worldwide. Within the same society, contraception varies amongst people of different socio-cultural, educational, religious, or occupational affiliations. It also varies between urban and rural settlements. Some contraceptive techniques also prevent sexually transmitted infections (STIs). The prevalence of STIs also varies with these same factors. There is very limited literature on contraception exclusively amongst bankers. We sought to investigate the level of awareness and practice of contraception amongst bankers in an urban society in Lagos State, Nigeria. Methods In this descriptive cross-sectional study, 200 self-administered structured questionnaires were retrieved from bankers from 5 banks selected by simple random sampling in Surulere Local Government Area of Lagos State, Nigeria. Data was subsequently statistically analyzed using SPSS. Results The age range was 21-45 years, mean28.8±1.4 years, 51.7% were males (72% single, 27% married, 1% separated) and 48.3% were females (52.4% single, 47.6% married). All (100%) respondents were aware of contraception, 93.3% males and 91.7% females were sexually active, 88.9% males and 84.5% females believe contraception is useful. Most (71.4%) respondents practice contraception, males (81%) being more than females (61.1%), p < 0.05. More (71.4%) females and fewer (37.8%) males believe that contraception prevents pregnancy but not STIs, 28.6% of females and 46.6% of males believe it prevents both pregnancy and STIs, whereas 14% of males and no female believe contraception prevents STIs but not pregnancy. Conclusion The awareness of and practice of contraception was very high among the bankers but more male bankers practice contraception whereas more female bankers perceive contraceptives to be for the married only. PMID:23646216

Meka, Ijeoma Angela; Okwara, Emmanuel Chidiebere; Meka, Anthony Obiamaka

2013-01-01

167

What influences adolescents' contraceptive decision-making? A meta-ethnography.  

PubMed

Increased access to and use of contraception has contributed significantly to the decline in teen birth rates since 1991, yet many teens use contraception inconsistently or not at all. This meta-ethnography was conducted to identify the factors that influence adolescents' contraceptive decision-making. Fourteen qualitative studies were examined using G. W. Noblit and R. D. Hare's (1988) meta-ethnographic approach. Three themes of self, partner and family were found to influence contraceptive decision-making in both positive and negative ways. Assisting adolescents to maximize positive and reduce negative influences regarding contraceptive decision-making has the potential to assist teens to more effectively avoid unintended pregnancy and sexually transmitted infections. PMID:24880101

Daley, Alison Moriarty

2014-01-01

168

Teen Council urges improved contraceptive accessibility.  

PubMed

The Center for Population Option's (CPO) Teen Council conducted a survey of contraceptive accessibility in 45 pharmacies and 15 convenience stores in the Washington D.C. area. The survey focussed on where nonprescription contraceptives are located in the stores, whether condoms and spermicidal contraceptives are displayed on the same shelf, how clerks treat teenagers when buying contraceptives, the price of condoms, and whether signs indicate where contraceptives are located. Besides learning that finding contraceptives is difficult for teenagers, the survey revealed that teenagers often experience negative behavior from clerks, especially female teenagers when confronted with male clerks. Based on the results of the survey, the CPO Teen Council met with regional representatives of drug and convenience store chains to suggest ways to make contraceptives more accessible to teens. Since only 13% of the stores surveyed had signs clearly marking where contraceptives are, the Council recommended that all stores clearly mark the aisles where contraceptives are. Additionally, it suggested placing all contraceptives on the same shelf. According to the survey 35% of the pharmacies and 32% of the convenience stores had condoms behind the counter. Since teenagers are often reluctant to ask for them because of the fear of being judged by clerks, the Council suggested placing contraceptives where teens can buy them without having to ask for them. In addition, it recommended that clerks treat teens with the same respect as older customers when purchasing contraceptives. The Council also suggested that pamphlets and information on sexually transmitted diseases be available. PMID:12282042

1988-01-01

169

Levels, trends, and determinants of unintended pregnancy in iran: the role of contraceptive failures.  

PubMed

The rate of contraceptive use in Iran is high, but because abortion is illegal, many unintended pregnancies among married women are likely to be terminated by clandestine and often unsafe procedures, resulting in adverse health outcomes. Drawing upon data from the 2009 Tehran Survey of Fertility, this study estimates the levels and trends of unintended pregnancy and examines determinants of pregnancy intentions for the most recent birth, using multinomial logistic regression analysis. The level of unintended pregnancy decreased from 32 percent in 2000 to 21 percent in 2009, while contraceptive use increased. Unintended pregnancies in the five years preceding the 2009 survey resulted from failures of withdrawal (48 percent) and of modern contraceptive use (20 percent), together with contraceptive discontinuation (26 percent) and nonuse (6 percent). Multivariate findings show that, compared with women experiencing withdrawal failures, the risk of unintended pregnancy was higher among women reporting modern contraceptive failure and lower among those reporting contraceptive discontinuation and nonuse. The high risk of unwanted pregnancy among women experiencing failures in practicing withdrawal or using modern contraceptive methods points to an unmet need for family planning counseling and education rather than to a shortage of contraceptive methods. PMID:24006075

Erfani, Amir

2013-09-01

170

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.

2014-01-01

171

Emergency Contraception: An Updated Review  

PubMed Central

Summary Emergency contraception is a common practice now. Many categories of drugs are marketed with modifications in dosage, in combination and even in the timing of administration. Recent re-analysis suggests that there is still no uniformity of opinion on the actual mechanism of action and this has often fueled the ethical controversy. This review analyzes the most common emergency contraception drugs: levonorgestrel, mifepristone and ulipristal acetate about their action underlining that the hormonal products, when used in emergency contraception, play different roles depending on the phase of the menstrual cycle during which they are administered.This review aims to examine rigorously the most accredited literature to verify if a evidence-based uniformity of opinions has been achieved about the biological effects of hormones administered after the sexual intercourse. PMID:23905038

Guida, M.; Marra, M.L.; Palatucci, V.; Pascale, R.; Visconti, F.; Zullo, F.

2011-01-01

172

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

1989-01-01

173

Prevalence Rates and Demographic Characteristics Associated With Depression in Pregnancy and the Postpartum  

Microsoft Academic Search

Examined the prevalence of depression in a heterogeneous sample of 360 pregnant women. Subjects were assessed with respect to both depressive symptomatology and diagnostic status during pregnancy and after delivery. At both assessments, approximately 25% of the sample reported elevated levels of depressive symptomatology. In contrast, 10% of the women met diagnostic criteria for depression during pregnancy, and 6.8% were

Ian H. Gotlib; Valerie E. Whiffen; John H. Mount; Kenneth Milne; Nikkie I. Cordy

1989-01-01

174

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

2013-01-01

175

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

2013-01-01

176

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

2007-01-01

177

Rethinking mandatory HIV testing during pregnancy in areas with high HIV prevalence rates: ethical and policy issues.  

PubMed

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

2007-07-01

178

Contraception in the prepill era.  

PubMed

Although medical history has documented the desire to control fertility since ancient times, safe and effective contraception did not exist until this century and has not been equally available to all people. Strong moral sentiments, economic and social class factors, religious beliefs, familial and gender relations, and political as well as legal constraints have often limited the ability of physicians in favor of contraception to provide advice and methods of birth control to their patients. By the early 1900s, a constellation of factors--in particular, the large influx of poor immigrants, and feminist groups advocating women's rights--helped to move forward a birth-control movement in this country and abroad. In the early 20th century, Margaret Sanger became one of the most avid proponents of contraception in the United States. By 1950, she and Katharine McCormick had contracted with biologist Gregory Pincus to develop an effective birth control pill. A collaborative effort by Pincus and other researchers led to trials of the pill in Puerto Rico, Haiti, and Mexico between 1956 and 1957, which provided the basis for an application to the Food and Drug Administration for approval of the first oral contraceptive. PMID:10342089

Connell, E B

1999-01-01

179

Contraception and the Adolescent Diabetic.  

ERIC Educational Resources Information Center

Data from a study of 11 teenage diabetics suggests that pregnancy among adolescent diabetics is more frequent than among the general population, at a time when diabetic control is poor because of psychosocial factors associated with adolescence. Current recommendations regarding contraception for diabetic women, focusing on barrier methods, are…

Fennoy, Ilene

1989-01-01

180

[The history of the contraceptive sheath].  

PubMed

The condom, effective in preventing both pregnancy and venereal disease, had a limited role until the 19th century, when its use spread through all social strata. The 1st condoms may have been linen sheaths designed to protect against syphilis. A 16th century Neapolitan doctor provided a recipe for an antiseptic preparation to be applied for 4-5 hourrs, but after intercourse had occurred. A physician to Louis XV mentioned the condom in a book published in 1736, and in 1770 the condom was again described without being named. 4 yeears later it was again described and called the condom or English redingote. Later it was mentioned by the Marques de Sade, who alluded to its contraceptive effect. In the early 19th century, condoms made of sheep entrails were mentioned. Descriptions of the preparation of 3 grades of condom, regular, fine, and superfine, were later found. The discovery of the process of vulcanization of rubber in 1839 made possible more solid, marketable, and usable latex condoms. The condom apparently began to be used in the late 17th or early 18th century. Some authors state that it was invented by a Dr. Condom or Conton, a physician or knight in the court of Charls II of England. Othrs suggested that it was named after the city of Condom in Gascony or derived from a foreign word. The antivenereal disease qualities of condoms were described by Casanova and Gustave Flaubert, and other references to them may be found in the literature. Later the contraceptive use of the condom became progressively more common, beginning in the wealthier classes and spreading to the rural and lower classes perhaps by the later 18th century. The diffusion of contraception during the 19th century was cited as the cause of th slow decline in illegitimacy rates starting at the end of the century. The Church condemned the use of condoms for contraception, but the medical profession took a less hostile view due to their health function. At the present time, condoms are widely used. 50 million units were sold in France in 1972, and 1 out of 3 Frenchmen had used the method. 150 million were sold in Germany in 1974, somewhat fewer in England, and 4 times more in the US. PMID:12313178

Guyotjeannin, C

1984-06-01

181

[Sexually transmitted diseases (STD) and contraception].  

PubMed

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

1989-06-01

182

Choices on contraceptive methods in post-abortion family planning clinic in the northeast Brazil  

PubMed Central

Background In Brazil, a Ministry of Health report revealed women who underwent an abortion were predominantly in the use of contraceptive methods, but mentioned inconsistent or erroneously contraceptive use. Promoting the use of contraceptive methods to prevent unwanted pregnancies is one of the most effective strategies to reduce abortion rates and maternal morbidity and mortality. Therefore, providing post-abortion family planning services that include structured contraceptive counseling with free and easy access to contraceptive methods can be suitable. So the objective of this study is to determine the acceptance and selection of contraceptive methods followed by a post-abortion family planning counseling. Methods A cross-sectional study was carried out from July to October 2008, enrolling 150 low income women to receive post-abortion care at a family planning clinic in a public hospital located in Recife, Brazil. The subjects were invited to take part of the study before receiving hospital leave from five different public maternities. An appointment was made for them at a family planning clinic at IMIP from the 8th to the 15th day after they had undergone an abortion. Every woman received information on contraceptive methods, side effects and fertility. Counseling was individualized and addressed them about feelings, expectations and motivations regarding contraception as well as pregnancy intention. Results Of all women enrolled in this study, 97.4% accepted at least one contraceptive method. Most of them (73.4%) had no previous abortion history. Forty of the women who had undergone a previous abortion, 47.5% reported undergoing unsafe abortion. Slightly more than half of the pregnancies (52%) were unwanted. All women had knowledge of the use of condoms, oral contraceptives and injectables. The most chosen method was injectables, followed by oral contraceptives and condoms. Only one woman chose an intrauterine device. Conclusion The acceptance rate of post-abortion contraceptive methods was greater and the most chosen method was the best-known one. Implementing a specialized family planning post abortion service may promote an acceptance, regardless of the chosen method. Most important is they do receive contraception if they do not wish for an immediate pregnancy. PMID:20459754

2010-01-01

183

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

PubMed

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

1997-04-01

184

Contraception-related venous thromboembolism in adolescents.  

PubMed

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

2014-02-01

185

Pregnancy Ambivalence and Contraceptive Use Among Young Adults in the United States  

PubMed Central

CONTEXT Pregnancy ambivalence, or conflicted desire about having a baby, has been associated with decreased contraceptive use and unintended pregnancy. However, prior studies have neither included men nor focused on young adults, even though people in their 20s have the highest rates of unintended pregnancy. METHODS Nationally representative data from 2008–2009 were used to examine pregnancy ambivalence and its association with contraceptive practices among 774 respondents who were 18–29 years old and in current sexual relationships. Bivariate and multivariate analyses assessed relationships between pregnancy ambivalence, contraceptive use, gender and other social, demographic and psychosocial variables. RESULTS Forty-five percent of respondents exhibited pregnancy ambivalence. The proportion was higher among men than among women (53% vs. 36%), and the diference remained significant in the multivariate analysis (odds ratio, 2.9). Ambivalence was associated with lowered likelihood of contraceptive use, but this relationship was statistically significant only for men: Compared with men with clear intentions to avoid pregnancy, ambivalent men were less likely to have used any method of contraception in the last month (0.4). CONCLUSIONS The association between men’s pregnancy ambivalence and contraceptive practices suggests that women should not remain the sole targets of pregnancy prevention programs. Further research should explore whether clinical interventions that assess and address pregnancy ambivalence for both women and men could lead to improved contraceptive counseling and use. PMID:23231331

Higgins, Jenny A.; Popkin, Ronna A.; Santelli, John S.

2013-01-01

186

'Stratified Contraception': Emergency Contraceptive Pills and Women's Differential Experiences in Contemporary India.  

PubMed

Available without prescriptions in India since 2005, emergency contraceptive pills (ECPs) and their advertisements have provided women with increased contraceptive options and a vocabulary to talk about their reproductive lives. I draw on long-term fieldwork with women in urban India about ECPs, demonstrating a new form of 'stratified contraception' enabled by these pills and their advertisements. I posit that there are within India spaces that replicate the luxuries and privileges of the global North. These material conditions, I suggest, are replicated when it comes to contraception as there are hubs of women consumers of contraception and contraceptive advertising that participate in an 'imagined cosmopolitanism' within the global South in close proximity to 'contraceptive ghettos.' Moving beyond simplistic binaries, I outline three major stratifications along which women experience this medical technology and outline the implications for women and their contraceptive choices when notions of northern privilege exist in the 'South.' PMID:24901232

Sheoran, Nayantara

2014-06-01

187

Contraceptive options for women living with HIV.  

PubMed

Women living with HIV are often of reproductive age, and many desire effective contraceptive options to delay or prevent pregnancy. We review the safety of various hormonal and non-hormonal contraceptive methods for women living with human immunodeficiency virus (HIV). Additionally, we discuss drug interactions between contraceptive methods and antiretrovirals and the safety of methods with respect to onward transmission to HIV-negative partners for women in sero-discordant partnerships. In general, most methods are safe for most women living with HIV. An understanding of the reproductive goals of each individual patient, as well as her medical condition and medication, should be taken into account when counselling women on their contraceptive options. Further research is needed to understand drug interactions between contraceptives and antiretrovirals better and how to fulfil the contraceptive needs of HIV-positive women. PMID:24947597

Phillips, Sharon; Steyn, Petrus; Temmerman, Marleen

2014-08-01

188

Use of hormonal contraceptives to control menstrual bleeding: attitudes and practice of Brazilian gynecologists  

PubMed Central

Background The purpose of this study was to assess the attitudes and prescribing practices of Brazilian obstetricians and gynecologists regarding use of contraceptive methods to interfere with menstruation and/or induce amenorrhea. Methods We undertook a nationwide survey of Brazilian obstetricians and gynecologists selected using a computer-generated randomization system. Participants completed a questionnaire on prescription of contraceptives and extended/continuous regimens of combined oral contraceptives (COCs). Results In total, 79.2% of Brazilian obstetricians and gynecologists reported that 20%–40% of their patients consulted them for menstrual-related complaints and 26%–34% of the gynecologists reported that 21%–40% of their patients consulted them for reduction in the intensity, frequency, and/or duration of menstrual bleeding. Overall, 93% stated that medically induced amenorrhea represents no risk to women’s health and 82.5% said that they prescribed contraceptives to control menstruation or induce amenorrhea. The contraceptives most commonly prescribed were extended-cycle 24/4 or 26/2 COC regimens and the levonorgestrel-releasing intrauterine system. Poisson regression analysis showed that Brazilian obstetricians and gynecologists prescribing contraceptives to control menstruation or induce amenorrhea consider extended-use or continuous-use COC regimens to be effective for both indications (prevalence ratio 1.23 [95% confidence interval 1.09–1.40] and prevalence ratio 1.28 [95% confidence interval 1.13–1.46], respectively). They also prescribed COCs with an interval of 24/4 or 26/2 to control bleeding patterns (prevalence ratio 1.10 [95% confidence interval 1.01–1.21]). Conclusion Brazilian obstetricians and gynecologists were favorably disposed toward prescribing extended-use or continuous-use COC regimens for control of menstrual bleeding or to induce amenorrhea on patient demand. PMID:24399887

Makuch, María Y; D Osis, Maria José; de Pádua, Karla Simonia; Bahamondes, Luis

2013-01-01

189

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

190

Contraceptive use in a rural general practice.  

PubMed Central

All women aged 20-49 in a general practice were sent a questionnaire about their reproductive health, and 72% responded. 78% of respondents were using a method of fertility control. More than a quarter of women were obtaining their contraceptive supplies (condoms especially) from non-medical outlets. Knowledge of the existence of emergency contraception was high (83%). The general practitioner (GP) was the most popular source of contraceptive supplies for those aged under 40 years and more than four-fifths of women said that they would rather turn to their GP than to other sources for future contraceptive advice. PMID:9771512

Rowlands, S

1998-01-01

191

Levonorgestrel, not etonogestrel, provides contraception in free-ranging koalas.  

PubMed

Management of high-density koala (Phascolarctos cinereus) populations is essential because of the browsing damage they inflict on their habitat. We have tested two types of gestagen implant, namely levonorgestrel and etonogestrel, as contraceptives for koalas. Free-ranging female koalas were given either a control, levonorgestrel (70 mg) or etonogestrel (34 or 68 mg) implant before the breeding season. Koalas were monitored every 4-12 weeks for births. Plasma progesterone was measured and a cytological smear of the urogenital sinus was taken. Fertility was high in the control group and the two etonogestrel-treated groups, with approximately 90% of females giving birth. In contrast, no levonorgestrel-treated female produced young during the study. Removal of levonorgestrel implants from six females reversed the contraceptive effect in the next breeding season, whereas the eight females in which the levonorgestrel implants were left in remained infertile for six breeding seasons. Vaginal cytology showed evidence of oestrous cycles during the breeding season in all females from all groups and there was no difference seen in the prevalence of cornified epithelial cells in the oestrous smears. This indirectly suggests that levonorgestrel does not prevent follicular development and oestrous cycling. Plasma progesterone in levonorgestrel-treated females remained low all year, but rose in controls concurrent with the onset of the breeding season. This suggests that levonorgestrel prevents pregnancy by blocking ovulation. Etonogestrel had absolutely no contraceptive effect at the two doses delivered and so is not suitable for controlling koala populations. In contrast, levonorgestrel was effective as a long-term, reversible contraceptive in wild koalas. PMID:20591325

Hynes, E F; Handasyde, K A; Shaw, Geoff; Renfree, Marilyn B

2010-01-01

192

Current status of oral contraceptive.  

PubMed

Oral contraceptives have been implicated as a causative factor of venous thrombosis and thromboembolism. Compounds containing over 50 mcg of estrogen have developed this complication most frequently. Steroid hormones have a marked influence on liver function. Large doses have caused cholestasis and hepatocellular damage. Disturbances in carbohydrate metabolism have been recorded. Lipid metabolism have also been shown to be disturbed with increased serum levels of triglycerides and low density lipoproteins. A rise in the cholesterol serum level seems to be correlated with the progestogen content of the compound. The ''minipill'' with a small dose of progestogen alone had been effective by alteration of the cervical mucus. The ''one-a-month pill'' is a combination of a long-acting estrogen, quinestrol, and a chorter acting progestogen, qunigestanol acetate. It has not been as acceptable or as effective as combined compounds. The ''morning-after'' pill consists of large doses of stilbestrol. The method has been effective but when de-ethylstilbestrol has been given to a patient already pregnant to prevent an early spontaneous abortion, adenocarcinoma of the cervix or vagina has been reported. Hypertension has been more common with increased duration of pill use. High dosage of progestogens and increasing age of patients have increased the incidence of hypertension. Cerebrovascular disease had also been more frequent among pill users. An increased incidence of gallbladder disease and of gallstones has been shown in pill users. Urinary tract and vaginal infections were reported more often in pill users. Increased sexual activity may have been a factor in this relationship. Resumption of ovualation after discontinuation of oral contraceptives usually follows within 4-6 weeks. In about 1% of patients amenorrhea and anovulation result for 6 months or more. This is often accopanied by galactorrhea. There is evidence that mestranol is demethylated to ethinyl estradiol in the liver. Progesterone seems to interfere with conversion. Therefore ethinyl estradiol is preferred as a compound of the pill. Also the different progestogens used are metabolized in the liver to norethisterone before they exert their biological effects. Several drugs, as ampicillin and barbiturates, have been shown to interfere with the efficacy of oral contraceptives. It is concluded that the overall results have shown oral contraceptives to be an excellent form of contraception with minimal and acceptable side effects and the least metabolic disturbance. PMID:822261

Ping, W W; Puvan, I S

1976-03-01

193

Association of intradialytic blood pressure changes with hospitalization and mortality rates in prevalent ESRD patients  

PubMed Central

The relationship between blood pressure (BP) and clinical outcomes among hemodialysis patients is complex and incompletely understood. This study sought to assess the relationship between blood pressure changes with hemodialysis and clinical outcomes during a 6-month period. This study is a secondary analysis of the Crit-Line Intradialytic Monitoring Benefit Study, a randomized trial of 443 hemodialysis subjects, designed to determine whether blood volume monitoring reduced hospitalization. Logistic regression was used to estimate the association between BP changes with hemodialysis (?systolic blood pressure = postdialysis–predialysis systoic BP (SBP) and the primary outcome of non-access-related hospitalization and death. Subjects whose systolic blood pressure fell with dialysis were younger, took fewer blood pressure medications, had higher serum creatinine, and higher dry weights. After controlling for baseline characteristics, lab variables, and treatment group, subjects whose SBP remained unchanged with hemodialysis (N = 150, ?SBP ?10 to 10 mm Hg) or whose SBP rose with hemodialysis (N = 58, ?SBP ? 10 mm Hg) had a higher odds of hospitalization or death compared to subjects whose SBP fell with hemodialysis (N = 230, ?SBP ? ?10 mm Hg) (odds ratio: 1.85, confidence interval: 1.15–2.98; and odds ratio: 2.17, confidence interval: 1.13–4.15). Subjects whose systolic blood pressure fell with hemodialysis had a significantly decreased risk of hospitalization or death at 6 months, suggesting that hemodynamic responses to dialysis are associated with short-term outcomes among a group of prevalent hemodialysis subjects. Further research should attempt to elucidate the mechanisms behind these findings. PMID:17213873

Inrig, JK; Oddone, EZ; Hasselblad, V; Gillespie, Barbara; Patel, UD; Reddan, D; Toto, R; Himmelfarb, J; Winchester, JF; Stivelman, J; Lindsay, RM; Szczech, LA

2011-01-01

194

Association of intradialytic blood pressure changes with hospitalization and mortality rates in prevalent ESRD patients.  

PubMed

The relationship between blood pressure (BP) and clinical outcomes among hemodialysis patients is complex and incompletely understood. This study sought to assess the relationship between blood pressure changes with hemodialysis and clinical outcomes during a 6-month period. This study is a secondary analysis of the Crit-Line Intradialytic Monitoring Benefit Study, a randomized trial of 443 hemodialysis subjects, designed to determine whether blood volume monitoring reduced hospitalization. Logistic regression was used to estimate the association between BP changes with hemodialysis (Deltasystolic blood pressure=postdialysis-predialysis systoic BP (SBP) and the primary outcome of non-access-related hospitalization and death. Subjects whose systolic blood pressure fell with dialysis were younger, took fewer blood pressure medications, had higher serum creatinine, and higher dry weights. After controlling for baseline characteristics, lab variables, and treatment group, subjects whose SBP remained unchanged with hemodialysis (N=150, DeltaSBP -10 to 10 mm Hg) or whose SBP rose with hemodialysis (N=58, DeltaSBP > or =10 mm Hg) had a higher odds of hospitalization or death compared to subjects whose SBP fell with hemodialysis (N=230, DeltaSBP < or =-10 mm Hg) (odds ratio: 1.85, confidence interval: 1.15-2.98; and odds ratio: 2.17, confidence interval: 1.13-4.15). Subjects whose systolic blood pressure fell with hemodialysis had a significantly decreased risk of hospitalization or death at 6 months, suggesting that hemodynamic responses to dialysis are associated with short-term outcomes among a group of prevalent hemodialysis subjects. Further research should attempt to elucidate the mechanisms behind these findings. PMID:17213873

Inrig, J K; Oddone, E Z; Hasselblad, V; Gillespie, Barbara; Patel, U D; Reddan, D; Toto, R; Himmelfarb, J; Winchester, J F; Stivelman, J; Lindsay, R M; Szczech, L A

2007-03-01

195

Breast cancer in women younger than 30 years: prevalence rate and imaging findings in a symptomatic population  

PubMed Central

Introduction To identify the prevalence rate of primary breast cancer in women younger than 30 years of age in a symptomatic population in Riyadh, Kingdom of Saudi Arabia. To analyze the imaging pattern and possible risk factors in cases with cancer. Breast cancer in this age group is generally rare and not clearly understood. Methods At King Abdulaziz Medical City for National Guard, Riyadh, a retrospective 5-year (January 2006 to December 2010) data was collected from the Medical Imaging departmental records on breast imaging. Patients younger than 30 years of age were identified including those with breast cancer. The clinical presentation, risk factors, imaging findings and final outcomes were analyzed in a descriptive way. The total number of patients diagnosed with primary breast cancer was recorded. Results Seventeen out of a total of 4873 patients younger than 30 years examined had primary breast cancer constituting a rate of 3.5 per 1000 symptomatic patients. The age range was 17 to 29 with mean of 27. The total number of patients with primary breast cancer diagnosed during that period was 413 making a percentage of 4.1% (17 out of 413) in those younger than 30 years. First presentation with a palpable mass and imaging findings of unequivocal category 5 of Breast Imaging Reporting and Data System (BI-RADS) occurred in all. Eight patients had stage I and II while nine had stage III and IV cancers. Only 2 of the 17 had first-degree family history. The youngest was 17 years old. Conclusion A prevalence rate of 3.5 per 1000 primary cancer occurred in the symptomatic population studied and 4 in every 100 primary cancer diagnosed in the unit occurred in women younger than 30 years. First presentation, low family trait and typical imaging features of malignancy was found in all cases.

Makanjuola, Dorothy; Alkushi, Abduulmohsen; Alzaid, Manal; Abukhair, Omalkhair; Al Tahan, Fatina; Alhadab, Abdulrahman

2014-01-01

196

A biodegradable long-term contraceptive implant developed in China  

Microsoft Academic Search

The paper describes a biodegradable long-acting contraceptive capsule-type implant-CaproF. A well know biodegradable polyester, poly(ε-caprolactone) (PCL) was used as the principle matrix and a water-leachable polyether, Pluronic F68 (F68), was used as drug releasing enhancer. The levonorgestrel (LNG) containing capsules showed an average LNG release rate of 7.0 ?g\\/day·cm length for a period of 2 years in rats. A stable

P. Y. Wang; C. X. Song; H. F. Sun; X. M. Cui; H. L. Shi; R. W. Shi; L. W. Quan

1998-01-01

197

Research Gaps in Defining the Biological Link between HIV Risk and Hormonal Contraception  

PubMed Central

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.

2014-01-01

198

Estimates of contraceptive failure from the 2002 National Survey of Family Growth  

PubMed Central

Background In 2001, the U.S. government’s Healthy People 2010 initiative set a goal of reducing contraceptive failure during the first year of use from 13% in 1995 to 7% by 2010. We provide updated estimates of contraceptive failure for the most commonly used reversible methods in the United States, as well as an assessment of changes in failure rates from 1995 to 2002. Study design Estimates are obtained using the 2002 National Survey of Family Growth (NSFG), a nationally representative sample of U.S. women containing information on their characteristics, pregnancies, and contraceptive use. We also use the 2001 Abortion Patient Survey to correct for underreporting of abortion in the NSFG. We measure trends in contraceptive failure between 1995 and 2002, provide new estimates for several population subgroups, examine changes in subgroup differences since 1995, and identify socioeconomic characteristics associated with elevated risks of failure for three commonly used reversible contraceptive methods in the U.S.: the pill, male condom and withdrawal. Results In 2002, 12.4% of all episodes of contraceptive use ended with a failure within 12 months after initiation of use. Injectable and oral contraceptives remain the most effective reversible methods used by women in the U.S., with probabilities of failure during the first 12 months of use of 7% and 9%, respectively. The probabilities of failure for withdrawal (18%) and the condom (17%) are similar. Reliance on fertility-awareness-based methods results in the highest probability of failure (25%). Population subgroups experience different probabilities of failure, but the characteristics of users that may predict elevated risks are not the same for all methods. Conclusion There was no clear improvement in contraceptive effectiveness between 1995 and 2002. Failure rates remain high for users of the condom, withdrawal and fertility-awareness methods, but for all methods, the risk of failure is greatly affected by socioeconomic characteristics of the users. PMID:18082661

Kost, Kathryn; Singh, Susheela; Vaughan, Barbara; Trussell, James; Bankole, Akinrinola

2010-01-01

199

La contraception de l'adolescente  

PubMed Central

Approximately one-half of all female adolescents are sexually active. Family physicians whose patients include female adolescents must be able to provide them with information and advice about contraception. In this article, adolescent contraception is examined in detail and a number of strategies for achieving optimum compliance are presented. PMID:21229024

Pinsonneault, Odette

1991-01-01

200

Menstrual Bleeding Patterns Following Levonorgestrel Emergency Contraception  

E-print Network

Menstrual Bleeding Patterns Following Levonorgestrel Emergency Contraception Erin Gainer1 Contraception 08/2006; 74(2): 118-24 #12;LNG EC Bleeding Patterns 2 Abstract Multiple trials by the World Health 34 (14.7%) cases of incident intermenstrual bleeding and statistically significant changes

Paris-Sud XI, Université de

201

Prospects for increased contraceptive pill use in Japan.  

PubMed

Although oral contraceptives are not commercially available in Japan, a low-dose contraceptive pill is expected to become available soon. The current rate of pill use is less than 1 percent, but recent survey data indicate that about 10 percent of currently married women of reproductive age intend to use the pill when it comes on the market. Those who favor the pill do so because it is highly effective in preventing unwanted pregnancies, and because it reduces the need for abortions. Many other women report uncertainty about the pill because of concern about side effects. Given that Japan has a contraceptive failure rate of about 25 percent, with 29 percent of women having had at least one abortion, many women who do not yet favor the pill may shift to it once the low-dose pill comes on the market and they are reassured about its safety. Thus, the rate of pill use is likely to rise well above 10 percent. PMID:1792677

Ogawa, N; Retherford, R D

1991-01-01

202

Costing adult male circumcision in high HIV prevalence, low circumcision rate countries.  

PubMed

The dramatic evidence that male circumcision has a substantial effect in preventing HIV infection might be the most important medical finding in the course of the AIDS epidemic since the introduction of highly active antiretroviral therapy (HAART). The transition from clinical trails to implementation of a general adult male circumcision (AMC) program is beginning, and this paper uses an AMC cost model (in Microsoft Excel) to estimate the cost of a rapid scale-up of an AMC program in Mozambique, a country with a generalized epidemic and low rate of male circumcision. There are three major findings: (1) Even the most modest of AMC programs would place great stress on human resources, and task-shifting might lead to more accidents or adverse events that would increase the cost per AMC. (2) The fiscal burden of AMC is surprisingly low, but a rapid scale-up of AMC poses additional fiscal stress for Mozambique's already under-funded public health system. (3) AMC as an HIV prevention tool is very robust in terms of its cost-effectiveness in Mozambique, even at a high AMC accident or complication rate. Any AMC roll-out in Mozambique would face severe constraints in the health system (namely human resources) that would likely limit the scale of an AMC program and perhaps its effectiveness against its generalized epidemic. PMID:18484318

Fieno, John Vincent

2008-05-01

203

Mobilizing demand for contraception in rural Gambia.  

PubMed

A community trial was conducted in rural Gambia in order to determine whether a community-based intervention designed to mobilize latent demand for contraception would increase use of modern contraceptives, even in the absence of improved availability of family planning services. Analysis of trial data indicates that the demand-mobilization intervention had a statistically significant positive effect on nonusers' adoption of modern contraception and that coterminous implementation of an intervention designed to improve access to services offered no additional benefit. The program component found to have the greatest impact was the "kabilo approach," in which village women provide basic health and family planning counseling to other women in their extended families. These results suggest that the principal barriers to increased contraceptive use in rural Gambia are psychosocial and that these barriers can be overcome through village-based interventions designed to provide socially appropriate counseling to potential contraceptive users. PMID:11198069

Luck, M; Jarju, E; Nell, M D; George, M O

2000-12-01

204

Social Transmission and the Spread of Modern Contraception in Rural Ethiopia  

PubMed Central

Socio-economic development has proven to be insufficient to explain the time and pace of the human demographic transition. Shifts to low fertility norms have thus been thought to result from social diffusion, yet to date, micro-level studies are limited and are often unable to disentangle the effect of social transmission from that of extrinsic factors. We used data which included the first ever use of modern contraception among a population of over 900 women in four villages in rural Ethiopia, where contraceptive prevalence is still low (<20%). We investigated whether the time of adoption of modern contraception is predicted by (i) the proportion of ever-users/non ever-users within both women and their husbands' friendships networks and (ii) the geographic distance to contraceptive ever-users. Using a model comparison approach, we found that individual socio-demographic characteristics (e.g. parity, education) and a religious norm are the most likely explanatory factors of temporal and spatial patterns of contraceptive uptake, while the role of person-to-person contact through either friendship or spatial networks remains marginal. Our study has broad implications for understanding the processes that initiate transitions to low fertility and the uptake of birth control technologies in the developing world. PMID:21799882

Alvergne, Alexandra; Gibson, Mhairi A.; Gurmu, Eshetu; Mace, Ruth

2011-01-01

205

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

2010-01-01

206

Shedding Rates and SeroPrevalence of Brucella melitensis in Lactating Goats of Shahrekord, Iran  

PubMed Central

Background: Brucellosis remains a major worldwide zoonosis. Caprine brucellosis is a significant problem for both public health and animal production. Brucella melitensis causes disease in goats, sheep, humans, and occasionally cattle. Transmission is by ingestion or contact with infected materials, vaginal discharge, or milk. Objectives: The current study aimed to determine the rate of B. melitensis seropositives and its probable shedding in lactating goats from flocks in Shahrekord district, Iran. Materials and Methods: In the current study, 1080 samples of milk, blood and vaginal swabs of 360 lactating goats (three samples from each animal) were randomly collected from 12 flocks in Shahrekord district. Serums from blood samples were examined by Rose Bengal plate (RBT) test and the titre of positives determined by tube agglutination test (TAT). Vaginal swab and milk (cream and sediment) samples were cultured on Brucella agar. Brucella spp. suspected pure cultures were incubated in the same conditions and then examined by Modified Zeil-Nelson (MZN) staining, oxidase and catalase tests. Positive isolates were examined by PCR. Results: Out of 360 serum samples, 50 (13.9%) were positive by RBT, and six (1/66%) were positive by TAT. Culturing of milk and vaginal samples lead to isolation of 12 (3.33%) and 10 (2.77%) Brucella spp. suspected colonies, respectively. The PCR examinations of these isolates showed that ten (2.77%) milk and 6 vaginal swab samples (1.66%) belonged to B. melitensis species. Eight goats (2.22%) had positive results in RBT, culture and PCR examinations, simultaneously. Conclusions: The regional distribution of caprine brucellosis and shedding of B. melitensis through vaginal secretions and milk secretions of lactating goats indicated that 50% and 83.33% of the goat flocks contained vaginal and milk shedders, respectively. PMID:25147691

Ebrahimi, Azizollah; Milan, Jalal Sheykh kanluye; Mahzoonieh, Mohamad Reza; Khaksar, Khadijeh

2014-01-01

207

The Male Role in Contraception: Implications for Health Education.  

ERIC Educational Resources Information Center

Many males still perceive contraception as a woman's responsibility. This paper describes male contraceptives and their effectiveness and draws implications for school and community health education professionals. More equitable sharing of the responsibility for contraception might result in more effective contraception. (PP)

Chng, Chwee Lye

1983-01-01

208

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.

2010-01-01

209

Psychological distress and post-abortion contraceptive method effectiveness level chosen at an urban clinic  

PubMed Central

Objective We investigated whether more psychological distress before an abortion is associated with the effectiveness of contraception selected (low, moderate, or high effectiveness) at an abortion clinic visit. Method Using data from 253 women attending an urban abortion clinic that primarily serves low-income women, we tested the association between pre-abortion psychological distress and the effectiveness level of post-abortion contraceptive choice. Based on typical use failure rates, we classified effectiveness of contraceptive choice into three levels—low, moderate, and high effectiveness. We measured psychological distress with four validated measures of depressive, anxious, and stress symptoms, and negative affect, as well as with a global measure comprised of these four measures. We used multivariable ordinal logistic regression to measure the association of each psychological distress measure with post-abortion contraceptive method effectiveness level, adjusting for sociodemographic factors, pregnancy history, trimester of abortion, and importance of avoiding pregnancy in the next year. Results We found that compared to women experiencing less stress symptoms, negative affect, and global psychological distress, women experiencing more stress symptoms [AOR = 1.028, 95% CI: 1.001-1.050], negative affect [AOR = 1.05, 95% CI: 1.01-1.09], and global psychological distress [AOR = 1.46, 95% CI: 1.09-1.95] were more likely to choose more effective versus less effective methods, ps < .05, in adjusted models. Using dichotomous psychological measures we found similar results. Conclusions Women experiencing more psychological distress before an abortion selected more effective contraceptive methods after their abortions. Future research should examine whether this distress is associated with subsequent contraceptive use or continuation. Implications The current study suggests that contraceptive providers should not assume that women experiencing more psychological distress prefer to use less effective contraceptive methods. PMID:24094755

Steinberg, Julia R.; Tschann, Jeanne M.; Henderson, Jillian T.; Drey, Eleanor A.; Steinauer, Jody E.; Harper, Cynthia C.

2013-01-01

210

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

PubMed

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

2014-04-01

211

Prevalence rates of male and female sexual violence perpetrators in a national sample of adolescents.  

PubMed

IMPORTANCE Sexual violence can emerge in adolescence, yet little is known about youth perpetrators-especially those not involved with the criminal justice system. OBJECTIVE To report national estimates of adolescent sexual violence perpetration and details of the perpetrator experience. DESIGN, SETTING, AND PARTICIPANTS Data were collected online in 2010 (wave 4) and 2011 (wave 5) in the national Growing Up With Media study. Participants included 1058 youths aged 14 to 21 years who at baseline read English, lived in the household at least 50% of the time, and had used the Internet in the last 6 months. Recruitment was balanced on youths' biological sex and age. MAIN OUTCOMES AND MEASURES Forced sexual contact, coercive sex, attempted rape, and completed rape. RESULTS Nearly 1 in 10 youths (9%) reported some type of sexual violence perpetration in their lifetime; 4% (10 females and 39 males) reported attempted or completed rape. Sixteen years old was the mode age of first sexual perpetration (n?=?18 [40%]). Perpetrators reported greater exposure to violent X-rated content. Almost all perpetrators (98%) who reported age at first perpetration to be 15 years or younger were male, with similar but attenuated results among those who began at ages 16 or 17 years (90%). It is not until ages 18 or 19 years that males (52%) and females (48%) are relatively equally represented as perpetrators. Perhaps related to age at first perpetration, females were more likely to perpetrate against older victims, and males were more likely to perpetrate against younger victims. Youths who started perpetrating earlier were more likely than older youths to get in trouble with caregivers; youths starting older were more likely to indicate that no one found out about the perpetration. CONCLUSIONS AND RELEVANCE Sexual violence perpetration appears to emerge earlier for males than females, perhaps suggesting different developmental trajectories. Links between perpetration and violent sexual media are apparent, suggesting a need to monitor adolescents' consumption of this material. Victim blaming appears to be common, whereas experiencing consequences does not. There is therefore urgent need for school programs that encourage bystander intervention as well as implementation of policies that could enhance the likelihood that perpetrators are identified. PMID:24100409

Ybarra, Michele L; Mitchell, Kimberly J

2013-12-01

212

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

PubMed

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

2014-11-01

213

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))

1991-08-01

214

Adolescent contraception: review and guidance for pediatric clinicians.  

PubMed

The majority of adolescents initiate sexual activity during their teenage years, making contraception an important aspect of routine adolescent health care. Despite common misperceptions, all available methods of reversible contraception are appropriate for adolescent use. Contraceptive side effects profiles and barriers to use of certain methods should be considered when providing contraceptives to adolescents. In particular, ease of use, confidentiality, and menstrual effects are main concerns of adolescents. Contraceptive counseling with adolescents should describe method efficacy, discuss user preferences, explore barriers to use, counsel regarding sexually transmitted infection prevention, and consider what to do if contraception fails. Emergency contraception should be widely discussed with adolescents, as it is appropriate for use during gaps in other contraceptive use, method failure, and adolescents who are not using another form of contraception. Dual method use (condom plus a highly effective method of contraception) is the gold standard for prevention of both pregnancy and sexually transmitted infections. PMID:25358846

Potter, J; Santelli, J S

2015-03-01

215

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

2009-01-01

216

CONTRACEPTION TECHNOLOGY: PAST, PRESENT AND FUTURE  

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.

2012-01-01

217

Contraception for women with heart disease.  

PubMed

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

2014-12-01

218

Political and economic factors influencing contraceptive uptake.  

PubMed

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

1993-01-01

219

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

2013-01-01

220

Knowledge and attitudes towards use of long acting reversible contraceptives among women of reproductive age in Lubaga division, Kampala district, Uganda  

PubMed Central

Background Uganda has one of the highest total fertility rates globally and in Sub-Saharan Africa. Her high fertility is mainly attributed to the high unmet need for family planning. Use of Long-acting reversible contraceptives (LARC) is low (13%) in Uganda yet they are the most cost-effective contraceptives. This study aimed to assess the reproductive aged women’s knowledge, attitudes, and factors associated with use of LARC. Methods A cross-sectional study was conducted involving 565 women (15–49 years) attending private and public health facilities in Lubaga division, Kampala district. Semi-structured questionnaires were used to measure knowledge, attitudes and factors associated with use of LARC; Intra-Uterine Devices, Implants and Injectables. The outcome variable was current use of LARC. A generalized linear regression model was run in STATA version12.0. Prevalence Risk Ratios for associations between current LARC use and independent factors were obtained and regarded significant at 95% CI with p?contraceptive choices adj.PRR 1.49; (95% CI 1.18, 1.88). Contrary, perception that LARC should be used by married women was negatively associated with use of LARC adj.PRR 0.63; (95% CI 0.44, 0.90). Conclusion Knowledge about site of administration, previous use of LARC and women’s attitude that male partners’ choice influence their contraceptive decisions were positively associated with current use of LARC. Contrary, the attitude that LARC was for married women was negatively associated with its use. This study suggests a need to strengthen client education about LARC to dispel possible myths and to consider integrating male partner’s decision making in contraceptive choices for women. PMID:24636154

2014-01-01

221

Students’ Perceptions of Contraceptives in University of Ghana  

PubMed Central

Objective This study sought to explore University of Ghana Business School diploma student's knowledge of contraceptives, types of contraceptives, attitudes towards contraceptive users, preference for contraceptives, benefits, and side-effects of contraceptives. Materials and methods Data was conducted with three sets of focus group discussions. Participants were systematically sampled from accounting and public administration departments. Results Findings showed that students had little knowledge of contraceptives. The male and female condoms were the main contraceptive types reported out of the many modern and traditional methods of contraceptives. The main benefits of contraceptives were; ability to protect against STIs, abortions, unwanted pregnancy and psychological trauma. Whilst most respondents preferred future use of pills, side-effects of contraceptives were mostly reported for condoms than other contraceptive methods. Results showed that participants had bad attitudes towards unmarried contraceptive users. Conclusion Generally, our findings show that detailed knowledge about contraceptives is low. There is a little gap of information on contraception knowledge, timing, and contraceptive types among university diploma students. Reproductive and maternal services should be available and accessible for tertiary students. PMID:24971101

Kayi, Esinam Afi

2013-01-01

222

Contraception and Induced Abortions for Women of Reproductive Age Married in Recent Years in Rural Areas of Shandong, China  

Microsoft Academic Search

Background: In 2001, the Chinese Government published the Population and Family Planning Law which gave citizens the right to know the facts about, and to choose, methods of birth control. Since then, the percentage use of different contraceptive methods has changed. More and more women have been using male condoms for birth control, which has resulted in an increasing prevalence

H. Li; D. Q. Li; Y. T. Diao

2009-01-01

223

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

1995-01-01

224

Family Planning Choices in Couples Using Contraception without Knowing They Are Infertile: Should NewlyWed Men Undergo a Routine Spermiogram?  

Microsoft Academic Search

Introduction: Newly-weds choose to use contraception either to spend the first years of their marriage more freely, because of economic reasons or because of the increase in working career women. We studied the reasons for infertility and the rate of contraception use in the first years of marriage among couples with primary infertility and evaluated the use of a spermiogram

Hakan Kiran; Deniz Cemgil Arikan; Ayhan Coskun; Mustafa Kaplanoglu; Gurkan Kiran; Ozgur Ozdemir; M. Turan Cetin

2012-01-01

225

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

2010-01-01

226

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

2014-01-01

227

Contraceptive use in Yemen: a component analysis.  

PubMed

The objective of this paper is to examine the role of modernization on current use of modern contraception in the Republic of Yemen. We used modernization theory as well as Ryder's cohort-historical model to investigate the change in fertility variables across cohorts. Data from Demographic and Health Surveys conducted in 1991 and 1997 in Yemen are used. It has been argued that in Islamic societies such as Yemen, the extent of contraceptive use is more likely to be determined by religious values than by external forces of change. However, our findings suggest that the social context of contraceptive use in Yemen is similar to the preconditions attained in societies that have experienced improvements in contraceptive use during the stage of fertility decline. We have discussed in detail the policy implications of our findings. PMID:18567952

Pillai, Vijayan K; Sunil, T S

2007-12-01

228

Truth about Oral Contraceptives and Acne  

MedlinePLUS

... 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 ...

229

Contraception and Birth Control: Other FAQs  

MedlinePLUS

... possible to become pregnant during the next menstrual cycle after stopping the pill, but it may take ... you return to the previous timing of your cycle.2 If you are using a contraceptive patch ...

230

The quest for a herbal contraceptive.  

PubMed

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

1993-01-01

231

Nurse-led management of contraceptive services.  

PubMed

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

2014-07-01

232

Prophylactic contraceptives for HIV\\/AIDS  

Microsoft Academic Search

The current pandemic of sexually transmitted human immunodeficiency virus (HIV) infection—the causative agent of acquired immunodeficiency syndrome (AIDS), has created an urgent need for a new type of contraceptive: one that is both a spermicide and a microbicide. Because most women at risk for HIV infection are of reproductive age (15-44 years), effective use of dual-function contraceptives is important to

Fatih M. Uckun; Osmond J. D'Cruz

233

Counseling and provision of long-acting reversible contraception in the US: National survey of nurse practitioners  

PubMed Central

Objective Nurse practitioners (NPs) provide frontline care in women’s health, including contraception, an essential preventive service. Their importance for contraceptive care will grow, with healthcare reforms focused on affordable primary care. This study assessed practice and training needs to prepare NPs to offer high-efficacy contraceptives - IUDs and implants. Method A US nationally representative sample of nurse practitioners in primary care and women’s health was surveyed in 2009 (response rate 69%, n=586) to assess clinician knowledge and practices, guided by the CDC US Medical Eligibility Criteria for Contraceptive Use. Results Two-thirds of women’s health NPs (66%) were trained in IUD insertions, compared to 12% of primary care NPs. Contraceptive counseling that routinely included IUDs was low overall (43%). Nurse practitioners used overly restrictive patient eligibility criteria, inconsistent with CDC guidelines. Insertion training (aOR=2.4, 95%CI: 1.10 5.33) and knowledge of patient eligibility (aOR=2.9, 95%CI: 1.91 4.32) were associated with IUD provision. Contraceptive implant provision was low: 42% of NPs in women’s health and 10% in primary care . Half of NPs desired training in these methods. Conclusion Nurse practitioners have an increasingly important position in addressing high unintended pregnancy in the U.S., but require specific training in long-acting reversible contraceptives. PMID:24128950

Harper, Cynthia C.; Stratton, Laura; Raine, Tina R.; Thompson, Kirsten; Henderson, Jillian T.; Blum, Maya; Postlethwaite, Debbie; Speidel, J Joseph

2013-01-01

234

Letter: Oral contraceptives and vitamin requirements.  

PubMed

Most women who use oral contraceptives should take daily vitamin supplements in dosages that are carefully regulated to avoid excesses of particular vitamins. Requirements for riboflavin, thiamine, B12, and B6 may be increased by the use of oral contraceptives, whereas niacin requirements may be reduced. Fat-soluble vitamins are also influenced by oral contraceptives. There is evidence of increases in plasma Vitamin-A and decreases in plasma tocopherols in users of oral contraceptives; Vitamin-D, Vitamin-K, and biotin, however, have not been shown to be affected. Normalization of vitamin status can be effected fairly quickly by use of a daily multivitamin. Desirable doses are as follows: ascorbic acid, 400-500 mg; ribovlavin, 10 mg; B6, 5 mg; B12, 4 mcg; and d-alpha-tocopherol, 10 mg; optimal thiamine intake is not known . Clinical signs of hypovitaminosis include depression, susceptibility to infections, and skin signs, all of which were found in users of oral contraceptives in an epidemiological survey of 46,000 women in Great Britain. Adverse psychological, dermatological, and hematological side effects of oral contraceptives have also responded to vitamin therapy. Routine prophylactic prescription of carefully formulated supplemental vitamin mixtures is recommended. PMID:1143135

Briggs, M; Briggs, M

1975-03-22

235

Determinants of Contraceptive Practices Among Eligible Couples of Urban Slum in Bankura District, West Bengal  

PubMed Central

Background: Primary care physicians should be aware of the alarming population growth in the developing countries including India. Objectives: To find couple protection rate (CPR) and risk variables that affect contraceptive practice among eligible couples in an urban slum of Bankura district. Materials and Methods: A cross-sectional observational study of 3 months was undertaken on 200 eligible couples in Bakultala urban slum, Lokepur, Bankura district, West Bengal to get relation between various factors that could affect contraceptive practices. Results: Majority of the study population (59%) was young adults (20–29 years age); 65% belonged to nuclear families; one-third were married in less than 18 years of their age. CPR was 67.50%; 49% used permanent methods. Among contraceptive users, significantly higher numbers of couples were married during 18–24 years of age (75%), belonged to nuclear family (70%), literate up to class 10 (73%), having three or more living children (77.50%), and from socioeconomic status of class II (80%). Female literacy rate was higher than national average; 92.50%wives of eligible couple were literate; and tubectomy was commonest contraceptive methods. Conclusion: CPR was high, though different factors like age at marriage, type of family, number of living children, literacy status of female partner, and socioeconomic status significantly affected contraceptive behavior of the study population. PMID:25657949

Gupta, Avisek; Roy, Tapas Kumar; Sarker, Gautam; Banerjee, Bratati; Ghosh, Somenath; Pal, Ranabir

2014-01-01

236

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.

2013-01-01

237

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

PubMed

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

2013-07-01

238

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

2014-01-01

239

Knowledge, Perceptions, and Motivations for Contraception: Influence on Teens' Contraceptive Consistency  

ERIC Educational Resources Information Center

Using data from the National Longitudinal Study of Adolescent Health, the authors examine the association between contraceptive use patterns in teens' first sexual relationships and their knowledge of, perceptions of, and motivations for contraception and pregnancy prevention. Results from logistic regression analyses show that knowledge,…

Ryan, Suzanne; Franzetta, Kerry; Manlove, Jennifer

2007-01-01

240

Use of hormonal contraceptives among immigrant and native women in Norway: data from the Norwegian Prescription Database  

PubMed Central

Objective To examine the use of hormonal contraceptives among immigrant and native women in Norway. Design Nationwide registry-based study based on merged data from the Norwegian Prescription Database, the Norwegian Population Registry, the Regular General Practitioner Database and the Medical Birth Registry. Setting Norway. Sample All women born abroad to two foreign-born parents (immigrants), or born in Norway to two Norwegian-born parents (natives) aged 16–45 years, who lived in Norway in 2008. Methods Data on all collected supplies of hormonal contraceptives in 2008 were merged with demographic, socio-economic and immigration data, information on any delivery and women's general practitioners. Main outcome measures User rates of hormonal contraception and predictors of contraceptive use. Results A total of 893 073 women were included, of whom 130 080 were immigrants. More native women (38%) used hormonal contraceptives compared with all immigrant groups (15–24%). The odds ratios for any use of hormonal contraceptives for immigrants compared with Norwegian-born women were; Nordic countries 0.53, South and Central America 0.53, Western countries 0.39, Asia 0.30, Eastern Europe 0.29, Africa 0.29. Work, education, long stay in Norway and young age of immigration predicted the use of hormonal contraceptives among immigrants. Conclusions The use of hormonal contraceptives varies between natives and immigrant groups. Further work is needed to ascertain whether these differences can be explained by higher desires for fertility, preferential use of non-hormonal contraceptives or other reasons identified through qualitative research. PMID:24931487

Omland, G; Ruths, S; Diaz, E

2014-01-01

241

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

PubMed

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

2014-06-01

242

[Chen Muhua holds meeting on contraceptives].  

PubMed

On February 19, Chen Muhua, vice premier of the State Council and head of the family planning leading group, held a discussion with responsible comrades of the State Council's Family Planning Office, the State Pharmaceutical Administration, the Ministry of Chemical Industry, the State Planning Commission, the Ministry of Finance and other departments concerned with the production and supply of contraceptive drugs and devices. Vice Premier Chen Muhua pointed out: Contraceptive drugs and devices are the material guarantees for the practice of family planning. Doing a good job in the production and supply of contraceptives is a political task. It is hoped that from now on all departments concerned will pay still greater attention to it. Vice Premier Chen Muhua put forward 4 points: 1. To control population, the stress should be placed on contraception. This is the basic way. 2. It is necessary to popularize in an all-round way methods of using contraceptive drugs and devices. 3. Supply channels should be kept open for the convenience of the masses and to guarantee supplies. 4. It is necessary to strengthen scientific research. The quality and packing of presently available drugs and devices should be improved. At the same time, it is necessary to develop new contraceptive drugs and devices welcomed by the masses. Special efforts should be made in research in the field of Chinese herbal medicine. At the meeting the State Council Family Planning Office and the State Pharmaceutical Administration were instructed to conduct a joint investigation on present production arrangements and supply channels of contraceptive drugs and devices and to adopt effective measures to solve existing problems. PMID:12279148

1981-02-26

243

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

2013-01-01

244

Reasons for ineffective pre-pregnancy contraception use in patients seeking abortion services  

PubMed Central

Background We sought to better understand reasons for not obtaining desired contraception among women presenting for a pregnancy termination. Study design A survey was completed by women prior to having an abortion procedure. Reasons for lack of access were categorized as institutional, individual and compliance issues. Descriptive statistics were calculated and variables compared using chi-square tests. Results Participants (n=298) ranged in age from 18–48 years. One third reported contraceptive use prior to pregnancy (37%). Approximately 72% of women reported some reason for not obtaining desired contraception, while 34% reported 2 or more. The distribution of reported individual, institutional, and compliance reasons were 44%, 28%, and 24%, respectively. Report of at least one reason was associated with a 35% increase in non-use (RR=1.35, 95% CI 1.02–1.80) after adjusting for age, race, education, parity and prior abortion. Conclusions Many reasons for not obtaining desired contraception exist and are associated with non-use of contraception. Removing these reasons may help reduce unintended pregnancies and rates of pregnancy termination. PMID:19913152

Homco, Juell B.; Peipert, Jeffrey F.; Secura, Gina M.; Lewis, Vanessa A.; Allsworth, Jenifer E.

2011-01-01

245

Practice and methods of contraception among Saudi women in Riyadh.  

PubMed

The use of contraceptives can have an impact on better spacing between children, better child care, improvement of children's health and preservation of the mother's health. In this study 2675 Saudi women attending a gynaecology out-patient clinic were interviewed about their contraceptive practices. The majority of the women (56.0%) were using or had used some form of contraceptive. Oral contraceptives were the most common method; 94.8% of the 1497 women who practised contraception were using or had used this form of contraception. Sterilization accounted for 0.9% of contraceptive practices, while the intrauterine device was a more common form of contraceptive among the more educated women. PMID:3391353

Jabbar, F A; Wong, S S; Al-Meshari, A A

1988-06-01

246

Prevention of unintended pregnancy: a focus on long-acting reversible contraception.  

PubMed

This article summarizes the literature regarding the epidemiology and prevention of unintended pregnancy in the United States. Because of the Affordable Care Act and its accompanying contraceptive provision, there is a need for more primary care clinicians to provide family planning services. Office-based interventions to incorporate family planning services in primary care are presented, including clinical tools and electronic health record use. Special attention is paid to long-acting reversible contraceptive methods (the subdermal implant and intrauterine devices); these highly effective and safe methods have the greatest potential to decrease the rate of unintended pregnancy, but have been underused. PMID:24830607

Pickle, Sarah; Wu, Justine; Burbank-Schmitt, Edith

2014-06-01

247

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

PubMed

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

2013-11-01

248

HEALTH MATTERS Frequently Asked Questions About the Contraceptive Patch  

E-print Network

patch? The contraceptive patch is a highly effective, weekly hormonal birth control patch that is worn does it work? The contraceptive patch prevents pregnancy the same way that birth control pills do. Certain drugs may interact with hormonal birth control, including the contraceptive patch, to make them

Yener, Aylin

249

Young Adults' Contraceptive Practices: An Investigation of Influences.  

ERIC Educational Resources Information Center

Investigated unmarried young adults' (N=283) contraceptive behaviors and attitudes. Results suggest that effective contraceptive behavior associated most strongly with respondents' perceiving relatively few barriers to their use of contraception, their maintenance of extensive interpersonal skills, and their regarding peer norms as consistent with…

Lowe, Candace S.; Radius, Susan M.

1987-01-01

250

Erythema nodosum associated with pregnancy and oral contraceptives  

Microsoft Academic Search

Erythema nodosum recurred in a woman during each of her four pregnancies and every time she was started on oral contraceptives. The lesions always disappeared in the fifth month of gestation or when contraceptives were withdrawn. Erythema nodosum is mediated by immune mechanisms, and both pregnancy and oral contraceptive use can interfere with the immune system. The concentrations of oestrogen

S Bombardieri; O D Munno; C Di Punzio; G Pasero

1977-01-01

251

Trends in Sexual Activity and Contraceptive Use among Teens. Child Trends Research Brief.  

ERIC Educational Resources Information Center

The current research and policy debate over why teen pregnancy and birth rates have declined in the 1990s has focused on whether increased abstinence or increased contraceptive use is primarily responsible. This research brief indicates that both factors appear to be contributing factors. It finds that: (1) the percentage of teens who reported…

Terry, Elizabeth; Manlove, Jennifer

252

Preparing Daughters: The Context of Rurality on Mothers' Role in Contraception  

ERIC Educational Resources Information Center

Context: The United States continues to have the highest rate of adolescent childbearing among developed countries. Lack of access and disadvantage contribute to this problem, which disproportionately impacts rural women. Given the increased difficulty rural young women face regarding contraceptive access, parental communication and support play…

Noone, Joanne; Young, Heather M.

2009-01-01

253

Having a Say Matters: Influence of Decision-Making Power on Contraceptive Use among Nigerian Women Ages 35–49 Years  

PubMed Central

Background Research suggests that women of reproductive age who are involved in household decision-making are more likely than those who are not involved to be able to control their fertility. Little is known, however, about this relationship among women at the upper end of the reproductive spectrum. The aim of this study was to determine the association between household decision-making power and modern contraceptive use among Nigerian women ages 35–49 years. Methods A descriptive, cross-sectional study involving a secondary analysis of data from the Nigerian 2008 Demographic and Health Survey was conducted among women ages 35–49 years who were considered to be in need of contraception. The outcome was modern contraceptive use while the main independent variable was a woman's household decision-making power score, constructed using principal component analysis. Multivariate logistic regression was performed to determine whether the women's household decision-making power score, categorized into tertiles, was independently associated with modern contraceptive use. Data were weighted and adjusted for the complex survey design. Results Prevalence of modern contraceptive use among Nigerian women deemed to be in need of contraception in this study was 18.7%. Multivariate logistic regression showed that women's decision-making power remained statistically significantly associated with modern contraceptive use, even after adjusting for age, education, religion, polygyny, parity, wealth and domicile. Women who were in the highest decision-making power tertile had more than one and a half times the odds of using modern contraception compared with women in the lowest tertile [Adjusted Odds Ratio?=?1.70; 95% Confidence Interval?=?1.31–2.21, p<0.001]. Significance Older Nigerian women who are involved in making household decisions are also able to make decisions related to their fertility. Programs in Nigeria focused on increasing modern contraceptive use should include strategies to increase women's status through encouraging more visible involvement in decision-making across different spheres of their lives. PMID:24897300

OlaOlorun, Funmilola M.; Hindin, Michelle J.

2014-01-01

254

[Cutaneous effects in hormonal contraception].  

PubMed

Oral contraceptives (OCs) can affect the skin through their hormonal effects or through iatrogenic effects associated with their toxicity in certain individuals. They may also be beneficial in certain androgen-dependent dermatoses. Toxic effects of OCs are rare but potentially serious; they should be diagnosed early and require permanent termination of OC use. The clinical manifestations are variable and not specific to the medication. The most frequently reported manifestations are allergic vascularities which may lead to serious renal complications, fixed pigmented erythema, urticaria, which may have other etiologic factors, and lichenoid eruptions. Combined OCs, because of their estrogen content, may cause sensitivity to light in susceptible women. Other dermatoses can be initiated or aggravated by OCs without direct relation to their hormonal effects. OCs are therefore contraindicated if there is a personal or family history of porphyries or a personal history of systemic lupus erythematosus, erythema nouex, herpes gestationis, or malignant melanoma. Hormonal-related dermatological effects caused by either progestins or estrogens have become less frequent as dose levels have declined. Chloasma, either melasma or a poorly defined spotty pigmentation, accounts for 2/3 of cases of OC-related dermatoses. It is more common in women of Mediterranean background. 80% of affected OC users have a history of "mask of pregnancy", but the condition is also found in nulliparas. Exposure to sunlight is a factor. Women with a history of chloasma of pregnancy and dark coloring should not use OCs. Seborrhea is directly related to the androgen effect of OCs and is less likely to occur with 17 OH progesterone derivatives than with 19 norsteroid derivatives. The role of androgens in acne is well known, but 2 other factors are necessary: an anomaly in keratinization and proliferation of corynebacterium acnes, a saprophyte of the follicles. OCs do not necessarily need to be suspended during well-conducted acne treatment. Alopecia is rare but difficult to diagnose because of its psychological aspects. Androgenic alopecia is aggravated by progestins derived from 19 norsteroids. True hirsutism caused by an androgen-producing ovarian pathology is not related to OC use. Estrogens are incriminated in the etiology of telangiectasies, permanent dilatations of the arterioles. Once developed the condition does not regress and requires treatment with sclerosing agents, electrocoagulation, or laser. The various dermatological risk factors should be ruled out before prescription of an OC. Classic contraceptive pills are not commonly used in treatment of common acne because the strongly estrogenic climate required for therapeutic utility carries the risk of hypertriglyceridemia, thrombophlebitis, and possibly carcinogenesis. The recent development of pills containing the antiandrogen cyproterone acetate instead of a progestin in combination with ethinyl estradiol reduces androgenic effects in women. This pill may be useful in cases of severe acne, severe seborrhea, androgenic alopecia, or excessive facial hair. PMID:12281276

Thomas, P; Dalle, E; Revillon, B; Delecour, M; Devarenne-nicolle, M F; Pagniez, I

1985-01-01

255

Prevalence and Correlates of Self-Rated Posttraumatic Stress Disorder and Complicated Grief in a Community-Based Sample of Homicidally Bereaved Individuals.  

PubMed

People confronted with homicidal loss have to cope with separation distress, related to their loss, and traumatic distress, associated with the circumstances surrounding the death. These reactions are related to complicated grief (CG) and posttraumatic stress disorder (PTSD). The psychological effects for people who have lost someone through homicide, in terms of PTSD and CG, are largely unclear. This cross-sectional study (a) examined the prevalence of self-rated PTSD and self-rated CG in a community-based sample of 312 spouses, family members, and friends of homicide victims and (b) aimed to identify socio-demographic, loss-related, and perpetrator-related correlates of PTSD and CG. Participants were recruited via support organizations for homicidally bereaved individuals in the Netherlands (i.e., support group), and by casemanagers of a governmental organization, which offers practical, non-psychological, support to bereaved families (i.e., casemanager group). Prevalence of self-rated PTSD was 30.9% (support group) and 37.5% (casemanager group), prevalence of CG was 82.7% (support group) and 80.6% (casemanager group). PTSD and CG severity scores varied as a function of the relationship with the victim; parents were at greater risk to develop emotional problems, compared with other relatives of the victim. Time since loss was negatively associated with PTSD and CG scores. PMID:25389188

van Denderen, Mariëtte; de Keijser, Jos; Huisman, Mark; Boelen, Paul A

2014-11-10

256

Contraceptive applications of progesterone receptor modulators.  

PubMed

Currently developed progesterone receptor modulators (PRMs) are steroid-derived compounds with mild or potent antiprogestin activity. PRMs may exert a contraceptive activity by different mechanisms such as blockade of ovulation and endometrial desynchronization. Their potential clinical applications are manifold and are very promising in major public health areas, including emergency contraception, long term oestrogen-free contraception (administered alone, or in association with a progestin-only pill to improve bleeding patterns), endometriosis and myoma treatment. The mechanisms of their anti-ovulatory effects and of the endometrial modifications elicited during long term PRM treatment are still not fully elucidated. In future clinical applications, PRMs will be administered orally, via intrauterine systems or vaginal rings. PMID:18821461

Chabbert-Buffet, Nathalie; Ouzounian, Sophie; Kairis, Axelle Pintiaux; Bouchard, Philippe

2008-09-01

257

Peri-Abortion Contraceptive Choices of Migrant Chinese Women: A Retrospective Review of Medical Records  

PubMed Central

Background Migrant Asian women reportedly have low levels of contraceptive use and high rates of abortion in New Zealand. Chinese make up the largest proportion of migrant Asian in New Zealand. This study aimed to describe the contraceptive choices of Chinese women seeking abortion; to examine method choice in relation to demographic characteristics (including length of stay) and to determine whether Chinese women were over-represented among abortion clinic attendees. Methods Retrospective review of medical records at a public hospital abortion clinic involving 305 Chinese women. Previously collected data for European (n?=?277) and Maori women (n?=?128) were used for comparative analyses. Regression analyses explored correlates of contraceptive method choice. Population census data were used to calculate rates of clinic attendance across ethnic groups. Results Chinese women were not over-represented among clinic attendees, and had similar rates of contraceptive non-use pre-abortion as women in comparison groups. Use of the oral contraceptive pill by Chinese was lower pre-abortion than for other ethnic groups, but choice of this method post-abortion was similar for Chinese (46.9%, 95% CI 41–52.7) and European women (43.7%, 95% CI 37.8–49.7). Post-abortion choice of an intrauterine device did not differ significantly between Chinese (28.9%, 95% CI 23.8–34.3) and Maori women (37%, 95% CI 28.4–45.7), but was higher than uptake of this method by European women (21.7%, 95% CI 17–27.0). Age, parity and previous abortion were significant predictors of post-abortion method choice by Chinese women (p<0.05). Conclusions Following contraceptive counseling at the clinic, Chinese women chose more effective contraceptive methods for use post-abortion than they had used previously. As the population of migrant Chinese in New Zealand continues to increase, strategies are urgently needed to provide new arrivals with appropriate information and advice about contraception and where to access it, so women can be better prepared to avoid unplanned pregnancy. PMID:22768231

Rose, Sally B.; Wei, Zhang; Cooper, Annette J.; Lawton, Beverley A.

2012-01-01

258

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

2014-01-01

259

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

2014-01-01

260

Contraception choice for HIV positive women.  

PubMed

UNAIDS/WHO estimates that 42 million people are living with HIV/AIDS worldwide and 50% of all adults with HIV infection are women predominantly infected via heterosexual transmission. Women with HIV infection, like other women, may wish to plan pregnancy, limit their family, or avoid pregnancy. Health professionals should enable these reproductive choices by counselling and appropriate contraception provision at the time of HIV diagnosis and during follow up. The aim of this article is to present a global overview of contraception choice for women living with HIV infection including effects on sexual transmission risk. PMID:15169996

Mitchell, H S; Stephens, E

2004-06-01

261

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

2014-01-01

262

Contraceptive use among clients of the Atlanta Feminist Women's Health Center at three to five weeks post-abortion.  

PubMed

Little is known about women's contraceptive use and sexual activity in the immediate post-abortion period although effective contraceptive use is paramount during this time because fertility returns almost immediately. This study sought to learn more about women's contraceptive use and sexual behaviors to inform abortion providers and help them serve their clients better, potentially leading to a decline in the rates of unintended pregnancy and repeat abortion. Abortion clients of an Atlanta, GA clinic were surveyed over the telephone 3-5 weeks post-abortion. Background information was collected from clinic medical charts. Simple and stratified frequencies and logistic regression were used to describe women's sexual activity and contraceptive use in the immediate post-abortion period and to determine if variables known at the time of the abortion could predict contraceptive use 3-5 weeks post-abortion. 54.2% (n = 39) of women had engaged in sexual intercourse in the immediate post-abortion period. Of these, 30.8% (n = 12) were not using a contraceptive method or were not using it effectively. Women who said they did not want or need information about birth control on their medical history form were less likely to be using contraception 3-5 weeks post abortion. Emphasizing the rapid return of fertility and risk of conception in pre-abortion counseling sessions could prevent future unintended pregnancies among abortion clients. Further research could explore the interaction between a willingness to talk about contraceptive methods at the time of abortion and method use post-abortion. PMID:20602161

Moslin, Trisha A; Rochat, Roger W

2011-08-01

263

Romanian FPA (SECS) starts sexual and contraceptive consultations on the Black Sea coast.  

PubMed

The youth activities of the Romanian family planning association, the Society for Education on Contraception and Sexuality (SECS), center on a youth camp at the seaside resort of Costinesti. A very small consulting room set up 1) to supply education information on contraceptive methods, family planning, STDs, and major sex problems, and 2) supplying condoms. Staff included 11 physicians of whom 3 were obstetrics specialists, 4 nurses, 1 biologist, 1 demographer, 2 economists, and 1 engineer. Within an 80 day period, there were 1345 consultations, or 17/day. 72% were males and 28% females. The explanations for the higher male rate were attributed to reservations of women toward sexual issues, a higher number of sexual problems and STDs among males, and the perceived need for condoms by men. 33.8% were 20-24 years and 17.5% were less than 20 years. 80% of the sexual problems were related to anxiety about unwanted pregnancy and the natural method of coitus interruptus. 77.4% had questions related to contraception. The next highest concern was for STDs at 12%; the negative image of STDs prevails. Other concerns were for sexual problems, anatomy and physiology, pregnancy and birth, and demographic problems in general. AIDs was a disputed topic. 1121 out of 1345 client acquired condoms, 95% of the men and 53% of the women. The requested purpose was primarily contraceptive; men were more worried about STDs than women. A workshop for girls 14-16 was conducted separately which discussed anatomy and physiology. Effective broadcasting from the local radio station increased the number of consultations. Another workshop with representatives from a yoga school also was held; topics were yoga as a contraceptive means, therapy for sexual problems, and benefit to AID's sufferers. The author concludes that knowledge is low and interest high for contraception. PMID:12343176

Vinereanu, D

1991-05-01

264

Patient adherence with the contraceptive patch dosing schedule versus oral contraceptives  

Microsoft Academic Search

Objective: To evaluate patient compliance with a novel contraceptive patch (EVRA) versus two oral contraceptive (OC) regimens.Methods: In three international studies (002\\/003\\/004), subjects were randomly (003\\/004) assigned to treatment with either: EVRA (designed to deliver 150 ?g of 17-deacetylnorgestimate [17d-NGM] and 20 ?g of ethinyl estradiol [EE] daily) (n = 3,329; studies 002\\/003\\/004), oral desogestrel 150 ?g \\/EE 20 ?g

George Creasy; Nancy Hall; Gary Shangold

2000-01-01

265

Contraceptive efficacy of the personal hormone monitoring system Persona.  

PubMed

This is a commentary on the contraceptive effectiveness of the personal hormone-monitoring system Persona; it points out the various errors committed in computing method pregnancy rates. The modifications presented by Bonnar et al. on the incorrect procedure for computing method pregnancy rates are criticized as erroneous because the denominator includes cycles in which there is no risk of a method pregnancy according to the authors' algorithm for classifying pregnancy in an imperfect-use cycle. It is also claimed that the new exercise is a more complicated and less accurate way of computing for pregnancy rates by comparison with the simpler alternative. Since this new algorithm, used in the Persona system, is based on flawed logic, the annual risk of pregnancy is actually higher than the estimated 6% among women using Persona and having intercourse in each cycle except on red days. PMID:10454651

Trussell, J

1999-07-01

266

Vector-borne disease surveillance in puerto rico: pathogen prevalence rates in canines ? Implications for public health and the u.s. Military ? Applying the one health concept.  

PubMed

Vector-borne diseases (VBDs) make up a large number of emerging infectious and zoonotic diseases. Vectors such as ticks, fleas, and mosquitoes parasitize dogs, thus making canine populations adequate reservoirs for infectious disease and zoonoses. The U.S. military deploys its personnel and Military Working Dogs (MWDs) throughout the world with possible risk of exposure to VBDs. Canine VBDs continue to have veterinary and public health significance for the host nations as well as for deployed U.S. personnel and MWDs. Thus, ongoing and consistent disease surveillance is an essential component to preserve health. The purpose of this study was to survey dogs from multiple cities and varying regions throughout Puerto Rico to determine the prevalence of ehrlichiosis (Ehrlichia canis), anaplasmosis (Anaplasma phagocytophilum), Lyme disease (Borrelia burgdorferi), and heartworm disease (Dirofilaria immitis) from May to July 2012. Canine blood samples (1?3 ml) from the cities of San Juan (n = 629), Guaynabo (n = 50), Ponce (n = 20) and Vieques Island (n = 53) were obtained and tested on-site using an IDEXX SNAP? 4Dx? (enzyme-linked immunosorbent assay) test kit. Prevalence for single or multiple disease status was calculated for each site. The overall period prevalence of VBD in Puerto Rico in the shelter population was 57.7% (71/123). In Guaynabo, the VBD prevalence was 30% (15/50); 2 (13%) of these positive dogs had VBD co-infection. In the coastal port city of Ponce, it was 60% (12/20); 6 (50%) dogs were infected by two or more VBDs. On Vieques Island, it was 83% (44/53); 27 (61%) dogs were coinfected. Conversely, samples collected at the Fort Buchanan Veterinary Clinic in the capitol city of San Juan resulted in a VBD prevalence of 8.9% (56/629). Lyme disease was not detected in any sample. This study showed the presence of D. immitis, E. canis, and A. phagocytophilum in all four sites of Puerto Rico, emphasizing the value of surveillance for VBDs to determine disease prevalence, complete risk assessments, and impleme t timely preventive medicine and other preventive measures. The lower VBD prevalence rate in the canine samples from Fort Buchanan demonstrates the value of responsible pet ownership and importance of preventive medicine and public health. PMID:23817880

McCown, Michael E; Opel, Taylor; Grzeszak, Benjamin

2013-01-01

267

Contraception, venous thrombosis and biological plausability.  

PubMed

Exogenous use of hormones leads to different impact on coagulation. Usually estrogen leads to an activation of coagulation, while use of progestogens alone do not. Combined oral contraceptives (COC) differs significantly regarding VTE risk depending on amount of estrogen and type of progestagen: COC containing desogestrol, gestoden or drospirenone in combination with ethinyl-estradiol (EE) (so called 3rd or 4th generation COC) are associated with a higher VTE risk than COC with EE and levonorgestrel or norethisterone (so called 2nd generation COC). The VTE risk for transdermal COC like vaginal ring (NuvaRing) or patch (Evra) is as high than than for COC of 3rd or 4th generation. 2nd generation COC should therefore be the first choice when prescribing hormonal contraception. Most PROGESTAGEN-only contraceptive methods do not increase VTE risk significantly. In patients with a history of venous thromboembolism (VTE) and /or a known thrombophilic defect COC are contraindicated, but progestagen-only contraceptives can be safely used in this patient group. New kinds of COC without EE but with Estradiolvalerat or Estradiol showed a much lower degree of coagulation activation than "classical" COC containing EE. If newer COC with Estradiolvalerat or Estradiol have a lower VTE risk, remains to be elucidated. PMID:23514992

Rott, H

2013-04-01

268

Experimental Gingivitis in Women Using Oral Contraceptives  

Microsoft Academic Search

Oral contraceptives (OC) have historically been considered a risk factor for gingival diseases. We set out to investigate this premise further, given that, over recent years, hormone concentrations in OC have been substantially reduced. Using a prospective, split-mouth, experimental gingivitis model, pre-menopausal women either taking (n = 14) or not taking (n = 16) OC refrained from all oral hygiene

P. M. Preshaw; M. A. Knutsen; A. Mariotti

2001-01-01

269

Progress and prospects in male hormonal contraception  

PubMed Central

Purpose of review Testosterone functions as a contraceptive by suppressing the secretion of luteinizing hormone and follicle-stimulating hormone from the pituitary. Low concentrations of these hormones deprive the testes of the signals required for spermatogenesis and results in markedly decreased sperm concentrations and effective contraception in a majority of men. Male hormonal contraception is well tolerated and acceptable to most men. Unfortunately, testosterone-alone regimens fail to completely suppress spermatogenesis in all men, meaning that in some the potential for fertility remains. Recent findings Because of this, novel combinations of testosterone and progestins, which synergistically suppress gonadotropins, have been studied. Two recently published testosterone/progestin trials are particularly noteworthy. In the first, a long-acting injectable testosterone ester, testosterone decanoate, was combined with etonogestrel implants and resulted in 80–90% of subjects achieving a fewer than 1 million sperm per milliliter. In the second, a daily testosterone gel was combined with 3-monthly injections of depot medroxyprogesterone acetate producing similar results. Summary Testosterone-based hormone combinations are able to reversibly suppress human spermatogenesis; however, a uniformly effective regimen has remained elusive. Nevertheless, improvements, such as the use of injectable testosterone undecanoate, may lead to a safe, reversible and effective male contraceptive. PMID:18438174

Amory, John K.

2009-01-01

270

Parental Involvement and Young Women's Contraceptive Use  

ERIC Educational Resources Information Center

Young adult women in the United States tend to delay family formation, pursue higher education and professional jobs, and become sexually active before marriage. Using effective contraception is the best way to ensure that nonmarital parenthood does not disrupt educational and career plans. Because parental involvement in education shapes…

Frisco, Michelle L.

2005-01-01

271

[Update on the progestin-only contraception].  

PubMed

Despite the lack of complete data concerning their effects, the use of progestin-only contraception is increasing in France (particularly the intra-uterine device, the subdermal implantation, and microprogestins). These prescriptions include a broad range of molecules and administration of doses. In some cases, prescriptions of progestogens are made out of the marketing authorisation indications (especially for macroprogestins). For all of these reasons, an Expert Advisory Board has been set up in order to answer the 35 questions addressed by an Expert Organization Board. The choice of these questions was based on controversial or nonconsensual points usually encountered in everyday clinical practice. When possible, answers given were strongly supported by data issued from medical literature. In situations where clinical studies were lacking, the Expert Advisory Board answered in the most consensual way. All answers given by the Expert Advisory Board were subsequently submitted to the Expert Assessment Board before the latest validation of this document. The progestogen only contraception has different levels of action (local and/or central) which may vary from one drug to another. Its prescription is granted satisfactory efficacy (the macroprogestins' efficacy has never been evaluated) but requires a strict pill-taking routine (especially for the microprogestin contraception). It has never been demonstrated that the use of progestogen is associated with an increased risk of breast cancer. Nevertheless, analysis of breast cancer and progestogen studies should be carried out carefully. Even though the effects, often misunderstood, of the different progestogens on mineral bone density are likely to vary according to the molecules, in particular due to the plasma estradiol level, there is no direct argument for considering the progestin only contraception as a fracture risk factor. As for the venous thromboembolism risk, progestogens are not considered to be risk factors. The progestogen only contraception is advised in the following cases: bad tolerance of exogenous oestrogens; in order to counteract an endogenous hyperoestrogenosis; metabolic or cardiovascular contraindications to estroprogestin; hormonal fluctuations generating premenstrual dysphoria or catamenial headaches. Lastly, the progestin-only contraception should be used as a prime contraception in some particular situations (breast feeding, adenomyosis...). PMID:18824306

Madelenat, P; Koskas, M

2008-11-01

272

Satisfaction and compliance in hormonal contraception: the result of a multicentre clinical study on women's experience with the ethinylestradiol/norelgestromin contraceptive patch in Italy  

PubMed Central

Background For many women finding the right contraceptive method can be challenging and consistent and correct use over a lifetime is difficult. Even remembering to take a birth control pill every day can be a challenge. The primary objective of this study was to evaluate women's experience with a weekly ethinylestradiol/norelgestromin contraceptive patch (EE/NGMN patch), given new technologies recently developed in hormonal contraception to increase women's options in avoiding daily dosing. Methods In 24 Italian sites, 207 women received the EE/NGMN patch for up to 6 cycles. At study end, overall satisfaction and preference, as well as compliance, efficacy and safety, were evaluated. Results 175 women (84.5%) completed the study. The overall satisfaction rate was 88%; convenience and once-a-week frequency of the patch were especially appreciated. At baseline, 82 women (39.4%) were using a contraceptive method, mainly oral contraceptives and barrier methods, but only 45.1% were very satisfied/satisfied; after 6 months with the patch, 86.3% of this subset was very satisfied/satisfied. Considering the method used in the 3 months before the study entry, 78.1% strongly preferred/preferred the patch, for convenience (53.9%), ease of use/simplicity (28.9%), fewer (9.2%) and less severe (2.6%) side effects. Compliance was very high: 1034/1110 cycles (93.2%) were completed with perfect compliance and the mean subject's compliance score was 90%. One on-therapy pregnancy occurred. The patch was safe and well tolerated: adverse events frequency was low, with predominantly single reports of each event. Most of them started and subsided during cycle 1. Conclusion This study demonstrated that the EE/NGMN patch is associated with high satisfaction levels and excellent compliance. At study end, the majority of women indicated that they would continue using the patch. PMID:19566925

Crosignani, Pier Giorgio; Nappi, Carmine; Ronsini, Salvatore; Bruni, Vincenzina; Marelli, Silvia; Sonnino, Davide

2009-01-01

273

[Contraception--with us and others].  

PubMed

The history of contraception practices back to the ancient Egyptians, Jews, Romans, and Greeks, the evolution of condom use, and the problems inherent in religious and secular attitudes concerning contraception are surveyed. Ancient Egyptians already made use of certain intravaginal pessary and tampon types in combination with douches and incense to prevent pregnancy. Passages in the Bible refer to the practice of "coitus interruptus" as a preventive method, and the Greeks and Romans used sponges immersed in copper salt solution, oil of cedar, and olive oil. Abortion was officially banned in Rome; however, it was still practiced among the upper classes. Various practices used by the Arabs, Africans, and Europeans in the Middle Ages included the utilization of various oils and salts, plant roots, beeswax slices, green soap, and abstinence. The earliest mention of condom use is by Fallopius in the 16th Century; this linen sheath was primarily used against syphilis, as was its more advanced version described by Daniel Turner around 1700. Marquis de Sade recommended its use in combination with an intravaginal sponge. The invention of vulcanized rubber in the 19th Cenury led to its widespread use around the world, and the present threat of AIDS has made its advantages obvious. Secular attitudes about contraception emphasize the impact of urbanization and industrialization and their corrosive effects on the masses caught up in them without the benefit of contraception. Religious views, however, oppose contraception because of the fiats of Buddhist, Islamic, and Christian teachings. The individual's dilemma of trying to reconcile these conflicting attitudes is further explored. PMID:3512499

Hallgren, R

1986-01-01

274

Divorced women's sexual and contraceptive issues.  

PubMed

This work attempts to answer the question: could divorce create a feeling of alienation in women which causes one to feel vulnerable and detached and thus making sexual decision-making and planning difficult? When a women is married her sexuality is taken for granted because she is expected to have children; however, after a divorce, she must face many of the conflicts she felt as a young single woman. Guilt, planning contraceptive use, and coming to terms with her sexual behavior all present themselves again. 1 factor that must be considered is that contraceptive use is always assumed to be the function of the married women. Very little research has gone into the contraceptive use habits of unmarried women. This is primarily due to the societal assumption that unmarried woman don't have sex. This work contains the clinical observation of the author in which 28% of 459 prenatal patients were interviewed specifically because they were divorced. The conclusion is that divorced women are being neglected by the health care profession and are in great need of contraceptive counseling. This work primarily discusses a study done to expand and examine the conclusions of the clinical research. The study consisted of 101 sexually active, legally divorced, single women between the ages of 18-44 and physiologically capable of becoming pregnant. 53 of these women had experienced post-divorce pregnancies. Each woman was interviewed and given 3 standard tests: the Rosenberg Self-Acceptance Scale, the Snyder's Self-Monitoring Scale and Beckham's Coping Strategies Scale. The conclusion of the author is that divorce and its associated psychological problems may temporarily or permanently affect one's thoughts, feelings, and life course. Sexual and contraceptive use decision-making are both directly both directly affected by these changes. Some divorced women may be experiencing inadequate self-esteem, identity, and self-awareness. PMID:12283880

Leslie, N J

1988-01-01

275

Sexuality, Contraception and Pregnancy in a High-School Population  

PubMed Central

Students in a middle-class and in an economically lower-class high school were surveyed regarding their attitudes and behavior with respect to sexuality, contraception, and pregnancy. A large majority of students approved of premarital intercourse for both sexes within the context of a loving relationship. The most important deterrent to sexual intercourse was fear of pregnancy. A majority of both sexes had had sexual intercourse. Forty percent of the sexually active had used no contraception on some occasions, and many of the remainder had used poor methods such as withdrawal or rhythm. The pregnancy rate was high—at least 20 percent in several of the sexually active subgroups. Parents were an infrequent source of information about sex. On the other hand, there was some evidence that students exposed to a sex education program retained useful information if it was relevant to their situation, and if they were appropriately motivated. A model for integrating the various aspects of this subject area is offered. PMID:4726947

Miller, Warren B.

1973-01-01

276

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.  

PubMed

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

2014-09-01

277

Contraceptive Use Among Canadian Women of Reproductive Age: Results of a National Survey  

Microsoft Academic Search

Objective: Past studies indicate that despite a wide range of contraceptive options, Canadian women tend to use a narrow selection of contraceptive methods. New contraceptive methods have recently been introduced in Canada. The objective of this research is to characterize Canadian women's current contraceptive choices and adherence to contraceptive regimens. Methods: A national cross-sectional survey was conducted in November 2006.

Amanda Black; Qiuying Yang; Shi Wu Wen; André B. Lalonde; Edith Guilbert; William Fisher

278

Employment status and the prevalence of poor self-rated health. Findings from UK individual-level repeated cross-sectional data from 1978 to 2004  

PubMed Central

Objectives To assess, using individual level data, how the proportion of people in different employment statuses may have played a role in the prevalence of poor self-rated health from 1978 to 2004 as there have been major changes in employment patterns in advanced market democracies and employment is an important correlate of health. Design Individual-level analysis of repeated cross-sectional surveys. Setting UK. Participants 125?125 men and 139?535 women of working age (25–59). Outcome measure Self-rated general health. Results Compared to 1978 there was evidence of higher levels of poor health in the subsequent years. For example, in 2004, the prevalence of poor health was 2.8 (95% CI 1.7 to 3.9) and 1.3 (0.1 to 2.5) percentage points higher than 1978 for men and women, respectively, after adjusting for age. After additional adjustment for socio-economic characteristics, annual differences compared to 1978 increased (5.4 (4.2 to 6.5) and 4.4 (3.2 to 5.6) for men and women in 2004). Further adjustment for employment status, however, attenuated the annual differences in poor health (0.7 (?0.3 to 1.7) for men and 1.5 (0.3 to 2.6) for women in 2004). Conclusions These results suggest that the proportion of people in different employment statuses, particularly the proportion in sickness- or disability-related economic inactivity, could play an important role in the prevalence of poor self-rated health in the UK. Whether decreasing economic inactivity would enhance population health is an open question that needs further investigation. Trial registration This observational study was not registered. PMID:23212993

Popham, Frank; Gray, Linsay; Bambra, Clare

2012-01-01

279

The means of contraception: the state of the art.  

PubMed

For each of the following methods, a description, means of application, and effectiveness expressed in theoretical and in use/failure rate is given: 1) douching, 2) breast-feeding, 3) withdrawal, 4) condoms, 5) diaphragm, 6) spermicidal foams and jellies, 7) IUD, 8) rhythm, 9) sterilization, and 10) interception (''morning-after'' remedies). The methods which will probably be available within 5 years are described: 1) C-film, 2) vaginal ring, 3) reversible tubal ligation, 4) reversible vasectomy, 5) 20-year copper IUD, 6) silastic capsules of progestin implanted under the skin, 7) prostaglandin use in delayed menstruation, and 8) vaccine to prevent implantation. Failure rates are taken from Contraceptive Technology 1976-1977. PMID:12229613

Kome, P

1977-05-26

280

Trends of Modern Contraceptive Use among Young Married Women Based on the 2000, 2005, and 2011 Ethiopian Demographic and Health Surveys: A Multivariate Decomposition Analysis  

PubMed Central

Introduction Accessing family planning can reduce a significant proportion of maternal, infant, and childhood deaths. In Ethiopia, use of modern contraceptive methods is low but it is increasing. This study aimed to analyze the trends and determinants of changes in modern contraceptive use over time among young married women in Ethiopia. Methods The study used data from the three Demographic Health Surveys conducted in Ethiopia, in 2000, 2005, and 2011. Young married women age 15–24 years with sample sizes of 2,157 in 2000, 1,904 in 2005, and 2,146 in 2011 were included. Logit-based decomposition analysis technique was used for analysis of factors contributing to the recent changes. STATA 12 was employed for data management and analyses. All calculations presented in this paper were weighted for the sampling probabilities and non-response. Complex sampling procedures were also considered during testing of statistical significance. Results Among young married women, modern contraceptive prevalence increased from 6% in 2000 to 16% in 2005 and to 36% in 2011. The decomposition analysis indicated that 34% of the overall change in modern contraceptive use was due to difference in women’s characteristics. Changes in the composition of young women’s characteristics according to age, educational status, religion, couple concordance on family size, and fertility preference were the major sources of this increase. Two-thirds of the increase in modern contraceptive use was due to difference in coefficients. Most importantly, the increase was due to change in contraceptive use behavior among the rural population (33%) and among Orthodox Christians (16%) and Protestants (4%). Conclusions Modern contraceptive use among young married women has showed a remarkable increase over the last decade in Ethiopia. Programmatic interventions targeting poor, younger (adolescent), illiterate, and Muslim women would help to maintain the increasing trend in modern contraceptive use. PMID:25635389

Worku, Abebaw Gebeyehu; Tessema, Gizachew Assefa; Zeleke, Atinkut Alamirrew

2015-01-01

281

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

2013-01-01

282

Utilization of Modern Contraceptives among HIV Positive Reproductive Age Women in Tigray, Ethiopia: A Cross Sectional Study  

PubMed Central

Background. HIV infected women in sub-Saharan Africa are at substantial risk of unintended pregnancy and sexually transmitted infections. In developing countries including Ethiopia counseling and provision of modern contraceptives of choice to HIV infected women including those on antiretroviral therapy (ART) is an important strategy to prevent unintended pregnancies and sexually transmitted infections. Little is known about the existing practices and utilization of modern contraceptives among HIV positive reproductive age women attending ART units. Objective. The aim of this study was to assess utilization of modern contraceptives and associated factors among HIV positive reproductive age women attending ART units in zonal hospitals of Tigray region, North Ethiopia. Method. Institution based cross-sectional study was conducted by interviewing 364 HIV positive reproductive age women in all zonal hospitals of Tigray region using systematic sampling technique. Structured and pretested questionnaire was used to obtain information from the respondents. Descriptive, bivariate, and multivariate methods were used to analyze utilization of modern contraceptives and the factors associated with it. Result. Three hundred sixty-four subjects participated with a response rate of 99.2%. The mean age of the respondents was 31.9 ± 6.5 (SD) years. About 46% of participants utilized modern contraceptives, 59.9% out of them used dual method. However, a significant proportion of the respondents (46%) reported that they wished to have a desire for children. Being secondary education and higher (AOR: 2.85; 95% CI: 1.17–6.95) and currently on HAART (AOR: 3.23; 95% CI: 1.49–7.01) they were more likely to utilize modern contraceptive. But those women who were ?25 years old, house wives, single, divorced, or widowed were less likely to utilize modern contraceptive. Conclusion. Results of this study revealed that the number of respondents who were ever heard of modern contraceptives was high. However, modern contraceptive utilization was still low. Additional efforts are needed to promote modern contraceptive utilization in general and dual method use in particular among HIV positive reproductive age women. PMID:24224116

Berhane, Yemane; Berhe, Haftu; Abera, Gerezgiher Buruh; Berhe, Hailemariam

2013-01-01

283

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.

2012-01-01

284

Knowledge, attitudes and beliefs about contraceptive and sexual consent negotiation among college women.  

PubMed

College women have the highest rates of sexual violence, sexually transmitted infections, and unintended pregnancy compared with women in all other age groups. Although much is known about sexual risk behaviors among college women, less is known about how women negotiate consent for contraceptive use during sexual encounters. Therefore, the purpose of this qualitative descriptive study was to explore college women's knowledge, attitudes, and beliefs about contraceptive and sexual consent during dating relationships. Twenty-six women participated in five focus groups on two college campuses in the northeastern United States. Content analysis was used to analyze the data. The three main categories that emerged from the analysis included the influence of alcohol on sexual behaviors, lack of negotiation for sexual consent and contraceptive use, and fear of pregnancy. The results of this study highlight the complex social interactions and norms that college women encounter when making decisions regarding sexual activity and contraceptive use. The results of this study can inform the role of college health providers and forensic nurses to promote sexual health and safety when they interact with college women. PMID:25411811

Fantasia, Heidi Collins; Sutherland, Melissa A; Fontenot, Holly; Ierardi, Janet A

2014-01-01

285

Post-abortion contraception choices of women in Ghana: A one-year review.  

PubMed

Low rates of contraception in much of sub-Saharan Africa result in unplanned pregnancies, which in young, unmarried women often result in unsafe abortion. Increasing the use of highly effective forms of contraception has the potential to reduce the abortion-related mortality and morbidity. In this cross-sectional study, information collected by the post-abortion family planning counsellor was analysed. De-identified data from one year (June 2012-May 2013) were extracted from the logbook. Multivariate linear and logistic regression was performed. A total of 612 women received care for post-abortion complications from June 2012 to May 2013. Young, unmarried women, and those who were being treated for complications arising from an induced versus spontaneous abortion were more likely to report they would use 'abstinence' as their method of contraception following their treatment. This vulnerable group could benefit from an increased uptake of long-acting reversible contraceptive methods to avoid repeated unplanned pregnancies and the potential of future unsafe abortions. PMID:25599278

Rominski, Sarah D; Morhe, Emmanuel S K; Lori, Jody

2015-03-01

286

Menstrual and oral contraceptive use patterns among deployed military women by race and ethnicity.  

PubMed

Menstrual cycle patterns and concerns and oral contraceptive use in the combat environment were examined in Caucasian, Asian, Hispanic, and African American women to guide the development of educational resources for women soldiers. An anonymous, questionnaire was completed by 455 U.S. Army women-Caucasian (CA: n = 141); Asian (AS: n = 67); Hispanic (HIS: n = 67); and African American (AA: n = 184) to compare menstrual patterns and concerns, dysmenorrhea, and oral contraceptive patterns. Total menstrual concerns were significantly lower among African Americans relative to Caucasians, Asians, or Hispanics; Asians and Hispanics reported the greatest concern. Overall, secondary amenorrhea was noted by 14.9% of women. Severe dysmenorrhea rates were significantly lower in African American (6.1%) compared to Caucasian (11.6%), Asian (20.9%) and Hispanic (19.7%) women. Asian women reported missing less work-only 9.3% with moderate to severe dysmenorrhea missed work compared to 25.1% of all other women. Only 9.2% of women with mild, compared to 25.8% with moderate to severe (OR = 3.44; p ? 0.0001) dysmenorrhea sought health care. Less than 50% of women took oral contraceptive, and less than half of those women took oral contraceptive continuously. African Americans seemed to experience menstruation as less bothersome than others, despite no difference in the proportion with menstrual irregularities, mean duration of menses, and/or mean time between cycles. PMID:21391160

Deuster, Patricia A; Powell-Dunford, Nicole; Crago, Mark S; Cuda, Amanda S

2011-01-01

287

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

2014-01-01

288

Contraceptive options for women with a history of solid-organ transplantation.  

PubMed

Women of reproductive age who have received a solid-organ transplant are at risk for unplanned pregnancy. Fertility can return as soon as 1 month after transplantation, and the baseline unplanned pregnancy rate in the United States is approximately 50%. Pregnancy, although not absolutely contraindicated in this population, carries risk greater than the general population and should be timed with regard to medication regimen and organ function. The Centers for Disease Control categorizes every form of contraception as Category 2-benefits outweigh risks-in women with an uncomplicated transplantation. There is a large range of contraceptive options, varying in drug formulation, route of delivery, and discrepancy between "perfect" and "typical" use. Long-acting reversible contraceptive methods include intrauterine devices (IUDs) and subdermal implants and show great promise for women with solid-organ transplant. These methods have excellent efficacy, eliminate user error, and, in the case of IUDs, have extremely low or no systemic drug absorption. Providers have historical concerns regarding the association of IUD and infection; however, modern studies have shown their safety in both immunocompetent and immunocompromised patients. Women with a history of solid-organ transplantation can be safely offered a wide range of contraceptive options to suit their individualized needs. PMID:23358183

Krajewski, Colleen M; Geetha, Duvuru; Gomez-Lobo, Veronica

2013-05-27

289

The Prevalence of Drug Abuse in the Army: A Comparison of Urinalysis and Survey Rates. Technical Report 75-17.  

ERIC Educational Resources Information Center

This report describes part of the research conducted under Work Unit MODE, which examined methodological approaches in acquiring valid research data pertinent to critical social problems. It describes a study in which rates of nontherapeutic drug use obtained by a random urine screening program among Army personnel were compared with rates

Reaser, Joel M.; And Others

290

Contraception: attitudes and experiences of Saudi Arabian women.  

PubMed

We carried out a survey to find the contraception practices and experiences of Saudi Arabian females. A preset questionnaire was developed, and married Saudi females were asked to answer the questionnaire. Between July and December 2008, 215 women completed the questionnaire. The average age was 37.6 ± 9.1 years. One hundred and sixty one of the women said they were using contraception. Fifty-nine (36.6%) said they were using oral contraception pills (OCP) and 32 (19.9%) said they were using intra-uterine contraceptive devices (IUCDs). One hundred and twenty-seven (78.8%) of the women were satisfied with the contraception they were using. We found that a majority of Saudi women are using contraception methods but without medical advice. PMID:21229428

Al-Turki, Haifa Abdulaziz

2011-02-01

291

Simulated clients reveal factors that may limit contraceptive use in Kisumu, Kenya  

PubMed Central

ABSTRACT A better understanding of the factors influencing use of family planning has the potential to increase contraceptive prevalence and improve the ability of women and their partners to freely choose the number and spacing of their children. Investigations into factors contributing to unmet need frequently rely on data collected using household surveys or interviews with family planning clients and providers. Our research utilizes qualitative information resulting from simulated client visits to investigate programmatic barriers to contraceptive use in a sample of 19 health care facilities in Kisumu East District, a city in western Kenya. Simulated client reports indicate deficiencies in provider competence as well as tenuous relations between providers and clients. In addition, simulated client data reveal occasional absences of providers during normal facility hours of operation and requests of informal fees for services. Trainings that address specific gaps in provider medical knowledge and counseling skills as well as client-provider relations may reduce such programmatic barriers to contraceptive use. In addition, improved supervision and oversight at facilities may increase physical and financial access to services. Future research investigating provider motivations may illuminate root causes of programmatic barriers. PMID:24683525

Tumlinson, Katherine; Speizer, Ilene S; Archer, Linda H; Behets, Frieda

2013-01-01

292

Hormonal Contraception and HIV-1 Infection: Medroxyprogesterone Acetate Suppresses Innate and Adaptive Immune Mechanisms  

PubMed Central

Recent observational studies indicate an association between the use of hormonal contraceptives and acquisition and transmission of HIV-1. The biological and immunological mechanisms underlying the observed association are unknown. Depot medroxyprogesterone acetate (DMPA) is a progestin-only injectable contraceptive that is commonly used in regions with high HIV-1 prevalence. Here we show that medroxyprogesterone acetate (MPA) suppresses the production of key regulators of cellular and humoral immunity involved in orchestrating the immune response to invading pathogens. MPA inhibited the production of interferon (IFN)-?, IL-2, IL-4, IL-6, IL-12, TNF?, macrophage inflammatory protein-1? (MIP-1?), and other cytokines and chemokines by peripheral blood cells and activated T cells and reduced the production of IFN? and TNF? by plasmacytoid dendritic cells in response to Toll-like receptor-7, -8, and -9 ligands. Women using DMPA displayed lower levels of IFN? in plasma and genital secretions compared with controls with no hormonal contraception. In addition, MPA prevented the down-regulation of HIV-1 coreceptors CXCR4 and CCR5 on the surface of T cells after activation and increased HIV-1 replication in activated peripheral blood mononuclear cell cultures. The presented results suggest that MPA suppresses both innate and adaptive arms of the immune system resulting in a reduction of host resistance to invading pathogens. PMID:23354099

Huijbregts, Richard P. H.; Helton, E. Scott; Michel, Katherine G.; Sabbaj, Steffanie; Richter, Holly E.; Goepfert, Paul A.

2013-01-01

293

Oral contraceptive causing renal artery thrombosis  

PubMed Central

A young female presented with acute left lower quadrant pain followed by nausea and vomiting. She was found to have haematuria and elevated serum creatine. CT scan revealed a wedge-shaped hypodensity along with an intraluminal filling defect on the left kidney. Renal artery duplex showed no evidence for stenosis and MRI was negative for any atherosclerotic disease. Technetium scan confirmed the diagnosis of left renal infarct. Following day the patient became febrile and was noted to have leucocytosis and elevated serum lactate dehydrogenase. She was started on enoxaparin and low-dose aspirin. Blood cultures were negative. The oral contraceptive was stopped. Fever and leucocytosis resolved in the following 3?days. Extensive thrombophilic work-up was negative. No recurrence of thrombosis was found during a 6-month follow-up period. To the best of our knowledge, this is the first report of renal artery thrombosis leading to acute renal infarction associated with oral contraceptive use. PMID:23349178

Bhargava, Ashish; Chopra, Anita; Bernabela, Luigino; Chopra, Teena

2013-01-01

294

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

ClinicalTrials.gov

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

2012-02-17

295

[Safety and risks of hormonal contraceptives].  

PubMed

It is stimulating to ascertain the comparative risk to the woman of hormonal contraceptives of the various kinds used today: combination preparations, which rely on blocking the secretion of gonadotropic hormones by the hypothesis; sequential preparations, which rearrange the physiological relationships of the menstrual cycle; gestagen preparations (minipills), which heighten the viscosity of the cervical mucus; longterm injectable preparations, which initially block ovulation and then act on the cervical mucus; postcoital preparations, which act by inducing abortion of the fertilized egg. Of these the most reliable are the fixed combinations, while sequential preparations are somewhat less so. The minipills are the least reliable. Interaction with other medications can reduce the reliability of these preparations; for instance, women on contraceptives have become pregnant after taking antiepileptic medications containing phenobarbitol and hydantoin. As far as risk is concerned, we must distinguish between those that merely harm the woman and those that pose a threat to life. Some of the former are: bleeding between cycles, failure of menses to appear after cessation of contraception, depression, breast-pains, hypertension, thrombophlebitis, and reduced libido. Hormonal contraceptives also have a series of beneficial effects, especially in women who ordinarily have menstrual difficulties. Among the more serious side effects are: risk of teratogenicity, carcinogenicity, liver problems, thromboses, and infarctions. To reduce the risks of these various side effects, the physician should observe carefully the contraindications: these are both absolute (cerebrovascular and retinal problems, thrombo-embolisms, hepatic disease, diabetes, porphyria, and sickle-cell anemia and relative (migraines, cardiac pains, hyperlipemia, epilepsy, and multiple sclerosis). PMID:7122652

Ammon, H P

1982-07-01

296

Striae distensae of augmented breasts after oral contraceptive therapy.  

PubMed

A case of striae distensae (SD) of bilateral augmented breasts following oral contraceptive therapy is presented. Striae maturation and the prevention of additional skin marks was achieved with immediate cessation of oral contraceptive pill therapy and long-term daily topical application of tretinoin cream. It is suggested that patients who are candidates for breast augmentation surgery should be informed of the possible risk of developing SD if they are taking or planning to take the contraceptive pill. PMID:10029486

Har-Shai, Y; Barak, A; Taran, A; Weissman, A

1999-02-01

297

Contraceptive Choices among Nigerian Women attending an Antenatal Clinic  

Microsoft Academic Search

The factors determining the choice of contraception were studied among 230 pregnant women attending the antenatal clinic at Nnewi, Nigeria. There were 174 (52.1%) choices for the natural methods of contraception, 86 (25.7%) for the traditional methods, and 74 (22.2%) for the artificial methods. The most commonly chosen contraceptive methods were rhythm, 95 (28.4%) and Billings, 79 (23.5%), while the

J. I. B. Adinma; A. O. Agbai; B. O. Nwosu

1998-01-01

298

Factors Affecting HIV Contraceptive Decision-Making Among Women  

Microsoft Academic Search

We examined contraceptive decision-making among African American, Latina, and European American women ages 18–50 years. Logistic regressions examined relationships between demographic and religious factors, unintended pregnancies, sexually transmitted diseases (STDs), reasons for sex, and contraceptive decision-making. Women who were older, single, African American, used pregnancy prevention, and had histories of STDs and unintended pregnancies made contraceptive decisions alone. Older and

Gail E. Wyatt; JenniferVargas Carmona; TamraBurns Loeb; Donald Guthrie; Dorothy Chin; Gwen Gordon

2000-01-01

299

Unmet need for contraception: issues and challenges.  

PubMed

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

2014-06-01

300

The contraceptive practice of one thousand abortion patients.  

PubMed

This is a report on the contraceptive practice of 1000 cases who attended the Parkview clinic for termination of pregnancy. Fifty percent were not using any method of contraception at the time of conception. The principal reasons for non-use were dissatisfaction with previous methods and risk taking behaviour. Fifty percent became pregnant while using contraception, and in 20 percent methods which are generally regarded as reliable had been used. Fourteen percent were using the pill at the time of failure and this group is studied in greater detail. Improvements in contraceptive practice are suggested. PMID:6962387

Sparrow, M J

1982-12-22

301

Unintended pregnancy and subsequent use of modern contraceptive among slum and non-slum women in Nairobi, Kenya  

PubMed Central

Background In spite of major gains in contraceptive prevalence over the last few decades, many women in most parts of the developing world who would like to delay or avoid pregnancy do not use any method of contraception. This paper seeks to: a) examine whether experiencing an unintended pregnancy is associated with future use of contraception controlling for a number factors including poverty at the household and community levels; and b) investigate the mechanisms through which experiencing an unintended pregnancy leads to uptake of contraception. Methods Quantitative and qualitative data from a cross-sectional research project conducted in 2009/10 in two slum settlements and two non-slum settings of Nairobi, Kenya are used. The quantitative component of the project was based on a random sample of 1,259 women aged 15–49 years. Logistic regression models were used to assess the effect of unintended pregnancy on future contraceptive use. The qualitative component of the project successfully interviewed a total of 80 women randomly selected from survey participants who had reported having at least one unintended pregnancy. Results Women whose last pregnancy was unintended were more likely to be using a modern method of contraception, compared to their peers whose last pregnancy was intended, especially among the wealthier group as shown in the interaction model. Among poor women, unintended pregnancy was not associated with subsequent use of contraception. The qualitative investigation with women who had an unplanned pregnancy reveals that experiencing an unintended pregnancy seems to have served as a “wake-up call”, resulting in greater attention to personal risks, including increased interest in pregnancy prevention. For some women, unintended pregnancy was a consequence of strong opposition by their partners to family planning, while others reported they started using contraceptives following their unintended pregnancy, but discontinued after experiencing side effects. Conclusion This study provides quantitative and qualitative evidence that women who have had an unintended pregnancy are “ready for change”. Family planning programs may use the contacts with antenatal, delivery and post-delivery care system as an opportunity to identify women whose pregnancy is unplanned, and target them with information and services. PMID:25012817

2014-01-01

302

Association Between Body Mass Index, Sexually Transmitted Infections, and Contraceptive Compliance  

PubMed Central

Abstract Background Recent studies have examined the relationship between body mass index (BMI) and sexual behaviors, but little information exists on this relationship among racially diverse, low-income women using objectively measured clinical data. The purpose of this study was to examine the association between BMI and sexual behaviors, rates of sexually transmitted infections (STIs) and unintended pregnancy, and contraceptive adherence among adolescent and young adult women. Methods As part of a larger study, 1,015 Hispanic (54.2%), Black (18.6%) and White (24.8%) women aged 16 to 24 years seeking family planning services at publicly funded reproductive health clinics provided data on their baseline sexual behaviors, and contraceptive use and pregnancy history over 12 months. Objective clinical data were available from medical records at baseline (i.e., height, weight, and Papanicolaou [Pap] smear results), and over a 12-month period (i.e., STI results). Multivariable analyses were used to compare sexual behaviors, STI rates, contraceptive compliance, and unintended pregnancy rates between obese, overweight, and normal weight participants after adjusting for age, race/ethnicity, and other confounders. Results Overall, 423 (36.6%), 304 (26.3%), and 288 (24.9%) participants were classified as normal weight, overweight, and obese, respectively. No statistically significant association was observed between BMI and sexual behaviors, STI rates (overweight odds ratio [OR] 0.67; 95% confidence interval [95% CI] [0.4, 1.08]; obese OR 0.68; 95% CI [0.42, 1.10]); contraceptive compliance (overweight OR 0.89; 95% CI [0.69, 1.16]; obese OR 0.89; 95% CI 0.68, 1.16]), or unintended pregnancy (overweight OR 1.08 95% CI [0.73, 1.60]; obese OR 1.09; 95% CI [0.72, 1.63]). Conclusion STI history and contraceptive compliance did not vary by BMI. Therefore, all women should receive equal contraceptive counseling (including condoms) to reduce the risk of unplanned pregnancy and STIs. PMID:24093760

DeMaria, Andrea L.; Lugo, Jonathan M.; Rahman, Mahbubur; Pyles, Richard B.

2013-01-01

303

Rate of blood loss and timing of exsanguination on prevalence of ecchymosis in fallow deer (Dama dama).  

PubMed

Blood loss associated with four combinations of stunning and exsanguination methods was determined as part of studying prevalence of ecchymosis in slaughtered fallow deer (Dama dama). A fifth treatment simulated incomplete severance of the extended neck after captive bolt stunning. Predicted mean weights of blood collected from the five slaughter treatments, including electrical stunning followed by the thoracic stick method of exsanguination, captive bolt stunning followed by the thoracic stick, captive bolt stunning followed by the gash cut method of exsanguination, electrical stunning followed by the gash cut, and captive bolt stunning followed by incomplete severance of the extended neck, were 1458.7, 1072.7, 684.5, 463.7, and 228.5 g, respectively. The overall effect of exsanguination method was highly significant (p<0.001) with the thoracic stick resulting in the greatest weight of blood collection in the 10s period immediately after initiation. The overall effect of stunning method on blood loss was not significant, although there was a significant (p<0.05) stunning method by exsanguination method interaction. Ecchymosis of varying severity occurred in some carcases from all treatment groups. Using the total loin and round ecchymosis scores, when little or no ecchymosis (grades 0 or 1) was compared with some ecchymosis (grade 2) by logistic regression, castrated bucks were 9.8 times more likely (p=0.002) and does 4.2 times more likely (p=0.06) to have some ecchymosis than entire bucks. The results indicate that ecchymosis can be reduced in fallow deer carcases by thoracic stick exsanguination incorporated less than 10s after stunning. PMID:20374859

Mulley, R C; Falepau, D F; Flesch, J S; Wiklund, E

2010-05-01

304

Determining Prevalence and Correlates of Elder Abuse Using Promotores: Low Income Immigrant Latinos Report High Rates of Abuse and Neglect  

PubMed Central

Low-income Latino immigrants are understudied in elder abuse research. Limited English proficiency, economic insecurity, neighborhood seclusion, a tradition of resolving conflicts within the family, and mistrust of authorities may impede survey research and suppress abuse reporting. To overcome these barriers, we recruited and trained promotores, local Spanish-speaking Latinos, to interview a sample of Latino adults age 66 and older residing in low-income communities. The promotores conducted door-to-door interviews in randomly selected census tracts in Los Angeles to assess the frequency of psychological, physical, and sexual abuse, financial exploitation, and caregiver neglect. Overall, 40.4% of Latino elders experienced some form of abuse and/or neglect within the previous year. Nearly 25% reported psychological abuse, 10.7% indicated physical assault, 9% reported sexual abuse, 16.7% indicated financial exploitation, and 11.7% were neglected by their caregivers. Younger age, higher education, and experiencing sexual or physical abuse before age 65 were significant risk factors for psychological, physical, and/or sexual abuse. Years lived in the United States, younger age, and prior abuse were associated with increased risk of financial exploitation. Years spent living in the U.S. was a significant risk factor for caregiver neglect. Abuse prevalence was much higher in all mistreatment domains than findings from previous research on community-dwelling elders, suggesting that low-income Latino immigrants are highly vulnerable to elder mistreatment, or that respondents are more willing to disclose abuse to promotores who represent their culture and community. PMID:22697790

DeLiema, Marguerite; Gassoumis, Zachary D.; Homeier, Diana C.; Wilber, Kathleen H.

2012-01-01

305

Divergence between the high rate of p53 mutations in skin carcinomas and the low prevalence of anti-p53 antibodies  

PubMed Central

Circulating anti-p53 antibodies have been described and used as tumoural markers in patients with various cancers and strongly correlate with the p53 mutated status of the tumours. No study has yet looked at the prevalence of such antibodies in skin carcinoma patients although these tumours have been shown to be frequently p53 mutated. Most skin carcinoma can be diagnosed by examination or biopsy, but aggressive, recurrent and/or non-surgical cases' follow up would be helped by a biological marker of residual disease. We performed a prospective study looking at the prevalence of anti-p53 antibodies using an ELISA technique in a series of 105 skin carcinoma patients in comparison with a sex-?and age-matched control skin carcinoma-free group (n = 130). Additionally, p53 accumulation was studied by immunohistochemistry to confirm p53 protein altered expression in a sample of tumours. Anti-p53 antibodies were detected in 2.9% of the cases, with a higher prevalence in patients suffering from the more aggressive squamous cell type (SCC) of skin carcinoma (8%) than for the more common and slowly growing basal cell carcinoma type or BCC (1.5%). p53 protein stabilization could be confirmed in 80% of tumours studied by IHC. This low level of anti-p53 antibody detection contrasts with the high rate of p53 mutations reported in these tumours. This observation shows that the anti-p53 humoral response is a complex and tissue-specific mechanism. © 2001 Cancer Research Campaign http://www.bjcancer.com PMID:11747330

Moch, C; Moysan, A; Lubin, R; Salmonière, P de La; Soufir, N; Galisson, F; Vilmer, C; Venutolo, E; Pelletier, F Le; Janin, A; Basset-Séguin, N

2001-01-01

306

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

2005-01-01

307

Barrier contraception in the teenager: a comparison of four methods in adolescent girls.  

PubMed

The use-effectiveness and continuation rates of 4 methods of contraception were studied during a 2 year follow-up period in a group of 405 teenage girls. Results were compared in 2 groups of adolescents, 1 of highly motivated, high socioeconomic status girls (A) and 1 of poorly motivated, low socioeconomic status adolescent clinic patients (B). The method of contraception was selected by the girls, who were instructed in their proper use. Results showed good rates of continuation among girls of the 1st group as compared to those of the 2nd group. Pregnancy rates after 24 months of use, as calculated by Pearl's formula, was 3.6 and 5.4 respectively with the use of a condom, and 5.8 and 10.8 when the diaphragm was used. When using vaginal foam alone, the rates were 4.2 and 12.3 and with the rhythm method, 8.5 and 13.1. The foam-alone method was unpopular in both groups. No serious side effects or complications were recorded. The study demostrated a reasonable acceptability and use-effectiveness for barrier contraceptives. It is suggested that these harmless and complication-free methods, especially the condom and diaphragm, may be reasonable alternatives for the more modern methods in teens of all socioeconomic strata; an effort must be made to educate and instruct the poorly motivated and encourage them to present themselves for regular follow-up. PMID:12268241

Goldman, J A; Dicker, D; Feldberg, D; Samuel, N; Resnik, R

1985-01-01

308

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.

2014-01-01

309

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.

2003-01-01

310

Contraceptive counselling and factors affecting women's contraceptive choices: results of the CHOICE study in Austria.  

PubMed

Empirical evidence of the impact of contraceptive counselling and factors affecting women's contraceptive choices are limited. CHOICE (Contraceptive Health Research Of Informed Choice Experience) was a large-scale study in 11 European countries. Women in Austria aged 15-40 years considering a short-acting, reversible form of combined hormonal contraceptive were eligible to participate. The choices included the combined daily pill, weekly transdermal patch, and monthly vaginal ring. This study assessed and compared 2478 women's original preferences with their post-counselling choices and evaluated their perceptions and criteria for their choice. Women who were 'undecided' decreased from 18.1% pre-counselling to 3.2% post-counselling; significantly more women post-counselling chose the monthly ring (8.7% to 23.8%; difference 15.1%, 95% CI 13.3-16.8%; P<0.0001) or the weekly patch (6.2% to 7.8%; difference 1.7%, 95% CI 0.5-2.9%; P=0.0014). Women's primary reasons for choosing a method included 'easy to use' (daily pill, weekly patch and monthly ring) and 'still effective if I experience vomiting, diarrhoea' (weekly patch and monthly ring). Structured and balanced counselling led to changes in the method chosen. PMID:22285247

Egarter, Christian; Grimm, Christoph; Nouri, Kazem; Ahrendt, Hans-Joachim; Bitzer, Johannes; Cermak, Christine

2012-06-01

311

Hormonal contraception in women with migraine: is progestogen-only contraception a better choice?  

PubMed Central

A significant number of women with migraine has to face the choice of reliable hormonal contraception during their fertile life. Combined hormonal contraceptives (CHCs) may be used in the majority of women with headache and migraine. However, they carry a small, but significant vascular risk, especially in migraine with aura (MA) and, eventually in migraine without aura (MO) with additional risk factors for stroke (smoking, hypertension, diabetes, hyperlipidemia and thrombophilia, age over 35 years). Guidelines recommend progestogen-only contraception as an alternative safer option because it does not seem to be associated with an increased risk of venous thromboembolism (VTE) and ischemic stroke. Potentially, the maintenance of stable estrogen level by the administration of progestins in ovulation inhibiting dosages may have a positive influence of nociceptive threshold in women with migraine. Preliminary evidences based on headache diaries in migraineurs suggest that the progestin-only pill containing desogestrel 75 ?g has a positive effect on the course of both MA and MO in the majority of women, reducing the number of days with migraine, the number of analgesics and the intensity of associated symptoms. Further prospective trials have to be performed to confirm that progestogen-only contraception may be a better option for the management of both migraine and birth control. Differences between MA and MO should also be taken into account in further studies. PMID:24456509

2013-01-01

312

Agreement between patient-reported and provider-reported choice of contraceptive method among family planning patients in New York City: implications for public health  

PubMed Central

National data on choice of contraceptive method and subsequent use are critical for monitoring progress toward meeting public health goals in reducing unintended pregnancy in the US. Yet few studies have focused on the reliability of clinically-reported or patient-reported measures of choice of contraceptive method for the range of available contraceptive methods. Among 1,844 women receiving reproductive health care at two federally funded centers in New York City, choice of contraceptive method at the end of the visit from two data sources was compared, ie, patient self-report, and provider-report as recorded in the clinical-administrative database. Agreement between the two data sources was assessed for the sample. Sociodemographic predictors of agreement were assessed using logistic regression. Agreement between the data sources was also assessed on a method-by-method basis using positive specific agreement. Participants were predominantly Latina (69%), foreign-born (76%), and low-income (99% with incomes <200% federal poverty level). Agreement of patient-reported and provider-reported contraceptive choice was highest for hormonal methods (positive specific agreement 94.0%) and intrauterine devices (89.9%), and lowest for condoms (53.5%). In the logistic regression model, agreement was lower among teens aged 16–19 years compared with women aged 25+ years (odds ratio 0.74; 95% confidence interval 0.55–0.99). Because teens are more likely to rely on condoms, the logistic regression model was repeated, adjusting for provider report of condom choice; after adjustment, no sociodemographic differences in agreement were observed. National data sources or studies relying on provider-reported method choice to derive estimates of contraceptive prevalence may overestimate choice of condoms. Our findings raise the question of whether condom choice can be accurately assessed by a single open-ended measure of choice of contraceptive method. PMID:24039456

Ventura, Alicia; Garbers, Samantha; Meserve, Allison; Chiasson, Mary Ann

2013-01-01

313

Urinary prevalence, metabolite detection rates, temporal patterns and evaluation of suitable LC-MS/MS targets to document synthetic cannabinoid intake in US military urine specimens.  

PubMed

Abstract Background: Identifying synthetic cannabinoid designer drug abuse challenges toxicologists and drug testing programs. The best analytical approach for reliably documenting intake of emerging synthetic cannabinoids is unknown. Primarily metabolites are found in urine, but optimal metabolite targets remain unknown, and definitive identification is complicated by converging metabolic pathways. Methods: We screened 20,017 US military urine specimens collected from service members worldwide for synthetic cannabinoids between July 2011 and June 2012. We confirmed 1432 presumptive positive and 1069 presumptive negative specimens by qualitative liquid chromatography tandem mass spectrometry (LC-MS/MS) analysis including 29 biomarkers for JWH-018, JWH-073, JWH-081, JWH-122, JWH-200, JWH-210, JWH-250, RCS-4, AM2201 and MAM2201. Specimen preparation included enzyme hydrolysis and acetonitrile precipitation prior to LC-MS/MS analysis. We evaluated individual synthetic cannabinoid metabolite detection rates, prevalence, temporal patterns and suitable targets for analytical procedures. Results: Prevalence was 1.4% with 290 confirmed positive specimens, 92% JWH-018, 54% AM2201 and 39% JWH-122 metabolites. JWH-073, JWH-210 and JWH-250 also were identified in 37%, 4% and 8% of specimens, respectively. The United States Army Criminal Investigation Command seizure pattern for synthetic cannabinoid compounds matched our urine specimen results over the time frame of the study. Apart from one exception (AM2201), no parent compounds were observed. Conclusions: Hydroxyalkyl metabolites accounted for most confirmed positive tests, and in many cases, two metabolites were identified, increasing confidence in the results, and improving detection rates. These data also emphasize the need for new designer drug metabolism studies to provide relevant targets for synthetic cannabinoid identification. PMID:25263309

Wohlfarth, Ariane; Scheidweiler, Karl B; Castaneto, Marisol; Gandhi, Adarsh S; Desrosiers, Nathalie A; Klette, Kevin L; Martin, Thomas M; Huestis, Marilyn A

2014-09-27

314

Hormonal Contraceptive Use and Breast Cancer in Thai Women  

PubMed Central

Background Breast cancer is the most common cancer in women worldwide. We investigated the association of hormonal contraceptive use and breast cancer in Thai women. Methods A cohort study was conducted in Khon Kaen, Thailand. There were 70 cases of histologically confirmed breast cancer among 11 414 women aged 30 to 69 years who were recruited as participants in the cohort study during the period from 1990 through 2001. The study population was followed-up until December 31, 2011. To identify factors associated with incidence of breast cancer, hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using a Cox proportional hazards model. Results The 11 414 women provided a total observation time of 157 200 person-years. Breast cancer risk among women with a history of hormonal contraceptive use was 1.31 times that of women without such a history, but the difference was not statistically significant (95% CI, 0.65–2.65). No type of hormonal contraceptive was associated with a significant increase in breast cancer risk as compared with women who had never used hormonal contraceptives (oral contraception: HR = 1.35, 95% CI, 0.65–2.78; injection contraception: HR = 1.25, 95% CI, 0.56–2.80), and there was no relationship between duration of hormonal contraceptive use and breast cancer. Conclusions There was no association between hormonal contraceptive use and breast cancer; however, this finding should be viewed with caution due to the small number of cases. PMID:24614914

Poosari, Arisara; Promthet, Supannee; Kamsa-ard, Siriporn; Suwanrungruang, Krittika; Longkul, Jirapat; Wiangnon, Surapon

2014-01-01

315

The Use of Contraception by Women with Intellectual Disabilities  

ERIC Educational Resources Information Center

Background: Worldwide, contraception is frequently used by women for the prevention of conception, to regulate or postpone menstrual bleeding. The study aims to determine the use (number and method) of contraception by women with intellectual disabilities (ID), the indications, sources of referrals and relations with level of ID and age of the…

van Schrojenstein Lantman-de Valk, H. M. J.; Rook, F.; Maaskant, M. A.

2011-01-01

316

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

2012-01-01

317

Oral contraceptive use and cigarette smoking in Crohn's disease  

Microsoft Academic Search

Previous studies have consistently found strong positive associations between smoking and Crohn's disease. The association between oral contraceptive use and Crohn's disease remains, however, controversial. In order to analyze whether smoking and oral contraceptive use are independent risk factors a case-control study was performed. In 90 women with Crohn's disease and 90 community controls information was assessed about their smoking

Bettina Katschinski; Dagmar Fingerle; Bernward Scherbaum; Harald Goebell

1993-01-01

318

Pharmacy Access to Emergency Contraception in Rural and Frontier Communities  

ERIC Educational Resources Information Center

Context: Timely access to emergency contraception (EC) has emerged as a major public health effort in the prevention of unintended pregnancies. The recent FDA decision to allow over-the-counter availability of emergency contraception for adult women presents important rural health implications. American women, especially those living in rural and…

Bigbee, Jeri L.; Abood, Richard; Landau, Sharon Cohen; Maderas, Nicole Monastersky; Foster, Diana Greene; Ravnan, Susan

2007-01-01

319

Teens Reflect on Their Sources of Contraceptive Information  

ERIC Educational Resources Information Center

Based on semistructured interviews with a racially and ethnically diverse sample of 58 U.S. high school students, this study examines teens' exposure to contraceptive information from a range of sources and the extent to which they trust this information. Teens report exposure to contraceptive information from many individuals and places, most…

Jones, Rachel K.; Biddlecom, Ann E.; Hebert, Luciana; Mellor, Ruth

2011-01-01

320

Psychosexual Background of Female Adolescents Seeking Contraceptive Assistance.  

ERIC Educational Resources Information Center

In order to better meet the needs of female adolescents coming to a Planned Parenthood League Teen Center for prescription contraceptives, a study was undertaken to understand their psychosexual history. The study focused on the past and present sexual and contraceptive behavior of 532 new clients under the age of 18. The data were collected…

Reichelt, Paul A.

321

A Social Learning Model of Adolescent Contraceptive Behavior.  

ERIC Educational Resources Information Center

Research findings and theories regarding adolescent contraceptive use are reviewed to propose an alternative framework relying on social learning theory. Environmental context, cognitive influences, and behavior execution constraints are suggested as the foundation for contraceptive behaviors. The behavioral skills teenagers need to use birth…

Balassone, Mary Lou

1991-01-01

322

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.

323

Chlamydia trachomatis and oral contraceptive use: a quantitative review  

Microsoft Academic Search

OBJECTIVES--Chlamydia trachomatis is now recognised as a major sexually transmitted disease; oral contraceptive use is rapidly increasing particularly in developing countries. There are thus important public health implications of the many reports that isolation of C trachomatis is more frequent among users of oral contraceptives. The aim of this analysis was to assess the strength and consistency of this association

J Cottingham; D Hunter

1992-01-01

324

Knowledge, attitude and practice of natural family planning methods in a population with poor utilisation of modern contraceptives.  

PubMed

Sub-Saharan Africa has one of the highest fertility rates in the world, which is further promoted by the low utilisation of modern contraceptive methods. Yet, many communities claim to have traditional methods of family planning that pre-date the introduction of modern contraceptives, implying that contraception is a culturally acceptable norm. It was therefore postulated that the study population would have a high level of awareness and practice of natural methods of family planning. We aimed to obtain an insight into the extent and correctness of knowledge about natural family planning methods, and its practice as a guide to the general acceptance of contraception as a concept. Pre-tested structured questionnaires were administered to women of childbearing age in households properly numbered for primary healthcare activities. The level of awareness of natural family planning methods was significantly less than awareness for modern methods of contraception. The awareness rate for rhythm method, lactational amenorrhoea method and coitus interruptus was 50.7%, 42.1% and 36.1%, respectively. For all three national family planning methods, there is a steady decline between awareness, correct description of method and utilisation, a difference that was statistically significant in all cases. The sociodemographic factors of the responders had varying influence on utilisation of all three natural family planning methods studied. Rural dwellers practised the lactational amenorrhoea method significantly more often than urban dwellers. Significantly more Muslims than Christians with four children or more practised coitus interruptus or the rhythm method, while the use of lactational amenorrhoea method was significantly increased with the number of living children in both religious groups. There is a relatively low level of awareness of natural family planning methods in the study population, poor utilisation and wrong use of methods. Therefore, improving the correct level of information on natural family planning methods is likely to improve the use of both natural family planning and modern contraceptive methods. PMID:17000506

Audu, B M; Yahya, S J; Bassi, A

2006-08-01

325

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

2014-01-01

326

Contraceptive sterilization: trends, options, and surprising new data.  

PubMed

In the US, 24% of women aged 15-50 rely on female or male sterilization for contraception. While all methods of sexual sterilization are highly effective, new data indicate that the risk of pregnancy after female sterilization varies according to type of procedure performed and the woman's age, but at 18.5/1000 procedures the risk is higher than previously believed. About 30% of all tubal sterilization failures result in ectopic pregnancy, with the greatest risk occurring 2-3 years after the procedure. Female sterilization can be performed at a time unrelated to conclusion of pregnancy or during the postpartum or postabortion periods using the minilaparotomy or laparoscopy surgical approach and surgical ligation or mechanical or electrical occlusion. Location of the vasa deferentia for occlusion in vasectomy can be achieved through two small incisions or with the no-scalpel method. Various methods are used to achieve occlusion. With a first-year pregnancy rate of only 0.15%, vasectomy is superior to female sterilization in terms of efficacy, safety, procedural complexity, and cost. The disadvantages of female sterilization include regret, the rare occurrence of surgical complications, a small risk of death (4/100,000), an increased risk of subsequent hysterectomy among younger women undergoing tubal ligation, and menstrual pain. Tubal sterilization, however, may protect against ovarian cancer. The few disadvantages associated with vasectomy include the small risk of immediate complications and regret. Because of the permanent nature of sterilization, effective counseling is important and should include presentation of information about the reversible, longterm contraceptive methods available to women. PMID:12292544

Burkman, R T

1997-01-01

327

[Family planning with different contraceptive methods].  

PubMed

Female hormonal contraceptives, introduced commercially in 1959, contained 10 mg of norethynodrel and .15 mg of mestranol. The estrogen and progesterone doses were progressively reduced over time. In 1989, approximately 60 million couples used oral contraceptives (OCs) ranging from 1% in Japan to 40% in the Netherlands. The monophasic pill contains .01 - .04 mg of ethinyl estradiol (EE), and the biphasic pill contains increasing doses of progesterone and estroprogesterone in the course of the menstrual cycle. Triphasic combined pills contain an initially dominant estrogen dose. In oral sequential pills, estrogen is given on days 14-16 followed by a estroprogesterone for 5-7 days. Micropills with progesterone, injectables with medroxyprogesterone, and 3rd-generation OCs such as gestoden with a low progesterone dose of .04 mg/day and reduced androgenic activity are among other OCs. The OCs are administered in 21-22 day packets. Absolute contraindications include history of venous thrombosis, atherogenic lipid profile, hormone-dependent cancer, and allergy. Relative contraindications include arterial ailments, smoking, hypertension, older age, obesity, and familial history of cardiovascular and cerebrovascular accidents. Interactions with antibiotics (ampicillin and tetracycline) occur as the modified intestinal flora reduces the level of deconjugated EE. Most frequent side effects are depression, modification of libido, ocular disorders, headache, and urinary infection. Benefits include favorable modification of menstrual cycle, and reduction of endometriosis and endometrial and ovarian cancer. Systemic risks such as cardiovascular and blood coagulation effects occur mainly with high-dose OCs. Further topics addressed are the cancer risk and protective effect of OCs, postcoital OCs, traditional contraception, the IUD, RU-486, implants, vaccination with the human antigonadotropine, and the vaginal ring. PMID:1823414

Dumitrache, F; Gheorghi??, E

1991-01-01

328

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

1998-01-01

329

Women's socioeconomic position and contraceptive behavior in Togo.  

PubMed

Few studies have examined empirically the influence of women's position on contraceptive behavior in sub-Saharan Africa. Using data from the 1988 Togo Demographic and Health Survey, this article explores the linkages between various indicators of women's position and spousal communication about family planning and contraceptive use. The results highlight the importance to their contraceptive behavior of women's economic power and individual control over choice of partner. The likelihood of spousal communication about family planning and modern contraceptive use is significantly higher among women who exercised complete control over selection of partner than among those with arranged marriages. Women who work for cash are significantly more likely than those who do not to communicate with their spouses about family planning, particularly if they participate in rotating credit or savings schemes. Such participation also increases significantly the likelihood of ever using traditional and modern methods of contraception. PMID:8571441

Gage, A J

1995-01-01

330

Contraception following abortion and the treatment of incomplete abortion.  

PubMed

Family planning counseling and the provision of postabortion contraception should be an integrated part of abortion and postabortion care to help women avoid another unplanned pregnancy and a repeat abortion. Postabortion contraception is significantly more effective in preventing repeat unintended pregnancy and abortion when it is provided before women leave the healthcare facility where they received abortion care, and when the chosen method is a long-acting reversible contraceptive (LARC) method. This article provides evidence supporting these two critical aspects of postabortion contraception. It suggests that gynecologists and obstetricians have an ethical obligation to do everything necessary to ensure that postabortion contraception, with a focus on LARC methods, becomes an integral part of abortion and postabortion care, in line with the recommendations of the International Federation of Gynecology and Obstetrics and of several other organizations. PMID:24739476

Gemzell-Danielsson, Kristina; Kopp Kallner, Helena; Faúndes, Anibal

2014-07-01

331

Pregnancy in HIV Clinical Trials in Sub Saharan Africa: Failure of Consent or Contraception?  

PubMed Central

Objective Higher than expected pregnancy rates have been observed in HIV related clinical trials in Sub-Saharan Africa. We designed a qualitative study to explore the factors contributing to high pregnancy rates among participants in two HIV clinical trials in Sub-Saharan Africa. Methods Female and male participants enrolled in one of two clinical HIV trials in south-west Uganda were approached. The trials were a phase III microbicide efficacy trial among HIV negative women using vaginal gel (MDP); and a trial of primary prevention prophylaxis for invasive cryptococcal disease using fluconazole among HIV infected men and women in Uganda (CRYPTOPRO). 14 focus group discussions and 8 in-depth interviews were conducted with HIV positive and negative women and their male partners over a six month period. Areas explored were their experiences about why and when one should get pregnant, factors affecting use of contraceptives, HIV status disclosure and trial product use. Results All respondents acknowledged being advised of the importance of avoiding pregnancy during the trial. Factors reported to contribute to pregnancy included; trust that the investigational product (oral capsules/vaginal gel) would not harm the baby, need for children, side effects that led to inconsistent contraceptive use, low acceptance of condom use among male partners. Attitudes towards getting pregnant are fluid within couples over time and the trials often last for more than a year. Researchers need to account for high pregnancy rates in their sample size calculations, and consider lesser used female initiated contraceptive options e.g. diaphragm or female condoms. In long clinical trials where there is a high fetal or maternal risk due to investigational product, researchers and ethics committees should consider a review of participants contraceptive needs/pregnancy desire review after a fixed period, as need for children, partners and health status of participants may alter over time. PMID:24039981

Ssali, Agnes; Namukwaya, Stella; Bufumbo, Leonard; Seeley, Janet; G. Lalloo, David; Kamali, Anatoli; Parkes-Ratanshi, Rosalind

2013-01-01

332

Intrauterine contraception after cesarean section and during lactation: a systematic review  

PubMed Central

Background All postpartum women, including those who are breastfeeding or have had a cesarean section, appear potentially suited to intrauterine contraception, a long acting reversible contraceptive (LARC). Like any other method used after delivery, it should not interfere with lactation or be affected by cesarean section. Study design We searched the MEDLINE, PubMed, Popline, Google Scholar, and Clinicaltrials.gov databases from January 1968 through to December 2012. Studies were included if they reported event rates in women who had a cesarean section and event rates and clinical outcomes in lactating women or their infants in the breastfeeding group. Summary odds ratios were not calculated because of the diverse methods of reporting event rates in the cesarean section group and the heterogeneity of the results in the breastfeeding group. Results We found 26 articles on event rates in interval and post-placental intrauterine device (IUD) use, and 18 on event rates and clinical outcomes in breastfeeding IUD users. Four prospective studies and one retrospective study showed an increased expulsion rate in interval insertion. There were 19 studies, of which five were controlled in post-placental IUD insertion after cesarean section. Four studies had expulsion rates of 10 or more per 100 woman-years of use and 15 expulsion rates below 10 per 100 woman-years of use. Three studies showed that event rates for lactating IUD users are the same as those for non-lactating users. Fifteen controlled studies showed that the IUD had no effect on milk production and seven of these showed no effect on infant growth. Pharmacovigilance databases report an increased rate of IUD perforations in lactating women, while the event rate studies report that insertion is generally easier and less painful than expected. These were uncontrolled reports. Conclusion The IUD is a long-acting reversible method of contraception with expulsion rates of 5–15 per 100 woman-years of use when used as a post-placental method immediately after cesarean section. As an interval procedure (6 or more weeks after cesarean section) it appears to have a high expulsion rate (5% or higher) notably in older devices. The IUD does not affect breastfeeding and is easy to insert in these women, but appears to be associated with a higher perforation rate (>1 per 100). Providers should not be deterred from using this contraception method, especially in developing countries, but should be attentive to preventing these potential problems. PMID:24348074

Goldstuck, Norman D; Steyn, Petrus S

2013-01-01

333

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)

1995-03-01

334

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

PubMed

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

2014-10-01

335

Peer-driven contraceptive choices and preferences for contraceptive methods among students of tertiary educational institutions in Enugu, Nigeria  

PubMed Central

Purpose To describe the methods preferred for contraception, evaluate preferences and adherence to modern contraceptive methods, and determine the factors associated with contraceptive choices among tertiary students in South East Nigeria. Methods A questionnaire-based cross-sectional study of sexual habits, knowledge of contraceptive methods, and patterns of contraceptive choices among a pooled sample of unmarried students from the three largest tertiary educational institutions in Enugu city, Nigeria was done. Statistical analysis involved descriptive and inferential statistics at the 95% level of confidence. Results A total of 313 unmarried students were studied (194 males; 119 females). Their mean age was 22.5±5.1 years. Over 98% of males and 85% of females made their contraceptive choices based on information from peers. Preferences for contraceptive methods among female students were 49.2% for traditional methods of contraception, 28% for modern methods, 10% for nonpharmacological agents, and 8% for off-label drugs. Adherence to modern contraceptives among female students was 35%. Among male students, the preference for the male condom was 45.2% and the adherence to condom use was 21.7%. Multivariate analysis showed that receiving information from health personnel/media/workshops (odds ratio 9.54, 95% confidence interval 3.5–26.3), health science-related course of study (odds ratio 3.5, 95% confidence interval 1.3–9.6), and previous sexual exposure prior to university admission (odds ratio 3.48, 95% confidence interval 1.5–8.0) all increased the likelihood of adherence to modern contraceptive methods. Conclusion An overwhelming reliance on peers for contraceptive information in the context of poor knowledge of modern methods of contraception among young people could have contributed to the low preferences and adherence to modern contraceptive methods among students in tertiary educational institutions. Programs to reduce risky sexual behavior among these students may need to focus on increasing the content and adequacy of contraceptive information held by people through regular health worker-led, on-campus workshops. PMID:25114515

Iyoke, CA; Ezugwu, FO; Lawani, OL; Ugwu, GO; Ajah, LO; Mba, SG

2014-01-01

336

Knowledge translation in Africa for 21st century integrative biology: the "know-do gap" in family planning with contraceptive use among Somali women.  

PubMed

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

2014-11-01

337

Geographical distribution of TTR met30 carriers in northern Sweden: discrepancy between carrier frequency and prevalence rate.  

PubMed Central

The first Swedish case of familial amyloidotic polyneuropathy (FAP) was published in 1965. The same transthyretin (TTR met30) mutation as that seen in Japanese, Portuguese, and other populations was also found in Swedish FAP patients. More than 350 patients with clinical manifestations of FAP have been diagnosed in northern Sweden, most of them originating from the areas around Skellefteå and Piteå. The mean age of onset is 56 years, much later than in patients from Japan and Portugal. To estimate the frequency of the TTR met30 mutation in the counties of Västerbotten and Norrbotten, sera from 1276 persons aged 24 to 65 years, randomly sampled from a health programme (MONICA), were screened with the monoclonal antibody FD6. In 19 persons, 13 females and six males, a positive reaction was seen in an Elisa test using this antibody. DNA analysis confirmed the TTR met30 mutation and showed that 18 were heterozygous and one homozygous for this mutation. Other mutations were not looked for in this study. The mean TTR met30 carrier frequency in the area was 1.5% ranging from 0.0 to 8.3% in 23 subpopulations. There was a notable discrepancy between the regional distribution of the TTR met30 allele and the morbidity rate for FAP. The estimated number of TTR met30 gene carriers in a total population of 500,000 in the area is approximately 7500. The penetrance of the TTR met30 mutation shows considerable variation between families, and the overall diagnostic (predictive) value in this population is as low as around 2%. PMID:8064809

Holmgren, G; Costa, P M; Andersson, C; Asplund, K; Steen, L; Beckman, L; Nylander, P O; Teixeira, A; Saraiva, M J; Costa, P P

1994-01-01

338

Mifepristone 5 mg versus 10 mg for emergency contraception: double-blind randomized clinical trial  

PubMed Central

Purpose To estimate the efficacy and safety of 5 mg and 10 mg mifepristone for emergency contraception up to 144 hours after unprotected coitus. Methods This double-blind randomized clinical trial was carried out at Eusebio Hernandez Hospital (Havana, Cuba). A total of 2,418 women who requested emergency contraception after unprotected coitus received either 5 mg or 10 mg mifepristone. The variables for assessing efficacy were the pregnancies that occurred and the fraction of pregnancies that were prevented. Other variables assessed were the side effects of mifepristone, vaginal bleeding, and changes in the date of the following menstruation. Results There were 15/1,206 (1.2%) and 9/1,212 (0.7%) pregnancies in the 5 mg and 10 mg group, respectively (P=0.107). There were 88% and 93% prevented pregnancies in the 5 mg and un ?7 days was experienced by 4.9% and 11.0% of subjects in the 5 mg and 10 mg group, respectively (P=0.001). There was a significant high failure rate for women weighing >75 kg in the 5 mg group. Conclusion It would be advisable to use the 10 mg dose of mifepristone for emergency contraception as there was a trend suggesting that the failure rate of the larger dose was lower. PMID:25624773

Carbonell, Josep Lluis; Garcia, Ramon; Gonzalez, Adriana; Breto, Andres; Sanchez, Carlos

2015-01-01

339

Peri-abortion contraceptive use in the French islands of Guadeloupe and La Réunion: variation in the management of post-abortion care  

PubMed Central

Objectives The abortion rate varies greatly within the French overseas territories including the Caribbean island of Guadeloupe and La Réunion in the Indian Ocean. We compare women’s contraceptive paths surrounding an abortion in both territories. Methods The data for this study are part of a nationally representative survey of women undergoing abortion in France in 2007. The analysis included 1211women from Guadeloupe and 1531 from La Réunion. Results Results show differences in women’s use of contraception before the abortion by study location. Women in Guadeloupe were more likely not to have used contraception in the month they conceived (40% vs. 32%, p < 001). Among those using no contraception or less effective contraception before the abortion, 74% in Guadeloupe and 86% in La Réunion received a prescription for a very effective method such as a hormonal method or intrauterine device after the procedure. In both settings, women with no health insurance or a government health plan were 70% less likely to have received a prescription for a very effective method. Conclusions While this study shows a significant increase in the prescription of very effective methods, it also indicates the ineffectiveness of the health care system in closing the gap in the pre-abortion contraceptive disparities observed between Guadeloupe and La Réunion. PMID:20465401

Moreau, Caroline; Trussell, James; Desfreres, Julie; Bajos, Nathalie

2013-01-01

340

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. PMID:25237657

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

2014-01-01

341

Recent methodological advances in male hormonal contraception  

PubMed Central

Landmark WHO-sponsored trials showed decades ago that male hormonal contraception (MHC) is an effective male-directed contraceptive approach. Considerable progress has been made particularly in the last 5 years, establishing for the first time the reversibility of MHC and its short-term safety. Methodological advances in recent years include: the pooling of information and individual-level integrated analysis; the first-time use of centralized semen analysis and fluorescence to detect low sperm concentrations; the establishment of sperm quality reference ranges in fertile men; the measurement of blood steroid concentrations by gas or chromatography/mass spectrometry; and the inclusion of placebo groups to delineate clearly possible adverse effects of androgens and progestins in men. We report integrated analyses of factors that are important in predicting suppression and recovery of spermatogenesis after MHC clinical trials for the past 15 years. These are the best data available and will provide guidance and reassurance for the larger scale Phase III specific regimen efficacy studies that will be required to bring MHC to the population (market). PMID:20933121

Liu, Peter Y.; Swerdloff, Ronald S.; Wang, Christina

2010-01-01

342

Prophylactic contraceptives for HIV/AIDS.  

PubMed

The current pandemic of sexually transmitted human immunodeficiency virus (HIV) infection--the causative agent of acquired immunodeficiency syndrome (AIDS), has created an urgent need for a new type of contraceptive: one that is both a spermicide and a microbicide. Because most women at risk for HIV infection are of reproductive age (15-44 years), effective use of dual-function contraceptives is important to prevent HIV transmission and unintended pregnancies. In the absence of an effective prophylactic anti-HIV therapy or vaccine, new emphasis has been placed on the development of intravaginal microbicidal agents capable of reducing the transmission of HIV. Topical microbicidal spermicides would ideally provide a female-controlled method of self-protection against HIV as well as preventing pregnancy. However, several microbicides that are undergoing preclinical and human clinical trials contain detergent-type ingredients. The detergent-type spermicide, nonoxynol-9, the only recommended microbicide for protection against sexual transmission of HIV has been shown to cause lesions in vaginal and cervical epithelia leaving women more vulnerable to HIV infection. Therefore, a major challenge in microbicide research has been to design mechanism-based microbicides that are highly effective against pregnancy and HIV transmission while lacking detergent-type effects on epithelial cells and normal vaginal flora. We present an overview of current microbicide research and report on the identification and preclinical development of novel non-detergent spermicidal nucleoside and non-nucleoside inhibitors aimed at decreasing pregnancy and preventing sexual transmission of HIV. PMID:10582788

Uckun, F M; D'Cruz, O J

1999-01-01

343

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; Säemann, Marcus D.; Ramirez, Sylvia P. B.; Gillespie, Brenda W.; Pisoni, Ronald L.; Robinson, Bruce M.; Port, Friedrich K.

2014-01-01

344

Lessons learned from the Philadelphia Collaborative Preterm Prevention Project: the prevalence of risk factors and program participation rates among women in the intervention group.  

PubMed

BackgroundWomen who deliver preterm infants are at a much greater risk for repeating a preterm birth (PTB), compared to women without a history of PTB. However, little is known about the prevalence of the risk factors which account for this markedly increased risk. Moreover, little or nothing is known about the feasibility of providing treatments and services to these women, outside of the context of prenatal care, during the inter-conception period, which provides the best opportunity for successful risk-reduction interventions.MethodsThe Philadelphia Collaborative Preterm Prevention Project (PCPPP), a large randomized control trial designed to identify and reduce six major risk factors for a repeat preterm birth among women immediately following the delivering of a preterm infant. For the women assigned to the PCPPP treatment group, we calculated the prevalence of the six risk factors in question, the percentages of women who agreed to receive high quality risk-appropriate treatments or services, and the of rates of participation among those who were offered and eligible for these treatments or services.ResultsUrogenital tract infections were identified in 57% of the women, while 59% were found to have periodontal disease. More than 39% were active smokers, and 17% were assessed with clinical depression. Low literacy, and housing instability were identified in, 22 and 83% of the study sample, respectively. Among women eligible for intervention, the percentages who accepted and at least minimally participated in treatment ranged from a low of 28% for smoking, to a high of 85% for urogenital tract infection. Most PCPPP enrollees (57%) had three or more major risk factors. Participation rates associated with the PCPPP treatments or services varied markedly, and were quite low in some cases, despite considerable efforts to reduce the barriers to receiving care.ConclusionThe efficacy of individual level risk-reduction efforts designed to prevent preterm/repeat preterm in the pre- or inter-conception period may be limited if participation rates associated with interventions to reduce major risk factors for PTB are low. Achieving adequate participation may require identifying, better understanding, and eliminating barriers to access, beyond those associated with cost, transportation, childcare, and service location or hours of operation.Trial registrationClinicalTrials.gov (NCT01117922). PMID:25361563

Webb, David A; Mathew, Leny; Culhane, Jennifer F

2014-11-01

345

The prevalence and genetic characterization of Chlamydia psittaci from domestic and feral pigeons in Poland and the correlation between infection rate and incidence of pigeon circovirus.  

PubMed

Chlamydiosis is a zoonotic disease caused by Chlamydia psittaci that occurs in a wide range of bird species. High infection rates with C. psittaci are found in pigeons, which can act as vectors transmitting this bacterium to poultry and humans. Chlamydia shedding by pigeons is intermittent and can be activated by stressors or immunosuppression. The most common immunosuppressive factor for pigeons is a pigeon circovirus (PiCV) infection. The main aim of the study was to evaluate the prevalence of C. psittaci in Polish populations of domestic and feral pigeons (Columba livia) in the context of its correlation with PiCV infections. The second objective was to determine the genetic characteristics of Polish C. psittaci isolates. The study was conducted on 377 pigeon samples (276 domestic and 101 feral pigeons) collected from pigeons from different regions of Poland. The average prevalence of C. psittaci in the Polish pigeon population was determined at 6.8%, and it was higher in domestic than in feral pigeons. This is the first ever study to suggest a potential correlation between C. psittaci and PiCV infections, which could be attributed to the fact that there are 2 to 3 times more pigeons infected with C. psittaci and coinfected with PiCV than pigeons infected with C. psittaci alone. This trend was observed mainly in the population of sick pigeons. As many as 88.2% of isolates were recognized as belonging to genotype B, and the remaining isolates were identified as belonging to genotype E. The isolates analyzed in this study demonstrated low levels of genetic variation (96-100% homology among the isolates and in relation to reference strains). Chlamydia psittaci could be expected to spread across pigeon populations due to the high probability of mutual infections between birds and the increasing number of PiCV infections. PMID:25306457

Stenzel, Tomasz; Pestka, Daria; Choszcz, Dariusz

2014-12-01

346

Long-acting reversible contraception: a practical solution to reduce unintended pregnancy.  

PubMed

Unintended pregnancy remains a significant global public health problem; 41% of all pregnancies worldwide in 2008 were unintended. The unintended pregnancy rate is greater in less developed regions (57 per 1000 women aged 15-44 years) than in more developed regions (42 per 1000), with the United States a notable exception at a rate of 52 per 1000 women. Among US women, nearly half of unintended pregnancies are due to incorrect or inconsistent use of a contraceptive method. Long-acting reversible contraception (LARC) includes the intrauterine device and subdermal implant and offers the potential to address the problem of unintended pregnancy. LARC is extremely safe and over 99% effective at preventing pregnancy. In real-world tests LARC methods were over 20 times more effective at preventing unintended pregnancy (HRadj=21.8, 95% confidence interval, 13.7 to 34.9) compared to the contraceptive pill, patch, or ring. Despite their level of effectiveness, less than 15% of contracepting women worldwide use LARC. LARC are only infrequently contraindicated, even among younger and nulliparous women. Instead education, access, and cost are the primary barriers. In a US study of nearly 10000 women aged 14-45 years, when the three barriers were removed 75% of study participants chose a LARC method. As a result, the study reported an 80% reduction in teen births and 75% reduction in abortions among women in the cohort compared to national statistics. If we are serious about reducing unintended pregnancy, we need to be serious about increasing the use of methods that we know work. Greater LARC use and continuation has been proven to effectively reduce unintended pregnancy, including abortion and teen pregnancy. PMID:23689169

Secura, G

2013-06-01

347

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

2008-01-01

348

Post-abortion contraception: care and practices1  

PubMed Central

Objective to analyze assistance regarding contraception methods received by women during hospitalization due to abortion, and contraceptive practices the month after this episode. Methods a longitudinal study of women hospitalized due to abortion in a public hospital in the city of São Paulo. Face-to-face interviews (n=170) followed by telephone interviews in the subsequent month (n=147) were conducted between May and December of 2011. Results a small number of women reported they received guidance on, and prescription for, contraceptive methods at hospital discharge. A trend of statistical significance was identified for prescription of contraceptive methods at discharge and its use in the following month, when adjusted for age. Most women reported sexual intercourse (69.4%) with the use of contraceptive method (82.4%), but no health professional guidance (63.1%). Conclusion despite the fact that post-abortion contraception assistance was lower than the recommended guidelines by public health policies, women demonstrated willingness to use contraceptive methods.

Borges, Ana Luiza Vilela; Monteiro, Renata Luciria; Hoga, Luiza Akiko Komura; Fujimori, Elizabeth; Chofakian, Christiane Borges do Nascimento; dos Santos, Osmara Alves

2014-01-01

349

A clinical appraisal of patients following long-term contraception.  

PubMed

This study presents a clinical evaluation of private patients between the ages of 16 and 40 who have used contraceptive measures from January 1, 1961, through December 31, 1973. The clinical evaluation involves 3,746 private patients. The contraceptive methods of 641 patients (17 per cent) who have been bollowed for a total of 99,996 months (13 years each) are presented and analyzed. The patients are evaluated as to weight, blood pressure, pregnancy, pap smears. laboratory changes, pelvic surgery, breast surgery, incidence of cancer, contraceptive failures and changes in contraceptive practices over this span of time. This paper evaluates the role of such sociologic factors as education, religion, economic level, occupation, working status, changing marital status, age at the time of contraceptive choice, and the attitude of the husband with regard to long-term contraceptive therapy. Side effects have been well publicized. Safety has been questioned but essentially proved for the vast majority of the patients. Collected data enable some insight into the life style and motivation of the long-term contraceptive users. PMID:1146899

Keifer, W S; Scott, J C

1975-06-15

350

Does structured counselling influence combined hormonal contraceptive choice?  

PubMed Central

Objective To assess the effect of structured counselling on women's contraceptive decisions and to evaluate gynaecologists’ perceptions of comprehensive contraceptive counselling. Methods Belgian women (18–40 years old) who were considering using a combined hormonal contraceptive (CHC) were counselled by their gynaecologists about available CHCs (combined oral contraceptive [COC], transdermal patch, vaginal ring), using a comprehensive leaflet. Patients and gynaecologists completed questionnaires that gathered information on the woman's pre- and post-counselling contraceptive choice, her perceptions, and the reasons behind her post-counselling decision. Results The gynaecologists (N = 121) enrolled 1801 eligible women. Nearly all women (94%) were able to choose a method after counselling (53%, 5%, and 27% chose the COC, the patch, and the ring, respectively). Counselling made many women (39%) select a different method: patch use increased from 3% to 5% (p < 0.0001); ring use tripled (from 9% to 27%, p < 0.0001). Women who were undecided before counselling most often opted for the method their gynaecologist recommended, irrespective of counselling. Conclusion Counselling allows most women to select a contraceptive method; a sizeable proportion of them decide on a method different from the one they initially had in mind. Gynaecologists’ preferences influenced the contraceptive choices of women who were initially undecided regarding the method to use. PMID:22066890

Merckx, Mireille; Donders, Gilbert G; Grandjean, Pascale; Van de Sande, Tine; Weyers, Steven

2011-01-01

351

Managing wildlife with contraception: why is it taking so long?  

PubMed

Biologists have been testing wildlife contraceptives in the field for nearly a half century. Although effective new contraceptive agents have been identified, new delivery technologies developed, and some success with population management demonstrated, progress in this area should be further along. Why is it taking so long? First, the task is complex. Most drugs and vaccines fail in development. The technical leaps from in vitro to in vivo, from controlled studies to field studies, from effectiveness in individuals to management of populations, are all formidable and frequent failures are inevitable. Testing the long-acting contraceptives required for successful population management demands experiments that take 3-5 yr to complete. Development of wildlife contraceptives has been further hampered by the lack of large-scale investment and the complex and shifting regulatory landscape that often greets novel enterprises. But there has also been focused resistance to the implementation of wildlife contraceptive studies and to the dissemination of results such studies have produced. This phenomenon, which sociologists label "socially constructed ignorance," has taken a variety of forms including denial of research permits, omission from research reports and management documents, and repetition of misleading or false information in public forums and the media. The persistence and effectiveness of this social resistance suggest that the ethical foundation of wildlife contraception is incomplete. As the institutional affiliations of participants of the 7th International Conference on Fertility Control for Wildlife confirmed, wildlife contraception has its ethical roots in the animal welfare and integrated pest-management communities. Absent from the discussion are the conservation community and the values they represent. To secure societal acceptance of wildlife contraception as a management technique, researchers and advocates for wildlife contraception must address conservation issues and build an ethical foundation that balances concern for individual animals and human needs with concern for the health of biologic communities. PMID:24437084

Rutberg, Allen T

2013-12-01

352

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

PubMed

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

2014-01-01

353

Contraceptive efficacy and clinical performance of Nestorone implants in postpartum women.  

PubMed

The objective of this study was to evaluate the contraceptive efficacy and clinical performance of a Nestorone subdermal implant (NES) in the postpartum period. NES (n = 100) and Copper T intrauterine device (T-Cu; n = 100) acceptors initiated contraception at 8 weeks postpartum and were followed at monthly intervals during the first year and at 3-month intervals thereafter. Pregnancy rates, breastfeeding performance, infant growth, bleeding pattern, and side effects were assessed. Blood and milk NES concentration were measured. No pregnancy occurred in 2195 and 2145 woman-months of NES implant and T-Cu use, respectively. No effect of NES on lactation and infant growth and no serious adverse events were observed. Lactational amenorrhea was significantly longer in NES users (353 +/- 20 days) than in T-Cu users (201 +/- 11 days). More NES users (55.8%) experienced prolonged bleedings than did T-Cu users (36.2%). Concentrations of NES in breast milk ranged between 54-135 pmol/liter. The Nestorone implant is a highly effective contraceptive, safe for breastfed infants because the steroid is inactive by the oral route. PMID:11834236

Massai, M R; Díaz, S; Quinteros, E; Reyes, M V; Herreros, C; Zepeda, A; Croxatto, H B; Moo-Young, A J

2001-12-01

354

Comparison of Two Different Injectable Contraceptive Methods: Depo-medroxy Progesterone Acetate (DMPA) and Cyclofem  

PubMed Central

Objective To compare side effects between users of two kinds of injectable contraceptives (Depo-medroxy progesterone acetate and Cyclofem). Materials and methods This cross-sectional descriptive study included 250 women, aged 18-40 years, using Depo-medroxy progesterone acetate (DMPA) or Cyclofem. The volunteers were examined six months after using contraceptive, and they were asked about following symptoms: weight changes, irregular bleeding, dysparounia, vaginal dryness, headache, breast pain, bone pain, and discontinuation reason. The data were analyzed by statistical methods. Results The important side effects of DMPA were: irregular bleeding (93.60%), weight gain (48%), bone pain (24%) and vaginal dryness (10.40%), while the side effects in the Cyclofem group were: irregular bleeding (65.60%), headache (14.4%) and breast sensitivity (20%). Bleeding pattern changes were the most important problem leading to discontinuation of both contraceptive methods in our participants. Conclusion The results of the study showed that the most important problem in both groups was change in bleeding pattern. Proper consulting by a trained expert reduces the high amount of discontinuation and their failure rates. PMID:24971112

Zangeneh, Maryam

2013-01-01

355

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

Cancer.gov

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.

356

Contraception and culture: the use of yuyos in Paraguay.  

PubMed

The use of herbs (yuyos) as contraception is common practice in Paraguay. This report analyzes data from the 1995-1996 Paraguayan Reproductive Health Survey. The analysis reveals that women are more familiar with yuyos (88%) than any other method of family planning. Modeling the determinants of ever having relied on yuyos as contraception demonstrates that older women (OR = 1.043) and women with more children (OR = 2.283) are significantly more likely to have used yuyos, but an interaction between older women with more children shows they are less likely to have used this method (OR = .982). Women living in rural areas (OR = .664) and those with more education (OR = .883) are less likely to have used the method. These findings show widespread acceptance and use of yuyos for contraception in Paraguay. More research into the chemical properties of yuyos is needed to determine their contraceptive efficacy and to prevent harmful effects from their misuse. PMID:9479094

Bull, S S; Melían, M

1998-01-01

357

Religion, contraception, and method choice of married women in Ghana.  

PubMed

Using pooled data from the 1998 and 2003 Demographic and Health Surveys, this paper investigates the association between religion and contraceptive behavior of married women in Ghana. Guided by the particularized theology and characteristics hypotheses, multinomial logit and complementary log-log models are used to explore denominational differences in contraceptive adoption among currently married women and assess whether the differences could be explained through other characteristics. We found that while there were no differences between women of different Christian faiths, non-Christian women (Muslim and Traditional) were significantly more likely to have never used contraception compared with Christian women. Similar observations were made on current use of contraception, although the differences were greatly reduced in the multivariate models. PMID:21567266

Gyimah, Stephen Obeng; Adjei, Jones K; Takyi, Baffour K

2012-12-01

358

Contraception in patients with systemic lupus erythematosus and antiphospholipid syndrome.  

PubMed

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

2014-10-01

359

Contraceptive dispensing and selection in school-based health centers  

Microsoft Academic Search

Purpose: To determine whether initiation of on-site dispensing of hormonal contraceptives (oral contraceptive pill, Depo-provera, and Norplant) in six urban school-based health centers reduced time to initial selection, and increased their consistent use among sexually active females.Methods: Participants were sexually active females who received family planning care in a school year before (1994–1995 cohort) or after (1996–1997 cohort) the initiation

Melanie J Zimmer-Gembeck; Linda S Doyle; Jill A Daniels

2001-01-01

360

Interactions between oral contraceptives and malaria infections in rhesus monkeys*  

PubMed Central

The interaction of oral contraceptives with malaria infection (Plasmodium cynomolgi B and P. coatneyi) in adult female rhesus monkeys (Macaca mulatta) was studied. The oral contraceptives (Norinyl and Ovral-28) were administered for 12 consecutive menstrual cycles, from day 5 to 25 of each cycle, at either ? of the human dose of Norinyl (norethisterone 0.33 mg + ethinylestradiol 0.012 mg) or ? of the human dose of Ovral-28 (norgestrel 0.083 mg + ethinylestradiol 0.008 mg). The animals were divided into three groups for each infection (control, Norinyl and Ovral-28 treated) with 10 monkeys in each group for P. cynomolgi B infection and 12 in each group for P. coatneyi infection. The animals were infected after 6 cycles of oral contraceptive administration, and the course of infection was studied during the 7th and 8th cycles. This was followed by radical cure during the 9th and 10th cycles and rechallenge in the 11th and 12th cycles. The present study showed that (1) the contraceptive-treated animals maintained a slightly increased cumulative parasite load; (2) the contraceptives did not interfere with the radical curative action of chloroquine; (3) the contraceptive-treated animals showed no significant change in the course of parasitaemia on rechallenge or in the malaria indirect fluorescent antibody levels; (4) the liver function tests were not altered significantly by the administration of contraceptives and subsequent infection; and (5) the haematological changes observed in the contraceptive-treated animals were similar to those observed in the control group. PMID:6335851

Dutta, G. P.; Puri, S. K.; Kamboj, K. K.; Srivastava, S. K.; Kamboj, V. P.

1984-01-01

361

Subdermal contraceptive implants in nurse-midwifery practice.  

PubMed

Subdermal contraceptive implants have only recently been approved for use in the United States. At present, only one subdermal contraceptive implant, Norplant, is approved in the United States. This article describes the development of Norplant, its efficacy and safety, a description of the system, education for clients, side effects, indications and contraindications, insertion and removal, incorporation into midwifery practice, and education for health professionals regarding its use. PMID:8483013

Emerling, J M; Paluzzi, P; Leiva, J; Cullins, V E

1993-01-01

362

Gynecological Services Utilization by Contraceptive Clients: A Cost Analysis  

Microsoft Academic Search

A cost analysis of gynecolgic-service utilization in a prepaid university health plan was undertaken. Audit of health records was completed for 495 women who used diaphragm contraception. Subsequently costs were computed for contraception and pregnancy-related and other gynecological services. The findings are discussed and the issues for deliberation among clinicians, consumers, and administrators are presented.“A Controlled Evaluation of the Risk

Jane G. Zapka; Barry W. Averill; Harris Pastides

1983-01-01

363

Effect of oral contraceptive agents on nutrients: II. Vitamins.  

PubMed

Clinical, biochemical and nutritional data were collected from a large population of women using oral contraceptive agents. Higher incidence of abnormal clinical signs related to malnutrition were observed in the lower (B) as compared to the higher (A) socioeconomic groups, and also in the nonsupplemented groups as compared to the supplemented groups in the B subjects. As a rule the intake of oral contraceptive agent subjects of vitamin A, C, B6 and folic acid did not differ from that of the controls As expected, subjects from the supplemented groups had higher intake of vitamin A, C, B6, thiamin, riboflavin and folic acid, and A groups had higher intake of vitamin C, B6, riboflavin and folic acid. Increased plasma vitamin A and decreased carotene levels were observed in oral contraceptive agent users. In general oral contraceptive agents had little or no effect on plasma ascorbic acid. Urinary excretion of both thiamin and riboflavin in subjects using oral contraceptive agents were lower in A groups. Erythrocyte folate and plasma pyridoxal phosphate was decreased in A groups due to oral contraceptive agents. Subjects who took supplements had higher levels of plasma vitamin A, ascorbic acid and folate. But urinary thiamin and riboflavin were higher only in group A subjects who took supplements. PMID:1168019

Prasad, A S; Oberleas, D; Moghissi, K S; Stryker, J C; Lei, K Y

1975-04-01

364

Extended and continuous combined contraceptive regimens for menstrual suppression.  

PubMed

Many women have medical indications for menstrual suppression or a personal preference to reduce or eliminate monthly bleeding, which can be achieved with extended and continuous regimens of combined estrogen and progestin contraceptives. Combined contraceptives are traditionally administered in a 28-day cycle, with 21 days of a contraceptive pill, vaginal ring, or transdermal patch followed by a hormone-free interval that is usually 7 days. During the hormone-free interval, women either take a placebo pill or do not use their combined contraceptive method. Hormone-related symptoms are significantly worse during the hormone-free interval than the days when the contraceptive is used. Alterations of the standard 28-day cyclic regimen for menstrual suppression include decreasing the frequency of the hormone-free interval, thus extending the time between withdrawal bleeding episodes (extended use), and eliminating the hormone-free interval altogether (continuous use). This article reviews menstrual suppression indications and physiology. Research demonstrating that the effectiveness, safety, and side effects of oral, vaginal, and transdermal extended and continuous regimens are comparable to cyclic regimens is summarized. Findings from studies of women's and health care providers' attitudes toward menstrual suppression also are reviewed. Important topics to include in evidence-based counseling for extended and continuous combined contraceptive use are presented. PMID:23217068

Jacobson, Janet C; Likis, Frances E; Murphy, Patricia Aikins

2012-01-01

365

Clinical pharmacokinetic interactions between antiepileptic drugs and hormonal contraceptives  

PubMed Central

Contraceptive management in women with epilepsy is critical owing to the potential maternal and fetal risks if contraception or seizure management fails. This article briefly describes the pharmacokinetic interactions between antiepileptic drugs (AEDs) and hormonal contraceptives and the rational strategies that may overcome these risks. Hormonal contraception, including the use of oral contraceptives (OCs), is widely used in many women with epilepsy – there is no strong evidence of seizures worsening with their use. AEDs are the mainstay for seizure control in women with epilepsy. However, there are many factors to consider in the choice of AED therapy and hormonal contraception, since some AEDs can reduce the efficacy of OCs owing to pharmacokinetic interactions. Estrogens and progestogens are metabolized by cytochrome P450 3A4. AEDs, such as phenytoin, phenobarbital, carbamazepine, felbamate, topiramate, oxcarbazepine and primidone, induce cytochrome P450 3A4, leading to enhanced metabolism of either or both the estrogenic and progestogenic component of OCs, thereby reducing their efficacy in preventing pregnancy. OCs can also decrease the concentrations of AEDs such as lamotrigine and, thereby, increase the risk of seizures. Increased awareness of AED interactions may help optimize seizure therapy in women with epilepsy. PMID:20369030

Reddy, Doodipala Samba

2010-01-01

366

Are partners available for post-abortion contraceptive counseling? A pilot study in a Baltimore City clinic.  

PubMed

About half of the 1.2 million abortions each year in the United States are repeat abortions. While most abortion providers counsel women about contraception, one reason for the high repeat rate could be failure to take into account the social context of the women--in particular, the male partner. To assess whether there might be a window of opportunity for a contraceptive intervention that includes the male partner at the time of the abortion, we undertook a pilot study at an urban abortion clinic to examine the role of the male partner among women receiving abortions. Between May 2001 and August 2002, two questionnaires were administered to 109 women receiving abortions in a Baltimore City clinic. On the procedure day, women were more likely to be accompanied by a male partner upon arrival (30%) or when leaving (34%) than by any other individual. The majority of women receiving abortions reported that their partners played positive decision-making and support roles throughout the abortion process. A significant proportion of couples could be available for contraceptive counseling following an abortion, providing rationale for couples' post-abortion contraceptive counseling for women whose partners are already actively and positively involved in the abortion process. Such an intervention may help to reduce repeat abortions. PMID:15105066

Beenhakker, Britta; Becker, Stan; Hires, Stephanie; Molano Di Targiana, Nell; Blumenthal, Paul; Huggins, George

2004-05-01

367

Randomized trial of leuprolide versus continuous oral contraceptives in the treatment of endometriosis-associated pelvic pain  

PubMed Central

Objective To compare the efficacy of leuprolide and continuous oral contraceptives in the treatment of endometriosis-associated pain. Design Prospective, randomized, double-blind controlled trial. Setting Academic medical centers in Rochester, New York, and Boston, Massachusetts. Patient(s) Forty-seven women with endometriosis-associated pelvic pain. Intervention(s) Forty-eight weeks of either depot leuprolide, 11.25 mg IM every 12 weeks with hormonal add-back using norethindrone acetate 5 mg orally, daily; or a generic monophasic oral contraceptive (1 mg norethindrone + 35 mg ethinyl estradiol) given daily. Main Outcome Measure(s) Biberoglu and Behrman (B&B) pain scores, numerical rating scores (NRS), Beck Depression Inventory (BDI), and Index of Sexual Satisfaction (ISS). Result(s) Based on enrollment of 47 women randomized to continuous oral contraceptives and to leuprolide, there were statistically significant declines in B&B, NRS, and BDI scores from baseline in both groups. There were no significant differences, however, in the extent of reduction in these measures between the groups. Conclusion(s) Leuprolide and continuous oral contraceptives appear to be equally effective in the treatment of endometriosis-associated pelvic pain. (Fertil Steril 2011;95:1568–73. 2011 by American Society for Reproductive Medicine.) PMID:21300339

Guzick, David S.; Huang, Li-Shan; Broadman, Betsy A.; Nealon, Maureen; Hornstein, Mark D.

2014-01-01

368

Pregnancy attitudes, contraceptive service utilization, and other factors associated with Los Angeles homeless youths’ use of effective contraception and withdrawal  

PubMed Central

Study Objective This study aims to understand the associations of contraceptive service utilization (i.e., accessing condoms or birth control), pregnancy attitudes, and lifetime pregnancy history among male and female homeless youth in relation to use of effective contraception and withdrawal. Design, Setting, and Participants Between October 2011 and February 2012, homeless youth (14–27 years old) from two drop-in centers in Los Angeles (N=380) were recruited and completed a questionnaire. The data in this paper are restricted to those who reported vaginal sex at last sex (N=283). Main Outcome Measures Analyses examined history of foster care, sexual abuse, exchange sex, pregnancy, lifetime homelessness duration, current living situation, contraceptive service utilization, and pregnancy attitudes in predicting use of effective contraception and withdrawal at last sex. Results Over 62% of females and 43% of males report having ever been pregnant or impregnating someone. There are no gender-based differences in pregnancy attitudes; 21% agree they would like to become pregnant within the year. Additionally, there are no gender-based differences in reported contraceptive use at last vaginal sex. In the multivariable model, high school education, contraceptive service utilization (RRR: 4.0), and anti-pregnancy attitudes (RRR: 1.3) are significant positive predictors of using effective contraception; anti-pregnancy attitudes (RRR:1.2) and gender (RRR: 0.3) are significantly associated with using withdrawal. Conclusions Health professionals should acknowledge that some homeless youth desire pregnancy; for those that do not, access to effective contraception is important. Programs must continue to promote pregnancy prevention, and include discussions of healthy pregnancy habits for pregnancy-desiring youth. PMID:24238265

Winetrobe, H.; Rhoades, H.; Barman-Adhikari, A.; Cederbaum, J.; Rice, E.; Milburn, N.

2013-01-01

369

Barriers to male involvement in contraceptive uptake and reproductive health services: a qualitative study of men and women’s perceptions in two rural districts in Uganda  

PubMed Central

Background Spousal communication can improve family planning use and continuation. Yet, in countries with high fertility rates and unmet need, men have often been regarded as unsupportive of their partner’s use of family planning methods. This study examines men and women’s perceptions regarding obstacles to men’s support and uptake of modern contraceptives. Methods A qualitative study using 18 focus group discussions (FGDs) with purposively selected men aged 15–54 and women aged 15–49 as well as eight key informant interviews (KIIs) with government and community leaders was conducted in 2012 in Bugiri and Mpigi Districts, Uganda. Open-ended question guides were used to explore men and women’s perceptions regarding barriers to men’s involvement in reproductive health. All FGDs and KIIs were recorded, translated, and transcribed verbatim. Transcripts were coded and analyzed thematically using ATLAS.ti. Results Five themes were identified as rationale for men’s limited involvement: (i) perceived side effects of female contraceptive methods which disrupt sexual activity, (ii) limited choices of available male contraceptives, including fear and concerns relating to vasectomy, (iii) perceptions that reproductive health was a woman’s domain due to gender norms and traditional family planning communication geared towards women, (iv) preference for large family sizes which are uninhibited by prolonged birth spacing; and (v) concerns that women’s use of contraceptives will lead to extramarital sexual relations. In general, knowledge of effective contraceptive methods was high. However, lack of time and overall limited awareness regarding the specific role of men in reproductive health was also thought to deter men’s meaningful involvement in issues related to fertility regulation. Conclusion Decision-making on contraceptive use is the shared responsibility of men and women. Effective development and implementation of male-involvement family planning initiatives should address barriers to men’s supportive participation in reproductive health, including addressing men's negative beliefs regarding contraceptive services. PMID:24597502

2014-01-01

370

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.

2000-01-01

371

Comparison of Estimated Glomerular Filtration Rates and Albuminuria in Predicting Risk of Coronary Heart Disease in a Population with High Prevalence of Diabetes Mellitus and Renal Disease  

PubMed Central

Improved accuracy in predicting coronary heart disease (CHD) risk in persons with diabetes and kidney disease is needed. Addition of albuminuria to established methods of CHD risk calculation was reported in the Strong Heart Study (SHS) cohort. In this article, the addition of estimated glomerular filtration rate (eGFR) is evaluated with data from 4,549 American Indian SHS participants, ages 45–74 years. After adjustment for Framingham CHD risk factors, hazard ratios for eGFR as a predictor of CHD were 1.69 (95% confidence interval: 1.34, 2.13) in women and 1.41 (95% confidence interval: 0.94, 2.13) in men. Models including albuminuria, eGFR, or both scored higher in discriminatory power than models using conventional risk factors alone in women; in men the improvement was seen only for albuminuria and the combination of albuminuria and eGFR. Hosmer–Lemeshow assessments showed good calibration for the models using eGFR alone in both genders, followed by models including albuminuria alone in both genders. Adding eGFR improved the NRI in women (0.085, p=.0004) but not in men (0.010, p=0.1967). NRI and IDI were improved in both genders using both albuminuria and eGFR (NRI: 0.135, p<.0001; IDI: 0.027, p<.0001 in women; NRI: 0.035, p<0.0196; IDI: 0.008 p<0.0156 in men). Therefore, a risk calculator including albuminuria enhances CHD prediction compared with one using only standard risk factors in men and women. Including eGFR alone improves risk prediction in women, but for men it is preferable to have both eGFR and albuminuria. In conclusion, this enhanced calculator should be useful in estimating CHD risk in populations with high prevalence of diabetes and renal disease. PMID:21257005

Shara, Nawar M.; Wang, Hong; Valaitis, Eduardas; Pehlivanova, Marieta; Carter, Elizabeth A.; Resnick, Helaine E.; Wang, Wenyu; Umans, Jason G.; Lee, Elisa T.; Howard, Barbara V.; Devereux, Richard B.; Wilson, Peter W. F.

2011-01-01

372

Marital processes, arranged marriage, and contraception to limit fertility.  

PubMed

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. Although we know that this transformation has important consequences for childbearing early in marriage, we know much less about longer-term consequences of this marital revolution. Drawing on theories of family and fertility change and a rural Asian panel study designed to measure changes in both marital and childbearing behaviors, this study seeks 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 and suggest that new research should consider a broader range of long-term consequences of changing marital processes. PMID:23709184

Ghimire, Dirgha J; Axinn, William G

2013-10-01

373

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

2014-01-01

374

The Language of Love?—Verbal versus Implied Consent at First Heterosexual Intercourse: Implications for Contraceptive Use  

PubMed Central

Background Little is known about how young people communicate about initiating intercourse. Purpose This study was designed to gauge the prevalence of implied versus verbal consent at first intercourse in a U.S. college population, assess effects of consent type on contraceptive use, and explore the influences of gender, race and other factors. Methods We conducted and analyzed a cross-sectional survey of non-Hispanic white and black students from four universities, exploring associations between verbal and nonverbal consent, contraceptive use and covariates. Results Among those with consensual first intercourse experiences (N=1883), half (49%) provided nonverbal consent. Black men were the most likely to provide nonverbal consent (61%), followed by white men (55%), black women (51%), and white women (43%). Respondents who used condoms at first intercourse were more likely to provide verbal consent, suggesting that condoms may prompt sexual discussions (or vice versa). In contrast, even when controlling for covariates, those who provided nonverbal consent were less likely to have used contraception (significantly so for women). Discussion These findings confirm the hypothesis that young people who do not discuss whether to engage in vaginal intercourse for the first time are less likely to use contraception. These results add an important layer to our current conceptual model of sexual development, in particular, how young people adopt, or fail to adopt, behaviors that will keep them healthy once they decide to become sexually active. Translation to Health Education Practice Enhanced sexual communication skills are greatly needed. Public health practitioners should investigate type of consent in future research and programming, with sensitivity to gender and racial influences. PMID:23460940

Higgins, Jenny A.; Trussell, James; Moore, Nelwyn B.; Davidson, J. Kenneth

2013-01-01

375

Contraceptive development lags in U.S.  

PubMed

Contraceptive development in the US has been halted by all but one company Ortho Pharmaceuticals. The reasons for this are complex and the problem is very serious. Legal and regulatory pressures have taken away the incentive to do research. There are 3 million unwanted pregnancies each year in this country. If contraceptive use were more widespread and the technology was constantly being improved by a highly competitive market, then this number would be much lower. There are several new forms of birth control being studies for use in the US, such as injectables using microspheres or microcapsules which can last for 1, 3, or 6 months, biodegradable pellets that are inserted under the skin of the hip or upper arm slowly release hormones, the vaginal ring which is saturated with time-released hormones and is worm around the opening of the uterus like a diaphragm, transdermal patches which are changed weekly for 3 weeks with a placebo patch to allow menstruation, osmotic pills which gradually release hormones on a lower and less frequent schedule, and vaccines which can immunize women against hormones in the placenta, egg or from sperm. This research is at an early stage. Luteinizing hormone-releasing hormone (LHRH) analogues suppress ovulation by affecting the pituitary gland. This method has the side effect of blocking ovarian production of estrogen and progesterone. Male methods like Inhibit inhibit the production of follicle-stimulating hormone (FSH). Gossypol has been used in China, but one side effect is that it is sometimes irreversible. Outside the US the injectables Depo-Provera and Noristerat are approved in 90 and 40 countries respectively. Norplant is a progesterone releasing implant, made in Finland, that lasts up to 5 years; it was recommended for approval in 1989 by the FDA's Fertility and Maternal Health Drug Advisory Committee RU-486 prevents the cells in the uterus from receiving progesterone, was developed in France. The Filshie clip is a titanium and silicone rubber barrier that blocks the fallopian tubes. Ovablock is a silicone plug that blocks the fallopian tubes and increase reversibility. PMID:2337017

Meade, V

1990-05-01

376

Worldwide trends in funding for contraceptive research and evaluation.  

PubMed

In the past 5 years funding has declined in constant dollars for reproductive and contraceptive research and for the evaluation of long-term contraceptive safety; there has been a general increase in coordination and planning among publicly supported programs, as well as between these programs and private industry. There has been no substantial relaxation of regulatory requirements, and little has been done to make contraceptive research and development (R and D) more attractive to industry. The threat of liability suits and the difficulty in obtaining product liability insurance have become more salient than 5 years ago. This is increasingly restricting clinical research into new methods by both private industry and publicly supported research groups. Nonetheless some major advances have been recorded over the same period. The NORPLANT system, the Today contraceptive sponge, the TCu 380A (a copper-bearing IUD), and biphasic and triphasic pills have all become available in at least some developed and developing countries. In addition, several methods are in advanced stages of clinical trial (e.g., injectable contraceptives for 1 and 6 months' duration; an improved implant, a progestin releasing vaginal ring and Gossypol for sperm inhibition). Presented here are the results of a worldwide survey conducted by the Alan Guttmacher Institute (AGI) of funding for reproductive research, contraceptive development and evaluation of the long-term safety of existing methods. Requests for data on expenditures for 1980-1983 were sent by the AGI to funding agencies, R and D organizations and pharmaceutical companies in the US, Australia, Europe, India and Japan, reported to be doing contraceptive research. Detailed information was sought about fundamental research in reproductive biology, training of pre- and postdoctoral reproductive scientistis, applied research in contraceptive technology and evaluation of the safety of currently marketed contraceptives. An estimated US$154.8 million was spent in 1979 for all 3 categories of research; this amount declined by 12% in 1980. By 1983, expenditures in constant dollars were 79% of the 1979 figure. Contraceptive R and D accounted for 41% of the total expenditures during 1980-1983, fundamental for 52% and long-term contraceptive safety evaluation for 7%. The principal methods under investigation during this period were improved oral contraceptives, other ovulation inhibitors, post-ovulatory methods and pregnancy vaccines. Expenditures for contraceptive development are also presented by contributing organization (publicly supported, private industry and mission-oriented research projects). 46% of funds for evaluation of long-term safety of existing methods were spent on evaluation of oral contraceptives and 16% on the long-term risks of vasectomy. Investigations of barrier methods hardly played any part in overall research on safety in 1980 and 1981; but by 1983 these expenditures were 2nd only to those for the pill. Over the 4-year period, 63% of the funds spent on all types of research were for projects involving female reporduction, 18% for male reproduction and 19% for both. PMID:3843535

Atkinson, L E; Lincoln, R; Forrest, J D

1985-01-01

377

Secrecy and silence: why women hide contraceptive use.  

PubMed

A recent Population Council survey of 1860 married women and 1056 of their husbands in urban Zambia found that many women who use contraception do so without their husbands' knowledge and that those women who hid their practice of contraception from their husbands did so because they found it very difficult to bring up the subject of family planning with them. These findings indicate that low levels of contraceptive use are not the result of a simple communication matter. Sex and sexuality are often the exclusive domain of African husbands. As such, if a wife initiates a discussion of family planning, she may threaten her husband's sense of control and create discord within the family. The culture of silence about sex and sexuality is very strong in Africa. 57% of women stated that were they to propose contraceptive use with their husbands and the husband opposed such practice, they would nonetheless use them without his knowledge. 7% of the women stated that if their husbands disapproved of contraceptive use, they would nonetheless openly use a method against his wishes. The majority of women correctly perceived their husbands' views on family planning use and fertility preferences. In focus groups, both men and women said that they did not believe that women have the right to independently act upon their reproductive preferences. A husband's inadequate financial support of his children could, however, justify clandestine contraceptive use. These findings point to the need to include easily hidden methods in the mix of contraceptives family planning programs offer. Moreover, service providers should not automatically encourage husbands' involvement. A client's right to privacy should always be respected. PMID:12321878

1998-09-01

378

[Family planning. Current levels and trends in contraceptive use].  

PubMed

The general law on population in Mexico has contributed to a noticeable increase in the use of contraceptives. In 1973 only 12% or 900,000 women practiced modern contraception, which increased to 30% by 1976 (with the inclusion of the rhythm and coitus interruptus methods), 47.7% by 1982, and 53% or 7 million couples by 1987. Business provided 70% of contraceptives in 1970, while by 1982 53.4% and by 1987 61.8% was provided by government. The most utilized method until 1982 was female sterilization, 35.5% (18.8% or 2.5 million had tubal ligation by 1987), IUDs 19.8%, pills 18.3%, the rhythm and coitus interruptus, 15.1%, respectively. 1/3 of the 35-39 and 40-44 age groups had tubal ligation and as did 1/4 of the 30-34 age group, as well as 12.6% and 3.3% of the 25-29 and 20-24 age groups, respectively. The surgical method was used by 46.4% of uneducated women and 23.9% with secondary or higher education. This seems to contradict the hypothesis that education is the motivating factor of in the use of contraception, although some kind of contraceptive was used by 70% of women with high school education vs. 23.5% of women with no education. In rural areas inhabited by less than 2500 people, 37.6% of women practiced contraception compared with 59% and 66% in the 3 largest metropolitan areas. The increase of contraceptive use was less in recent years than in the period 1976-1982, but about 20% of women do not want more children. The various methods of regulating fertility need to be evaluated because of increasing integration of segments of population previously excluded by geographical, cultural, and social barriers. PMID:12158026

Palma Cabrera, Y

1988-01-01

379

“A cup of tea with our CBD agent … ”: community provision of injectable contraceptives in Kenya is safe and feasible  

PubMed Central

ABSTRACT Background: In rural areas of Kenya, where the majority of Kenya?s population lives, contraceptive use remains low compared with that in urban areas (37% vs. 47%). Inadequate access to family planning services in rural areas is partly due to fewer health facilities and the shortage of health care workers. Community-based access to injectable contraceptives can improve access for rural populations and expand the range of contraceptive methods available. Our pilot project sought to generate local evidence on safety, feasibility, and acceptability of the provision of injectable depot medroxyprogesterone acetate (DMPA) by community health workers (CHWs). Design: We trained 31 CHWs in Tharaka District to provide injectable DMPA in addition to pills and condoms. Data were collected on family planning clients served by CHWs in Tharaka District as well as those who received services from health facilities from August 2009 to September 2010. Service statistics were collected from 3 pilot health facilities in the CHW service catchment area. Results: In the 12-month study period, CHWs reached 1,210 women with family planning services including referrals for long-acting and permanent methods. Family planning use in the pilot sites for all methods increased an estimated fivefold, from 9% in facilities to 46% when facilities and CHWs were combined (32% for CHWs and 14% for facilities). The majority (69%) of clients served by CHWs chose DMPA. No client reported any signs of infection at the injection site nor did any CHW report needlestick injuries or other adverse events. The re-injection rate was 68% at the third visit, which compares favorably with other DMPA continuation studies. Two main reasons given for discontinuing were change of residence and temporary separation from spouse. Conclusion: Community-based provision of DMPA along with other contraceptive methods increased the use of family planning and improved method choice during the study period. Injectable contraception provided by trained CHWs is a safe, acceptable, and feasible service delivery option in Kenya. PMID:25276546

Olawo, Alice Auma; Bashir, Issak; Solomon, Marsden; Stanback, John; Ndugga, Baker Maggwa; Malonza, Isaac

2013-01-01

380

Emergency contraception in Senegal: Challenges and opportunities.  

PubMed

Abstract Objectives This paper highlights lessons from introductory efforts and presents new data on community, provider and key opinion leader perspectives to support expanded use of emergency contraception (EC) in Senegal. Sources of information The paper draws on four data sources: (i) a literature review; (ii) a secondary analysis of a household survey conducted by the Urban Reproductive Health Initiative; (iii) in-depth interviews with key opinion leaders; and (iv) a quantitative survey of healthcare providers from a range of service delivery points. Analysis of data Knowledge of EC among women is low in urban areas, with only 20% of women having heard of the method and 4% having ever used it. There were serious gaps in providers' technical knowledge about EC; only 57% knew its mode of action and 34% were aware of the need for timely use (within 120 h). Moreover, nearly half reported reluctance to provide EC to married women and even fewer were willing to provide it to youths, particularly to adolescent girls. Responses from key opinion leaders were mixed, demonstrating ambivalence about EC and how it could be offered. Conclusion In Senegal, the current positive political climate for family planning provides a good opportunity for strengthening EC programming to address knowledge and attitudinal barriers among providers, key opinion leaders and communities. PMID:25229389

Mané, Babacar; Brady, Martha; Ramarao, Saumya; Thiam, Ababacar

2015-02-01

381

What happens the morning after? The costs and benefits of expanding access to emergency contraception.  

PubMed

Emergency contraception (EC) can prevent pregnancy after sex, but only if taken within 72 hours of intercourse. Over the past 15 years, access to EC has been expanded at both the state and federal level. This paper studies the impact of those policies. We find that expanded access to EC has had no statistically significant effect on birth or abortion rates. Expansions of access, however, have changed the venue in which the drug is obtained, shifting its provision from hospital emergency departments to pharmacies. We find evidence that this shift may have led to a decrease in reports of sexual assault. PMID:24358529

Gross, Tal; Lafortune, Jeanne; Low, Corinne

2014-01-01

382

Current contraceptive status among women aged 15-44: United States, 2011-2013.  

PubMed

Nearly all women use contraception at some point in their lifetimes, although at any given time they may not be using contraception for reasons such as seeking pregnancy, being pregnant, or not being sexually active. Using data from the 2011-2013 National Survey of Family Growth (NSFG) on contraceptive use in the month of the interview, this report provides a snapshot of current contraceptive status among women aged 15-44 in the United States. In addition to describing use of any method by age, Hispanic origin and race, and educational attainment, patterns of use are described for the four most commonly used contraceptive methods: the oral contraceptive pill, female sterilization, the male condom, and long-acting reversible contraceptives, which include contraceptive implants and intrauterine devices. PMID:25500343

Daniels, Kimberly; Daugherty, Jill; Jones, Jo

2014-12-01

383

Hormonal contraception can suppress natural antimicrobial gene transcription in human endometrium  

Microsoft Academic Search

ObjectiveTo determine the effect of hormonal contraception with a combined oral contraceptive pill and levonorgestrel intrauterine system on the expression of the natural antimicrobials secretory leukocyte protease inhibitor, ?-defensins 1 and 2, and granulysin in human endometrium.

Diana C. Fleming; Anne E. King; Alistair R. W. Williams; Hilary O. D. Critchley; Rodney W. Kelly

2003-01-01

384

Cancer and contraception. Release date May 2012. SFP Guideline #20121.  

PubMed

As a result of advances in cancer diagnosis and treatment, young women within the reproductive-aged group are now more likely to survive cancer. Reproductive-aged women with cancer may be interested in deferring pregnancy either temporarily or permanently at cancer diagnosis, during therapy or after treatment. Currently, there are limited guidelines to aide clinicians in managing the contraceptive needs in this special population. After reviewing the evidence regarding the safety and efficacy of available methods of contraception for women who have been diagnosed with cancer, the Society of Family Planning recommends that women of childbearing age who are being treated for cancer avoid combined hormonal contraceptive methods (containing estrogen and progestin) when possible because they may further increase the risk of venous thromboembolism (VTE) (Level A). The copper T380A intrauterine device, a highly effective, reversible, long-acting, hormone-free method, should be considered the first-line contraceptive option for women with a history of breast cancer (Level A), although for women being treated with tamoxifen, the levonorgestrel-containing intrauterine system (IUS) which decreases endometrial proliferation may be preferable (Level B). Women who develop anemia may benefit from use of a progestin-containing contraceptive (Level A). Women who develop osteopenia or osteoporosis following chemotherapy should avoid the progestin-only contraceptive injection (Level B). More information is needed in many areas. There are insufficient data to evaluate the risk of VTE when progestin-only contraceptives are used by women at high risk of VTE. Information is also needed on whether the levonorgestrel-containing IUS affects the risk of breast cancer recurrence and whether hormonal contraceptives affect the risk of breast cancer among women who have received chest wall, or "mantle field," radiation. Finally, studies of the safety and effectiveness of IUS use by women who are immunosuppressed and studies of whether progestin-only contraceptives affect the risk of fracture among cancer survivors or, more generally, women with osteopenia would be useful. PMID:22682881

Patel, Ashlesha; Schwarz, E Bimla

2012-09-01

385

Partner Choice, Relationship Satisfaction, and Oral Contraception: The Congruency Hypothesis.  

PubMed

Hormonal fluctuation across the menstrual cycle explains temporal variation in women's judgment of the attractiveness of members of the opposite sex. Use of hormonal contraceptives could therefore influence both initial partner choice and, if contraceptive use subsequently changes, intrapair dynamics. Associations between hormonal contraceptive use and relationship satisfaction may thus be best understood by considering whether current use is congruent with use when relationships formed, rather than by considering current use alone. In the study reported here, we tested this congruency hypothesis in a survey of 365 couples. Controlling for potential confounds (including relationship duration, age, parenthood, and income), we found that congruency in current and previous hormonal contraceptive use, but not current use alone, predicted women's sexual satisfaction with their partners. Congruency was not associated with women's nonsexual satisfaction or with the satisfaction of their male partners. Our results provide empirical support for the congruency hypothesis and suggest that women's sexual satisfaction is influenced by changes in partner preference associated with change in hormonal contraceptive use. PMID:24818612

Roberts, S Craig; Little, Anthony C; Burriss, Robert P; Cobey, Kelly D; Klapilová, Kate?ina; Havlí?ek, Jan; Jones, Benedict C; DeBruine, Lisa; Petrie, Marion

2014-05-12

386

Parental Family Experiences, the Timing of First Sex, and Contraception  

PubMed Central

By investigating the intergenerational consequences of multiple aspects of family experiences across the life course this paper advances what we know about the forces shaping children's initiation of sexual and contraceptive behaviors. Our aim is to advance the scientific understanding of early sexual experiences by explicitly considering contraceptive use and by differentiating between the consequences of parental family experiences during childhood and those during adolescence and young adulthood. Thanks to unique, highly detailed data measuring parental family experiences throughout the life course and sexual dynamics early in life it is possible to provide detailed empirical estimates of the relationship between parental family experiences and contraceptive use at first sex—a relationship about which we know relatively little. Findings reveal (1) significant simultaneous consequences of many different dimensions of parental family experiences for the timing of first sex and the likelihood of using contraception at first sex, but the specific dimensions of family important for the specific behavior vary across racial groups; and (2) that parental family experiences influence the timing of sex and contraceptive use differently. PMID:21079724

Brauner-Otto, Sarah R.; Axinn, William G.

2010-01-01

387

Benefits of meeting the contraceptive needs of Cameroonian women.  

PubMed

(1) In 2013, an estimated 40% of pregnancies in Cameroon were unintended. (2) More than six in 10 women who want to avoid pregnancy either do not practice contraception or use a relatively ineffective traditional method. These women can be said to have an unmet need for modern contraception. (3) Meeting just half of this unmet need would prevent 187,000 unplanned pregnancies each year, resulting in 65,000 fewer unsafe abortions and 600 fewer maternal deaths annually. (4) If all unmet need for modern methods were satisfied, maternal mortality would drop by more than one-fifth, and unintended births and unsafe abortions would decline by 75%. (5) Investing in contraceptive commodities and services to fulfill all unmet need among women who want to avoid pregnancy would result in a net annual savings of US$5.4 million (2.7 billion CFA francs) over what would otherwise be spent on medical costs associated with unintended pregnancies and their consequences. (6) Expanding contraceptive services confers substantial benefits to women, their families and society. All stakeholders, including the Cameroon government and the private sector, should increase their investment in modern contraceptive services. PMID:25199220

Vlassoff, Michael; Jerman, Jenna; Beninguisse, G; Kamgaing, Floriane; Zinvi-Dossou, F

2014-01-01

388

Hormone Replacement Therapy, Oral Contraceptive Use, and Distal Large Bowel Cancer: A Population-Based Case–Control Study  

Microsoft Academic Search

OBJECTIVES:Lower incidence rates of distal large bowel cancer in women when compared with men support the protective role of female hormones. We aimed to determine the associations between hormone replacement therapy, oral contraceptive use, and distal large bowel cancer.METHODS:We conducted a population-based case–control study of incident distal large bowel cancer in North Carolina between 2001 and 2006. Data on hormone

Millie D Long; Christopher F Martin; Joseph A Galanko; Robert S Sandler

2010-01-01

389

Comparison of estimated glomerular filtration rates and albuminuria in predicting risk of coronary heart disease in a population with high prevalence of diabetes mellitus and renal disease.  

PubMed

Improved accuracy in predicting coronary heart disease (CHD) risk in patients with diabetes and kidney disease is needed. The addition of albuminuria to established methods of CHD risk calculation was reported in the Strong Heart Study (SHS) cohort. In this study, the addition of estimated glomerular filtration rate (eGFR) was evaluated using data from 4,549 American Indian SHS participants aged 45 to 74 years. After adjustment for Framingham CHD risk factors, hazard ratios for eGFR as a predictor of CHD were 1.69 (95% confidence interval 1.34 to 2.13) in women and 1.41 (95% confidence interval 0.94 to 2.13) in men. Models including albuminuria, eGFR, or both scored higher in discriminatory power than models using conventional risk factors alone in women; in men, the improvement was seen only for albuminuria and the combination of albuminuria and eGFR. Hosmer-Lemeshow assessments showed good calibration for the models using eGFR alone in both genders, followed by models including albuminuria alone in both genders. Adding eGFR improved the net reclassification improvement (NRI) in women (0.085, p = 0.0004) but not in men (0.010, p = 0.1967). NRI and integrated discrimination improvement (IDI) were improved in both genders using albuminuria and eGFR (NRI 0.135, p <0.0001, and IDI 0.027, p <0.0001 in women; NRI 0.035, p <0.0196, and IDI 0.008, p <0.0156 in men). Therefore, a risk calculator including albuminuria enhances CHD prediction compared to a calculator using only standard risk factors in men and women. Including eGFR alone improves risk prediction in women, but for men, it is preferable to include eGFR and albuminuria. In conclusion, this enhanced calculator should be useful in estimating CHD risk in populations with high prevalence of diabetes and renal disease. PMID:21257005

Shara, Nawar M; Wang, Hong; Valaitis, Eduardas; Pehlivanova, Marieta; Carter, Elizabeth A; Resnick, Helaine E; Wang, Wenyu; Umans, Jason G; Lee, Elisa T; Howard, Barbara V; Devereux, Richard B; Wilson, Peter W F

2011-02-01

390

Informed push distribution of contraceptives in Senegal reduces stockouts and improves quality of family planning services.  

PubMed

Contraceptive use in Senegal is among the lowest in the world and has barely increased over the past 5 years, from 10% of married women in 2005 to 12% in 2011. Contraceptive stockouts in public facilities, where 85% of women access family planning services, are common. In 2011, we conducted a supply chain study of 33 public-sector facilities in Pikine and Guediawaye districts of the Dakar region to understand the magnitude and root causes of stockouts. The study included stock audits, surveys with 156 consumers, and interviews with facility staff, managers, and other stakeholders. At the facility level, stockouts of injectables and implants occurred, on average, 43% and 83% of the year, respectively. At least 60% of stockouts occurred despite stock availability at the national level. Data from interviews revealed that the current "pull-based" distribution system was complex and inefficient. In order to reduce stockout rates to the commercial-sector standard of 2% or less, the Government of Senegal and the Senegal Urban Reproductive Health Initiative developed the informed push distribution model (IPM) and pilot-tested it in Pikine district between February 2012 and July 2012. IPM brings the source of supply (a delivery truck loaded with supplies) closer to the source of demand (clients in health facilities) and streamlines the steps in between. With a professional logistician managing stock and deliveries, the health facilities no longer need to place and pick up orders. Stockouts of contraceptive pills, injectables, implants, and intrauterine devices (IUDs) were completely eliminated at the 14 public health facilities in Pikine over the 6-month pilot phase. The government expanded IPM to all 140 public facilities in the Dakar region, and 6 months later stockout rates throughout the region dropped to less than 2%. National coverage of the IPM is expected by July 2015. PMID:25276582

Daff, Bocar Mamadou; Seck, Cheikh; Belkhayat, Hassan; Sutton, Perri

2014-05-01

391

Impact of Individual Values on Adherence to Emergency Contraception Practice Guidelines Among Pediatric Residents  

PubMed Central

Objective To evaluate the impact of individual, system, and interpersonal factors on emergency contraception practices. We hypothesized that abortion attitudes and attitudes toward teen sex would be significant individual factors influencing emergency contraception practices. Design This was a cross-sectional, anonymous Internet survey. Setting Four pediatric residency programs in the Baltimore, Maryland–Washington, DC, metropolitan area during April to June 2007. Participants One hundred forty-one pediatric residents completed the survey. Main Exposure Abortion attitudes were assessed by participants’ level of agreement with abortion in 7 scenarios. Attitudes toward teen sex were assessed by participants’ level of agreement with 5 statements about the acceptability of teens having sex. Main Outcome Measures Emergency contraceptive counseling behavior was assessed by reported frequency of including emergency contraception in routine contraceptive counseling. Intention to prescribe emergency contraception was assessed by reported likelihood of prescribing in 5 scenarios. Results When controlling for demographics and other predictors, residents with less favorable abortion attitudes were more likely to have the lowest intention to prescribe emergency contraception. Residents with more positive attitudes toward teen sex and who had a preceptor encourage emergency contraception prescription were more likely to include emergency contraception in routine contraceptive counseling most/all the time and to have the highest intention to prescribe. Conclusion Efforts to challenge and affect attitudes toward teen sex and to prompt residents to prescribe emergency contraception in clinical settings may be needed to encourage more proactive emergency contraceptive practice in accordance with national practice guidelines. PMID:19805714

Upadhya, Krishna K.; Trent, Maria E.; Ellen, Jonathan M.

2014-01-01

392

Are affluent, well-educated, career-orientated women knowledgeable users of the oral contraceptive pill?  

Microsoft Academic Search

ObjectiveStudies have shown poor knowledge of oral contraceptives among women attending government health clinics and women in rural areas. Little is known about the level of contraceptive knowledge in educated, affluent, career-orientated women, although it could be expected that access to information would be greater. The study objective was to describe the profile, knowledge and understanding of oral contraceptive users

Megan van der Westhuizen; David Hall

2005-01-01

393